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According to the New York Times:

A new study found that low-salt diets increase the risk of death from heart attacks and strokes and do not prevent high blood pressure.

Should the general population eat more salt or are there problems with the study and this interpretation?

  • A very quick Google Scholar search for 'sodium', 'dialysis' & 'morbidity' [papers since 2001] seems to knock this NYT article on its head. – user2466 Jun 13 '11 at 13:52
  • However, I've seen a number of studies that suggest that not everyone is salt sensitive. If they're not, they'll be losing out on all that tasty, tasty salt. – Martha F. Jun 13 '11 at 18:21
  • @Oddthinking - You changed (reversed) the original title: I guess that counts as your vote on the topic of Misleading question titles. – ChrisW Jun 25 '11 at 17:04
  • @ChrisW, I fixed a (mild) problem I saw. That doesn't mean I saw all the problems. Also, I think it is clearly understood that "effective" in this context means something like "effective at maintaining and improving health", so I don't see it as misleading. If others feel it is unclear, they should edit it. – Oddthinking Jun 26 '11 at 2:53
  • I've grown up on low salt after my father was barred from it because of kidney problems, and I'm still alive 30 years later. Probably as much evidence in favour or low salt diets right there than in a NYT study that "proves" high salt diets are good for you. – jwenting Jun 27 '11 at 6:47
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The study quoted, according to Dr. Peter Briss of the CDC, has the following problems, which may lead one to conclude that the study doesn't affect the same population that the CDC is concerned about when they discuss low salt diets:

  • It was small
  • It included relatively young subjects
  • It had relatively few cardiovascular deaths
  • It appears that some significant portion of the study participants were reporting urine volumes less than expected, suggesting that not all 24 hour urine sample periods were completed correctly, which would shift many people from the higher salt ranges into the lower salt ranges, thus increasing the apparent morbidity of the lower salt ranges

Further, one needs to understand that the CDC does NOT recommend a low salt diet, except for those in the following categories:

  • You are 51 years of age or older.
  • You are African American.
  • You have high blood pressure.
  • You have diabetes.
  • You have chronic kidney disease.

They recommends that everyone else maintain 2,300 mg sodium per day or less. This is not a low sodium diet.

In fact, most Americans consume 20 more times the sodium than what the body needs. What the CDC recommends is that people consume the recommended daily amount (RDA) or less. Most people are consuming more. So the general call to reduce sodium intake is, for most Americans, a call to get back down to the RDA, not to start on a 1,500 mg diet which is typical for an at-risk patient.

Further, this is the first study to correlate higher morbidity with lower sodium intake, and due to the issues with it no doctors are currently using it as a basis for patient care. There are many, many studies that back up the CDC's recommendations, and thus people should wait for more information before rejecting the current recommendations for a possible correlation, suggested by one flawed study.

  • Could you link to one of the many studies that back up the RDA for sodium intake for average people? - Is the study in JAMA using a definition for low-sodium-diets that's comparable to the CDC definition? - Why is small an argument when the effect size was big enough for P<0.001? - Why should the urine reporting effect low-sodium people in the same way that it does high-sodium people. Why is it a systematic bias? – Christian Jun 29 '11 at 0:46

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