- Salt Reduction -

Trojan Horse of Public Health Policy

Appears attractive on surface, but conceals great risk to consumers!

Morton SatinVice President, Science and ResearchSalt InstituteAlexandria, VA 22314

The benefits of blood pressure reduction depend on how it’s done!

Salt Institute (SI) agrees blood pressure reduction may benefit hypertensive individuals

Exercise, the Mediterranean diet or relaxation reduce BP with no negative consequences

Salt reduction is a dangerous strategy to reduce BP because of the negative consequences

The latest evidence, just published in the American Journal of Hypertension:

However,

= + +

The benefits of population-wide salt reduction are

minimal!

Graudal, N.A., Hubeck-Graudal, T & Jurgens, J., “Effects of Low-Sodium Diet Vs High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol and Triglyceride (Cochrane Review), Am J Hypertension, 2011, 24

The risks of population-wide salt reduction are significant!

Stolarz-Skrzypek K, Kuznwtsova T, Thijs L, et al. “Fatal and nonfatal outcomes, incidence of hypertension, and BP changes in relation to urinary sodium excretion,” JAMA. 2011;305:1777-1785.

All are risk factors for cardiovascular disease, diabetes and increased all-cause mortality!

Graudal, N.A., Hubeck-Graudal, T & Jurgens, J., “Effects of Low-Sodium Diet Vs High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol and Triglyceride (Cochrane Review), Am J Hypertension, 2011, 24

Graudal, N.A., Hubeck-Graudal, T & Jurgens, J., “Effects of Low-Sodium Diet Vs High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol and Triglyceride (Cochrane Review), Am J Hypertension, 2011, 24

The risks of population-wide salt reduction are significant!

Stolarz-Skrzypek K, Kuznwtsova T, Thijs L, et al. “Fatal and nonfatal outcomes, incidence of hypertension, and BP changes in relation to urinary sodium excretion,” JAMA. 2011;305:1777-1785.

Risk factors for cardiovascular disease, heart attach, stroke and increased all-cause mortality!

No relationship between rates of hypertension and salt

consumption!

1981

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219

83-1

984

1985

-198

619

87-1

988

1989

-199

019

91-1

992

1993

-199

419

95-1

996

1997

-199

8

0

50

100

150

200

250

300

350

Blacks

Whites

Salt Intakes (≈ 9.2g)

Hyp

erte

nsiv

es p

er

100,

000

• Hypertension increasing

• Salt intake stable

• No relationship

Bernstein, A.M, Willett, W.C., “Trends in 24-h urinary sodium excretion in theUnited States, 1957–2003: a systematic review,” Am J Clin Nutr 2011;92:1172–80.

Ayala, C., Croft, J.B., Wattigney, W.A., and Mensah, G.A., “Trends in Hypertension-Related Death in the United States: 1980-1998,” J Clin Hypertens, 6(12):675-681, (2004).

Salt reduction precipitates strong international

criticism

“Given the side effects of sodium reduction, this effect is not sufficient to recommend general sodium reduction. Sodium reduction is probably the largest

delusion in the history of preventive medicine.” BMJ 2011;343:d6119

Scandinavian Cardiovascular Journal, 2011; 45: 194–197

“The IOM recommendations regarding a population-based policy of salt restriction may not be valid since important

evidence has not been included in their analysis.”

Population-wide salt reduction will place consumers at risk!

The peer-reviewed clinical evidence is clear and incontrovertible!

If we limit salt intake to the levels recommended in the Dietary Guidelines, American consumers will be the victims of increased morbidity and mortality!

All who knowingly chose to ignore the clinical evidence and pursue the myth of salt reduction must bear this responsibility and burden.