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We have to be careful here that only says that it regulates sodium appetite.
Um, I don't understand what you're saying, or cautioning, exactly. The word appetite is only used once in this article (I have not read the scientific publication about the study). And possibly, our appetite (or cravings) indicate that physiologically, we could use some more. The article seems to indicate (to me) that we have need of a certain amount of sodium, and limiting it is, or may be, physiologically 'challenging'.
For example;
"For decades, U.S. health policies have emphasized the importance of limiting salt consumption in order to lower the risks of cardiovascular disease related to high blood pressure. This new scientific review, however, found that people have a very predictable and narrow range of daily sodium intake (approximately 2,600 mg to 4,800 mg per day) that has remained quite constant during more than 50 years and across at least 45 countries."
“In releasing that report, the Institute of Medicine acknowledged for administrative reasons that it remained silent on what constituted the ‘normal range’ of sodium intake for humans and specifically what defined ‘excessive’ intake,” McCarron said. He noted that the institute’s report was explicit in stating that the current U.S. sodium guidelines for healthy individuals (no more than 2,300 mg per day) and for those at risk of heart disease (no more than 1,500 mg per day) were unsupported by data in the medical literature.
“However, our research team’s new study, combined with our 2009 publication, now defines what for humans is the normal range of sodium or salt intake and suggests what would constitute both an excessive and deficient sodium intake in terms of promoting optimal health,” McCarron said. “Our data demonstrate that past U.S. guidelines for sodium (salt) intake are well below human needs.”
Um, I don't understand what you're saying, or cautioning, exactly. The word appetite is only used once in this article (I have not read the scientific publication about the study). And possibly, our appetite (or cravings) indicate that physiologically, we could use some more. The article seems to indicate (to me) that we have need of a certain amount of sodium, and limiting it is, or may be, physiologically 'challenging'.
For example;
"For decades, U.S. health policies have emphasized the importance of limiting salt consumption in order to lower the risks of cardiovascular disease related to high blood pressure. This new scientific review, however, found that people have a very predictable and narrow range of daily sodium intake (approximately 2,600 mg to 4,800 mg per day) that has remained quite constant during more than 50 years and across at least 45 countries."
“In releasing that report, the Institute of Medicine acknowledged for administrative reasons that it remained silent on what constituted the ‘normal range’ of sodium intake for humans and specifically what defined ‘excessive’ intake,” McCarron said. He noted that the institute’s report was explicit in stating that the current U.S. sodium guidelines for healthy individuals (no more than 2,300 mg per day) and for those at risk of heart disease (no more than 1,500 mg per day) were unsupported by data in the medical literature.
“However, our research team’s new study, combined with our 2009 publication, now defines what for humans is the normal range of sodium or salt intake and suggests what would constitute both an excessive and deficient sodium intake in terms of promoting optimal health,” McCarron said. “Our data demonstrate that past U.S. guidelines for sodium (salt) intake are well below human needs.”
The scientific article that it links to says the following:
In contrast, neuroscientists have identified neural circuits in vertebrate animals that regulate sodium appetite within a narrow physiologic range. So it seems the whole artilce is more about what is causing us to desire or crave sodium.
The scientific article that it links to says the following:
In contrast, neuroscientists have identified neural circuits in vertebrate animals that regulate sodium appetite within a narrow physiologic range.
So it seems the whole article is more about what is causing us to desire or crave sodium.
Possibly, we are saying the same thing.......
"BACKGROUND The recommendation to restrict dietary sodium for management of hypertensive cardiovascular disease assumes that sodium intake exceeds physiologic need, that it can be significantly reduced, and that the reduction can be maintained over time. In contrast, neuroscientists have identified neural circuits in vertebrate animals that regulate sodium appetite within a narrow physiologic range. This study further validates our previous report that sodium intake, consistent with the neuroscience, tracks within a narrow range, consistent over time and across cultures."
To me this article says there is less need for caution regarding sodium consumption, because (based on 24-hr urine excretion monitoring) the body passed the sodium not physiologically needed. Similarly the study stated that, "As documented here, this range is determined by physiologic needs rather than environmental factors."
Environmental factors, such as trying to reduce sodium intake, etc, are likely for not, as the body will regulate sodium uptake/intake/retention for us, physiologically, and excrete the unneeded sodium.
Recent data from the observational studies reviewed provide additional support for the sodium-to-potassium ratio as a superior metric to either sodium or potassium alone in the evaluation of blood pressure outcomes and incident hypertension
You have probably grown up as I did hearing that you shouldn't put salt on everything as it increases your chances for a heart attack. But now enough evidence has emerged that says that is not exactly true.
We now know that not getting enough salt can be just as risking as getting too much salt. It is a balancing act between two minerals here. Here is useful information to debunk the idea that we should avoid salt:
The studies included in the review are mostly small and of short duration and followed many different study formats, making them hard to compare.
When evaluating reviews like this, it is important to note that relatively small changes in blood pressure may be statistically significant in a study but not clinically significant for an individual person.
The ratio used in the studies comes from diet, not from measurements in the participants themselves, and has no implications for blood levels of sodium or potassium, which, as has been noted above in previous posts, is regulated by the kidneys and tightly controlled, presuming the kidneys are normal. Since hypertension can affect kidney function, anyone with hypertension should consult a physician before taking mineral supplements. Hair analysis cannot be used to determine mineral status in humans, since such analysis is confounded by everything from use of hair dyes to environmental pollution.
The diet actually includes a significant amount of sodium, up to 2400 milligrams per day, equivalent to 6 grams of salt (sodium chloride), from all sources. Six grams of salt is about one teaspoon. The diet provides about 4700 mg potassium per day.
"The reduction of sodium intake to levels below the current recommendation of 100 mmol [that's about 2300 mg] per day and the DASH diet both lower blood pressure substantially, with greater effects in combination than singly. Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods."
Control of hypertension depends on many factors besides salt intake. Exercise and maintaining a healthy weight can normalize blood pressure for many people. Some groups, including African Americans and the elderly, are more salt sensitive than others.
The study in the quoted post addresses hypertension, not heart attack. Certainly people with hypertension have an increased risk of heart attack, but the review cannot say anything about a direct effect of sodium on heart attack risk. That is not what was studied. Patients with existing heart disease should follow their doctors' recommendations about sodium intake, because there may be factors in play beyond blood pressure.
The study referenced in the post above is not a reason for an unlimited intake of sodium. If you are concerned about sodium intake, the DASH diet is a reasonable approach with good results. It's also tasty.
In an otherwise healthy individual, the kidneys (assuming you have 2, functioning ones) are incredibly efficient at purging excess salt and the body can easily regulate itself to maintain requisite levels.
Salt is really only a problem in people with hypertension, and hypertension is multifactorial and caused by many things, salt being only one of them.
The biggest problem with respect to sodium and food is not salt added later in the cooking or seasoning process, but the incredibly high levels of salt (not to mention preservatives) in processed foods. No question we could all do with less of that.
I agree ^^^ - the biggest problem we have with salt is how much is in processed foods! I can't believe the ungodly amounts in some of that stuff - not to mention Chinese food!
Your electrolytes must be in balance, if I feel I am getting a lot of salt, I make sure to eat a lot of potassium-rich foods.
Also, as mentioned before, some people will need more salt than others. I live in a hot climate, sweat a lot and work out a lot. I need a lot more salt than other people, or I would be dehydrated.
I agree ^^^ - the biggest problem we have with salt is how much is in processed foods! I can't believe the ungodly amounts in some of that stuff - not to mention Chinese food!
Your electrolytes must be in balance, if I feel I am getting a lot of salt, I make sure to eat a lot of potassium-rich foods.
Also, as mentioned before, some people will need more salt than others. I live in a hot climate, sweat a lot and work out a lot. I need a lot more salt than other people, or I would be dehydrated.
Very wise observations. We do have too much salt in our diets. Unfortunately that has become a springboard for others to say just lower your salt intake and not be concerned about sodium potassium balance.
The study in the OP does not make a recommendation for the amount of either salt or potassium for people to eat. The ratio referred to is for populations with hypertension, not individuals: "the sodium-to-potassium ratio appears to be more strongly associated with blood pressure outcomes than either sodium or potassium alone in hypertensive adult populations. Recent data from the observational studies reviewed provide additional support for the sodium-to-potassium ratio as a superior metric to either sodium or potassium alone in the evaluation of blood pressure outcomes and incident hypertension."
If you read the entire review, not just the abstract linked above, you find this:
The DASH study;
"…the combined effects on blood pressure of a low sodium intake and the DASH diet were greater than the effects of either intervention alone and were substantial…. We found that the reduction of dietary sodium significantly lowered the blood pressure of persons without hypertension who were eating a diet that is typical in the United States. These results should settle the controversy over whether the reduction of sodium has a worthwhile effect on blood pressure in persons without hypertension [prehypertensive status].”
The diet lowered blood pressure at all levels of sodium intake, but more at higher levels.
"As compared with the control diet with a high sodium level, the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension [prehypertension], and 11.5 mm Hg lower in participants with hypertension.”
Nowson, Australia:
"In each diet group the most significant dietary alteration was the reduction in the dietary sodium/potassium ratio [lowest in the low Na/high K group].
Dutch study:
"moderate restriction of dietary sodium intake has little effect on blood pressure in young subjects with mildly elevated blood pressure levels, but the combination of moderate sodium restriction with high potassium intake may have an antihypertensive effect.”
Italian study:
"a reduction in sodium intake from about 100 to 50 mmol/day, linked to a small (20 mmol/day) potassium supplementation, further and significantly decreases blood pressure in essential hypertensives,"
Japan:
"The results suggest that KCl may prevent a rise in blood pressure with NaCl loads in hypertensive patients"
UK:
"The BP of mildly hypertensive patients responds to moderate alterations in the dietary intake of sodium and potassium continued for up to 12 wk and, in contrast to normotensive subjects, a high K/low Na intake significantly lowers BP.
Austria:
“The results of this study suggest that moderate salt restriction combined with a high potassium intake helps to prevent hypertension.…"
All the studies are saying that moderate sodium restriction and increased intake of potassium will promote lower blood pressure.
"Thus, the body of evidence supports population-wide sodium intake reduction and recommended increases in dietary potassium intake as outlined by current guidelines as an essential public health effort to prevent kidney disease, stroke, and cardiovascular disease."
The review in the OP does not contraindicate current recommendations for sodium and potassium intake, it does not imply that there is an ideal ratio of sodium to potassium in the diet, and it does not advocate unrestricted consumption of salt. Less salt and more potassium is desirable, something doctors have known for a long time.
The study in the OP does not make a recommendation for the amount of either salt or potassium for people to eat.
Of course I don't make a recommendation. This is about a ratio not about individual levels.
Quote:
The ratio referred to is for populations with hypertension, not individuals: "the sodium-to-potassium ratio appears to be more strongly associated with blood pressure outcomes than either sodium or potassium alone in hypertensive adult populations. Recent data from the observational studies reviewed provide additional support for the sodium-to-potassium ratio as a superior metric to either sodium or potassium alone in the evaluation of blood pressure outcomes and incident hypertension."
If you read the entire review, not just the abstract linked above, you find this:
The DASH study;
"…the combined effects on blood pressure of a low sodium intake and the DASH diet were greater than the effects of either intervention alone and were substantial…. We found that the reduction of dietary sodium significantly lowered the blood pressure of persons without hypertension who were eating a diet that is typical in the United States. These results should settle the controversy over whether the reduction of sodium has a worthwhile effect on blood pressure in persons without hypertension [prehypertensive status].”
The diet lowered blood pressure at all levels of sodium intake, but more at higher levels.
"As compared with the control diet with a high sodium level, the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension [prehypertension], and 11.5 mm Hg lower in participants with hypertension.”
Nowson, Australia:
"In each diet group the most significant dietary alteration was the reduction in the dietary sodium/potassium ratio [lowest in the low Na/high K group].
Dutch study:
"moderate restriction of dietary sodium intake has little effect on blood pressure in young subjects with mildly elevated blood pressure levels, but the combination of moderate sodium restriction with high potassium intake may have an antihypertensive effect.”
Italian study:
"a reduction in sodium intake from about 100 to 50 mmol/day, linked to a small (20 mmol/day) potassium supplementation, further and significantly decreases blood pressure in essential hypertensives,"
Japan:
"The results suggest that KCl may prevent a rise in blood pressure with NaCl loads in hypertensive patients"
UK:
"The BP of mildly hypertensive patients responds to moderate alterations in the dietary intake of sodium and potassium continued for up to 12 wk and, in contrast to normotensive subjects, a high K/low Na intake significantly lowers BP.
Austria:
“The results of this study suggest that moderate salt restriction combined with a high potassium intake helps to prevent hypertension.…"
All the studies are saying that moderate sodium restriction and increased intake of potassium will promote lower blood pressure.
"Thus, the body of evidence supports population-wide sodium intake reduction and recommended increases in dietary potassium intake as outlined by current guidelines as an essential public health effort to prevent kidney disease, stroke, and cardiovascular disease."
The review in the OP does not contraindicate current recommendations for sodium and potassium intake, it does not imply that there is an ideal ratio of sodium to potassium in the diet, and it does not advocate unrestricted consumption of salt. Less salt and more potassium is desirable, something doctors have known for a long time.
There is no dispute that lowering salt intake can lower blood pressure. So that is a strawman argument. However, the dispute is that we all need to just refrain from salt. That is dangerous because salt that is too low is just as life threatening as salt that is too high. You just don't realize this because the western diet is high in sodium and many people need to reduce salt intake instead of increase it. But to BLINDLY recommend somone cut their salt intake is MALPRACTICE by anyone in the medical profession.
No one here is claiming that people should eliminate any/all salt from their diets. There's no dispute that "we all need to just refrain from salt." THAT is a strawman and you're basing your opinion on something no one is claiming.
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