No Association Between Salt And Blood Pressure, Study Finds

I'm a medical student who actually read the paper this article refers to. I would be very careful trying to draw conclusions from a study like this. I don't think many people in the healthcare community would be very surprised by it.

1) All clinically treated hypertensive patients were excluded - that means if you have kidney or vascular disease (hypertension) and are being treated for it, you aren't counted here. Doctors WILL care about your salt intake if you have these conditions, as they should! It is very common to prescribe something called the DASH diet to lower sodium intake and increase potassium intake.

2) If you're healthy, it means your kidneys are healthy (simplifying). One of the purposes of the kidneys is to maintain homeostatic blood pressure by excreting a combination of salt and water. To put it simply, if you eat a huge load of NaCl, say in a dominoes pizza, your blood pressure WILL NOT be affected for a very long time. I'd guess 20 minutes or so after the salt enters your bloodstream. Which means these folks can't measure that blood pressure change by testing blood pressure yearly.

3) Either medical doctors or the press that listens to them have a nasty habit of taking treatments that often work for very sick people - morbidly obese, type 1 diabetics, bed-ridden centenarians - and applying it to normal healthy folks. I will go out on a limb and say that these unilateral recommendations are almost all BS, and should be ignored. If you're healthy: eating eggs will not affect your cholesterol, eating cheesecake will not give you diabetes, sitting in a chair will not misalign your spine. It would be prudent for you to be skeptical when you hear these claims, often on daytime television or on the internet.

The state of nutrition science is pathetic.

The science is conflicted over a simple question of fact -- whether or not a trivially measurable short-term effect occurs when you eat one of the most common food additives in the world.

If we can't even answer THIS -- it seems like it should be incredibly easy to answer -- I don't see why people can claim anything at all about diets and macronutrients.

Nutrition science needs a fundamental breakthrough and I don't know where it's going to come from but I desperately hope it happens quickly. Because a lot of people are suffering and dying of poor nutrition and we don't know basic things about what's good and bad for us.

I decided to go through the IOMs Sodium Intake in Populations report[1] when the FDAs new DRIs were released. The FDA guidelines pushing for 1500mg a day stand in contrast to the findings of the Cochrane review meta-analysis(summary[2]). After looking over all the studies reviewed by both the IOM and the Cochrane review I can't figure out how the FDA are justifying their recommendations of very low intake. The only truly consistent finding seems to be that below around 2g and above about 4g is clearly harmful in that it definitely results in more hospital visits. In between is a lot more shaky. The FDA basically asked the IOM to write the bottom line first and still the IOM wasn't able to come up with any evidence that lowering sodium intake below that range was helpful. It is important to note that the vast majority of sodium studies additionally do not control for a very important confounder which is potassium intake, and that those that do seem to agree strongly with the conclusions of the Cochrane Review. IOM makes note of this shortcoming but does not draw any conclusions from it.

MealSquares (http://mealsquares.com) will be sticking with the Cochrane Review conclusions for now, but of course we will update and inform our customers based on the recommendations with the strongest evidence behind them. It's interesting to note that Soylent 1.0 went with around 1g of salt/day and was forced to change this when people started getting dizzy. it will be interesting to see what they change it to.

1. http://books.nap.edu/openbook.php?record_id=18311&page=R1

2. http://www.nhs.uk/news/2011/11November/Pages/cochrane-review...

Oxygen is bad for us. It oxidizes and damages all kinds of organic chemicals in our bodies that are required for use to live. Oxidization, however, is exactly what provides us with the energy that supports life.

Salts are electrolytes. (Electrolytes are salts?) You need them in your body so that your nervous system can conduct signals and keep things going - like your heart.

We live. We grow. We hurt. We heal. We get sick. We recover. We age. We wear out. We die.

Rather that avoiding "omg sugar" or "omg salt" or "omg fat," we should just be eating well-rounded diets. Have some beef today. And some pork tomorrow. And some fish after that. Have some fruit. And veggies. And a bit of dessert. And a spoonful of honey. And some powdered sugar on that syrup'd French toast. Just don't eat large piles of stuff for a meal. And don't eat the same thing every day.

Life's gonna kill you. Just don't clog up your body with excessive amounts of the same thing and you probably won't die early.

Nutrition hasn't much since I took some nutritional chemistry classes in college decades ago. It's still a very complex system which is almost impossible to study because you can't easily isolate different the different bits from each other. The only thing even less settled is how the brain operates and stores information.

Scientific American was beating this drum a while ago:

> It's Time to End the War on Salt > http://www.scientificamerican.com/article/its-time-to-end-th...

The orignal study that caused the salt scare didn't claim that increased salt intake caused increased blood pressure. The claim was that a sodium intake on the high end of regular sodium intake was closely correlated with increased mortality rates in heart attack victims. There was no claim made about sodium intake and blood pressure, nor was there a claim about sodium intake and heart attack rates.

This is why I hate the intersection of journalism, science, and the public.

Analyzing the effects on health of a single nutritional item - salt in this case - in pretty useless IMHO. The more I read about nutrition, the more I come to realize that it is the ratio of different nutrients what is key to our health.

Take Omega3 for example: It´s much healthier to reduce the content of Omega 6 in your diet than popping a couple of Omega 3 pills a day. This is so because our current diet has screwed up this optimal ratio [1]

Same applies to salt: The problem is not Sodium, but refined salt, that has a mineral composition so unbalanced that makes Sodium problematic.

Just eat unprocessed food.

[1] Optimal ratio Omega6/Omega3=around 1. Typical ratio in western diets: 15/1 http://www.sciencedirect.com/science/article/pii/S0753332202...

Did they really prove there was 'no association' or did they just fail to reject the null hypothesis that there is no association? These are diabolically different things!

Can't confirm. Whenever I use salt, my blood pressure goes up fairly quick. That's why I use Ansible instead.

The results section of the paper has some possibly contradictory information:

1. "Salt intake was positively associated with SBP in men but not in women."

2. "Salt intake was not associated with SBP in either sex after multiple adjustments."

Also isn't this kind of journalism and article titles unethical? There should be some kind of regulatory board for articles in any media.

Anyone can write anything and can cause serious harm.

This title is more misleading than the article. Notice the question in the headline? That almost always means No.

> those patients who were hypertensive consumed significantly more salt than those without hypertension

Doesn't that mean there is a causative effect, or are they saying it just a correlation? People with high blood pressure tend to eat more salt? Or if it is not statistically significant, why mention it at all?

In recent years oncology is seeing there might be a connection between lack of iodine and increase risk of cancer. So when people curb their salt intake for long periods of time they may be risking cancer since it is one of the only ways inlanders get enough of it.

Sadly, the unsettled or contradicted nature of the science won't stop politicians like Bloomberg from trying to force the behavior he wants through legislation.

Does the headline square with "patients who were hypertensive consumed significantly more salt than those without hypertension"?

The latest health scare is that sitting causes all kinds of trouble. Expect articles in 10 years saying it was all a lie.

To me, it sounds like poor, little, old, suffering 'Time' magazine is trying to get eyeballs.

The article sounds like a total yawn to me, that is, just old and obvious. So, I long understood: If eat some food with some table salt, that is, NaCl, then within an hour or so likely the salt concentration in blood will increase and then blood pressure will increase. But, the body has a system that regulates salt concentration; so, if the salt concentration is too high, then the body will lower the salt concentration, and the usual way is to flush out the extra salt in urine. So, net, likely within a few hours, the salt concentration will be back to where the body wants it. Typically, for reasonably healthy people, no biggie.

Somewhat separately there is a disease called hypertension which means high blood pressure, and such blood pressure can be dangerous, e.g., cause blood vessels to break and leak, say, in the brain -- not good. If a person has this disease, then extra salt that further increases blood pressure, even just for a few hours, can be not good. So, for such a person, a standard recommendation is to reduce input of salt: So, e.g., don't sit around eating salted peanuts, potato chips, etc.

But does eating salt cause the disease hypertension? Nope.

Then, bingo, presto, wonder of wonders, the mass media, always eager for getting eyeballs, often by grabbing people, by the heart, the gut, below the belt, always below the shoulders, never between the ears, comes out screaming about salt suggesting that salt, exploiting really simplistic thinking, is somehow bad. Or, since people are sensitive to suggestions or symptoms of danger, suggesting that salt is bad can get eyeballs.

Then companies that manufacture and want to sell food products, say, bread, may see a selling opportunity, lower the amount of salt in their products, and then scream on their product labels that their products are healthy because they are low salt.

We can see how the mass media and their food product advertising customers have a common interest: The media raises fears about salt, and the food companies scream that their products are healthy because they are low in salt. It's deliberate confusion and deception, that is, in a word, a scam, all in an attempt to get money from ordinary people.

This scam has been going on for decades. E.g., back in the 1980s I was in the house of some friends; they were in their 20s and in perfect health, with perfect weight, etc. The husband was a good athlete, and his wife was drop dead gorgeous. But the wife was cooking with low salt based on the scam, i.e., that salt would cause hypertension, which of course it would not.

Or, as in the title here, "No Association Between Salt And Blood Pressure", of course not. There never was any such association. Salt does not cause hypertension; there's never been any competent claim that salt did cause hypertension.

So, now Time gets another way to grab eyeballs -- debunk the scam that for at least three decades has had way too many people thinking the total nonsense that salt causes hypertension.

For the media, there's a pattern here: To get eyeballs, create a scam. Then, later, maybe decades later, to get more eyeballs, debunk the scam. Then continue with more scams -- there are many possible scams.

So, net, salt does not cause the disease hypertension, and the media likes to use scams to get eyeballs. Virginia, if you didn't already know this, then listen up and learn. I mean, by now, we expected something else?

Or is there? Nutrition "Science" is fucking Phrenelogy

Low Sodium Intake — Cardiovascular Health Benefit or Risk? Suzanne Oparil, M.D. N Engl J Med 2014; 371:677-679 August 14, 2014DOI: 10.1056/NEJMe1407695

"In response to controversy about the health effects of low sodium intake, the Institute of Medicine convened an expert committee to evaluate the evidence for a relation between sodium and health outcomes.4,5 The committee concluded that most evidence supports a positive relation between high sodium intake and risk of cardiovascular disease but that results from studies with health outcomes were insufficient to conclude whether low sodium intake (<2.3 g per day or <1.5 g per day, as recommended in current dietary guidelines6,7) is associated with an increased or reduced risk of cardiovascular disease in the general population. The committee found limited evidence that low salt intake may be associated with adverse health effects in some subgroups, including some patients with heart failure or other forms of cardiovascular disease, diabetes, or chronic kidney disease. Results from three studies, reported in this issue of the Journal, bear on this matter. The Prospective Urban Rural Epidemiology (PURE) study provides new evidence about the association between sodium and potassium intake, estimated from morning urine specimens, and blood pressure, death, and major cardiovascular events.8,9 The procedure for estimating electrolyte excretion was validated elsewhere.10 The PURE study included more than 100,000 adults sampled from the general population of 17 countries that varied in their economic development and acculturation to an urban lifestyle. Approximately 90% of the participants had either a high (>5.99 g per day) or moderate (3.00 to 5.99 g per day) level of sodium excretion; approximately 10% excreted less than 3.00 g per day, and only 4% had sodium excretion in the range associated with current U.S. guidelines for sodium intake (2.3 or 1.5 g per day).

Across this broad range of populations, the relation between sodium excretion and blood pressure was positive but nonuniform: it was strong in participants with high sodium excretion, modest in those in the moderate range, and nonsignificant in those with low sodium excretion. The authors concluded from the findings that a very small proportion of the worldwide population consumes a low-sodium diet and that sodium intake is not related to blood pressure in these persons, calling into question the feasibility and usefulness of reducing dietary sodium as a population-based strategy for reducing blood pressure. There was also an interaction between sodium excretion and potassium excretion: high sodium excretion was more strongly associated with increased blood pressure in persons with lower potassium excretion. The authors suggested that the alternative approach of recommending high-quality diets rich in potassium might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction alone. After a mean of 3.7 years of follow-up, the composite outcome of death and cardiovascular events occurred in 3317 participants (3.3%). As compared with those who had a moderate level of sodium excretion, those with a higher or lower level of sodium excretion had an increased risk of cardiovascular-disease outcomes.

The authors attempted to rule out residual confounding or reverse causation as explanations for their findings by showing that participants with a low level of sodium excretion had a similar mean INTERHEART Modifiable Risk Score and higher intake of fruit and vegetables, as compared with those with a moderate level of sodium excretion, and that more than 90% of the cohort was free of antecedent cardiovascular disease. The findings were not altered by the exclusion of participants with prior cardiovascular disease, cancer, or use of blood-pressure medication, by the exclusion of outcome events occurring in the first 2 years of observation, or by adjustment for all identifiable confounders.

The major weaknesses of the PURE study, inherent in its study design and scope, include the absence of direct measurement of 24-hour urinary excretion on multiple occasions, which is the accepted model for assessing electrolyte intake, and the lack of an intervention component to assess the direct effects of altering sodium and potassium intake on blood pressure and cardiovascular-disease outcomes, thus making it impossible to establish causality. Nevertheless, this large study does provide evidence that both high and low levels of sodium excretion may be associated with an increased risk of death and cardiovascular-disease outcomes and that increasing the urinary potassium excretion counterbalances the adverse effect of high sodium excretion. These provocative findings beg for a randomized, controlled outcome trial to compare reduced sodium intake with usual diet. In the absence of such a trial, the results argue against reduction of dietary sodium as an isolated public health recommendation.

The authors of the third article, from the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCode),11 used modeling techniques to estimate global sodium consumption and its effect on cardiovascular mortality.12 The investigators quantified global sodium intake on the basis of published surveys from 66 countries and used a hierarchical Bayesian model to estimate global sodium consumption. They then estimated the effects of sodium on blood pressure in a meta-analysis of 107 published trials and estimated the effects of systolic blood pressure on cardiovascular mortality by combining the results of two large international pooling projects that included individual-level data. They found a strong linear relationship between sodium intake and cardiovascular events and estimated that 1.65 million cardiovascular deaths in 2010 were attributable to excess sodium consumption. The NutriCode investigators should be applauded for a herculean effort in synthesizing a large body of data regarding the potential harm of excess salt consumption. However, given the numerous assumptions necessitated by the lack of high-quality data, caution should be taken in interpreting the findings of the study. Taken together, these three articles highlight the need to collect high-quality evidence on both the risks and benefits of low-sodium diets."

ALL NUTRITION SCIENCE IS A BUNCH OF GODDAM LIES.

EAT FOOD THAT TASTES GOOD. STAY AWAY FROM PROCESSED FOOD. GET OFF YOUR ASS AS MUCH AS POSSIBLE. THAT IS ALL!

/rant

This article is BS. I mean, its a FUD advertorial.

I say that based on my personal experience:

A nurse in the clinic checked my BP (as a routine) when I went to get checked for some eye infection. And she was shocked that it was 170/100 (normal is 120/80).

It was shocking for her (and of course me) because: I was 25 I looked healthy and lean (not too thin). I showed/experienced no signs of hyper tension.

My eating habits, was to go on a Frozen Prepared Food diet (for lunch and dinner) because that was the cheapest tasty food I could afford along with cereals for breakfast, for about 3 months before my BP was checked.

I dropped this diet since that day, reduced salt intake considerably. And it took about 9 months for my BP to come down to normal levels, without any medication, and with a little extra exercising.

I'd have taken this article with a pinch of salt. But, I have cut down on salt intake. So I prefer to not take it :)