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Sodium

Related Topics:

• DASH Diet / hypertension

Recommendations:

• Morton Lite salt at Amazon.com.

News & Research:

• High Salt Intake Linked to Atherosclerosis Even With Normal BP - Medscape, 4/5/23 - "salt could be a damaging factor in its own right before the development of hypertension ... rising salt consumption was linked with increasing atherosclerosis in a linear fashion in both the coronary and carotid arteries ... Each 1000 mg rise in sodium excretion was associated with a 9% increased occurrence of carotid plaque (odds ratio [OR], 1.09; P < .001; confidence interval [CI], 1.06 - 1.12), a higher coronary artery calcium score (OR, 1.16; P < .001; CI, 1.12 - 1.19), and a 17% increased occurrence of coronary artery stenosis (OR, 1.17"
• Poor Hydration May Be Linked to Early Aging and Chronic Disease, a 25-Year Study Finds - NBC, 1/2/23 - "The researchers looked at levels of sodium in the participants' blood as a proxy for hydration, because higher concentrations are a sign that they most likely weren't consuming enough fluids. The researchers found that the participants with high blood-sodium levels aged faster physiologically than those with lower levels, which was reflected in health markers associated with aging, like high blood pressure, cholesterol and blood sugar ... The study participants all had blood-sodium concentrations considered to be within the normal range: 135 to 146 millimoles per liter. But the findings suggested that people with levels at the higher end of that normal range — above 144 millimoles per liter — were 50% more likely to show signs of physical aging beyond what would be expected for their years compared to people with lower blood-sodium levels. They also had a roughly 20% increased risk of premature death"
• Overly Tight Sodium Restriction May Worsen HFpEF Outcomes - Medscape, 7/18/22 - "Compared with patients with a cooking salt score of zero, patients with a cooking salt score greater than zero had significantly lower risks of the primary outcome (hazard ratio [HR] 0.760; P = .002) and HF hospitalization (HR, 0.737; P = .003) but not all-cause (HR, 0.838) or CV (HR, 0.782) death ... Results of subgroup analyses suggested that patients aged 70 years or younger (HR, 0.644) and those of Black and other ethnicities (HR, 0.574) were at greater risk of the primary outcome from aggressive restriction of cooking salt ... What limits the importance of the authors' findings, which they acknowledge, is that the sodium intake for each patient was self-reported ... No confirmatory testing was done and recall bias could clearly have played a role"
• Heart-healthy, lower sodium version of traditional Chinese cuisine lowered blood pressure - Science Daily, 7/11/22 - "The heart-healthy Chinese diet reduced sodium intake in half, from nearly 6,000 mg daily to about 3,000 mg daily, and featured reduced fat, increased protein and carbohydrates, twice as much dietary fiber and increased potassium ... Participants who ate the Chinese heart-healthy diet had lower blood pressure, with the systolic (top number) blood pressure lowered by an average 10 mm Hg, and diastolic blood pressure fell by an average 3.8 mm Hg, compared to the group who ate regular cuisine ... In the heart-healthy group, calorie intake from carbohydrates (8%) and protein (4%) increased and from fat decreased (11%). Consumption of fiber (14 grams), potassium (1,573 mg), magnesium (194 mg) and calcium (413 mg) increased, while sodium decreased (2,836 mg). The nutrient intake of the group that consumed regular diets, however, remained almost unchanged from the start to the end of the study ... hese findings suggest the effects achieved by the heart-healthy Chinese diet, if sustained, may reduce major cardiovascular disease by 20%; heart failure by 28% and all-cause death by 13% ... Health professionals should recommend a heart-healthy diet with low sodium and high potassium, fiber, vegetables and fruits as the first-line treatment to their patients with high blood pressure" - See Morton Lite salt at Amazon.com.
• Low-Sodium Diet Did Not Cut Clinical Events in Heart Failure Trial - Medscape, 4/2/22 - "a greater reduction in sodium than achieved in this study or a longer follow-up may be required to show an effect on clinical events ... By 12 months, events comprising the primary outcome (hospitalization or emergency department visits due to cardiovascular causes or all-cause death) had occurred in 15% of patients in the low-sodium diet group and 17% of those in the usual care group (hazard ratio [HR], 0.89 ... All-cause death occurred in 6% of patients in the low-sodium diet group and 4% of those in the usual care group (HR, 1.38 ... All-cause death occurred in 6% of patients in the low-sodium diet group and 4% of those in the usual care group (HR, 1.38; P = .32). Cardiovascular-related hospitalization occurred in 10% of the low-sodium group and 12% of the usual care group (HR, 0.82; P = .36), and cardiovascular-related emergency department visits occurred in 4% of both groups (HR, 1.21 ... Quality-of-life measures on the Kansas City Cardiomyopathy Questionnaire (KCCQ) suggested a benefit in the low-sodium group, with mean between-group differences in the change from baseline to 12 months of 3.38 points in the overall summary score, 3.29 points in the clinical summary score, and 3.77 points in the physical limitation score (all differences were statistically significant)"
• What Is the Healthiest Salt for You? - Medscape, 2/28/22 - "Potassium chloride substitution in staple foods such as bread and bread products have serious and potentially fatal consequences for people who need to restrict dietary potassium. Improved food labeling is required for consumers to avoid excessive consumption" -  Note: It's true that people on some medications can retain too much potassium but in most people they don't get enough potassium. I feel that nearly everyone should be using Lite salt and not even have regular salt in their household. There was a study about a couple of months ago that said that you potassium should be in the upper third of normal. 4.6 to 5.1 off the top of my head. See Morton Salt Lite Salt, 11 oz, 2 pk at Amazon.com.
• Surprising findings on how salt affects blood flow in the brain - Science Daily, 11/11/21 - "When you ingest salty food, the brain senses it and activates a series of compensatory mechanisms to bring sodium levels back down ... The body does this in part by activating neurons that trigger the release of vasopressin, an antidiuretic hormone that plays a key role in maintaining the proper concentration of salt. In contrast to previous studies that have observed a positive link between neuron activity and increased blood flow, the researchers found a decrease in blood flow as the neurons became activated in the hypothalamus ... Reduced blood flow is normally observed in the cortex in the case of diseases like Alzheimer's or after a stroke or ischemia" - Note: So don't eat pizza before an important exam or meeting.
• Association Between Dietary Sodium, Potassium Intake and Lung Cancer Risk - Medscape, 4/29/21 - "Appropriate intake of potassium has a protective effect against lung cancer, while high consumption of sodium is associated with an increased risk of lung cancer" - See potassium citrate at Amazon.com.
• Is Cutting Salt Ever Harmful? - Medscape, 4/12/21 - "It is clear that sodium-restricted diets lower blood pressure. A Cochrane review of 185 studies demonstrated that a mean reduction in dietary sodium from a whopping 11.5 g/day to 3.8 g/day was associated with an average decrease of 5.5 mm Hg systolic and 2.9 mm Hg diastolic blood pressure in hypertensive individuals ... One observational study in JAMA assessed the effects of sodium restriction on cardiovascular events in two cohorts at high risk for cardiovascular disease. They identified a J-shaped curve with sodium intake below 3 g/day associated with an increase in cardiovascular events ... The PURE study similarly found an association between sodium intake under 3 g and an increase in cardiovascular events. The majority of participants in this observational trial had no underlying cardiovascular disease"
• High-salt diet promotes cognitive impairment through the Alzheimer-linked protein tau - Science Daily, 10/23/19 - "The 2018 study found that a high-salt diet caused dementia in mice. The rodents became unable to complete daily living tasks such as building their nests and had problems passing memory tests. The research team determined that the high-salt diet was causing cells in the small intestine to release the molecule interleukin-17 (IL-17), which promotes inflammation as part of the body's immune response ... IL-17 then entered the bloodstream and prevented the cells in the walls of blood vessels feeding the brain from producing nitric oxide. This compound works by relaxing and widening the blood vessels, allowing blood to flow. Conversely, a shortage of nitric oxide can restrict blood flow ... Based on these findings, Dr. Iadecola, Dr. Faraco and their colleagues theorized that salt likely caused dementia in mice because it contributed to restricted blood flow to the brain, essentially starving it"
• Community-Wide Salt Swap Moves BP Needle, Halves Hypertension - Medscape, 9/2/19 - "Replacing regular high-sodium salt with a substitute containing 75% sodium and 25% potassium reduced overall systolic BP by 1.23 mm Hg (P = .004) and diastolic BP by 0.72 mm Hg (P = .022) from a baseline average of 113/72 mm Hg ... Systolic BP fell by 1.92 mm Hg among residents with hypertension and by 2.17 mm Hg in those aged 60 years and older ... even modest decreases in blood pressure at the population level bring us larger gains ... Previous work has shown that even a 2–mm Hg reduction in systolic BP can lower stroke mortality by 10% and mortality from ischemic heart disease or other vascular causes in middle age by 7%. Recent studies also have linked potassium supplementation with reduced BP ... A random 24-hour urine sampling of 600 participants showed that sodium levels remained unchanged from baseline (3.94 g vs 3.95 g) but that potassium levels increased from 1.97 g to 2.60 g ... "This is very important because when considering population use of salt substitute, the first thing that arises in every discussion is, 'What about the risks of hyperkalemia?' " Neal said. "I think those risks are probably greatly overstated because they probably only apply to a small proportion of the population with severe kidney disease, most of whom would be aware they have severe kidney disease and should also avoid potassium-salt substitutes." - Note:  This was only 25% potassium, Lite Salt is over 50% (290 mg sodium, 350 mg potassium] .  See potassium citrate at Amazon.com.
• Benefits of US salt reduction strategy to US food industry - Science Daily, 7/24/19 - "We have shown that reducing the salt hidden in processed foods would have huge economic benefits because fewer people get high blood pressure which leads to strokes and heart attacks. That remains true even when just looking at people working in the food industry itself, because they cost their company less in healthcare, and they can continue working and looking after their families for longer."
• Poor Diets Are Linked to 20% of All Deaths Worldwide, Study Says. But These Foods Could Help - Time, 4/3/19 - "Eating too much sodium — which is linked to high blood pressure and heart conditions — was the largest cause of diet-related death globally, the researchers found. But on the whole, “the main problem we see is the low intake of healthy food,” rather than high intake of unhealthy food, Afshin says. Aside from over-eating sodium and trans fats, most of the top dietary risk factors were related to not eating enough nutritious foods, including whole grains, nuts and seeds, fruits, vegetables, polyunsaturated fats and legumes, Afshin says."
• Sodium Restriction in HF: Take It With a Grain of Salt? - Medscape, 1/10/19 - "There was a beautiful paper in JAMA Internal Medicine by Mahtani and colleagues[1] out of Oxford that went deeply into the literature to figure out why we are so insistent on low-sodium diets. It is in every guideline. I have been cantankering patients for years, having them look at everything that they eat, read the labels, add up the sodium, and never exceed that famous [threshold of] 2 g sodium. I think we probably extrapolated it from the hypertension literature, as we know that there are salt-sensitive individuals who have significant hypertension ... They reviewed every paper and found 2700 articles that dealt with sodium. However, when it came down to having good data and good analysis, they came down to fewer than 30.—therefore, less than 100 patients per study. Most of them did not have accurate or very thorough measurements of the diet and what the recommendations have been. Some studies showed benefits, some did not. Some were neutral ... The bottom of this is that we really have no good evidence, yet we are so evidence-driven"
• Too Much Salt Might Help Spur A-Fib - WebMD, 12/7/18 - "Those with the highest levels of salt in their diet had a higher rate of atrial fibrillation than those with the lowest salt intake. After accounting for several other risk factors -- including age, body fat, blood pressure and smoking -- the researchers found that salt consumption was independently associated with the risk of atrial fibrillation"
• Benefit of Salt Restriction in Heart Failure Uncertain - Medscape, 11/7/18 - "We found no clinically relevant data on whether reduced dietary salt intake affected outcomes such as cardiovascular-associated or all-cause mortality, cardiovascular-associated events, hospitalization, or length of hospital stay"
• A high-salt diet produces dementia in mice - Science Daily, 1/16/18 - "We discovered that mice fed a high-salt diet developed dementia even when blood pressure did not rise ... The scientists discovered that an impaired ability of cells lining blood vessels, called endothelial cells, reduced the production of nitric oxide, a gas normally produced by the endothelial cells to relax blood vessels and increase blood flow. To see if the biological effects of a high-salt diet could be reversed, Dr. Iadecola and colleagues returned some mice to a regular diet for four weeks and found that cerebral blood flow and endothelial function returned to normal"
• Sodium (salt) intake is associated with a risk of developing type 2 diabetes - Science Daily, 9/14/17 - "sodium intake was associated with an average 43% increase in the risk of developing T2D for each extra gram of sodium (equivalent to 2.5 extra grams of salt) consumed per day. When dividing participants into three groups of sodium consumption (low under 2.4g; medium 2.4-3.15g; high above 3.15g), the group with highest consumption had a 58% higher risk of developing T2D compared with the lowest consumption group. However, since salt is only 40% sodium by weight, for actual salt consumption the low consumption group is 6.0 grams and under; the medium consumption group is 6.0-7.9g; and the high group is above 7.9 grams per day"
• Night-time urination reduced by cutting salt in diet - Science Daily, 3/27/17 - "223 members of the group were able to reduce their salt intake from 10.7 gm per day to 8.0 gm/day. In this group, the average night-time frequency of urination dropped from 2.3 times/night to 1.4 times. In contrast, 98 subjects increased their average salt intake from 9.6 gm/night to 11.0 gm/night, and they found that the need to urinate increased from 2.3 times/night to 2.7 times/night"
• A Low-Salt Diet May Be Bad for the Heart - NYT, 5/25/16 - "Current guidelines recommend a daily maximum of 2.3 grams of sodium a day — the amount found in a teaspoon of salt — for most people, and less for the elderly or people with hypertension ... Among 69,559 people without hypertension, consuming more than seven grams of sodium daily did not increase the risk for disease or death, but those who ate less than three grams had a 26 percent increased risk for death or for cardiovascular events like heart disease and stroke, compared with those who consumed four to five grams a day ... In people with high blood pressure, consuming more than seven grams a day increased the risk by 23 percent, but consuming less than three grams increased the risk by 34 percent, compared with those who ate four to five grams a day"
• Salt and Battery: Debate on Sodium Targets Gets Feisty - Medscape, 5/7/14 - "Dr Bruce Neal (University of Sydney, Australia), a leading proponent of reducing sodium levels to low targets and a critic of the food industry, disagrees with the conclusions. Neal discounted the data, stating that he is "disappointed to see otherwise highly competent epidemiologists get it so wrong in this space." He also said that Yusuf and colleagues were using their position to be overly vocal against the low sodium targets and that it was unhelpful ... those who consumed less than 3000 mg of sodium per day had a 25% increased risk of all-cause mortality and cardiovascular events compared with those who consumed between 4000 mg and 5990 mg/day (reference group). At the high end, those who consumed 7000 mg/day or more had a 15% increased risk of death and cardiovascular events. After further adjustment for dietary factors and blood pressure, those who consumed less than 3000 mg/day still had a 21% increased risk of death and cardiovascular events"
• CDC Salt Guidelines Too Low for Good Health, Study Suggests - WebMD, 4/2/14 - "researchers analyzed 25 prior studies. They found that low levels of salt consumption may be linked with a greater risk of death ... both too much salt and too little are harmful ... Salt intake above 12,000 mg [milligrams] is associated with increased risk of cardiovascular disease and mortality ... The safest range? Between 2,645 and 4,945 mg of salt a day ... most of the world's populations consume that amount"
• Ask Well: Table Salt vs. Sea Salt - NYTimes.com, 11/14/13 - "While sea salt proponents claim the trace minerals found in sea salts confer added health benefits, nutritionists say the amounts of added minerals are too small to offer a meaningful benefit"
• Lowering salt intake improves heart, kidney health of chronic kidney disease patients - Science Daily, 11/7/13 - "The LowSALT CKD study represents the first blinded randomized controlled trial comparing a high vs low salt intake in people with CKD ... compared the effects of a high salt diet (180 to 200 mmol/day) vs a low salt diet (60 to 80 mmol/day) maintained for two weeks each in a random order in 20 patients with CKD. (Dietary guidelines recommend limiting sodium to less than 100 mmol -- which is 2300 mg or one teaspoon -- per day.) ... on average, low salt intake reduced excess extracellular fluid volume by 1 liter, lowered blood pressure by 10 /4 mm Hg, and halved protein excretion in the urine, without causing significant side effects ... She was particularly impressed with the 50% reduction in protein excretion in the urine. "If maintained long-term, this could reduce risk of progression to end-stage kidney disease -- where dialysis or transplant is required to survive -- by 30%."" - Note:  Some studies show low sodium diets have increased mortality but I've never seen a study that said that it was with people who already had kidney disease.
• Yin-Yang Effect of Sodium and Chloride Presents Salt Conundrum - Science Daily, 9/8/13 - "low levels of chloride was associated with a higher risk of death and cardiovascular disease ... The group with the lowest level of chloride in their blood had a 20% higher mortality rate compared to the other subjects ... Sodium is cast as the villain for the central role it plays in increasing the risk of high blood pressure, with chloride little more than a silent extra in the background ... The results we see from this study are confounding against the knowledge that excess salt is a bad thing, yet higher levels of chloride in the blood seems to be an independent factor that is associated with lower mortality and cardiovascular risk"
• No Benefit in Sharply Restricting Salt, Panel Finds - New York Times, 5/14/13 - "But the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day ... One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and a more than twice as many deaths — 15 as compared with 6 in the higher-salt group ... Another study ... the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming less than 3,000 milligrams of sodium a day"
• Too much salt may damage blood vessels and lead to high blood pressure - Science Daily, 6/18/12 - "Higher sodium intake was associated with increasing levels of uric acid and albumin over time. The higher the levels of these markers, the greater the risk of developing hypertension if dietary salt intake was high, researchers found. Compared with participants eating the least amount of sodium (about 2,200 milligrams a day), those eating the most (about 6,200 mg/d) were 21 percent more likely to develop high blood pressure. However, those who had high uric acid levels and ate the most salt were 32 percent more likely to develop high blood pressure while those with high urine albumin levels and highest salt intake were 86 percent more likely to develop high blood pressure ... A high-salt diet is believed to be responsible for 20 percent to 40 percent of all cases of high blood pressure in the United States"
• Excess Salt May Stiffen Heart Vessels - Science News, 3/6/12 - "Coronary flow reserve, or CFR, offers a gauge of how well tiny blood vessels in the heart dilate or contract in response to hormonal commands. The lower the CFR, the stiffer the vessels — and the less responsive they become to the heart’s constantly changing workloads ... The new study examined CFR and salt intake among 143 pairs of male twins in their 50s or older. CFR declined by about 10 percent for each additional 1,000 milligrams of sodium that a man consumed per day compared with his brother ... “That’s huge,” ... adults who routinely consume too much sodium might have trouble raising sufficient blood flow in the heart — which could lead to angina or disturbances of heart function"
• Ten Foods Provide Half of Sodium Eaten in US - Medscape, 2/10/12 - "bread, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta mixed dishes, meat mixed dishes, and savory snacks"
• Low-salt diets may raise heart disease risk - MSNBC, 11/9/11 - "Overall, the good and bad consequences of a low-salt diet may cancel each other out, so the diet has relatively little effect on the development of disease .. Graudal and colleagues examined data from 167 studies in which participants were randomly assigned to either a low-salt or high-salt diet. On average, participants were followed for at least four weeks ... The effect was most significant for people with high blood pressure, or hypertension —a low-salt diet reduced their blood pressure by 3.5 percent ... However, a low-salt diet led to a 2.5 percent increase in cholesterol levels, and a 7 percent increase in triglycerides. Further, it also led to increases in hormones that regulate the body's salt levels, which would cause the body to preserve salt, rather than excreting it in the urine"
• Less salt, less strokes, says new research - Science Daily, 8/11/11 - "a reduction of 3 grams of salt intake per day would prevent up to 8,000 stroke deaths and up to 12,000 coronary heart disease deaths per year in the UK ... A similar reduction in the USA would result in up to 120,000 fewer cases of coronary heart disease, up to 66,000 strokes and up to 99,000 heart attacks annually. It would also save up to $24 billion annually in health care costs"
• Study investigates association between intake of sodium and potassium and deaths among U.S. adults - Science Daily, 7/13/11
• Sodium/Potassium Ratio Important for Health - Medscape, 7/12/11 - "During a mean follow-up of 14.8 years, there were a total of 2270 deaths, including 825 cardiovascular deaths and 443 ischemic heart-disease deaths. After multivariable adjustment, higher sodium intake was associated with increased all-cause mortality (HR 1.20 per 1000 mg/day), whereas higher potassium intake was associated with lower mortality risk (HR 0.80 per 1000 mg/day) ... For sodium-potassium ratio, the adjusted hazard ratios comparing the highest quartile with the lowest quartile were 1.46 for all-cause mortality, 1.46 for CVD mortality, and 2.15 for ischemic heart disease (IHD) mortality ... The results show that sodium/potassium ratio of <1 is protective ... One simple way of boosting potassium, she notes, is to replace regular snacks with fruit"
• Go ahead, shake it? We may be wrong about salt - Health - Diet and nutrition - MSNBC, 5/26/11 - "A study published this month in the Journal of the American Medical Association came to the surprising conclusion that too much salt might not raise the risk of cardiovascular disease complications after all. Making matters even more confusing, death rates appeared to be higher in those with lower sodium levels ... For the most part, the problem with salt is the setting in which you find it. The vast majority of “processed” or convenience foods are high in both fat and salt. It’s the fat that’s the big problem. As for the benefits of reducing salt, only about 5 percent of people have a salt sensitivity that is the primary cause of their hypertension. The major contributors to hypertension are obesity and diabetes"
• Study evaluates relationship of urinary sodium with health outcomes - Science Daily, 5/3/11 - "The assumption that lower salt intake would in the long run lower blood pressure, to our knowledge, has not yet been confirmed in longitudinal population-based studies ... among 3,681 participants followed up for a median (midpoint) 7.9 years, cardiovascular deaths decreased across increasing tertiles (one of three groups) of 24-hour urinary sodium: from 50 deaths in the low (death rate, 4.1 percent), 24 deaths in the medium, (death rate, 1.9 percent) and 10 deaths in the high tertile (death rate, 0.8 percent). Analysis indicated that the risk of cardiovascular mortality was significantly elevated in the low tertile with a significant inverse association between cardiovascular mortality and tertile of sodium excretion. Baseline sodium excretion predicted neither total mortality nor fatal combined with nonfatal CVD events. ... The associations between systolic pressure and sodium excretion did not translate into less morbidity or improved survival. On the contrary, low sodium excretion predicted higher cardiovascular mortality. Taken together, our current findings refute the estimates of computer models of lives saved and health care costs reduced with lower salt intake. They do also not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level. However, they do not negate the blood pressure-lowering effects of a dietary salt reduction in hypertensive patients"
• Study Finds Low-Salt Diet Ineffective but Draws Criticism From C.D.C. - NYTimes.com - NY Times, 5/3/11 - "At the moment, this study might need to be taken with a grain of salt ... The investigators found that the less salt people ate, the more likely they were to die of heart disease – 50 people in the lowest third of salt consumption (2.5 grams of sodium per day) died during the study as compared with 24 in the medium group (3.9 grams of sodium per day) and 10 in the highest salt consumption group (6.0 grams of sodium per day). And while those eating the most salt had, on average, a slight increase in systolic blood pressure — a 1.71-millimeter increase in pressure for each 2.5-gram increase in sodium per day — they were no more likely to develop hypertension ... One of the problems with the salt debates, Dr. Alderman said, is that all the studies are inadequate"
• Physical activity decreases salt's effect on blood pressure, study finds - Science Daily, 3/23/11 - "Investigators compared study participants' blood pressure on two one-week diets, one low in sodium (3,000 mg/day) and the other high in sodium (18,000 mg/day) ... The American Heart Association recommends consuming less than 1,500 mg/day of sodium ... Compared with the sedentary group, the odds of being salt-sensitive, adjusted for age and gender, fell: 10 percent in the next-to-lowest activity group ... 17 percent in the next-to-highest activity group ... 38 percent in the most active group"
• Diet soda may raise odds of vascular events; Salt linked to stroke risk - Science Daily, 2/9/11 - "In findings involving 2,564 people in the large, multi-ethnic Northern Manhattan Study (NOMAS), scientists said people who drank diet soda every day had a 61 percent higher risk of vascular events than those who reported no soda drinking ... In separate research using 2,657 participants also in the Manhattan study, scientists found that high salt intake, independent of the hypertension it causes, was linked to a dramatically increased risk of ischemic strokes (when a blood vessel blockage cuts off blood flow to the brain)"
• Bicarbonate adds fizz to players' tennis performance - Science Daily, 10/25/10 - "sodium bicarbonate supplementation can prevent the fatigue-induced decline in skilled tennis performance seen during matches. The service and forehand ground stroke consistency was maintained after a simulated match in the bicarbonate trial. On the other hand, these consistency scores were decreased after the match in the placebo trial" - Note:  If you're not an athlete I wouldn't try it.  I'm sure the sodium in sodium bicarbonate will have the same effect as sodium chloride (table salt) on your blood pressure.
• Consumption of 'good salt' can reduce population blood pressure levels, research finds - Science Daily, 9/13/10 - "the average potassium intake in 21 countries including the US, China, New Zealand, Germany and the Netherlands varies between 1.7 and 3.7 g a day. This is considerably lower than the 4.7 g a day, which has been recommended based on the positive health effects observed at this level of intake ... A hypothetical increase in the potassium intake to the recommended level would reduce the systolic blood pressure in the populations of these countries by between 1.7 and 3.2 mm Hg ... Earlier studies have shown that salt reduction of 3 g per day in food could reduce blood pressure and prevent 2500 deaths per year due to cardiovascular diseases in the Netherlands. In Western countries, salt consumption can be as high as 9-12 g a day whereas 5 g is the recommended amount according to WHO standards"
• Cutting Salt as Good as Quitting Smoking - WebMD, 1/22/10 - "Cutting U.S. salt intake by just half a teaspoon a day would prevent up to 92,000 deaths, 99,000 heart attacks, and 66,000 strokes -- a benefit as big as smoking cessation"
• High salt intake directly linked to stroke and cardiovascular disease - Science Daily, 11/24/09 - "analyzed the results of 13 published studies involving over 170,000 people that directly assessed the relationship between levels of habitual salt intake and rates of stroke and cardiovascular disease ... Their analysis shows unequivocally that a difference of 5 g a day in habitual salt intake is associated with a 23% difference in the rate of stroke and a 17% difference in the rate of total cardiovascular disease"
• Cut Hypertension Drugs With Low-Salt Diet - WebMD, 7/21/09
• New Light Shed On Enigma Of Salt Intake And Hypertension - Science Daily, 5/4/09
• Consuming A Little Less Salt Could Mean Fewer Deaths - Science Daily, 3/11/09 - "A 3-gram–a-day reduction in salt intake (about 1200 mg of sodium) would result in 6 percent fewer cases of new heart disease, 8 percent fewer heart attacks, and 3 percent fewer deaths ... Currently, Americans eat 9-12 grams of salt per day"
• Low-Sodium, High Potassium is Effective in Lowering Blood Pressure - Science Daily, 1/26/09 - "Those with the highest sodium levels in their urine were 20% more likely to suffer strokes, heart attacks, or other forms of cardiovascular disease compared with their counterparts with the lowest sodium levels. However this link was not strong enough to be considered statistically significant ... By contrast, participants with the highest sodium-to-potassium ratio in urine were 50% more likely to experience cardiovascular disease than those with the lowest sodium-to-potassium ratios. This link was statistically significant ... To lower blood pressure and blunt the effects of salt, adults should consume 4.7 grams of potassium per day unless they have a clinical condition or medication need that is a contraindication to increased potassium intake" - See potassium citrate at Amazon.com.
• Reducing Salt Intake Isn't The Only Way To Reduce Blood Pressure - Science Daily, 1/26/09 - "A new study suggests that people trying to lower their blood pressure should also boost their intake of potassium, which has the opposite effect to sodium ... To lower blood pressure and blunt the effects of salt, adults should consume 4.7 grams of potassium per day unless they have a clinical condition or medication need that is a contraindication to increased potassium intake" - See potassium citrate at Amazon.com.
• Salt May Restrict Blood Flow to Heart - WebMD, 1/22/09 - "Overweight and obese study participants with normal blood pressure who restricted the sodium in their diets showed evidence of improved endothelial function compared to participants who did not restrict salt ... The improvement appeared to be unrelated to the impact on blood pressure, suggesting that salt restriction is independently protective of blood vessel function"
• Salt Reduction May Offer Cardioprotective Effects Beyond Blood Pressure Reduction - Science Daily, 1/16/09 - "sodium reduction is beneficial for people who have normal blood pressure and those who are overweight or obese, and the benefits start in just a few weeks"
• Low Potassium Linked To High Blood Pressure - Science Daily, 11/8/08 - "As a risk factor for high blood pressure, low levels of potassium in the diet may be as important as high levels of sodium" - See potassium citrate at Amazon.com.
• Grapes May Aid A Bunch Of Heart Risk Factors, Animal Study Finds - Science Daily, 10/29/08 - "Could eating grapes help fight high blood pressure related to a salty diet? And could grapes calm other factors that are also related to heart diseases such as heart failure? A new University of Michigan Cardiovascular Center study suggests so" - See grape seed extract at Amazon.com.
• Blood Pressure Response To Daily Stress Provides Clues For Better Hypertension Treatment - Science Daily, 8/14/08 - "Research shows that two-thirds of patients’ high blood pressure is not controlled despite the best efforts of their doctors. That is terrible ... Studies will explore fundamentals such as why about 30 percent of young healthy blacks and 15 percent of whites can’t effectively excrete sodium, a problem that raises blood pressure by increasing the body’s fluid volume. “We think there is a defect in their kidneys, in the normal mechanisms that allow them to excrete salt,” ... America’s current obesity and type 2 diabetes epidemic also has them looking at insulin, glucose and cholesterol levels and whether fat exacerbates all the factors they are following, which they believe it does"
• Cardiovascular Risk: Low Sodium Diets Might Be Worse Than High Salt Diets - Science Daily, 5/15/08 - "Contrary to long-held assumptions, high-salt diets may not increase the risk of death ... The Einstein researchers actually observed a significantly increased risk of death from cardiovascular disease (CVD) associated with lower sodium diets" - This has been going back and forth for years.  I try to cut down and use Morton Lite salt, etc.
• Reducing Salt Intake Can Lower the Long-Term Risk for Cardiovascular Events - Medscape, 4/24/08 - "Cutting back on salt intake, while known to lower blood pressure, also appears to significantly reduce the long-term risk of cardiovascular events. Observational follow-up from the Trials of Hypertension Prevention (TOHP) showed that a reduction in salt intake could reduce the risk of cardiovascular disease outcomes by 25%"
• Salt intake brings new levels of alarm - USATODAY.COM, 2/10/08 - "Salt "is the single most harmful element in the food supply, even worse than saturated fat and trans fat, or food additives and pesticides," ... most Americans consume about 3,500 to 4,000 milligrams of sodium a day ... Government guidelines recommend that certain groups in which there is a greater prevalence of high blood pressure, including black, middle-aged and older people, limit their daily sodium intake to 1,500 milligrams"
• High-salt diet link to ulcer risk - BBC News, 5/22/07
• Cut Heart Risk by Eating Less Salt - WebMD, 4/19/07 - "people who reduced their dietary sodium while participating in the studies saw 25% reductions in heart disease and stroke risk 10 to 15 years later, compared with people who ate their usual diets"
• Salt Intake Is Strongly Associated With Obesity - Science Daily, 11/13/06 - "Perhaps the most interesting finding of the study is the close link between salt intake and obesity. The study reports that increasing intakes of sodium (salt) obligatorily produce a progressive increase in thirst. The progressive increase in the average intake of salt explains the observed concomitant increase in the intake of beverages which, in turn, has caused a marked net increase in the intake of calories during the same period in the United States"
• The War Over Salt  - New York Times, 9/13/06
• Good News for Salt Lovers - New Hope Natural Media Online, 8/3/06 - "The men who ate from the kitchens using potassium-enriched salt were about 40% less likely to die from cardiovascular disease than the men who ate from the kitchens using regular salt"
• Salt Substitute May Help Hearts - WebMD, 6/16/06
• Substituting Salt With a Potassium Salt May Benefit Elderly Veterans - Medscape, 6/14/06 - "subjects in the potassium chloride cohort had a hazard ratio of 0.59 for CVD mortality vs the control group ... Subjects in the potassium chloride group enjoyed an increased average life expectancy of 0.3 to 0.9 years vs the control group ... Dietary potassium chloride was associated with a significant reduction in the cost of inpatient care vs sodium chloride, with subjects in the experimental group incurring an average of $426 less inpatient cost per individual"
• Too Much Salt in Restaurant, Processed Foods? - WebMD, 8/18/05
• Salt Kicks Hypertension Up A Notch - Science Daily, 6/7/05
• Some True Facts About Salt - CBS 2 Chicago, 2/24/05
• Is Sodium Restriction Important to Hypertension? - Medscape, 6/23/04
• Salt Getting Overlooked In Health Craze - Intelihealth, 5/24/04 - "On average we take in about twice the recommended amount ... Although the recommended government guideline for a healthy American adult is no more than 2.4 grams of sodium a day, or about one teaspoon of salt, several studies suggest much lower amounts"
• Current “Healthy” Salt Recommendations Still Too High - Healthwell, 5/20/04
• Americans Advised to Cut Salt, Follow Thirst - WebMD, 2/11/04
• Reducing Sodium Does Not Adversely Affect Lipids - Doctor's Guide, 10/3/03
• Remember Sodium? We're Still Getting Too Much - Intelihealth, 3/14/03 - "The average American consumes 4,000 milligrams of sodium per day, far exceeding the maximum of 2,400 milligrams recommended ... only an estimated 25 percent of daily sodium intake is added at the table. The remainder is unseen, consumed in restaurant and processed foods ... A Weight Watchers Smart Ones frozen entree may be low in fat and calories, but it's not so light in sodium ... a Burger King Broiler Chicken Sandwich has 1,110 milligrams of sodium ... about 90 percent of the population is diagnosed with hypertension by the age of 80. People with high blood pressure have an increased risk for heart disease and stroke. High sodium levels also raise the risk of osteoporosis and kidney problems ... In the case of osteoporosis, potassium appears to offset calcium losses from excessive sodium ... postmenopausal women with diets high in salt lost higher amounts of bone mineral. Eating potassium-rich foods such as bananas, tomatoes and orange juice helped stem the calcium loss"
• Health Group Urges Less Salt In Food - Intelihealth, 11/13/02 - "The nation's largest public health group is recommending a 50 percent decrease in salt in processed food and restaurant meals over the next 10 years ... Government guidelines already recommend limiting intake of sodium - which increases blood pressure - to no more than 2.4 grams daily, or the equivalent of about a teaspoon of table salt. But the average American adult consumes nearly 4 grams a day"
• Salt Reduction Has Little Impact On Cardiovascular Events Or Mortality - Doctor's Guide, 9/23/02 - "Reducing patient dietary sodium intake has little effect or either cardiovascular events or mortality ... There also are doubts about effects of salt reduction on overall health"
• DASH Diet And Reduced Sodium Lowers Blood Pressure For All - Doctor's Guide, 12/18/01
• For Some Women, Limiting Salt Can Drastically Lower Health Risks - WebMD, 7/31/01 - "those women who ate only a teaspoon of salt per day reduced their blood pressure by 16 points, experiencing as much benefit as they would from some blood pressure lowering medicines"
• Dietary Sodium May Be Risk Factor For Proteinuria In African-Americans With High Blood Pressure - Doctor's Guide, 7/11/01
• Will Licking Your Salt Habit Beat High Blood Pressure? - WebMD, 6/18/01 - "lower levels of dietary salt -- 1,500 mg a day -- cut blood pressure in individuals with and without hypertension"
• Has Hypertension Met Its Match? - Nutrition Science News, 4/01 - "These study results indicate that reducing sodium lowers blood pressure in people with or without hypertension. The researchers concluded that the recommended sodium intake, already substantially lower than the average intake, should be lowered further, and that more low-sodium products should be made available"

Abstracts:

• How Does Salt Intake Relate to Mortality? - Medscape, 9/9/22 - "Always adding salt to foods was associated with the lower life expectancy at the age of 50 years by 1.50 (95% CI, 0.72 – 2.30) and 2.28 (95% CI, 1.66 – 2.90) years for women and men, respectively, compared with participants who never or rarely added salt to foods" - See Morton Lite salt at Amazon.com.
• Adding salt to foods and hazard of premature mortality - Eur Heart J 2022 Jul 10 - "compared with the never/rarely group, always adding salt to foods was related to 1.50 (95% CI, 0.72-2.30) and 2.28 (95% CI, 1.66-2.90) years lower life expectancy at the age of 50 years in women and men, respectively" - [Science Daily]
• Association between intake of sodium, potassium, sodium-to-potassium ratio, and blood pressure among US adults - Int J Vitam Nutr Res 2021 Dec 22 - "High dietary sodium and low potassium intake is associated with high blood pressure (BP). The current study aimed to determine if the sodium-to-potassium ratio is more strongly associated with low (130-139/80-89 mm Hg) and high (≥140/90 mm Hg) BP thresholds among US adults than either sodium or potassium alone ... The study confirms an inverse association between higher potassium intake and higher BP threshold. The Doses-response analyses showed sodium-to-potassium ratio is a better predictor of BP thresholds than sodium or potassium alone" - See potassium citrate at Amazon.com.
• Effects of sodium bicarbonate supplementation on exercise performance: an umbrella review - J Int Soc Sports Nutr 2021 Nov 18 - "Based on meta-analyses of moderate to high quality, it can be concluded that sodium bicarbonate supplementation acutely enhances peak anaerobic power, anaerobic capacity, performance in endurance events lasting ~45 s to 8 min, muscle endurance, 2000-m rowing performance, and high-intensity intermittent running"
• International Society of Sports Nutrition position stand: sodium bicarbonate and exercise performance - J Int Soc Sports Nutr 2021 Sep 9 - "Combining sodium bicarbonate with creatine or beta-alanine may produce additive effects on exercise performance. It is unclear whether combining sodium bicarbonate with caffeine or nitrates produces additive benefits. 10. Sodium bicarbonate improves exercise performance primarily due to a range of its physiological effects. Still, a portion of the ergogenic effect of sodium bicarbonate seems to be placebo-driven"
• Is there a relationship between dietary sodium and potassium intake and clinical findings of a migraine headache? - Br J Nutr 2021 Aug 11 - "Migraine Headache Index Score (MHIS) ... After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration (β=0.29; 95% CI: 0.06, 0.53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13.05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile ... Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS"
• Potassium chloride-based replacers: modeling effects on sodium and potassium intakes of the US population with cross-sectional data from NHANES 2015-2016 and 2009-2010 - Am J Clin Nutr 2021 Mar 23 - "Sodium intake in the USA exceeds recommendations. The replacement of added sodium chloride (NaCl) with potassium chloride (KCl) provides a potential strategy to reduce sodium intake ... feasible and practical (F&P) replacement of added NaCl with KCl in foods ... The F&P replacement of NaCl with KCl in top-ranking sources of dietary sodium modeled in this study can result in decreased sodium to a level consistent with the short-term intake goal targeted by the FDA of 3000 mg/d, with the mean potassium intake remaining in the range recommended for the apparently healthy population" - See Lite Salt at Amazon.com.
• High Salt Diet Impacts the Risk of Sarcopenia Associated with Reduction of Skeletal Muscle Performance in the Japanese Population - Nutrients 2020 Nov 12 - "The World Health Organization has recommended 5 g/day as dietary reference intakes for salt. In Japan, the averages for men and women were 11.0 g/day and 9.3 g/day, respectively. Recently, it was reported that amounts of sodium accumulation in skeletal muscles of older people were significantly higher than those in younger people ... Four groups based on age and salt intake ("younger low-salt," "younger high-salt," "older low-salt," and "older high-salt") were compared. Stratifying by age category, body fat percentage significantly increased in high-salt groups in both younger and older people. Handgrip strength/body weight and chair rise tests of the older high-salt group showed significant reduction compared to the older low-salt group. However, there was no significant difference in renalase concentrations in plasma. The results suggest that high-salt intake may lead to fat accumulation and muscle weakness associated with sarcopenia. Therefore, efforts to reduce salt intake may prevent sarcopenia"
• How Much Intake of Sodium Is Good for Frailty?: The Korean Frailty and Aging Cohort Study (KFACS) - Nutr Health Aging. 2019;23(6):503-508 - "Of the 954 participants, 461 (48.3%) were male and the mean age was 76.3 years old. The average daily sodium intake was 3857 mg. The frailty prevalence in first to third quartiles was 21.8%, 7.5%, and 5.4%, respectively, and increased in the fourth quartile of sodium intake to 8.9%. Using the second quartile of sodium intake (2504-3575 mg) as reference, the odds ratios of frailty were 1.64 (95% confidence interval: 0.84-3.22), 1.33 (0.57-3.06), and 4.00 (1.72-9.27) for the first (<2504 mg), third (3575-4873 mg), and fourth (≥4873 mg) quartiles, respectively, in a multivariate-adjusted analysis ... Low sodium intake (<2504 mg) is related to frailty in older people, but it seems to be a less important factor than other nutritional factors. The prevalence of frailty did not increase up to a daily sodium intake of 3575 mg, but it increased upon a daily sodium intake higher than 3575 mg"
• Small Amounts of Inorganic Nitrate or Beetroot Provide Substantial Protection From Salt-Induced Increases in Blood Pressure - Hypertension. 2019 May;73(5):1042-1048 - "To reduce the risk of salt-induced hypertension, medical authorities have emphasized dietary guidelines promoting high intakes of potassium and low intakes of salt that provide molar ratios of potassium to salt of ≥1:1. However, during the past several decades, relatively few people have changed their eating habits sufficiently to reach the recommended dietary goals for salt and potassium ... the Dahl salt-sensitive rat, we found that supplemental dietary sodium nitrate confers substantial protection from initiation of salt-induced hypertension when the molar ratio of added nitrate to added salt is only ≈1:170. Provision of a low molar ratio of added nitrate to added salt of ≈1:110 by supplementing the diet with beetroot also conferred substantial protection against salt-induced increases in blood pressure. The results suggest that on a molar basis and a weight basis, dietary nitrate may be ≈100× more potent than dietary potassium with respect to providing substantial resistance to the pressor effects of increased salt intake. Given that leafy green and root vegetables contain large amounts of inorganic nitrate, these findings raise the possibility that fortification of salty food products with small amounts of a nitrate-rich vegetable concentrate may provide a simple method for reducing risk for salt-induced hypertension." - [Nutra USA] - See beet root powder at Amazon.com.
• Association of dietary sodium:potassium ratio with the metabolic syndrome in Chinese adults - Br J Nutr. 2018 Aug 2:1-7 - "higher dietary Na:K ratio significantly increased the risk of the MetS in Chinese adults"
• Effects of salt loading and potassium supplement on the circadian blood pressure profile in salt-sensitive Chinese patients - Blood Press Monit. 2017 Jun 16 - "Salt-sensitive (SS) patients ... Approximately 49 normotensive and mildly hypertensive Chinese patients received a study protocol of a 3 days of baseline examination, 7 days of a low-salt diet (3 g NaCl/day), 7 days of a high-salt diet (18 g NaCl/day), and 7 days of a high-salt diet with a potassium supplement (18 g NaCl and 4.5 g KCl/day) ... Compared with the high-salt loading period, the night-to-day blood pressure ratio was significantly reversed by potassium supplement in SS patients (systolic 0.91±0.01 vs. 0.96±0.01, P<0.05; diastolic 0.91±0.01 vs. 0.96±0.01, P<0.05)" - See potassium citrate at Amazon.com.
• Association between Dietary Sodium Intake and Cognitive Function in Older Adults - J Nutr Health Aging. 2017;21(3):276-283 - "Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets"
• Dietary sodium and potassium intake in relation to non-alcoholic fatty liver disease - Br J Nutr. 2016 Oct;116(8):1447-1456 - "Increasing prevalence of NAFLD was observed with increasing Na intake. The multivariable-adjusted prevalence ratios (PR) of NAFLD comparing the highest with the lowest quintile of energy-adjusted Na intake were 1·25 (95 % CI 1·18, 1·32; P trend<0·001) in men and 1·32 (95 % CI 1·18, 1·47; P trend <0·001) in women ... No inverse association was observed for energy-adjusted K intake. Our findings suggest that higher Na intake is associated with a greater prevalence of NAFLD in young and middle-aged asymptomatic adults, which might be partly mediated by adiposity"
• Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention - J Am Coll Cardiol. 2016 Oct 11;68(15):1609-1617 - "There was a direct linear association between average sodium intake and mortality, with an HR of 0.75, 0.95, and 1.00 (references) and 1.07 (p trend = 0.30) for <2,300, 2,300 to <3,600, 3,600 to <4,800, and ≥4,800 mg/24 h, respectively; and with an HR of 1.12 per 1,000 mg/24 h (95% CI: 1.00 to 1.26; p = 0.05). There was no evidence of a J-shaped or nonlinear relationship. The HR per unit increase in sodium/potassium ratio was 1.13 (95% CI: 1.01 to 1.27; p = 0.04) ... We found an increased risk of mortality for high-sodium intake and a direct relationship with total mortality, even at the lowest levels of sodium intake. These results are consistent with a benefit of reduced sodium and sodium/potassium intake on total mortality over a 20-year period"
• Association Between Small Decrease in Serum Sodium Concentration within the Normal Range and All-Cause and Cardiovascular Mortality in Elderly Adults over 5 Years - J Am Geriatr Soc. 2016 Mar;64(3):510-7 - "Participants were divided into corrected sodium groups as follows: 73 (7.7%) in Group 1 (sodium 135.0-138.0 mEq/L), 635 (66.9%) in Group 2 (sodium 138.1-142.0 mEq/L), and 241 (25.4%) in Group 3 (sodium 142.1.0-145.0 mEq/L). There were 34 (46.6%) deaths in Group 1, 124 (19.5%) in Group 2, and 52 (21.6%) in Group 3 (P < .001). In a Cox proportional hazards analysis, a 2-mEq/L higher sodium level reduced the risk of death by 14.9% (95% confidence interval (CI) = 0.1-27.4%, P = .048). Group 1 had risk of mortality that was 2.7 times as high as that of Group 2 (95% CI = 1.76-4.11, P < .001)" - Hmm.  Blows a hole in the low sodium theory and several studies back this up.  My sodium has been at 142 for years not matter what I do.  I thought that was a bad thing but I'm exactly between Group 2 and 3.
• Assessing the Associations of Sodium Intake With Long-Term All-Cause and Cardiovascular Mortality in a Hypertensive Cohort - Am J Hypertens. 2014 Aug 26 - "In adjusted models, sodium intake was not significantly associated with cardiovascular mortality (QI vs. QIV: hazard ratio (HR) = 1.00; 95% confidence interval (CI) = 0.71-1.42; P = 0.99). A borderline significant direct association with all-cause mortality was observed (QI vs. QIV: HR = 0.81; 95% CI = 0.66-1.00; P = 0.05) driven partly by noncardiovascular deaths"
• Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis - Am J Hypertens. 2014 Mar 20 - "all-cause mortality (ACM) and cardiovascular disease events (CVDEs) in populations exposed to dietary intakes of low sodium (<115 mmol), usual sodium (low usual sodium: 115-165 mmol; high usual sodium: 166-215 mmol), and high sodium (>215 mmol) ... the risks of ACM and CVDEs were decreased in usual sodium vs. low sodium intake (ACM: HR = 0.91, 95% confidence interval (CI) = 0.82-0.99; CVDEs: HR = 0.90, 95% CI = 0.82-0.99) and increased in high sodium vs. usual sodium intake (ACM: HR = 1.16, 95% CI = 1.03-1.30; CVDEs: HR = 1.12, 95% CI = 1.02-1.24). In population representative samples adjusted for multiple confounders, the HR for ACM was consistently decreased in usual sodium vs. low sodium intake (HR = 0.86; 95% CI = 0.81-0.92), but not increased in high sodium vs. usual sodium intake (HR = 1.04; 95% CI = 0.91-1.18). Within the usual sodium intake range, the number of events was stable (high usual sodium vs. low usual sodium: HR = 0.98; 95% CI = 0.92-1.03)"
• Association of urinary sodium-to-potassium ratio with obesity in a multiethnic cohort - Am J Clin Nutr. 2014 Feb 19 - "2782 participants in the community-dwelling, probability-sampled, multiethnic Dallas Heart Study were analyzed. The primary outcome established a priori was total-body percentage fat (TBPF) measured by dual-energy X-ray absorptiometry ... TBPF increased by 0.75 (95% CI: 0.25, 1.25) and 0.43 (0.15, 0.72), respectively (P = 0.003 for both), for every 3-unit increase in U[Na+]/[K+] ... The ratio of dietary Na+ to K+ intake may be independently associated with TBPF, and this association may be more pronounced in non-African Americans" - See potassium citrate at Amazon.com.
• Nutrients other than carbohydrates: their effects on glucose homeostasis in humans - Diabetes Metab Res Rev. 2014 Feb 8 - "lowering sodium intake too much, as recommended to avoid the development of hypertension, particularly in sodium-sensitive people, might lead to insulin resistance and thereby might risk increasing fasting as well as postprandial blood glucose concentrations"
• Blood Pressure Responses to Dietary Sodium and Potassium Interventions and the Cold Pressor Test: The GenSalt Replication Study in Rural North China - Am J Hypertens. 2013 Sep 4 - "The dietary intervention included a 7-day low sodium (51.3 mmol/day), a 7-day high sodium (307.8 mmol/day), and a 7-day high sodium with potassium supplementation (307.8 mmol sodium and 60 mmol potassium/day) ... Systolic and diastolic BP responses (mean +/- SD (range), mm Hg) were 8.1+/-8.4 (-39.1 to 18.2) and -3.5+/-5.1 (-25.1 to 11.1) to low sodium, 9.1+/-8.4 (-13.3 to 33.1) and 4.0+/-5.4 (-16.0 to 20.7) to high sodium, and -4.6+/-5.8 (-31.8 to 11.6) and -1.9+/-4.3 (-16.9 to 14.2) to potassium supplementation, respectively" - Note:  Put in simpler terms:  Low sodium, systolic increased 8.1, diastolic decreased 3.5.  High sodium, systolic increased 9.1, diastolic increased 4.0.  Sodium with potassium, systolic decreased 4.6, diastolic decreased 1.9.  So the sodium with potassium was better than the low sodium. - See potassium citrate at Amazon.com.
• A High-Salt Diet Further Impairs Age-Associated Declines in Cognitive, Behavioral, and Cardiovascular Functions in Male Fischer Brown Norway Rats - J Nutr. 2013 Jul 17 - "we tested the effect of high salt (HS) on anxiety, learning-memory function, and blood pressure (BP) in male Fischer brown Norway (FBN) rats. Adult (A; 2 mo) and old (O; 20 mo) male rats were fed normal-salt (NS; 0.4% NaCl) or HS (8% NaCl) diets for 4 wk after being implanted with telemeter probes for conscious BP measurement. Thereafter, tests to assess anxiety-like behavior and learning-memory were conducted. The rats were then killed, and samples of plasma, urine, and brain tissue were collected. We found that systolic BP was higher in O-NS (117 +/- 1.2 mm Hg) than in A-NS (105 +/- 0.8 mm Hg) rats (P < 0.05). Furthermore, BP was higher in O-HS (124 +/- 1.4 mm Hg) than in O-NS (117 +/- 1.2 mm Hg) rats (P < 0.05). Moreover, anxiety-like behavior (light-dark and open-field tests) was not different between A-NS and O-NS rats but was greater in O-HS rats than in A-NS, O-NS, or A-HS rats (P < 0.05). Short-term memory (radial arm water maze test) was similar in A-NS and O-NS rats but was significantly impaired in O-HS rats compared with A-NS, O-NS, or A-HS rats (P < 0.05). Furthermore, oxidative stress variables (in plasma, urine, and brain) as well as corticosterone (plasma) were greater in O-HS rats when compared with A-NS, O-NS, or A-HS rats (P < 0.05). The antioxidant enzyme glyoxalase-1 expression was selectively reduced in the hippocampus and amygdala of O-HS rats compared with A-NS, O-NS, or A-HS rats (P < 0.05), whereas other antioxidant enzymes, glutathione reductase 1, manganese superoxide dismutase (SOD), and Cu/Zn SOD remained unchanged. We suggest that salt-sensitive hypertension and behavioral derangement are associated with a redox imbalance in the brain of aged FBN rats"
• Salt loading and potassium supplementation: effects on ambulatory arterial stiffness index and endothelin-1 levels in normotensive and mild hypertensive patients - J Clin Hypertens (Greenwich). 2013 Jul;15(7):485-96 - "The authors investigated effects of excessive salt intake and potassium supplementation on ambulatory arterial stiffness index (AASI) and endothelin-1 (ET-1) in salt-sensitive and non-salt-sensitive individuals. AASI and symmetric AASI (s-AASI) were used as indicators of arterial stiffness. Plasma ET-1 levels were used as an index of endothelial function ... After 3 days of baseline investigation, participants were maintained sequentially for 7 days each on diets of low salt (51.3 mmol/d), high salt (307.7 mmol/d), and high salt+potassium (60 mmol/d) ... High-salt intervention significantly increased BP, AASI, s-AASI (all P<.001); potassium supplementation reversed increased plasma ET-1 levels. High-salt-induced changes in BP, s-AASI, and plasma ET-1 were greater in salt-sensitive individuals. Potassium supplementation decreased systolic BP and ET-1 to a significantly greater extent in salt-sensitive vs non-salt-sensitive individuals ... dietary salt and increasing daily potassium improves arterial compliance and ameliorates endothelial dysfunction" - See potassium citrate at Amazon.com.
• Dietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved? - Am J Hypertens. 2012 May 25 - "Universal reduction in sodium intake has long been recommended, largely because of its proven ability to lower blood pressure for some. However, multiple randomized trials have also demonstrated that similar reductions in sodium increase plasma renin activity and aldosterone secretion, insulin resistance, sympathetic nerve activity, serum cholesterol, and triglyceride levels. Thus, the health consequences of reducing sodium cannot be predicted by its impact on any single physiologic characteristic but will reflect the net of conflicting effects. Some 23 observational studies (>360,000 subjects and >26,000 end points) linking sodium intake to cardiovascular outcomes have yielded conflicting results. In subjects with average sodium intakes of less than 4.5 g/day, most have found an inverse association of intake with outcome; in subjects with average intakes greater than 4.5 g/day, most reported direct associations. Finally, in two, a "J-shaped" relation was detected. In addition, three randomized trials have found that heart failure subjects allocated to 1.8 g of sodium have significantly increased morbidity and mortality compared with those at 2.8 g. At the same time, a randomized study in retired Taiwanese men found that allocation to an average intake of 3.8 g improved survival compared with 5.3 g. Taken together, these data provide strong support for a "J-shaped" relation of sodium to cardiovascular outcomes. Sodium intakes above and below the range of 2.5-6.0 g/day are associated with increased cardiovascular risk"
• Dietary Sodium and Risk of Stroke in the Northern Manhattan Study - Stroke. 2012 Apr 12 - "The American Heart Association recommends limiting sodium intake to ≤1500 mg/day for ideal cardiovascular health ... Participants were from the Northern Manhattan Study (mean age 69+/- 10 years, 64% women, 21% white, 53% Hispanic, 24% black), a population-based cohort study of stroke incidence. Sodium intake was assessed with a food frequency questionnaire at baseline and evaluated continuously and categorically: ≤1500 mg/day (12%), 1501 to 2300 mg/day (24%), 2301 to 3999 mg/day (43%), and ≥4000 mg/day (21%). Over a mean follow-up of 10 years ... Participants who consumed ≥4000 mg/day sodium had an increased risk of stroke (hazard ratio, 2.59; 95% CI, 1.27-5.28) versus those who consumed ≤1500 mg/day with a 17% increased risk of stroke for each 500-mg/day increase"
• Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies - Clin Nutr. 2012 Jan 30 - "Seven studies (10 cohorts) met the inclusion criteria (268 718 participants, 1474 events, follow-up 6-15 years). In the pooled analysis, "high" and "moderately high" vs "low" salt intake were both associated with increased risk of gastric cancer (RR = 1.68 [95% C.I. 1.17-2.41], p = 0.005 and respectively 1.41 [1.03-1.93], p = 0.032), with no evidence of publication bias"
• Effects of Low-Sodium Diet vs. High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol, and Triglyceride (Cochrane Review) - Am J Hypertens. 2011 Nov 9 - "The effect of sodium reduction in: (i) Normotensives: Caucasians: systolic BP (SBP) -1.27 mm Hg (95% confidence interval (CI): -1.88, -0.66; P = 0.0001), diastolic BP (DBP) -0.05 mm Hg (95% CI: -0.51, 0.42; P = 0.85). Blacks: SBP -4.02 mm Hg (95% CI: -7.37, -0.68; P = 0.002), DBP -2.01 mm Hg (95% CI: -4.37, 0.35; P = 0.09). Asians: SBP -1.27 mm Hg (95% CI: -3.07, 0.54; P = 0.17), DBP -1.68 mm Hg (95% CI: -3.29, -0.06; P = 0.04). (ii) Hypertensives: Caucasians: SBP -5.48 mm Hg (95% CI: -6.53, -4.43; P < 0.00001), DBP -2.75 mm Hg (95% CI: -3.34, -2.17; P < 0.00001). Blacks: SBP -6.44 mm Hg (95% CI: -8.85, -4.03; P = 0.00001), DBP -2.40 mm Hg (95% CI: -4.68, -0.12; P = 0.04). Asians: SBP -10.21 mm Hg (95% CI: -16.98, -3.44; P = 0.003), DBP -2.60 mm Hg (95% CI: -4.03, -1.16; P = 0.0004). Sodium reduction resulted in significant increases in renin (P < 0.00001), aldosterone (P < 0.00001), noradrenaline (P < 0.00001), adrenaline (P < 0.0002), cholesterol (P < 0.001), and triglyceride"
• Feasibility and antihypertensive effect of replacing regular salt with mineral salt- rich in magnesium and potassium- in subjects with mildly elevated blood pressure - Nutr J. 2011 Sep 2;10(1):88 - "subjects consumed processed foods salted with either NaCl or Smart Salt ... 24-h dU-Na decreased significantly in the Smart Salt group (-29.8 mmol; p=0.012) and remained unchanged in the control group: resulting in a 3.3 g difference in NaCl intake between the groups. Replacement of NaCl with Smart Salt resulted in a significant reduction in SBP over 8 weeks (-7.5 mmHg; p=0.016). SBP increased (+3.8 mmHg, p=0.072) slightly in the Regular salt group" - See smartsalt.com.
• Reduced Dietary Salt for the Prevention of Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials (Cochrane Review) - Am J Hypertens. 2011 Jul 6 - "Despite collating more event data than previous systematic reviews of RCTs (665 deaths in some 6,250 participants) there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or CVD morbidity. Our estimates of benefits from dietary salt restriction are consistent with the predicted small effects on clinical events attributable to the small BP reduction achieved"
• Sodium intake in men and potassium intake in women determine the prevalence of metabolic syndrome in Japanese hypertensive patients: OMEGA Study - Hypertens Res. 2011 Jun 9 - "High sodium intake was significantly related to increased SBP (P=0.0003) and DBP (P=0.0130). Low potassium intake was significantly related to increased SBP (P=0.0057) and DBP (P=0.0005). Low soybean/fish intake was significantly related to increased SBP (P=0.0133). A significantly higher prevalence of MS was found in men in the highest quartile of sodium intake compared with the lower quartiles (P=0.0026) and in women in the lowest quartile of potassium intake compared with the higher quartiles (P=0.0038). A clear relation between dietary habits and blood pressure was found in Japanese hypertensive patients using a patient-administered questionnaire. Sodium and potassium intake affect MS prevalence. Dietary changes are warranted within hypertension treatment strategies"
• The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality In Patients With Type 1 Diabetes - Diabetes Care. 2011 Feb 9 - "Many guidelines recommend reduced consumption of salt in patients with type 1 diabetes, but it is unclear whether dietary sodium intake is associated with mortality and end-stage renal disease (ESRD) ... The median follow-up for survival analyses was 10 years, during which 217 deaths were recorded (7.7%). Urinary sodium excretion was nonlinearly associated with all-cause mortality, such that individuals with the highest daily urinary sodium excretion, as well as the lowest excretion, had reduced survival. This association was independent age, sex, duration of diabetes, the presence and severity of chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] and log AER), the presence of established cardiovascular disease, and systolic blood pressure. During follow-up 126 patients developed ESRD (4.5%). Urinary sodium excretion was inversely associated with the cumulative incidence of ESRD, such that individuals with the lowest sodium excretion had the highest cumulative incidence of ESRD. CONCLUSIONS In patients with type 1 diabetes, sodium was independently associated all-cause mortality and ESRD. Although we have not demonstrated causality, these findings support the calls for caution before applying salt restriction universally. Clinical trials must be performed in diabetic patients to formally test the utility/risk of sodium restriction in this setting"
• Low-salt diet increases insulin resistance in healthy subjects - Metabolism. 2010 Oct 29 - "Low-salt (LS) diet activates the renin-angiotensin-aldosterone and sympathetic nervous systems, both of which can increase insulin resistance (IR) ... Low-salt diet was significantly associated with higher homeostasis model assessment index independent of age, sex, blood pressure, body mass index, serum sodium and potassium, serum angiotensin II, plasma renin activity, serum and urine aldosterone, and urine epinephrine and norepinephrine. Low-salt diet is associated with an increase in IR. The impact of our findings on the pathogenesis of diabetes and cardiovascular disease needs further investigation"
• Salt intake, blood pressure and clinical outcomes - Curr Opin Nephrol Hypertens. 2008 May;17(3):310-314 - "The recent Trials of Hypertension Prevention follow-up study found that, despite small changes in blood pressure, the risk of cardiovascular disease was reduced by 25% among those in the sodium reduction intervention. A study of potassium salt substitution among Taiwanese veterans supports this finding. Sodium and potassium may act jointly in the development of hypertension and cardiovascular disease"
• Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients - Atherosclerosis. 2008 Feb 8 - "low sodium intake (LSI) ... LSI induced alterations in the plasma lipoproteins and in inflammatory markers that are common features of the metabolic syndrome"
• Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP) - BMJ. 2007 Apr 20 - "Risk of a cardiovascular event was 25% lower among those in the intervention group (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04), adjusted for trial, clinic, age, race, and sex, and 30% lower after further adjustment for baseline sodium excretion and weight (0.70, 0.53 to 0.94)"
• The DASH Diet and Sodium Reduction Improve Markers of Bone Turnover and Calcium Metabolism in Adults - J Nutr. 2003 Oct;133(10):3130-3136 - "the DASH diet significantly reduced bone turnover, which if sustained may improve bone mineral status"