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Weak research on dietary sodium should not generate strong conclusions on a major public health policy

Journal of Human Hypertension volume 37, pages 507–508 (2023)Cite this article

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Delgado-Ron et al. report an analysis of US NHANES datasets exploring the association between mean daily sodium intake and prevalent hypertension among a small sub-set (<10%) of adults on a caloric deficit diet [1]. They find no association between estimated sodium consumption and odds of hypertension. They conclude by suggesting the need to explore new population strategies for the reduction of sodium intake. More specifically, they make strong recommendations that current population interventions to reduce sodium in the diet should be replaced by ‘prescriptions’ for specific populations [1].

High dietary sodium is a leading dietary risk, responsible for an estimated 1.8 million deaths and 44 million disability adjusted life years lost (DALYS) in 2019 [2]. Over 130 randomized controlled trials in diverse population groups including children, elderly, obese, people with and without hypertension demonstrate that blood pressure decreases with decreasing dietary sodium to as low as 800 mg/day [2,3,4], with no lower threshold established. Approximately 400–500 million people are estimated to have hypertension caused by dietary sodium [2]. The World Health Organization indicates a reduction in dietary sodium as one of the most cost-effective interventions to improve population health [2].

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References

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Authors and Affiliations

  1. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

    Norm R. C. Campbell

  2. Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard University, Cambridge, Massachusetts, USA

    Nancy R. Cook

  3. Tulane University School of Public Health and Tropical Medicine, New Orleans, Lousiana, USA

    Paul K. Whelton

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  3. Paul K. Whelton
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NRCC drafted the letter, while NRC and PKW reviewed and revised the letter.

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Correspondence to Norm R. C. Campbell.

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Competing interests

NRCC reports personal consulting fees from Switch Health and Novartis Canada which were donated in entirety to the University of Calgary to support a community Cardiovascular disease prevention and control recognition award. NRCC also reports personal consulting fees from the World Bank, Resolve to Save Lives and the Pan American Health Organization for hypertension control and dietary sodium reduction programs. NRC and PKW have no conflicts of interest to declare.

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Campbell, N.R.C., Cook, N.R. & Whelton, P.K. Weak research on dietary sodium should not generate strong conclusions on a major public health policy. J Hum Hypertens 37, 507–508 (2023). https://doi.org/10.1038/s41371-023-00819-9

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