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Perspectives

To salt or not to salt - still remains the question

Rob MacGinley, Merlin Thomas

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Abstract

Observational studies have variously reported that low salt intakes and high salt intakes are associated with reduced risk, increased risk or no risk at all in cardiovascular outcomes. Although the methodologies of the studies have been widely criticised, it is important to clarify whether there will be a reduction in hypertension in the population from the reduced salt content of foods and the value of blanket individual salt-reduction advice now that population salt reduction initiatives are under way.

Key Points

  • Government, industry and advocacy groups are launching projects to decrease the population sodium intakes in our community with the aim of lessening cardiovascular disease (CVD) linked to excessive salt consumption.
  • Selected populations, including people with heart failure and those with long-term diabetes, may have an excessive response to severe salt restriction. Caution is advised in these populations when reducing sodium intake.
  • The population program of salt reduction is separate to the individualised prescription of salt restriction. A primary care physician should act based on the patient in front of him or her.
  • At an individual patient level, a healthy diet – and particularly one that has a low salt content – is essential and is likely to improve blood pressure control and also have extensive overall health benefits.
  • Patients who already have a very high CVD risk will need a slow and gradual reduction in their salt intake to lessen nutritional issues and ensure counter-regulatory physiological responses are in balance when the low-salt diet is commenced.

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