Report questions benefits of salt reduction
May 14th, 2013
02:28 PM ET

Report questions benefits of salt reduction

Reducing salt consumption below the currently recommended 2,300 milligrams - about 1 1/2 teaspoons– per day maybe unnecessary, according to a new report released Tuesday by the Institute of Medicine (IOM).

The news follows a decades-long push to get Americans to reduce the amount of salt in their diet because of strong links between high sodium consumption and hypertension, a known risk factor for heart disease.

The IOM, at the request of the Centers for Disease Control and Prevention, reviewed recent studies published through 2012 that explored ties between salt consumption and direct health outcomes like cardiovascular disease and death. The organization describes itself as "an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public."

Researchers determined there wasn't enough evidence to say whether lowering salt consumption to levels between 1,500 and 2,300 mg per day could increase or decrease your risk of heart disease and mortality. But lowering sodium intake might adversely affect your health, the panel found.

"These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health," said committee chair Brian Strom, the George S. Pepper professor of public health and preventive medicine at the University of Pennsylvania's Perelman School of Medicine. "But they also suggest that lowering sodium intake too much may actually increase a person's risk of some health problems."

Those problems, he said, could include heart attack or death.

The current Dietary Guidelines for Americans recommend that a sub-group of people - anyone older than  51, African Americans, and people with high blood pressure, diabetes or chronic kidney disease - limit their salt intake to 1,500 mg a day.

The IOM committee found no benefit, but possibly a risk of poor health outcomes with lower salt intake in people with these pre-existing conditions, but said that evidence is inconsistent and limited.

"While the current literature provides some evidence for adverse health effects of low sodium intake among individuals with diabetes, CKD (kidney disease), or pre-existing CVD (cardiovascular disease), the evidence on both the benefit and harm is not strong enough to indicate that these subgroups should be treated differently from the general U.S. population," the report said.

"Thus, the committee concluded that the evidence on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to, or even below, 1,500 mg per day."

American adults eat on average 3,400 mg of salt a day, according to the IOM. Groups like the American Heart Association (AHA) support reducing that number. In 2011, the AHA called for a reduction in daily consumption, recommending all Americans eat no more than 1,500 mg a day.

The IOM report, the AHA said Tuesday, does not accurately assess salt impact on health. "While the American Heart Association commends the IOM for taking on the challenging topic of sodium consumption, we disagree with key conclusions," said the association's CEO, Nancy Brown. "The report is missing a critical component – a comprehensive review of well-established evidence which links too much sodium to high blood pressure and heart disease."

The Salt Institute says it welcomes the IOM study, calling it a major breakthrough in the salt debate.

"This whole thing has been blood pressure-driven and this study finally looks at overall health outcomes," said Morton Satin, vice president of science and research for the institute.

"The study makes it very, very clear that the level of 1,500 mg that has been recommended in the dietary guidelines is not warranted, despite this full-throated cry for these levels by some organizations ... We hope this is the opening of the much broader review of the available evidence and a devotion to ensuring that our guidelines reflect the science."

The IOM panel was not asked to make recommendations on what a healthy range should be. It says more research is needed to help shed light on how lower sodium levels affect health in all Americans.

On Monday, the Center For Science In The Public Interest published results of a new investigation on what they call the food industry's failed efforts to reduce sodium levels in pre-packaged and restaurant foods.  It called for phased-in limits in an effort to prevent heart disease.  The group tracked nearly 500 food products between 2005 and 2011.

"The strategy of relying on the food industry to voluntarily reduce sodium has proven to be a public health disaster," said  CSPI executive director Michael F. Jacobson.  "Inaction on the part of industry and the federal government is condemning too many Americans to entirely preventable heart attacks, strokes, and deaths each year."

soundoff (347 Responses)
  1. Valentijn

    Hypertension may be linked to greater chance of death, but salt is only implicated in causing short term blood pressure increases – not chronic hypertension. The reduced sodium recommendations are based on guess-work, assuming that short term blood pressure increase either leads to chronic hypertension or is somehow as harmful as chronic hypertension. It's good that this lack of evidence for cause-and-effect is being examined.

    May 14, 2013 at 15:12 | Report abuse | Reply
    • BillRubin

      After reading the actual committee report, it seems that too much & too little of anything is bad for you. The committee found that reducing salt intake to 2300mg/day was beneficial, but anything below that was not. They did not recommended that Americans continue with their high salt intake of 3400mg/day..

      May 15, 2013 at 08:52 | Report abuse |
    • BillRubin

      Correction: I meant sodium intake, not salt intake.

      May 15, 2013 at 08:58 | Report abuse |
    • dt

      Define "short term" relative to the space between meals.

      There's always some nay-sayer who will find an aspect of a logical argument. Meanwhile Americans are explodingly fat and unhealthy.

      May 16, 2013 at 13:39 | Report abuse |
    • Hillcrester

      Do short-term BP increases heighten the risk of stroke in vulnerable persons?

      May 16, 2013 at 19:23 | Report abuse |
    • GrowUp

      Americans need to limit all intake. Take a look at your fellow Costco, Walmart, Sam's Club, Big Lots, K Mart, Target, 99 cents Store and Best Buy shoppers–for starters. And people wonder why our health care costs are skyrocketing? Just sayin'.

      May 17, 2013 at 00:29 | Report abuse |
    • Curmodgeon

      @Growup: I assume by your post that you consider shoppers that patronize Costco, Walmart, Sam's Club, Big Lots, K Mart, Target, 99 cents Store and Best Buy are all unhealthy. Does it not enter your feeble mind that some people patronize these establishments because they want to save money or perhaps they find some of the product offerings superior to those found elsewhere?

      I shop at Walmart because that is the only store where I can find plain, ordinary tomato juice that is not made from processed concentrate. Likewise, Walmart's store brand raisins are of higher quality than the Sunmaid brand and cost appreciably less.

      In general, I find that the fresh fruits and vegetables that Walmart carries are equal in quality to any other store (Target, Cub, Rainbow) and are on average 25% cheaper. A Dole pineapple at Walmart $2.48. A Dole pineapple at Target $3.48.

      May 19, 2013 at 12:39 | Report abuse |


    May 14, 2013 at 16:28 | Report abuse | Reply
    • jzaks

      I believe you hit the nail on the head. And do everything in moderation.

      May 14, 2013 at 17:26 | Report abuse |
    • LCC

      EVERYTHING in moderation, including the Caps Lock button.

      May 16, 2013 at 12:55 | Report abuse |
    • Cynthia

      I think SELECTIVE yelling should be practiced as a more effective form of yelling:

      I have NO MEDICAL training whatsoever, but IMO the HUMAN being needs SALT, Fats, mEAT, eGgs, VEGGIES, cofFEE, and some SWeetS to function OPTIMAlly. Not ProCESSED, doctoRed ADDICTive additives that today PASS FOR FOOD.

      When you add ~**STUFF**~ and LIMIT intake you are BOUND to have UNFORESEEN ProBLEMS.

      May 17, 2013 at 22:09 | Report abuse |
    • bibleverse1

      Moderation in moderation.

      May 18, 2013 at 09:08 | Report abuse |
    • Dale

      I do have medicacal training and I wholeheartedly agree with you Elissa; processed, artificially flavored/enhanced foods are generally not good for you. On the other hand, wholefoods are the way to go.

      May 23, 2013 at 09:48 | Report abuse |
  3. HRutledge

    American Heart Association gives so much bad advice. Any other reputable organization is to be trusted over it.

    May 14, 2013 at 16:45 | Report abuse | Reply
    • Steve - Dallas

      Except maybe the American Cancer Society.

      May 16, 2013 at 17:24 | Report abuse |
  4. Jim Vizzaccaro

    2300mgs of sodium sounds like plenty of sodium. The problem is not that the standard is too high, rather that noone follows it. It is near impossible to eat 2 or 3 meals a day and not consume more than 2300. Matter of fact if you eat anything like me or my buddy, it's more like 4000-5000. Seriously people, read the labels and add the numbers. I would be hard pressed to find anyone who eats less than 2300mg of sodium in one day.

    May 14, 2013 at 17:20 | Report abuse | Reply
    • AngelaD

      Jim, that number is no problem if you cook your own meals. If you eat stuff out of a box or from a restaurant you will exceed that number, of course.

      May 15, 2013 at 08:31 | Report abuse |
    • anne112

      If you make your own meals you can control how much sodium you take in.

      May 16, 2013 at 10:49 | Report abuse |
    • Linda

      If you stick with fresh food prepared yourself it's not all that hard to keep sodium intake to an ok level. There is some natural sodium in everything you eat, but it's the processed foods that really pack in the salt.

      May 16, 2013 at 14:39 | Report abuse |
    • caw

      In terms of money or time most people can't afford to cook their own food from natural ingredients.

      May 16, 2013 at 19:08 | Report abuse |
    • lynn

      My husband had a heart attack in October and I am just amazed at how much sodium is in everything. We now watch everything we eat and make everthing ourselves. His doctor wants him to keep his sodium intake around 1500 mg a day and we have been achieving that but it is a lot of work. We haven't been out to eat in six months but I have to tell you I'm dying for a blooming onion at Outback. Look up a blooming onion at Outback. It has enough sodium for the whole day plus some.

      May 16, 2013 at 19:55 | Report abuse |
    • Sun

      Caw, your ignorance is showing. And you obviously do not know how to cook or shop.

      May 17, 2013 at 07:50 | Report abuse |
  5. John Schaeffer

    I am almost 70, been addicted to salt since I was a kid and never had high BP. Why don't they stop with all these silly surveys and scaring people half to death.

    May 14, 2013 at 17:25 | Report abuse | Reply
    • MySlant

      I just turned 64 and I have always been "addicted" to sugar. I have always craved sweet foods and beverages and consume great amounts of them. I am tall, slim and muscular. And people constantly tease me and ask to see my driver's license to prove my age because I look 15 to 20 years younger. My blood sugar level and triglicerides are normal. Go figure.

      May 14, 2013 at 18:06 | Report abuse |
    • Jay Harris

      Just because one person has eaten a ton of salt or sugar in their life and doesn't have medical issues doesn't mean those things don't contribute majorly to other people having them. That's why we run studies over many people. Put another way, anecdotes are not evidence and don't have statistical significance. Its so tiring to see people say things like "I've run across free ways 5 times a week my entire life and have never been hit by a car! Its so dumb that we teach children that highways are no safe to walk across!"

      May 14, 2013 at 20:49 | Report abuse |
    • BillRubin

      no one ever said people with high salt intake will develop hypertension 100% of the time.

      May 15, 2013 at 08:55 | Report abuse |
    • A

      Ah yes, the old "These researchers are wrong! Look at me! I..."

      Anecdotal evidence, sir.

      May 16, 2013 at 15:31 | Report abuse |
    • Dean

      Yea boy! And my uncle lived to be 99 and smoked 2 packs a day for over 70 years. Wish the medical experts would quit talking about the effects of smoking on your health.

      May 16, 2013 at 15:52 | Report abuse |
  6. Jennifer J

    Is it just me, or is this just another story reporting just another study, with neither really saying anything? Sort of like agreeing to disagree!

    May 14, 2013 at 19:42 | Report abuse | Reply
  7. j.burgess


    May 14, 2013 at 20:11 | Report abuse | Reply
    • Jon

      Will it be held at their site in Columbia, TN?

      May 14, 2013 at 20:27 | Report abuse |
  8. Jon

    "per day maybe unnecessary..." Guys, I think you mean "per day may be unnecessary..." Did the editors at CNN even graduate high school?

    May 14, 2013 at 20:23 | Report abuse | Reply
  9. Jon

    Hasn't this information been known for many years by other studies? What took so long to publicize it? Was it political correctness about not wanting to have dietary guidelines that differentiated Africans as a race?

    May 14, 2013 at 21:15 | Report abuse | Reply
    • rc

      "African" is a geographical designation. As in "there are many people of Caucasian as well as Middle Eastern descent who are African."

      May 16, 2013 at 17:01 | Report abuse |
    • davey

      Nah ahh, obama's father's race was african.

      May 19, 2013 at 02:10 | Report abuse |
  10. Joyce

    My mother was declared dead briefly from going on a low sodium diet with my dad. I was in college & didn't know this. Years later I went on a low sodium diet & had symptoms & went to a emergency center & was given Lexapro 10 mg for symptoms of poor sleep, not feeling myself. Lexapro lowers sodium as does other SSRI. After 3 days I nearly died. I was delirious for several days. I eat salty snacks with impunity. It may relate to genetic factors.

    May 15, 2013 at 00:42 | Report abuse | Reply
    • Pete

      Sorry to hear about your family problems, but eating lots of salty foods doesn't make sense. Say I starve myself for a month and nearly kill myself from malnutrition/starvation. It doesn't mean that proves I should eat as much as I possibly to avoid that situation from happening again. Just stick to recommended amounts.

      May 16, 2013 at 19:45 | Report abuse |
  11. Donna

    It looks like there's a basic technical error in this article, in that the author seems to be equating the weight of sodium with the weight of the salt that contains it. I'm referring to this paragraph:

    "American adults eat on average 3,400 mg of salt a day, according to the IOM. Groups like the American Heart Association (AHA) support reducing that number. In 2011, the AHA called for a reduction in daily consumption, recommending all Americans eat no more than 1,500 mg a day."

    That makes it sound like the AHA recommended less than 1500 milligrams of *salt* per day. But it was actually a recommendation for 1500 mg or less of *sodium* – which is the amount of sodium contained in about 3750 milligrams of salt. So if americans eat only 3400 mg of *salt* per day, then they are well within the limit of 1500 mg of sodium per day. But I suspect that statement about daily salt intake is erroneous, and it refers to average sodium intake instead.

    Please remember to distinguish the weight of sodium from the weight of salt.
    Table salt – sodium chloride or halite – is only about 40% sodium.
    Most (60%) of the weight of table salt is in the chlorine, not the sodium.

    (Sodium is atomic number 11 , and atomic weight ~ 23 amu. Chlorine is atomic number 17 and atomic weight 34.5 amu. So the molecular weight of the compound is about 57.5 amu, and the sodium portion is only 23/57.5, or around 0.40, or 40%.)

    From the wikipedia article on salt: There is 1500–2300 mg of sodium in 3750–5750 mg of salt (sodium chloride).


    May 15, 2013 at 01:33 | Report abuse | Reply
    • Pete

      While many of your assertions are true, many people use the terms interchangeably (wrongly). It seems the author may have made a small goof. On the AHA website they specifically call out 3436 mg of sodium as the average intake and 1500 mg of sodium as the recommended amount. So no, people are still eating way more than they should even if the amount was 2300 mg.

      May 16, 2013 at 20:03 | Report abuse |
  12. Jen

    The best dietary advice is simply to eat real food, nothing fake. I wouldn't worry too much about the amount of salt* you add to home cooking.

    *unprocessed, additive-free salt, that is.

    May 15, 2013 at 03:54 | Report abuse | Reply
  13. Greg Vick

    As with any study you need to see who funded it. I just read a study the other day on chocolate milk as a great recovery drink for exercise. It hit all the right buttons ... But it was funded by the National Dairy Association. Do you really think they would fund something, then publish anything negative?

    My point is that any study that is funded by a party that has an interest/investment in will be flawed in nature. Why do you think that pharmaceutical companies make billions of dollars?

    As the saying goes, take what you hear/read with a grain of salt. 😉

    May 15, 2013 at 08:15 | Report abuse | Reply
  14. us_1776

    Salt does not lead to heart disease.

    Untreated inflammation and low grade infections are what leads to heart disease.


    May 16, 2013 at 11:35 | Report abuse | Reply
  15. us_1776

    Please use IODIZED salt.

    Iodine is very necessary nutrient that is lacking in modern society.


    May 16, 2013 at 11:36 | Report abuse | Reply
    • Katie

      Well, not everyone can tolerate extra iodine, which is found in trace amounts in most dairy and other foods, as iodines are used to help sterilize. Iodine can interfere with thyroid functions. If you use sea salt and eat fish and shellfish, and you are not lactose intolerant, you don't need iodized salt.

      May 16, 2013 at 14:08 | Report abuse |
  16. LCC

    Most well-performed studies have pointed to this for decades. Don't decrease your sodium intake.

    May 16, 2013 at 12:56 | Report abuse | Reply
  17. dt

    What a ridiculous article. They're saying you shouldnt lower your salt under the amount you NEED. OOOOOK. Thanks for the tip.

    Heres a real tip: Sprinkle Potassium on your food instead of salt/sodium. Tastes almost the same and wont mess up your body chemistry as much.

    May 16, 2013 at 13:52 | Report abuse | Reply
    • You are right

      Exactly. Most people have too much sodium chloride in their diet and not enough potassium chloride.

      May 31, 2013 at 20:26 | Report abuse |
  18. Melba

    I had high blood pressure, and I lost 80 pounds and I am solidly in the middle of the healthy range (22 BMI) and it didn't make any difference. Cut salt way down, still didn't make any difference. I think it is really mostly genetic. I went ahead and started using "lite" salt when I want to. I don't eat any processed foods at all.

    May 16, 2013 at 14:23 | Report abuse | Reply
  19. PatrickInBama

    Interesting article. My high blood pressure goes from 135/89 on a normal diet to 118/78 with a low carb diet. Yet, I consume much more sodium with the low carb diet. If too much sodium equates to HBP, then how does one explain why a low carb diet results in lower HBP?

    May 16, 2013 at 17:59 | Report abuse | Reply
    • EatMoreSalt

      Because each one of us is an individual and our bodies behave differently to salt consumption.

      May 19, 2013 at 16:24 | Report abuse |
  20. Pete

    This article is really misleading. Reducing your intake of sodium from 2300 to 1500 mg may or may not help, but that is not what the average American consumes in a day. The majority of Americans (some countries eat fine) eat well over that 2300 mg amount and need to lower their intake. Sure its mentioned in the article, but its deeply buried.

    May 16, 2013 at 19:26 | Report abuse | Reply
  21. Shelli edwards

    After a couple of random fainting spells, the cardiologist monitoring my tilt table test test suggested I add salt to my diet... (I cook from scratch, healthy 50 yr old female of normal weight). His prediction that once I did so would solve the problem was right on. No problems since!

    May 16, 2013 at 21:29 | Report abuse | Reply
  22. jonny

    I had horrible high blood pressure in my late 20's and early 30's. I was otherwise perfectly fit, in shape and lean. All I did was cut sodium out and my blood pressure is now normal. Hypertension runs in my family. I think some people are just more sensitive to the effects of salt.

    May 16, 2013 at 22:59 | Report abuse | Reply
    • NBD

      ^^^ This is the truth. Some people are more sodium sensitive than others, likely genetic (probably why folks of sub-saharan Africa descent are singled out as more sensitive).

      May 17, 2013 at 16:11 | Report abuse |
  23. GrowUp

    Americans need to limit all intake. Take a look at your fellow Costco, Walmart, Sam's Club, Big Lots, K Mart, Target, 99 cents Store and Best Buy shoppers–for starters. And people wonder why our health care costs are skyrocketing? Just sayin'.

    May 17, 2013 at 00:31 | Report abuse | Reply
  24. Joseph Sroka

    "Salt", sodium chloride, is less than 40% sodium, so milligrams of sodium vs milligrams of "salt" are completely different numbers.

    It seems like half the time the villainous chemical is called "sodium" and the other half the time it's called "salt". Now WHICH IS IT?! Especially when taking about milligrams, is it milligrams of sodium chloride or is it milligrams of sodium? A can of Campbell's soup calls it milligrams "sodium" - do they really mean milligrams of sodium chloride? Not to berate Campbell's in particular, it's no worse than this CNN article where no distinction seems to be made between "sodium" and "salt".

    May 17, 2013 at 17:11 | Report abuse | Reply
  25. Bnode

    "Everything in moderation including moderation itself" seems like a good start.

    May 18, 2013 at 12:46 | Report abuse | Reply
  26. lp

    the best remedy is eat any amount of what you want sugar, salt, whatever and make sure you are very physically
    active on a daily basis so you sweat it out. back in the in west indies island before the current generation stop working the
    farm folkes in the country areas who were planting and caring for cattle thereby working up a good sweat daily there was such thing as high bp,cholesteral,diabetes, smoked real tobacco not the one they processed etc and they live healthy way into their 90plus. the real deal get off the coach eat drink and work ut that body and stop listening to dumb research. one day do this, next day oh stop it. best remedy cook your own food. all these restaurant food are loaded with salt/sodium

    May 19, 2013 at 00:39 | Report abuse | Reply
  27. mickinmd

    The word's still out on the benefits. If you have hypertension and are controlling it with "water pills" like HCTZ, low sodium is a must. There's been some evidence that low sodium benefits those with heart problems – probably due to lower blood pressures. I was switched from HCTZ to an ACE Inhibitor and salt doesn't affect my blood pressure so I don't worry much about it, though I try to limit my intake.

    May 19, 2013 at 13:48 | Report abuse | Reply
  28. Frank

    I knew it! Okay, so all the salty foods are alright, now all I need is the study that shows that sitting in front of the computer for 16 hours a day playing video games all summer long is good for you and I'm set!

    May 19, 2013 at 16:10 | Report abuse | Reply
    • cali girl

      And no Frank, you won't go blind if you masterb8 too much.

      January 29, 2014 at 16:40 | Report abuse |
    • Frank

      cali girl did you read a study or perform the research yourself?

      January 29, 2014 at 16:43 | Report abuse |
  29. hender1123

    Two thirds of IoM's funding comes from the government. Most of the rest comes from vaccine manufacturers and other drug companies. Their report ordered from the White Hose on contraception for women was the basis of Obama's promise of contraception for women during his campaign. Hardly objective. The conflicts of interest between IoM members and organizations like the CDC, the FDA, the White House and the pharmaceutical and health insurance industry are staggering.

    May 21, 2013 at 06:13 | Report abuse | Reply
  30. l desks corner desks

    I think similar blog owners need to look into this valuable online site as a model. Completely clean and straightforward layout, not to mention beneficial articles and other content! You're an authority in this type of niche 🙂

    May 26, 2013 at 03:33 | Report abuse | Reply
  31. Vincent A. Demonbreun

    This post is jumping back and forth between sodium and salt. 1500 mg of sodium is enough for proper body function. This does depend on lifestyle. Iodized or table salt whcih contains 49% sodium and 51% chloride is only 11% of the sodium intake. Sodium is in almost every food. Companies and some medical facilities have money invested in sickness and raising the argument of lowering sodium impacts their money.

    May 28, 2013 at 09:14 | Report abuse | Reply
  32. Daniek K

    salt/sodium is hard to control considering the labeling on the food

    June 4, 2013 at 03:42 | Report abuse | Reply
  33. Stymie Consentino

    Mayor Bloomturd frowns upon your so called study.....

    July 11, 2013 at 13:12 | Report abuse | Reply
  34. DW

    Like anything, salt should neither be over consumed nor completely eliminated from the diet. Although salt has gained a bad reputation for its increased health-related risks, it also has been linked to beneficial effects. According to Natural Standard database, salt has uses for the treatment of sore throat, sinus problems, and even for mucus clearance in people with cystic fibrosis.

    October 4, 2013 at 16:49 | Report abuse | Reply
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