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No risk with two teaspoons of salt a day


A salt intake equivalent to slightly more than two teaspoons per day does not increase the risk of cardiovascular disease, heart attack or stroke, according to a comprehensive international study published in The Lancet.

“Generally people do not need to be overly concerned about salt alone,” says co-author Annika Rosengren, professor of medicine at Sahlgrenska Academy and the person responsible for the Swedish part of the study.

The study, which involves researchers from more than 20 countries, concludes that most individuals do not increase their health risks as long as their daily salt consumption remains below 12.5 grams, or two and a half teaspoons (equivalent to five grams of sodium).

It appears that the health risks are not necessarily elevated even for those who consume more salt. The risks associated with high sodium intake can in practice be compensated by an improved diet, with more fruit, vegetables, dairy products, potatoes and other foods rich in potassium.

China stood out

The study included 94,000 people ages 35 to 70 from 18 regions around the world. They were followed for an average of eight years. The only country in the study where a large majority, 80 percent, consumed more than five grams of sodium per day was China, with a higher incidence of heart attacks and strokes as a result.

In the majority of other countries, consumption ranged from three to five grams of sodium per day. The World Health Organization (WHO) recommends no more than two grams of sodium per day, and the American Heart Association’s recommendation is even lower, 1.5 grams per day.

The results of salt consumption and the health benefits of improved diet correlate well with previous reports. However, this is the first time the underlying data is so extensive, with representation from virtually the whole world assembled in a single database.

On the whole, the researchers maintain that there is no convincing evidence that people with moderate sodium or salt intake need to lower their consumption to prevent heart disease and stroke. They assert that it is generally more important to improve the overall quality of diet.

Warning for invisible salt

“We are becoming more and more aware that adults need not be overly concerned about salt,” says Annika Rosengren. “If you’ve reached middle age, do not eat too much salt and have normal blood pressure, you can stop worrying and do need not concentrate on salt, but instead should make sure that you generally eat a healthy diet with lots of vegetables.”

“At the same time, we should not forget that there is a clear link between salt and high blood pressure. About three quarters of the salt we eat comes from processed foods, cheese, bread and butter over which we have no control, and as a consequence, children and young people may develop high blood pressure when they become adults. The food industry has to stop pouring salt in food unnecessarily.”

Sweden is the only Western European country with researchers in the study, which was based in Canada. Other countries include Argentina, Bangladesh, Brazil, Chile, Colombia, the Philippines, United Arab Emirates, India, Iran, China, Malaysia, Pakistan, Poland, Saudi Arabia, South Africa, Tanzania, Turkey, Zimbabwe and the occupied Palestinian territory.

Title: Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study

Contact: Annika Rosengren