Salt update

On January 20th,2010, about a week after NYC Mayor Bloomberg proposed a controversial salt reduction initiative, evidence was presented in the New England Journal of Medicine that salt reduction truly can save lives.

Using mathematical models, the authors were able to make estimates of cardiovascular disease rates based on a population-wide 3 g decrease in salt consumption (1200 mg sodium). 

By their projections, a 3 g salt reduction would result in 60,000 fewer cases of coronary heart disease, 32,000 fewer strokes, and 54,000 fewer heart attacks each year. This is comparable to the cardiovascular benefit from smoking cessation efforts.   These estimates don’t even take into account the beneficial effects on other diseases related to salt excess, like osteoporosis, kidney disease, and stomach cancer.

Health care costs were predicted to decrease by $10 billion to $24 billion, making this type of intervention much more cost-effective than medicating people who have hypertension. With health care reform at the forefront of American politics, this study highlights the value of prevention in bringing down costs. Since about 80% of salt in the diet is already in the food when it is purchased, this intervention must occur at a national policy level rather than a personal responsibility level – hopefully, these data will not be ignored by policymakers.

A 1200 mg decrease in sodium consumption would represent a 34.3% drop in sodium consumption of average Americans, somewhat more ambitious than the 25% reduction proposed by Mayor Bloomberg. But based on the above figures even a 25% reduction is likely to bring cardiovascular benefits.



Bibbins-Domingo K et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. NEJM. Published at January 20, 2010 (10.1056/NEJMoa0907355)

Appel LJ and Anderson CAM. Compelling Evidence for Public Health Action to Reduce Salt Intake. Published at January 20, 2010 (10.1056/NEJMe0910352)


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Comments (5) Read through and enter the discussion with the form at the end
Cindy - January 25, 2010 1:28 PM

Mayor Bloomberg is to be commended. I don't think most Americans are aware of these current, specific recommendations. Most of us just have a vague notion about reducing salt without the realization of the sodium content of processed foods and its impact on our health. Awareness and education are the first necessary steps.

Matt R. - January 28, 2010 3:35 PM

This is another example of the ultimate nanny state, whereby the government is decided what's best for us. Want to avoid salt? Fine, avoid the regular kind, however, real salt with all the minerals intact is fine.

Deana Ferreri - January 28, 2010 3:49 PM

Matt, 'real' salt is still 98% sodium chloride - it is not any healthier than table salt.

You can get much more trace mineral benefit from vegetables than you can from sea salt. And no excess sodium.

Michael - January 28, 2010 4:43 PM

The problem is that if you eat out, practically all the food is loaded with salt before you have a chance to use your salt shaker. I would prefer they make the food with a lower salt content and give people the choice to put as much or little salt on their food as they like. I see it as the opposite of a nanny state, we have more choice and control over what we put in our mouths.

karen ansell - May 12, 2010 12:21 AM

I am ignorant as to how much salt we actually SHOULD have in our diet. It is an important electrolyte. Great Gram and Gramp LOVED that salt shaker. I quit salting everything when almost 40 years ago. I don't often eat frozen entrees, rinse canned vegetables and cook in plain water. I eat fresh everything whenever I can. Salt is VERY dangerous to the elderly, diabetics, and those with any type of cardiac problems. Independent elderly tend to buy frozen entrees, food off tv, and salt things the way people did 120 years ago. Diabetics and those with dentures have trouble tasting things, so they like to use lots of salt to pull the flavor out of foods. We should focus on the absolute maximum of salt we NEED in our diets to keep our electrolytes in balance. That is ALL we should have, and get rid of the rest of it.

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