Salt Industry Calls for Repeal of Sodium Guidelines

  • by Washington Correspondent, MedPage Today
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"The Dietary Guidelines on sodium should be withdrawn and all legislative or regulatory actions based on them reversed or halted in order to protect the health of Americans," the Salt Institute's letter read.

In 2005, the federal government set the recommended daily allowance for sodium intake at 2,300 mg per day for the general population and 1,500 mg for high-risk populations.

But in 2010, a government panel suggested intake of less than 1,500 mg a day for people older than 50, African Americans, and anyone who has hypertension, diabetes, or chronic kidney disease. That covers about half of the U.S. population.

Earlier this year, the American Heart Association (AHA) took that recommendation further, saying that no one should consume more than 1,500 mg of sodium in a given day, and recently, leading epidemiologists called for a global reduction in salt intake. Reducing dietary salt intake by 3 grams of salt per day would reduce cardiovascular morbidity and mortality and save up to $24 billion in healthcare costs, according to their analysis published online in the British Medical Journal.

What does 1,500 mg of sodium look like? A cup of canned re-fried beans and a slice of wheat bread contain about 1,500 mg of sodium, as would a quarter-pounder with cheese and medium fries from McDonald's.

The Salt Institute said 1,500 mg of sodium per day is too low, and may actually have "potentially fatal consequences"

"To survive and thrive, the body needs salt. That's a medical fact," Salt Institute President Lori Roman wrote in a Monday press release. "But the official food policy of our federal government aims to radically reduce salt levels, violating the medical mandate to 'first, do no harm.' We oppose 300 million Americans being treated like lab rats in a risky trial."

The group argues that the government is violating federal law because dietary guidelines should be based on "the preponderance of the scientific and medical knowledge," but instead the recommendations cherry-pick studies that vilify salt, while ignoring those that suggest a negative consequence of reducing sodium, including those that connect low-salt diets to premature death; insulin resistance, which is a precursor to diabetes; and an increased likelihood of falls in the elderly.

The Salt Institute also said that the committee that promulgated the dietary recommendations failed to consider the impact of salt consumption on the production of plasma renin which plays a key role in the regulating blood pressure, thirst, and urine production. Disruption of the renin-angiotensin system kicks in when sodium intake falls below 3,450 mg daily, which is more than double the amount of salt the government is recommending people consume each day.

In January, however, the AHA laid out the science behind lowering salt intake in an advisory statement published in the group's journal, Circulation.

Two key components of improving cardiovascular health are population-wide lowering of blood pressure below 120/80 and reducing sodium chloride intake below 1,500 mg per day, according to the statement. The group said there is ample evidence -- more than 50 randomized clinical trials -- that links reducing sodium to lowering blood pressure. Aside from affecting blood pressure, consuming too much sodium affects the heart, kidneys, and blood vessels, the AHA said.

"The science supports the recommendation of 1,500 mg of sodium a day, and helping all Americans limit sodium consumption to less than 1,500 mg of sodium a day is a high priority for the American Heart Association," said an AHA spokesperson. "In our science advisory, we explain how we reached our conclusions, based on a large body of scientific studies."

Nine out of 10 American adults will develop high blood pressure in their lifetime, the spokesperson said. "People who don't currently have high blood pressure will benefit, because lowering the amount of sodium in the diet to no more than 1,500 mg per day will significantly blunt the rise in blood pressure that occurs as we age. For those who are already at high risk of developing high blood pressure or who already have it, lowering sodium consumption to no more than 1,500 mg per day will help them manage it more effectively."

The Salt Institute doesn't dispute salt's connection to high blood pressure.

"We're not saying that reduction of blood pressure is bad, we're just saying that using salt as the main lifestyle reduction strategy to obtain that reduction is a dangerous strategy," Morton Satin, the vice president of science and research at the Salt Institute told MedPage Today.





A spokeswoman for HHS defended the dietary guidelines.



From the American Heart Association: