July 11, 2011

expert reaction to Cochrane review of salt reduction and cardiovascular disease

A meta-analysis of randomised controlled trials by the Cochrane Review looked at the association between reducing dietary salt and the incidence of cardiovascular disease.

Professor Francesco Cappuccio, Head of the WHO Collaborating Centre for Nutrition at the University of Warwick, said:

“These results strengthen the already compelling evidence that low sodium intake reduces the risk of dying prematurely. The results also highlight the need to consider an increase in potassium intake amongst the nutritional policies to prevent cardiovascular disease. Reformulation of many processed foods may well have to consider adequate potassium content, in addition to a reduced sodium content, to maximise the health benefits.”

Dr Lee Hooper, Nutrition Department, Norwich Medical School, University of East Anglia, said:

“This large US cohort study suggests that the amount of potassium we eat is a more important predictor of our risk of death, than the amount of sodium (or salt) we eat. Using the ratio of sodium to potassium as a predictor of risk of death, or cardiovascular death, is only a little better than using potassium alone. We need large randomized controlled trials to better understand the effects of our altering our diets to include more potassium and less sodium. Potassium is found in a wide variety of fruits and vegetables, and also in meats, fish and dairy foods. Sodium (salt) comes mainly from ready-made foods such as bread, cereals, and many processed foods.”

Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool, said:

“This is a valuable study from experienced researchers based at CDC and Harvard.

“It adds further evidence that dietary salt is harmful, while dietary potassium is beneficial.

“The public health messages already recommended by AHA, WHO, PAHO, NICE are further strengthened.

“We should continue to reduce our dietary salt intake and increase our potassium intake using all effective interventions. As individuals, we can eat more fruit and vegetables, and avoid junk food.

“But we may all have difficulty sustaining long term healthy diet changes, because today we live in a toxic environment.The processed food industry clearly has a huge responsibility here. They need to back up their public statements with genuine actions to reformulate products, progressively shifting their recipes from harmful to healthy mixes.”

‘Sodium and Potassium Intake and Mortality Among US Adults: Prospective Data From the Third National Health and Nutrition Examination Survey’ by Quanhe Yang et al., published in Archives of Internal Medicine on 11 July 2011.