New studies support limiting daily sodium consumption to less than 1,500 milligrams, according to a new American Heart Association presidential advisory.
The advisory, published in the American Heart Association's journal Circulation, is based on a thorough review of recent laboratory, animal, observational and clinical studies that reaffirm the association's 2011 advisory that limiting sodium (salt) to less than 1,500 mg per day is linked to a decreased risk of high blood pressure and cardiovascular disease, including stroke.
"Our recommendation is simple in the sense that it applies to the entire U.S. population, not just at-risk groups," said Nancy Brown, chief executive officer of the American Heart Association. "Americans of all ages, regardless of individual risk factors, can improve their heart health and reduce their risk of cardiovascular disease by restricting their daily consumption of sodium to less than 1,500 milligrams."
Some recent reports have led to confusion and mixed messages about the healthiest levels of daily sodium for all subgroups of the population.
"People should not be swayed by calls for a change in sodium intake recommendations based on findings from recent studies reporting that a reduction in sodium consumption does not improve cardiovascular health," said Paul K. Whelton, M.D., M.Sc., lead author and Show Chwan Professor of Global Public Health in the Tulane University School of Public Health and Tropical Medicine in New Orleans, La. "Our detailed review of these studies identified serious methodological weaknesses, which limit the value of these reports in setting or revising sodium intake policy.
"Our focus should be on finding effective ways to implement, not change, the existing American Heart Association policy on sodium intake."
Reducing sodium intake can help fight high blood pressure, which affects more than 76 million U.S. adults and is a major cause of cardiovascular disease.
Yet, most American adults and children consume sodium far in excess of their physiologic needs and guideline recommendations---with an average daily intake more than 3400 mg per day. Only individuals, primarily those with specific, rare disorders, who have been advised by their physicians to do otherwise, should not reduce their sodium intake to 1500 mg/day, but this is difficult in the current environment. Most of the sodium the public consumes is "hidden" in processed and prepared foods. The American Heart Association advocates improved nutritional labeling of sodium content and stringent limits on sodium in all foods – fresh, processed and prepared -- provided to everyone and in particular in schools, marketed to children and purchased by employers and government programs.
Study authors conclude that a comprehensive approach to cardiovascular health promotion and disease prevention is multifactorial that includes regular physical activity, healthy body weight, managing blood pressure, controlling blood sugar, avoiding tobacco and a healthy diet. Sodium reduction is a very important component of a healthy diet.
"An integral component of our campaign to improve the nation's cardiovascular health by 20 percent by 2020 is a nationwide decrease in sodium consumption," said Donna Arnett, Ph.D., M.S.P.H., president of the American Heart Association. "It will require a joint effort between health organizations, policy makers and the food industry to achieve this goal by creating an environment conducive to helping all Americans make healthy, low-sodium food choices."
Co-authors are: Lawrence J. Appel, M.D., M.P.H.; Ralph L. Sacco, M.D., M.Sc.; Cheryl A. M. Anderson, Ph.D., M.P.H., M.S.; Elliott M. Antman, M.D.; Norman Campbell, M.D.; Sandra B. Dunbar, R.N., D.S.N.; Edward D. Frohlich, M.D.; John E. Hall, Ph.D.; Mariell Jessup, M.D.; Darwin R. Labarthe, M.D., M.P.H., Ph.D.; Graham A. MacGregor, M.B., B.C.H.; Frank M. Sacks, M.D.; Jeremiah Stamler, M.D.; Dorothea K. Vafiadis, M.S.; and Linda V. Van Horn, Ph.D., R.D.
Author disclosures are on the manuscript.
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