Salt reductions may not reduce heart disease risk: Cochrane review FYI

[Guest guest]

Moderate reductions in salt intake do not reduce the likelihood of dying or

experiencing cardiovascular disease, according to a new Cochrane review.

The systematic review published by *The Cochrane Library* set out to assess

whether advice to cut

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altered the risk of death or cardiovascular

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sease & FromNews>.

The authors, led by Professor Rod from Peninsula College of Medicine

and Dentistry in the UK, found no strong evidence to support the idea that salt

reduction<http://www.foodnavigator.com/content/search?SearchText=salt+reduction & \

FromNews>reduces

cardiovascular disease or all-cause mortality in people with normal

or raised blood pressure.

*“Intensive support and encouragement to reduce salt intake did lead to a

reduction in salt eaten and a small reduction in blood pressure after more

than six months … *[However]* there was not enough information to understand

the effect of these changes in salt intake on deaths or cardiovascular

disease,”* said the authors.

Consensus Action on Salt and Health (CASH) campaign director Katharine

Jenner, told FoodNavigator that it is *“very disappointing”* to see the

message from the review indicates that salt reduction may not be beneficial.

*“This is a completely inappropriate conclusion, given the strong evidence

and the overwhelming public health consensus that salt raises blood pressure

which leads to cardiovascular disease,”* said Jenner.

*Salt reduction*

and colleagues noted that there is lots of evidence to suggest that

reducing dietary salt intake reduces blood pressure.

*“The relationship of salt intake to blood pressure is the basis for the

belief that restriction in dietary sodium

intake<http://www.foodnavigator.com/content/search?SearchText=sodium+intake & From\

News>will

prevent blood pressure related cardiovascular events,”

* they added.

As a result, current public health recommendations in many countries are to

reduce salt intake by about half, to around five grams per day.

“*Intensive support and encouragement to reduce salt intake did lead to a

reduction in salt eaten and a small reduction in blood pressure after more

than six months*,” said .

*“What we wanted to see was whether this dietary change also reduced a

person’s risk of dying or suffering from cardiovascular events,”* he added.

and his colleagues also noted that an earlier Cochrane review of

dietary advice, published in 2004, did not provide enough evidence to allow

the researchers to draw conclusions about the effects of reducing salt

intake on mortality or cardiovascular events.

*Systematic review*

The new review located seven studies, which included 6,489 participants –

Thus giving a sufficiently large set of data to be able to start drawing

conclusions, suggested the authors.

They found that for cardiovascular morbidity and all cause mortality in

people with normal or raised blood pressure at baseline showed no strong

evidence of benefit from salt intake restriction. Salt restriction did,

however, increase the risk of death from all causes in those with congestive

heart failure, reported the authors.

and his colleagues noted that despite collating more event data than

previous systematic reviews, there is still insufficient evidence to suggest

that moderate reductions in salt intake have beneficial effects on all cause

mortality or the risk of cardiovascular disease.

CASH’s Jenner disagreed with the findings of the study, noting that there

are no robust outcome trials for many other chronic exposures, including

smoking, excess weight, and insufficient fruit and vegetable intakes, due to

the complexities of undertaking such trials.

*“The evidence against salt, as it is for smoking cessation, is so strong it

would be highly unethical to conduct a large trial where people have to have

a long term high salt intake,”* she said.

*Moderate effect?*

*“We believe that we didn’t see big benefits in this study because the

people in the trials we analyzed only reduced their salt intake by a

moderate amount, so the effect on blood pressure and heart disease was not

large,”* said .

*“With governments setting ever lower targets for salt intake, and food

manufacturers working to remove it from their products, it’s really

important that we do some large research trials to get a full understanding

of the benefits and risks of reducing salt intake,” *he added.

However, Jenner told FoodNavigator that *“there is no sense in waiting for

further trials before progressing with an international salt reduction

programme, which will immediately save many thousands of lives.”*

*“We are, however, pleased that this review recognises that reformulation by

the food industry, rather than individual dietary advice, is the most

cost-effective strategy for salt reduction in developed countries, and fully

support the evaluation of such programmes,”* she said.

Source: *The Cochrane Library*

Cochrane Database of Systematic Reviews, doi: 10.1002/14651858.CD009217

*“Reduced dietary salt for the prevention of cardiovascular Disease”*

Authors: R.S. , K.E. Ashton, T. Moxham, L. Hooper, S. Ebrahim

--

Ortiz, MS, RD

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