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Around the globe, public policy-makers, restaurateurs, and food manufacturers are asking what it would take to reduce the soaring sodium content of daily staples and whether the predicted drop in blood pressures at a societal level would translate into reduced cardiovascular events.
A new study modeling the impact of a mere 10% reduction in sodium content in processed foods, combined with adding a 40% tax to salty products in 19 low- and middle-income countries, could lead to 250 000 fewer deaths per year.
Dr Bob Harrington talks to Drs Michael Alderman and Lawrence Appel about the challenges in understanding the role of salt in cardiovascular disease and why it is such a controversial topic.
A controversial meta-analysis claiming that the net health effect of a low-salt diet could be zero has been published a day ahead of a public meeting on sodium reduction to be held by the US FDA and other agencies. But most experts in the field view the new study as a minor irritation, deflecting from the universal goal of trying to lower the world's sodium consumption.
Simply giving advice to people to reduce the amount of salt they eat may not be a particularly effective way to have a major impact on the burden of CVD, a new meta-analysis concludes. Critics, however, say the review was not rigorous. However, everyone agrees that reducing the sodium content in processed foods, rather than individual dietary advice, is likely the best strategy for the future.
Teenagers eat the most salt of any age group in the US and as such represent a key target for sodium-reduction policies, with the adolescent years being "a window of opportunity" to set up lifelong good eating habits, say researchers. Cutting the amount of salt teens consume by a third could cut hypertension by half and reduce deaths at age 50 by almost 10%, they calculate.
A new Australian study finds that the most cost-effective way of improving cardiovascular health from sodium-reduction strategies would be for the government there to legislate to reduce the salt content of food.
A new review of urinary sodium excretion from a variety of US studies over the past 50 years has found little change in salt consumption. But salt intake there remains excessively high and needs to be drastically reduced, the researchers say.
Dutch scientists have calculated that increasing individual potassium intake to the recommended level of 4.7 g per day would, across populations, result in a lowering of systolic blood pressure of around 3 mm Hg, with an attendant significant drop in the number of deaths from heart attacks and strokes.
The US Dietary Guidelines Advisory Committee has issued its recommendations for the new Dietary Guidelines for Americans 2010, which are now open for a period of public comment before being published at the end of the year.
UPDATED WITH COMMENTARY // The Healthy People 2010 goal of having blood pressure controlled in 50% of those with hypertension has been met, according to new data from NHANES. But while this is a cause for celebration, the prevalence of hypertension remains twice as high as desired, so there is still much work to be done, say experts.
Consumption of unprocessed red meat did not increase the risks of coronary heart disease or diabetes in a new review, in contrast with processed meats, which did. The researchers suggest that it is the salt and preservatives in processed productsrather than the fat and cholesterol content of the meatthat could be harmful. Future studies on the health effects of meat should ensure that unprocessed and processed meats are examined separately, they stress.
Meals from fast-food chains in New York City contain excessive amounts of salt, a new study has shown. Sandwich and fried-chicken outlets and one pizza chain were the worst culprits.
UPDATED WITH INTERVIEW // As widely expected, the US Institute of Medicine is advising the FDA that it should set new federal standards for the amount of salt that can be added to foods and beverages.
Adding more weight to the argument for a populationwide approach to reduce dietary sodium levels in the US is a new study suggesting such a move would save $32 billion in medical costs.
Messages to limit the amount of salt added to food have had little impact on sodium intake in the West, where more than 75% of salt in the diet there is contained in readily prepared foods. The UK has recently gotten tough with the food industry and cut salt intake by 10%; is it time the US and others took a similar stance? heartwire examines the issues.
New statistical projections suggest that slashing salt in the US diet by 3 g per day would have huge benefits, reducing cardiovascular events and deaths to the same extent as interventions such as smoking cessation.
A new economic analysis concludes that regulations to reduce sodium content in processed foods and/or voluntary reductions in salt by companies could save up to $50 billion a year in healthcare costs in the US.
Slashing sodium consumption in resistant-hypertension patients has the same benefit as adding two antihypertensive medications, a small but striking study hints.
Doctors from the Portuguese Society of Hypertension have spearheaded a unique mass-media campaign about the harmful consequences of consuming too much salt, which in turn has led to the Portuguese Parliament approving a law restricting the sodium content of processed foods.
Researchers say a 24-year cohort study provides what will likely be some of the best evidence of the enduring benefit of low-sodium/plant-food-rich diets, given the impossibility of conducting a long-term clinical trial. (Fung TT et al. Archives Int Med 2008; 168:713-729.)
The American Medical Association has now published the scientific report behind last year's recommendations calling for a reduction in the amount of sodium in processed and restaurant foods. With the continued absence of voluntary measures from industry, however, new regulations will be required to achieve lower sodium concentrations, they say. (Dickinson BD et al. Arch Intern Med 2007; 167:1460-1468.)
More and more Americans are losing out in their mad DASH to good eating habits. A new study reveals that the dietary quality of hypertensive adults has deteriorated since the DASH diet became part of the national guidelines. (American Society of Hypertension 2007 Scientific Sessions.)
Observational follow-up from the Trials of Hypertension Prevention showed that a reduction in salt intake could reduce the risk of cardiovascular disease 25%. The findings, say investigators, reinforce recommendations to lower dietary sodium intake as a means of preventing cardiovascular disease in the general population. (Cook NR et al. BMJ; published online before print April 19, 2007.)
Results of a randomized trial have shown that introduction of a lower-sodium salt substitute significantly reduced blood pressure by about 5 mm Hg in a population in rural Northern China. (American College of Cardiology 2006 Scientific Sessions.)