Thursday 18 Sep 2014

Information and opinions presented here do not always represent the views of the American Heart Association.

Study underscores excessive sodium consumption as global health problem

Published: 7:27 pm CDT, August 13, 2014

Excessive sodium consumption is having a dire health impact on people around the world, killing about 1.65 million people globally each year from related cardiovascular diseases and stroke, according to a new study released Thursday.

The study published in the New England Journal of Medicine looked at a range of data sources and existing studies to determine that 1 in 10 cardiovascular deaths happen to people who consume more than 2,000 milligrams of sodium per day. As it turns out, 99.2 percent of people consume more than 2,000 milligrams of sodium per day worldwide.

“Excess dietary sodium intake exacts a tremendous toll on our societies and economies around the world,” said American Heart Association President Elliott Antman, M.D.

In the United States, almost 57,600 cardiovascular deaths per year were attributed to consuming more than 2,000 milligrams of sodium daily. Of those U.S. deaths, 61 percent were from cardiovascular heart disease and 17 percent were from stroke. The remaining 22 percent were other cardiovascular ailments.

Dr. Antman said because 75 percent of dietary sodium comes already added to prepackaged, processed and restaurant foods, it can be tough for Americans to lower their intake below the current average of 3,400 milligrams per day. The American Heart Association recommends eating no more than 1,500 milligrams of sodium per day.

“We need the help of food manufacturers, food processors and restaurant industries to help us make those changes to the food supply,” Dr. Antman said. “We have little problem rallying behind the need for tobacco control.  So too, we should simultaneously advocate for sodium reduction.”

The study, led by Dariush Mozaffarian, M.D., adjunct associate professor of epidemiology at Harvard and an AHA volunteer,  also found that 4 out of 5 deaths from excessive sodium intake occurred in low- to middle-income countries, and 2-in-5 deaths happened before age 70. Overall, cardiovascular deaths related to sodium intake was highest in the American state of Georgia, and lowest in Kenya.

Meanwhile, a study called PURE which also was released Thursday questioned the link between excessive sodium intake and health risks. It said that only those with hypertension, the elderly, and people who consume more than 5,000 milligrams of sodium daily, should bother reducing their sodium consumption.

But Dr. Antman said observational studies like PURE could have skewed results from inaccurate measurements of sodium intake and the potential inclusion of people who are already sick. More potential issues have been detailed in the American Heart Association’s February 2014 Science Advisory.

“The bulk of the available evidence to date suggests that reduced sodium intake is associated with reduced blood pressure, which itself is associated with a reduction in cardiovascular events,” Dr. Antman said. “Along with improving overall diet, controlling weight, and increasing physical activity, lowering sodium intake is key to lowering blood pressure in the general population and improving blood pressure control in those with hypertension.

The AHA recently launched a new campaign to help consumer lower their sodium intake, and recently, more than 30 leading scientists affirmed that the full scope of the evidence continues to anchor the scientific basis for reducing sodium intake.

“We need the help of food manufacturers, food processors and restaurant industries to help us make those changes to the food supply,” Dr. Antman said. “We cannot afford to tarry any longer and continue to do a disservice to the public’s health by inadequate action, given that the weight of the evidence indicates the substantive public health benefits and healthcare cost savings that would result from sodium reduction.”