In Alan Aragon’s August Research Review, he covers the topic of sodium. The topic of sodium is up there with other controversial subjects, including saturated fat, red meat, dairy, and eggs.
The American Heart Association (AHA) currently advises that the maximum intake of salt should be 2,300 mg/day, but states 1,500 mg/day is more ideal. However, are these recommendations appropriate given the current data?
Sodium is an essential macromineral, and the minimum intake of sodium/day is thought to be less than 500 mg/day. The average sodium intake in Americans appears to be around 3,600 mg/day, while Aragon cites data that puts average global sodium intakes around 3,660 – 4,000 mg/day.
With that said, the Institute of Medicine (IOM) states:
“Existing evidence, however, does not support either a positive or negative effect of lowering sodium intake to <2300 mg/d in terms of cardiovascular risk or mortality in the general population.”
Further, the IOM states:
“For other at-risk populations (e.g., those with diabetes or prehypertension), the available data do not support additional benefits of lowering sodium intake to <2300 mg/d.”
According to a meta-analysis done by Graudal et al., there is a U-shaped association between sodium intakes and health outcomes. Meaning, both low and high intakes of sodium are associated with increased mortality.
Instead of mentioning what constitutes low vs. high, we will look at what is optimal. The same meta-analysis by Graudal et al. states the optimal range of 2,645 – 4,945 mg/day of sodium is associated with the most favorable health outcomes.
Lastly, Aragon mentions there has unfortunately been a lack of emphasis on dietary potassium, despite an inverse relationship between potassium intake and blood pressure. Therefore, the greater potassium intake, ideally from one’s diet, the lower one’s blood pressure tends to be.
The takeaways:
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Sources:
Antman, E. M., Appel, L. J., Balentine, D., Johnson, R. K., Steffen, L. M., Miller, E. A., Pappas, A., Stitzel, K. F., Vafiadis, D. K., & Whitsel, L. (2014). Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the American Heart Association Sodium Conference 2013 Planning Group. Circulation, 129(25), e660–e679. https://doi.org/10.1161/CIR.0000000000000051
Aragon, A. AARR. Aug. 2020.
Cogswell, M. E., Loria, C. M., Terry, A. L., Zhao, L., Wang, C. Y., Chen, T. C., Wright, J. D., Pfeiffer, C. M., Merritt, R., Moy, C. S., & Appel, L. J. (2018). Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults. JAMA, 319(12), 1209–1220. https://doi.org/10.1001/jama.2018.1156
Farquhar, W. B., Edwards, D. G., Jurkovitz, C. T., & Weintraub, W. S. (2015). Dietary sodium and health: more than just blood pressure. Journal of the American College of Cardiology, 65(10), 1042–1050. https://doi.org/10.1016/j.jacc.2014.12.039
Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014). Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. American journal of hypertension, 27(9), 1129–1137. https://doi.org/10.1093/ajh/hpu028
McGuire S. (2014). Institute of Medicine. 2013. “Sodium intake in populations: assessment of evidence.” Washington, DC: The National Academies Press, 2013. Advances in nutrition (Bethesda, Md.), 5(1), 19–20. https://doi.org/10.3945/an.113.005033
Poorolajal, J., Zeraati, F., Soltanian, A. R., Sheikh, V., Hooshmand, E., & Maleki, A. (2017). Oral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trials. PloS one, 12(4), e0174967. https://doi.org/10.1371/journal.pone.0174967
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2 Responses
Thanks for the information, it is always good to know which salt is best. I do find the pink very flavorful!
Glad you found the information helpful 🙂 Pink sea salt is good, I also like Redmond Real Salt. (https://www.amazon.com/REDMOND-Real-Sea-Salt-Unrefined/dp/B000R5PKD0)
As long as you have foods rich in iodine, like eggs with the yolk, fish/seafood, and seaweed, in your diet, you shouldn’t need to use the iodized table salt. Let me know if you have other questions, though 🙂