Winter 2015

For a Longer Life, Add Less Salt

Study finds too much sodium a worldwide killer 

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Salt accounts for more than 1.6 million cardiovascular-related deaths each year. Illustration: Juliette Borda

Americans are not alone in their taste for salty foods. Whether the salt comes from french fries or miso soup, people all over the world are getting more than the current recommendations. And according to an analysis of global sodium intake published in The New England Journal of Medicine, that overabundance of salt accounts for more than 1.6 million cardiovascular-related deaths each year.

The researchers looked at existing data on sodium intake in 187 countries representing nearly three-quarters of the world’s adult population. Separately, they determined the effects of sodium on blood pressure and of blood pressure on cardiovascular diseases—including heart disease and stroke—by analyzing more than 100 previous clinical trials. These findings were combined with current rates of cardiovascular disease around the world to estimate the number of cardiovascular deaths attributable to taking in more than 2,000 mg of sodium per day, the World Health Organization’s recommended amount.

“These new findings inform the need for strong policies to reduce dietary sodium in the United States and across the world.” —Dariush Mozaffarian

In 2010, the average global sodium consumption was nearly double that recommendation—3,950 mg—the researchers found. In fact, all regions of the world were above recommended levels, with averages ranging from 2,180 mg per day in sub-Saharan Africa to 5,510 mg per day in Central Asia.

“These 1.65 million deaths represent nearly one in 10 of all deaths from cardiovascular causes worldwide. No world region and few countries were spared,” said first and corresponding author Dariush Mozaffarian, M.D., Dr.P.H., dean of the Friedman School, who led the research while at the Harvard School of Public Health. Some of the highest rates were in East Asia and Southeast Asia, where excess salt consumption accounted for more than 20 percent of cardiovascular deaths in people under age 70, the study found.

In the United States, the researchers found that nearly 58,000 cardiovascular deaths each year could be attributed to daily sodium consumption greater than 2,000 mg. Average U.S. sodium intake was 3,600 mg per day, 80 percent higher than the WHO’s recommendation and 57 percent higher than the 2,300 mg recommended by the Dietary Guidelines for Americans.

“These new findings inform the need for strong policies to reduce dietary sodium in the United States and across the world,” said Mozaffarian, who chairs the Global Burden of Diseases, Nutrition and Chronic Disease Expert Group, an international team of more than 100 scientists studying the effects of nutrition on health that contributed to the research.

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