Reducing Sodium: Don’t Take Warnings with a Grain of Salt
One could almost follow the headlines to chart the sad story of Canada’s commitment to reducing sodium – a known risk factor for hypertension, heart attack and stroke.
2007: “Health minister announces sodium reduction group”
2010: “Dietary salt limits OK'd by health ministers”
2010: “Government won't act on all sodium recommendations, despite costly panel”
2010: “Ottawa disbands sodium reduction task force”
2011: “Canada’s Health ministers meet to try to shake up food salt content”
2011: “Minister rejects salt reduction proposal”
2012: “Federal inaction on limiting Canadians' salt intake criticized”*
After seven years, strong evidence linking high sodium intake to a range of cardiovascular diseases and thousands of dollars invested, what is stopping the federal government from implementing a comprehensive sodium reduction strategy for Canada? According to the federal health minister, they don’t want to alienate the source of or our high salt intake – food manufacturers and restaurants.*
Canadians consume about 3500 mg of sodium each day, well over the upper intake limit of 2500mg/day (and the nationally agreed upon target for 2016).
With between 70% and 80% of our dietary sodium coming from processed and restaurant foods, one might also question Health Canada’s investment of $4 million to beef up its education campaign focused on providing advice to Canadians on how to follow Canada’s Food Guide.
Absent from government discussions, as well as the recently released guidance document outlining benchmarks (not targets) for industry to voluntarily reduce sodium levels, is the role of the federal government in mandating and monitoring the harmful amounts of sodium the food industry is adding to our foods.
CPhA, along with several other health and scientific organizations, has endorsed a petition urging the Government of Canada to establish and commit to a national sodium reduction strategy for Canada that includes setting and monitoring sodium reduction targets and timelines.
The federal government needs to stop putting industry’s interests ahead of the health of Canadians. Join the movement and urge our government for the same. Please sign and share the petition with your friends, colleagues and patients.
Thanks for joining us,
Ross T. Tsuyuki, University of Alberta and Norm Campbell, University of Calgary
CPhA Guest Bloggers
*”Federal inaction on limiting Canadians’ salt intake criticized,” Postmedia News, June 12, 2012.
"Awkward alert: Health Canada heading to Ontario Sodium Summit," Postmedia News, January 25, 2012.
"Harper must demand action on sodium levels, health groups urge," Globe and Mail, January 9, 2012.
"Feds take facts with grain of salt," 24 Hours, December 6, 2011.
Comments
- Wade
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From the cochrane collaboration,
'CONCLUSIONS:
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.'
- August 22, 2012, 1:55 AM
- Reply
- Wade
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Sodium Intake and Mortality in the NHANES II
Follow-up Study
Hillel W. Cohen, MPH, DrPH, Susan M. Hailpern, MS, DrPH, Jing Fang, MD, Michael H. Alderman, MD
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
ABSTRACT
PURPOSE: US Dietary Guidelines recommend a daily sodium intake 2300 mg, but evidence linking
sodium intake to mortality outcomes is scant and inconsistent. To assess the association of sodium intake
with cardiovascular disease (CVD) and all-cause mortality and the potential impact of dietary sodium
intake 2300 mg, we examined data from the Second National Health and Nutrition Examination Survey
(NHANES II).
METHODS: Observational cohort study linking sodium, estimated by single 24-hour dietary recall and
adjusted for calorie intake, in a community sample (n 7154) representing 78.9 million non-institutionalized
US adults (ages 30-74). Hazard ratios (HR) for CVD and all-cause mortality were calculated from
multivariable adjusted Cox models accounting for the sampling design.
RESULTS: Over mean 13.7 (range: 0.5-16.8) years follow-up, there were 1343 deaths (541 CVD).
Sodium (adjusted for calories) and sodium/calorie ratio as continuous variables had independent inverse
associations with CVD mortality (P .03 and P .008, respectively). Adjusted HR of CVD mortality for
sodium 2300 mg was 1.37 (95% confidence interval [CI]: 1.03-1.81, P .033), and 1.28 (95% CI:
1.10-1.50, P .003) for all-cause mortality. Alternate sodium thresholds from 1900-2700 mg gave similar
results. Results were consistent in the majority of subgroups examined, but no such associations were
observed for those 55 years old, non-whites, or the obese.
CONCLUSION: The inverse association of sodium to CVD mortality seen here raises questions regarding
the likelihood of a survival advantage accompanying a lower sodium diet. These findings highlight the
need for further study of the relation of dietary sodium to mortality outcomes. © 2006 Elsevier Inc. All
rights reserved.
- August 22, 2012, 2:25 AM
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