Low-salt diet prevents heart attacks and strokes

Eating less salt can reduce the risk of cardiovascular disease by 25% and cut the risk of death from all causes by a fifth, according to a new study.

The 15-year study of 2400 people demonstrates for the first time that cutting back on salt can reduce the risk of diseases such as stroke and heart attack, in addition to lowering blood pressure.

Volunteers in the study who were assigned to a low-salt regime had a 20% lower risk of death from all causes over the course of the study than their control counterparts. The findings should compel governments to take more action to reduce the salt content of processed foods, says Nancy Cook at the Brigham and Women's Hospital in Boston, Massachusetts, US, who led the study.

Numerous studies have documented how consuming foods high in salt can lead to high blood pressure. This happens because the salt draws more water into the blood, and the increase in fluid volume exerts more pressure on vessel walls. High blood pressure is known to contribute to heart disease, but few studies have shown a direct link between salty foods and the condition.

Salt snapshot

In the late-1980s and early-1990s Cook and colleagues collected urine samples from more than 3000 people with above-normal blood pressure. Analysing the urine samples collected over the course of a 24-hour-period gave the researchers a snapshot of the subjects' salt intake. On average, they were consuming 10 grams of salt per day.

Cook's team then randomly assigned half of these participants to attend weekly workshops that taught how to cook low-salt meals and read nutrition labels on packaged foods.

After approximately three months of this nutrition counselling, urine sampling revealed that the subjects reduced their daily salt intake by about 3 grams per day on average – the equivalent of about half a teaspoon.

Fifteen years later Cook's team was able to obtain follow-up health information about 2415 of the participants from medical records and telephone interviews.

Healthy choices

Phone interviews indicated that those who had received training on how to reduce their salt intake many years ago continued to consume less of it than their control counterparts. For example, 47% of those who received this intervention said they looked for reduced-salt foods in the supermarket, compared with 29% of the control group.

Of the 200 people who had developed cardiovascular disease – including heart attacks and stroke – in the past 15 years, 112 had received no dietary recommendations and 88 were in the group taught to reduce their salt intake.

After controlling for factors such as weight and age, the researchers calculated that reducing one's salt intake by 30% could decrease the risk of cardiovascular disease by 25%.

Cook says that the results of the study should encourage governments to "work with the food industry to come up with lower sodium foods", and notes that salt content is highest in processed and fast-foods. "People generally consume much more salt than what is biologically needed."

In 2006, the American Medical Association urged the US Food and Drug Administration to revoke the "generally recognised as safe" (GRAS) status of salt and to adopt stricter salt guidelines.

Current US dietary guidelines recommend that people consume less than one teaspoon of salt per day.

Journal reference: BMJ (DOI: 10.1136/bmj.39147.604896.55)