Lowest Salt Use Linked To Highest Mortality
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Lowest Salt Use Linked To Highest Mortality

LONDON, UK -- March 13, 1998 -- A study by Dr Michael Alderman and colleagues, from the Albert Einstein College of Medicine in New York, USA, found that after adjustment for age and sex, the mortality rate from any cause was highest among people who reported the lowest salt (sodium) intake (23·18 per 1000 person-years). The mortality rate was lowest (19·01 per 1000 person-years) in the group with the highest sodium intake.

The results of their study appears in this week’s The Lancet.

The data on which the study was based were collected in 1971-75 in the first National Health and
Nutrition Examination Survey (NHANES I). In this study, 11 346 US adults (aged 25-75) were medically
examined and gave details of their food intake, by recalling all they had eaten during a 24-hour
period.

In 1992, the researchers searched the US national death index and traced and interviewed
surviving participants. They then calculated the death rates in four groups (quartiles) defined by the
salt intake or the total calorie intake reported at the original survey. 3293 people had died, 1970
from cardiovascular causes.

The findings were similar for death from any cause and for death from cardiovascular disease
specifically. The rates decreased from the highest to the lowest quartile of sodium or calorie intake.
For the ratio of sodium to calorie intake (ie, salt as a fraction of everything eaten), however, the
death rate increased slightly from the lowest to the highest quartile (from 20·27 to 21·71 per 1000
person-years).

These data are valuable, say the investigators, because they relate sodium intake to the eventual
mortality rather than to an intermediate variable such as blood pressure. They emphasise that these
data do not justify any particular dietary recommendation. The findings "do not support current
recommendations for routine reduction of sodium consumption, nor do they justify advice to
increase salt intake or to decrease its concentration in the diet".


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