Lancet 392, 496–506 (2018).

The current World Health Organization recommendation that sodium consumption should not exceed 2 g per day to prevent cardiovascular disease is challenged by a large epidemiological study.

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The Prospective Urban Rural Epidemiology study is ongoing in 21 countries. An international group of researchers from Canada and China analyzed data from 95,767 participants from 18 countries. They used fasting morning urine sodium content as a surrogate for sodium intake and correlated this with major cardiovascular events, mortality and blood pressure.

They found a positive association between sodium intake and blood pressure, but no increase in cardiovascular disease and strokes was seen in communities in which sodium intake was between 3 and 5 g per day. Sodium was associated with stroke only among communities with very high sodium intake (greater than 5 g per day), which was mostly communities from China. This suggests that strategies to reduce sodium intake should be focused only in these communities.