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Adding nuance to dietary prescriptions: does sodium reduction benefit people already losing weight?

Journal of Human Hypertension volume 37, pages 584–585 (2023)Cite this article

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Healthy diets are paramount to preventing non-communicable diseases, including hypertension. We analyzed the association between mean daily sodium intake and prevalent hypertension among participants of the U.S. National Health and Nutrition Examination Survey (NHANES), restricting our sample to those with a calorie deficit. Among 5756 individuals, we did not detect any significant association between increased sodium and the odds of hypertension (OR: 0.97; 95% CI: 0.90; 1.05). The lack of association between sodium intake and hypertension led us to conclude that people who lose weight healthily would see little benefit in reducing their sodium intake [1].

McLean and colleagues [2] and Campbell and colleagues [3] have drafted a detailed breakdown of the limitations of our study in response to our findings. Most of these are restatements of what we have already acknowledged in the original manuscript (see “Strengths and limitations”). For example, we clearly stated that the exposure was assessed based on self-reported measures and provided our rationale for this choice. They bring up reverse causality; however, we already stated that our results were based on a cross-sectional design (see the title of our paper), which did not allow us to establish temporality [1]. We could not find any sentence in our manuscript suggesting we were interpreting the results causally. We clearly outlined our assumptions based on hypothesized causal relationships based on our understanding of the literature. Furthermore, given the study’s design, we drafted all interpretations in “associational” languages. Based on the null findings from a nationally representative study, we concluded, “These results highlight the need to explore new population-specific strategies for sodium intake reduction…” and we stand by this conclusion.

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References

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Authors and Affiliations

  1. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Jorge Andrés Delgado-Ron

  2. Fundación Oftalmológica de Santander, Instituto Masira, Universidad de Santander, Bucaramanga, Santander, Colombia

    Patricio López-Jaramillo

  3. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Mohammad Ehsanul Karim

  4. Centre for Health Evaluation and Outcome Sciences (CHEOS), St. Paul’s Hospital, Vancouver, BC, Canada

    Mohammad Ehsanul Karim

Authors
  1. Jorge Andrés Delgado-Ron
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  2. Patricio López-Jaramillo
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  3. Mohammad Ehsanul Karim
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All authors contributed equally to this communication and approved the current version.

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Correspondence to Jorge Andrés Delgado-Ron.

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Competing interests

MEK holds research grants from the Natural Sciences and Engineering Research Council of Canada. MEK is supported by the Michael Smith Health Research BC Scholar award. Over the past three years, MEK has received consulting fees from Biogen Inc. for projects unrelated to the current topic.

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Delgado-Ron, J.A., López-Jaramillo, P. & Karim, M.E. Adding nuance to dietary prescriptions: does sodium reduction benefit people already losing weight?. J Hum Hypertens 37, 584–585 (2023). https://doi.org/10.1038/s41371-023-00820-2

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