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Examiner
  • Lori Boyajian-O'Neill: Americans' salt intake and cardiovascular disease

  • When It Rains, It Pours. This slogan for Mortons salt is one of the most recognizable in history. The picture of a little girl walking in the rain carrying an umbrella at the same time spilling Mortons salt is an iconic cultural image. When this debuted in 1911, Americans consumed an average of 2-3 grams of salt daily. Tod...
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  • When It Rains, It Pours. This slogan for Mortons salt is one of the most recognizable in history. The picture of a little girl walking in the rain carrying an umbrella at the same time spilling Mortons salt is an iconic cultural image. When this debuted in 1911, Americans consumed an average of 2-3 grams of salt daily. Today that number approaches 8.5 grams per day. Is that bad for our health? Salt and health, what do you know, T or F?
    1. 75 percent of salt intake is from processed foods.
    2. Average adult Americans consume about 5,000 milligrams of sodium daily.
    3. Adults should consume about 1,200 milligrams of sodium daily.
    The history of salt is a fascinating tale involving explorers, miners, tax collectors, wars and consumers. Our understanding about salt and health has changed throughout history. Romans thought it improved sexual desire and prowess, giving us the word, salacious. In the 1800s scientists determined that high salt intake affected blood pressure.
    When was the last time you saw anyone with a goiter? In 1924 iodine was widely added to salt to prevent goiters, with great success. We hit our peak salt intake in the 19th and early 20th centuries before refrigeration methods provided an alternative to salt-curing meats for preservation. In the mid-20th century we began to prize the convenience of processed and packaged foods and steadily our salt intake has risen. Today about 75 percent of our salt intake is from processed and restaurant foods.
    The historical scientific conversations and at times, heated debates about the role of salt in our health, specifically the sodium component of salt, have framed public health policy. Salt is a combination of sodium and chloride. Sodium is particularly important for normal cell function. Too much or too little causes illness or even death. High sodium intake is related to high blood pressure which increases risk for cardiovascular and kidney diseases.
    On average we consume 3,400mg of sodium daily. The American Heart Association, among others, endorses much lower limits to improve health. The Department of Health and Human Services and the Department of Agriculture developed the 2010 Dietary Guidelines for Americans. It recommended that all Americans limit daily sodium intake to no more than 2,300 mg/day. Further, it recommended that populations at high risk for cardiovascular disease including African Americans, those older than age 51 and those with hypertension, diabetes or chronic kidney disease limit daily intake to 1,500mg/day. A new report issued by the Institutes of Medicine, Sodium Intake in Populations: Assessment of Evidence challenges those limits. The report indicates that sodium may not be as bad as we have thought.
    The IOM committee reviewed the relationship between sodium intake and hypertension and also to direct health outcomes. It found that there is a relationship between higher levels of sodium intake and increased risk of cardiovascular disease, primarily due to effects of elevated blood pressure. But, they did not find evidence to support the general recommended limit of 2,300 mg /day.
    Page 2 of 2 - The committee also concluded there was no relationship between lower sodium intake and improved health outcomes in African Americans, those with diabetes, hypertension or chronic kidney disease or those older than age 51 and found no evidence to support recommendations to limit sodium to 1,500mg daily in these populations.
    The report has been met with intense scrutiny and criticism, which is the foundation of all good science. Daily walking is a public health recommendation that is not controversial. Stick with that and you may not have to worry about heart disease or your daily sodium intake.
    Answers: 1 T; 2 F ; 3 F
    Dr. Lori Boyajian-ONeill can be contacted at lori.boyajian-oneill@hcahealthcare.com.
     
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