Does Avoiding Salt Reduce Death Risk? The Truth Is Grainy

A new study failed to find a benefit for cutting back on salt. But don't let that shake you.

July 6, 2011

Yes, it's a good idea to cut back on salt. No, you don't have to banish the salt shaker from the kitchen.

RODALE NEWS, EMMAUS, PA—British researchers released the results of a controversial study Wednesday that claims that moderately reducing your salt intake will not significantly cut your risk of death. "As with most studies, it should be taken with—pardon the pun—a grain of salt. It is hardly conclusive evidence on the role of salt and heart disease," says Joy Manning, nutrition editor of Prevention magazine. "There is plenty of conflicting science on this subject."

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Manning also notes that some people are more sensitive to salt—they know from experience that it affects their blood pressure. "These people should carefully keep sodium in check," she says. "As for the rest of us, I think we should turn our attention not to the salt shaker we use in our home cooking, but to the boxes, bags, cans, and other packaged foods that make up so much of our diets. That is where the serious salt is."

THE DETAILS: The study, published online Wednesday in the American Journal of Hypertension, is an analysis of six previous studies. All together, the analysis included data from 6,257 people, with 665 deaths reported.

The authors concluded that moderately reducing sodium intake does not significantly reduce the risk of death from any cause or from cardiovascular disease. The study authors found a 10 percent reduction in all causes of death when participants reduced salt intake, and a nearly 30 percent drop in heart disease deaths among people with normal blood pressure, but noted the number was not statistically significant because the deaths could have been by chance.

Still, diet experts cite plenty of other studies that point to major benefits from reducing salt intake. "Extensive research shows that too much salt in the diet raises high blood pressure, which in turn can cause heart attacks, strokes, and kidney disease," says Heather Jones, RD, author of The Salt Solution. "The researchers of this new study acknowledge that the number of participants in the study wasn't enough to find small changes in risk of death, and that further study is needed."

In fact, here's what they write in the study: "Our findings support the recent call for further rigorous large long-term RCTs [randomized controlled trials], capable of definitively demonstrating the CVD [cardiovascular disease] benefit of dietary salt reduction."

In other words, this new study isn't a game changer; it's too soon to say that salt reduction is not necessary.

WHAT IT MEANS: The link between salt and high blood pressure and heart disease has been studied for years, but Jones also points out some other reasons to avoid too much salt. Risks associated with excess sodium include dementia, diabetes, osteoporosis, and cancer. "Brain scans show that consuming salt causes the brain to release dopamine, the neurotransmitter associated with the pleasure center, making it highly addictive—like nicotine and cocaine," explains Jones.

And while the most recent U.S. Department of Agriculture (USDA) dietary guidelines call for a drastic drop in salt intake—new recommendations are a max of 2,300 milligrams daily for adults; 1,500 milligrams for African Americans or anyone living with high blood pressure, diabetes, or chronic kidney disease—many experts say the agency missed the mark. "They're overkill, and misguided as well," says Manning. "The USDA should issue a dietary restriction on heavily processed and fast food—if you eliminate these foods from your diet, sodium will not be an issue."

Plus, when you take those processed foods out of the mix, you reduce your exposure to genetically engineered food and some pesticides.

Here are some easy, commonsense ways to reduce your salt intake:

• Just cook at home. Manning says the cycle of people relying on takeout and prefab meals is what's causing the real sodium problem, not necessarily salt shakers. "When it comes to these warnings about salt, I worry that people restrict salt only in their home cooking. After all, it's easy enough to halve the amount of salt in recipe, but it's impossible to take it out of a delivery pizza," Manning says.

Unless you're salt sensitive or your doctor's ordered a limited salt intake, worry less about how you use salt to season homemade dishes and more about eliminating every source of packaged, fast, convenience, chain-restaurant, and prepared food you can, Manning recommends.

• Be wary of store labels. When your shopping list deviates from whole ingredients, such as fruits, whole grains, veggies, and lean proteins, beware of "reduced-sodium" and "low-sodium" labels on processed food. It only means that a product contains 25 percent less sodium than the original version, which could still be well above all the sodium you need in an entire day. As a general rule of thumb, frozen pizzas, lunch meat, and TV dinners are often loaded with sodium.

• Halve it. If you're eating out and have no idea how much sodium your dish contains, play it safe and just eat half. If you're ordering a sandwich, ask for half the amount of lunch meat and double the veggies to shrink the sodium content.