Estimated 1.65 million global cardiovascular deaths each year linked to high sodium consumption

More than 1.6 million cardiovascular-related deaths per year can be attributed to sodium consumption above the World Health Organization's recommendation of 2.0g (2,000mg) per day, researchers have found in a new analysis evaluating populations across 187 countries. The findings were published in the August 14 issue of The New England Journal of Medicine.

"High sodium intake is known to increase , a major risk factor for cardiovascular diseases including heart disease and stroke," said first and corresponding author Dariush Mozaffarian, M.D., Dr.P.H., dean of the Friedman School of Nutrition Science and Policy at Tufts University, who led the research while at the Harvard School of Public Health. "However, the effects of excess sodium intake on cardiovascular diseases globally by age, sex, and nation had not been well established."

The researchers collected and analyzed existing data from 205 surveys of sodium intake in countries representing nearly three-quarters of the world's adult population, in combination with other global nutrition data, to calculate sodium intakes worldwide by country, age, and sex. Effects of sodium on blood pressure and of blood pressure on cardiovascular diseases were determined separately in new pooled meta-analyses, including differences by age and race. These findings were combined with current rates of cardiovascular diseases around the world to estimate the numbers of cardiovascular deaths attributable to sodium consumption above 2.0g per day.

The researchers found the average level of global sodium consumption in 2010 to be 3.95g per day, nearly double the 2.0g recommended by the World Health Organization. All regions of the world were above recommended levels, with regional averages ranging from 2.18g per day in sub-Saharan Africa to 5.51g per day in Central Asia. In their meta-analysis of controlled intervention studies, the researchers found that reduced sodium intake lowered blood pressure in all adults, with the largest effects identified among older individuals, blacks, and those with pre-existing high blood pressure.

"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," added 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 and who contributed to this effort. "These new findings inform the need for strong policies to reduce in the United States and across the world."

In the United States, average daily sodium intake was 3.6g, 80 percent higher than the amount recommended by the World Health Organization. [The federal government's Dietary Guidelines for Americans recommend limiting intake of sodium to no more than 2,300mg (2.3g) per day.] The researchers found that nearly 58,000 cardiovascular deaths each year in the United States could be attributed to daily sodium consumption greater than 2.0g. Sodium intake and corresponding health burdens were even higher in many developing countries.

"We found that four out of five global deaths attributable to higher than recommended sodium intakes occurred in middle- and low-income countries," added John Powles, M.B., B.S., last author and honorary senior visiting fellow in the department of public health and primary care at the University of Cambridge. "Programs to reduce sodium intake could provide a practical and cost effective means for reducing premature deaths in adults around the world."

The authors acknowledge that their results utilize estimates based on urine samples, which may underestimate true sodium intakes. Additionally, some countries lacked data on consumption, which was estimated based on other nutritional information; and, because the study focuses on cardiovascular deaths, the findings may not reflect the full health impact of , which is also linked to higher risk of nonfatal cardiovascular diseases, kidney disease and stomach cancer, the second most-deadly cancer worldwide.

More information: Mozaffarian, D; Fahimi, S; Singh, G; Micha, R; Khatibzadeh, S; Engell, R; Lim, S; Goodarz, D; Ezzati, M; and Powles, J. "Global sodium consumption and death from cardiovascular causes." N Engl J Med 2014. 371:7, 624-634. DOI: 10.1056/NEJMoa1304127

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jwilcos
1.5 / 5 (8) Aug 13, 2014
Salt and sugar, two poisons of our times. We are wired to like them, and hence food companies load foods with these. They will be reluctant to change, for obvious reasons. Without strong regulation, these two poisons will continue to kill us.
big_hairy_jimbo
3.2 / 5 (5) Aug 13, 2014
Hmmm, and smoking kills 5 million per year (http://www.cdc.go...facts/).
In Australia they cover ciggie packs with disgusting picks of cancers and other smoking diseases. Should they now do the same with SALT?????
What about new cars?? I reckon all new cars should have graphic pictures of car accidents sprayed all over them, to remind them what could happen when driving.
Debbie M_
4 / 5 (4) Aug 13, 2014
This headline is erroneous and the study has at least one major problem. It is a meta analysis of a meta analysis. They used a meta-analysis of data to determine the amount of people who had high blood pressure that was sodium sensitive and then they used that data to do another meta-analysis of how that high blood pressure resulted in heart disease. Meta-analyses are useful to indicate areas where further research might be warranted, but basing government policies based on a meta-analysis of a meta-analysis is just plain stupid.

In addition, the data on sodium consumption was based on sodium *secretion* for the most part (some of the data was just based on average diet info). In a healthy person, it's probably safe to correlate secretion and intake. But since a major drug of choice for hypertension actually increases sodium secretion, they are overestimating consumption and confusing the issue further.

Psilly_T
2.7 / 5 (6) Aug 13, 2014
poison is a really strong word to use here.... like ridiculously out of line word to use... Sure you we need to cut back on our intake of these but it's not like its rat poison in our food.
Strictly speaking about salt and sugar not additives etc. Pretty basic things needed by the body hardly poison. We could regulate milk intake on an individual level though too. I hear drinking 8 glasses of that consecutively can kill. Better run to regulation for the cure.
skills4u
2.5 / 5 (4) Aug 13, 2014
Even if you believe this "study" which I don't, deaths are dropping !

Eating too much salt led to 2.3 million heart-related deaths worldwide in 2010 [ Mar 21, 2013]
Eating too much salt contributed to 2.3 million deaths from heart attacks, strokes and other heart-related diseases throughout the world in 2010, representing 15 percent of all deaths due to these causes, according to research
Solon
1.8 / 5 (5) Aug 14, 2014
Salt and sugar, two poisons of our times. We are wired to like them, and hence food companies load foods with these. They will be reluctant to change, for obvious reasons. Without strong regulation, these two poisons will continue to kill us.

It may be MSG that is the real problem. My stubbornly high BP, even with meds, is now at the level it was when I was 17 (now 62) with no medication, when I quit eating/drinking anything containing MSG. Also wheezy asthma cleared up, eyesight much better. All symptoms associated with MSG, which I didn't know until I became violently ill and tracked down the problem. Search for "MSG, Cancer, and Your Heart" to find videos on the subject.
Padre53
1 / 5 (4) Aug 14, 2014
2000 mg/day Na is wrong recommendation, the optimum for an adult is not more than 500 mg. The WHO misleads all the humanity. In the scientific literature and in media the salt has political, and astonishing amount pseudo-science, but the pure scientific science of salt we can find only in traces. It's time to understand (and to teach and to use) some very important but forgotten, ignored and censored knowledges, and the consequences:
1. "Anything that can go wrong not only will go wrong, it must go wrong, as decreed by the Second Law of Thermodynamics,
2. The profound nature of the Second Law manifests itself in every aspect of human existence. Entropy permeates all aspects of human existence.
3. Every biochemical function requires a decrease in entropy, which can only be achieved by the infusion of energy into a life-sustaining system.
dogbert
2 / 5 (4) Aug 14, 2014
Debbie M_

This headline is erroneous and the study has at least one major problem. It is a meta analysis of a meta analysis. They used a meta-analysis of data to determine the amount of people who had high blood pressure that was sodium sensitive and then they used that data to do another meta-analysis of how that high blood pressure resulted in heart disease. Meta-analyses are useful to indicate areas where further research might be warranted, but basing government policies based on a meta-analysis of a meta-analysis is just plain stupid.


A very insightful observation, Debbie. I get so tired of meta-analyses being presented as if they were definitive double blind studies. Basing policy on such manipulations of data is simply egregious.
Padre53
1 / 5 (3) Aug 14, 2014
4. Wherever we look, whatever we do, we must be acutely aware of the immutable laws of thermodynamics, especially the easily overlooked Second Law: Entropy."
http://www.ration...ropy.htm
5. The spontaneous diffusion of sodium ions into the cells and the diffusion of potassium ions out of the cells, continuously enhances the entropy (the disorder).
6. The task of the continuously working sodium-potassium pump to keep constant the intracellular concentration of Na and K ions. These cellular pumps continuously use energy of ATP molecules.
7. Excess sodium intake = excess diffusion = excess increase of entropy = excess work for pumps = excess energy expenditure against excess entropy => excess food consumption.
8. But, all the rest of our vital processes (functional processes of the cells) receive less energy - because our capacity (to make energy from foods) is limited (see Kleiber's Law).
Padre53
1 / 5 (3) Aug 14, 2014
9. Everything work worse in our body, and this increases the incidence of all illnesses without any exception, our aging and devolution accelerate, etc.
10. That is why salt (and other Na-compounds) is perfect food of entropy, and as I wrote on science20, this all is the Sodium-Induced Disorder Syndrome.
http://www.scienc...s-120016
The entropy is our number one public enemy on every level (physical and mental health, and social level) globally. Our history and our entire individual life is a continuous war against entropy. The evolution of life on Earth was and is also a continuous war against entropy. But we, humans started our devolution = the entropy is growing in human genome. Even we nourish the entropy in all of our cells (by unnecessary sodium intakes), but the health scientists do not talk about this. And this is a fatal error. It's time to change that!
Padre53
2.3 / 5 (3) Aug 14, 2014
jwilcos
Salt and sugar, two poisons of our times. We are wired to like them, and hence food companies load foods with these. They will be reluctant to change, for obvious reasons. Without strong regulation, these two poisons will continue to kill us.

The fats and the sugars are foods, and are sources of our energy. But the salt is perfect food of entropy (and is a strong appetizer)!
http://www.scienc...s-120016
Padre53
1 / 5 (3) Aug 14, 2014
Solon
It may be MSG that is the real problem.

Sodium is sodium, MSG and NaCl are perfect food of entropy! The salt is the greatest blunder of the Homo Sapiens. Only the man nourishes the entropy in his own body. There are not free-living animals like this on this Earth. The entropy and the natural selection destroyed the such species. (The natural selection already has little effect to human genome, does not repair it already.) The salted humanity genetically degenerates and will be idiotic.
Grendel
3 / 5 (2) Aug 14, 2014
And then there's this: http://medicalxpr...lt.html. You pays your money and you takes your chances. Good luck!
Padre53
1 / 5 (2) Aug 14, 2014
Grendel
And then there's this: http://medicalxpr...lt.html.

"A large international study questions the conventional wisdom that most people should cut back on salt, suggesting that the amount most folks consume is OK for heart health - and ..."
This is only pseudo-science. Read my correspondence with Niels Graudal:
http://padre.uw.h...udal.htm
skills4u
1 / 5 (1) Aug 14, 2014
2000 mg/day Na is wrong recommendation, the optimum for an adult is not more than 500 mg. .
Really ? So those that sweat a lot needs the same amount as those that don't ? I have been consuming at least 3000mg a day for 40 years.I have lowish blood pressure 110/70, I have not been to a hospital in over 30 years and I look 20 years younger than most of my peers. We are all unique in our genetic make-up and mutations, what is good for one is not always good for another ! I hate blanket statement ..Smoking does not cause cancer, salt does not cause high blood pressure or hypertension,fat does not cause hardening of the arteries,etc. They can only exacerbate a genetic condition. This is why someone can smoke for 70 years and never get cancer and someone who never smoked dies young from lung cancer & same as the other conditions mentioned.
skills4u
1 / 5 (1) Aug 14, 2014
http://www.nbcnew...-n179941
An international study of more than 100,000 people published Wednesday in the New England Journal of Medicine suggests that while there is a relationship between salt intake and high blood pressure, if you don't already have high blood pressure and you're not over 60 or eating way too much salt, salt won't have much impact on your blood pressure.
In fact, people who consumed 3,000 to 6,000 milligrams per day had a lower risk of death and cardiovascular events than those who had more than 6,000 mg or less than 3,000 mg.


Padre53
1 / 5 (2) Aug 15, 2014
skills4u
Really? So those that sweat a lot needs the same amount as those that don't?
Really! 10 th. ed. of RDA (1989) 500 mg sodium per day, current Australian: 460-920 mg/day. http://www.nrv.go...dium.htm
The optimal Na/K ratio and the ratio between sum of alkaline metals and sum of polyvalent metals, and the ratio between alkaline metals and energy content, etc. is in the human milk. From every viewpoint, the human milk is an evolutionary perfect food, including the minimal energy expenditure of the Na-K pump and kidney of the babies = possible minimum entropy-transfer into the babies = the baby is growing healthily and with maximal economicalness. Thus, the human milk is the perfect guide to calculate the optimal adult intakes. You can calculate e.g. from tis article: http://www.ncbi.n...16325533
Padre53
1 / 5 (2) Aug 15, 2014
Padre53
1 / 5 (2) Aug 15, 2014
Debbie M_
Meta-analyses are useful to indicate areas where further research might be warranted, but basing government policies based on a meta-analysis of a meta-analysis is just plain stupid.
Right! Why big data & fancy statistics aren't science?
Eight (no, nine!) problems with big data
http://www.nytime...ata.html
"By combining the power of modern computing with the plentiful data of the digital era, it promises to solve virtually any problem - crime, public health, the evolution of grammar, the perils of dating - just by crunching the numbers."
The education is wrong globally.The researchers are not thinking, the existing knowledge is not used (it is ignored and censored), but statistical data are collected and presented pro and contra. Instead of statistics would be better to learn more and to think more.
Padre53
1 / 5 (2) Aug 15, 2014
Gary Taubes: The (Political) Science of Salt, Science 14 August 1998: Vol. 281 no. 5379 pp. 898-907 http://www.stat.b...alt.html
is only a new touchstone of the meaningless, pseudoscientific salt debate.
Padre53
1 / 5 (2) Aug 15, 2014
Gary Taubes: The (Political) Science of Salt, Science 14 August 1998: Vol. 281 no. 5379 pp. 898-907 http://www.stat.b...alt.html
Pro and contra, bottom of the page (in references): "does support" and "does not support" etc.
This new study: "US study questions need for most to cut salt"
http://medicalxpr...alt.html
is only a new touchstone of the meaningless, pseudoscientific salt debate (centenarian Salt Wars).
Osiris1
1 / 5 (1) Aug 17, 2014
Yeah, Yanks, keep eatin' that poison McDonald's and other fast food joints hand out' ta' ya'. Den' wen' yer country gets de-people-ated, we foreigner's will mooooooooove on in.
MR166
2.3 / 5 (3) Aug 17, 2014
Salt is not the problem unless you have already wrecked your health eating simple carbohydrates. Most natural fats including animal fats are good for your health unless they are combined with simple carbs like bread, potatoes, and corn. It is the combination of simple carbs and fats that increase the LDL cholesterol levels that do all of the harm. Diabetes has skyrocketed in the US since the advent of low fat high carb diets.
skills4u
2.3 / 5 (3) Aug 17, 2014
Padre53

skills4u
Really? So those that sweat a lot needs the same amount as those that don't?
Really! 10 th. ed. of RDA (1989) 500 mg sodium per day, current Australian: 460-920 mg/day. http://www.nrv.go...dium.htm


You evidently do not read or underfstand your own sources !

In industrialised countries, the majority of ingested sodium chloride is excreted in the urine, provided that sweating is not excessive


. In sodium and fluid balance, with minimal sweat losses, the amount of sodium excreted in urine roughly equals intake


Physical activity can potentially affect sodium chloride balance, mostly from increased losses in sweat. People who regularly undertake strenuous activity in the heat can lose substantial amounts of sodium. Loss of sodium in sweat is dependent on overall diet, sodium intake, sweating rate, hydration status and degree of acclimatisation to the heat


So in a health body, you pee out as much as you intake !
skills4u
2.3 / 5 (3) Aug 17, 2014
Padre53

You also like to quote
10 th. ed. of RDA (1989) 500 mg sodium per day, current Australian

But you fail to mention the rational behind the recommendation !
Rationale: As there are insufficient data from dose-response trials, an EAR could not be established, and thus a RDI could not be derived. An AI for adults for sodium was set at 460-920 mg/day (20-40 mmol/day) to ensure that basic requirements are met and to allow for adequate intakes of other nutrients. This AI may not apply to highly active individuals, such as endurance athletes or those undertaking highly physical work in hot conditions, who lose large amounts of sweat on a daily basis.
Padre53
1 / 5 (2) Aug 17, 2014
skills4u
Read this (including comments!!!): http://www.scienc...s-120016
this is the ignored and censored real science of salt. The Australian recommendation is good but the rationale is junk. The science of salt is globally pseudo!
Padre53
1 / 5 (2) Aug 17, 2014
skills4u
You evidently do not read or underfstand your own sources! ... mostly from increased losses in sweat.
You must think again and read the real science of salt and sodium intakes. The significant loss in sweat is only urban legend!
Padre53
1 / 5 (2) Aug 17, 2014
MR166
... and fats that increase the LDL cholesterol levels that do all of the harm. Diabetes has skyrocketed in the US since the advent of low fat high carb diets.
2010! "Patients are advised to stay away from fatty foods, which obviously does not help because fatty meal is not the cause for atherosclerosis. Therefore, the researchers should first examine the cause of the disease before trying to cure it; otherwise, we will be treating symptoms rather than curing the disease itself. ... We have a mission but are lacking the vision. That is why we have not made any progress even though we have worked on it for more than 50 years." http://www.ncbi.n...2945206/
Five decades global censorship and corruption. Read the comments here also: http://medicalxpr...alt.html
Padre53
1 / 5 (2) Aug 17, 2014
"Although we have recently elucidated many of the genetic variants underlying the risk of developing autoimmune diseases, the significant increase in disease incidence, particularly of multiple sclerosis and type 1 diabetes, indicates that there have been fundamental changes in the environment that cannot be related to genetic factors. Diet has long been postulated as a potential environmental risk factor for this increasing incidence of autoimmune diseases in developed countries over recent decades. One such dietary factor, which rapidly changed along with the Western diet and increased consumption of processed foods or fast foods, is salt (NaCl). The salt content in processed foods can be more than 100 times higher in comparison to similar home-made meals." http://www.nature...868.html
skills4u
2.3 / 5 (3) Aug 17, 2014
skills4u
You evidently do not read or underfstand your own sources! ... mostly from increased losses in sweat.
You must think again and read the real science of salt and sodium intakes. The significant loss in sweat is only urban legend!


WOW really ? Those quotes were from the sources you used to make your point ! So are you now saying your sources are bunk ???
Padre53
1 / 5 (3) Aug 17, 2014
... fatty meal is not the cause for atherosclerosis. ... we have not made any progress ...

And now in 2014, from here: http://www.heart....icle.jsp
"Exactly how atherosclerosis begins or what causes it isn't known, but some theories have been proposed."
Forgotten, ignored and censored articles: Klahr and Bricker 1965, Henningsen 1985, Sandor 1998, Osaka et al. 2001, etc.
Padre53
1 / 5 (2) Aug 17, 2014
skills4u
So are you now saying your sources are bunk ???
You must think again, what is bunk in one source and what is not bunk in the same source! You have to realise what is true and what is not true, what is science and what is pseudoscience. You need more knowledge and logic.
Padre53
1 / 5 (2) Aug 17, 2014
I collected the necessary knowledge, who does not read it may understand it difficultly, because this is not teached.
skills4u
3 / 5 (2) Aug 17, 2014
NO, you pick what agrees with your thoughts and disregard what doesn't agree with you.Cherry picking. The quotes I provided were from the studies you quoted.
Padre53
1 / 5 (2) Aug 17, 2014
No! I picked the traces of the real science. Your knowledge and logic is not enough. Can you understand this: "what is bunk in one source and what is not bunk in the same source!"?
Padre53
1 / 5 (2) Aug 17, 2014
Here: http://www.scienc...t-216959
egstras says: "How awesome to be the only one with the truth." He or She understood the truth. And You??
barakn
5 / 5 (2) Aug 17, 2014
Padre53: I would have thought that you, having spent so much time perseverating on the topic, would have investigated how or why sodium gets into cells in the first place. You make it sound like cells are barely surviving an onslaught of sodium that they somehow can't prevent from leaking in. But in actuality the cell intentionally creates a sodium gradient, and as such the concentration outside the cell matters not so much as the difference in concentrations inside and out. The cells are using sodium moving into the cell to move other chemicals in or out, and therefore the amount of sodium moving in depends on the metabolic and catabolic activity level of the cell, not on the exterior concentration. If too much material is moving in or out (and therefore too much sodium), the cell simply starts inactivating transport proteins and creating fewer new ones, thus down-regulating sodium import. It's too bad you've wasted so much time on your pet theory.
skills4u
1 / 5 (1) Aug 17, 2014
Padre53

No! I picked the traces of the real science. Your knowledge and logic is not enough. Can you understand this: "what is bunk in one source and what is not bunk in the same source!"?

EXACTLY ! This is what cherry picking is ! You can not use a study and say their findings are correct but with exceptions,otherwise it is not credible !
Padre53
1 / 5 (1) Aug 18, 2014
skills4u
The science is not faith! I recognise the waste, but I do not deal it. If you do not understand (or believes) the facts (the reality), but you believe the tales and urban legends, it's your problem, you must learn more. Sorry.
Padre53
1 / 5 (1) Aug 18, 2014
barakn
You wrote an interesting child tale but is far from the science. You must learn some more about active and passive transport processes of Na and K ions, function of the Na/K pumps, membrane potentials, aerobic and anaerobic glycolysis and reproduction of ATP. But unfortunately I'm not a teacher.
http://www.realcl..._quotes/