Salt update

On Wednesday, January 20th, about a week after NYC Mayor Bloomberg proposed his controversial salt reduction initiative, evidence was presented in the New England Journal of Medicine that salt reduction truly can save lives.

Salt shaker

Using mathematical models, the authors were able to make estimates of cardiovascular disease rates based on a population-wide 3 g decrease in salt consumption (1200 mg sodium). 

By their projections, a 3 g salt reduction would result in 60,000 fewer cases of coronary heart disease, 32,000 fewer strokes, and 54,000 fewer heart attacks each year. This is comparable to the cardiovascular benefit from smoking cessation efforts.   These estimates don’t even take into account the beneficial effects on other diseases related to salt excess, like osteoporosis, kidney disease, and stomach cancer.

Health care costs were predicted to decrease by $10 billion to $24 billion, making this type of intervention much more cost-effective than medicating people who have hypertension. With health care reform at the forefront of American politics, this study highlights the value of prevention in bringing down costs. Since about 80% of salt in the diet is already in the food when it is purchased, this intervention must occur at a national policy level rather than a personal responsibility level – hopefully, these data will not be ignored by policymakers.

A 1200 mg decrease in sodium consumption would represent a 34.3% drop in sodium consumption of average Americans, somewhat more ambitious than the 25% reduction proposed by Mayor Bloomberg. But based on the above figures even a 25% reduction is likely to bring cardiovascular benefits.

 

References:

Bibbins-Domingo K et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. NEJM. Published at www.nejm.org January 20, 2010 (10.1056/NEJMoa0907355)

Appel LJ and Anderson CAM. Compelling Evidence for Public Health Action to Reduce Salt Intake. Published at www.nejm.org January 20, 2010 (10.1056/NEJMe0910352)