Diet/Sodium
Reduced Salt & Healthy Eating = Reduced Blood Pressure
Evidence suggests that a diet that emphasizes healthy eating habits significantly lowers blood pressure in people who have hypertension and even normal blood pressure. This diet is often known as the DASH (Dietary Approaches to Stop Hypertension) diet and is outlined as follows:
* Emphasis on fruits, vegetables, and low-fat dairy foods.
* Includes whole grains, poultry, fish, and nuts.
* Contains small amounts of red meats, sweets, and sugar containing beverages.
This study aimed further to define the effect of salt on blood pressure and to investigate the effect of a combined low salt / DASH diet.
* Emphasis on fruits, vegetables, and low-fat dairy foods.
* Includes whole grains, poultry, fish, and nuts.
* Contains small amounts of red meats, sweets, and sugar containing beverages.
This study aimed further to define the effect of salt on blood pressure and to investigate the effect of a combined low salt / DASH diet.
Four hundred and twelve subjects were randomly assigned to eat a controlled diet, which was typical of a normal US diet, or the DASH diet. Within each dietary group, subjects ate foods with a high, intermediate and low level of salt for 30 days.
Reducing sodium intake from the high to the intermediate level reduced the mean systolic blood pressure among those on the control diet by 2.1 mm Hg and 1.3 mm Hg for those on the DASH diet. When salt was reduced to the lowest level, there was an additional reduction in systolic pressure among those receiving the control diet and for those on the DASH diet. The greatest reduction in systolic blood pressure occurred in subjects consuming the low-salt DASH diet, representing a 7.5 mm Hg decrease in non-hypertensive patients and 11.5 mm Hg decrease in those with hypertension.
Conclusion: the reduction of sodium intake to levels below the current recommendation of 100 mmol/d and the DASH diet both lower blood pressure substantially, with greater effects in combination. Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods.
Note: The duration of this study was very brief - only 30 days. Yet there were still significant decreases in systolic blood pressure. Even greater potential improvement in blood pressure may be possible if patients adhere to a diet that is low in sodium and combines principles of the DASH diet.
Reducing sodium intake from the high to the intermediate level reduced the mean systolic blood pressure among those on the control diet by 2.1 mm Hg and 1.3 mm Hg for those on the DASH diet. When salt was reduced to the lowest level, there was an additional reduction in systolic pressure among those receiving the control diet and for those on the DASH diet. The greatest reduction in systolic blood pressure occurred in subjects consuming the low-salt DASH diet, representing a 7.5 mm Hg decrease in non-hypertensive patients and 11.5 mm Hg decrease in those with hypertension.
Conclusion: the reduction of sodium intake to levels below the current recommendation of 100 mmol/d and the DASH diet both lower blood pressure substantially, with greater effects in combination. Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods.
Note: The duration of this study was very brief - only 30 days. Yet there were still significant decreases in systolic blood pressure. Even greater potential improvement in blood pressure may be possible if patients adhere to a diet that is low in sodium and combines principles of the DASH diet.
High-Sodium Diet and Congestive Heart Failure
In contrast to declines in mortality related to coronary heart disease and stroke, more Americans are dying from congestive heart failure (CHF); roughly 4.7 million in the U.S. experience CHF annually.
High sodium intake may increase the risk for left ventricular hypertrophy, based on previous studies.
Utilizing the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, the authors of this study compared CHF cases in 5,233 normal-weight and 5,129 overweight (BMI over 25) subjects. Up to 21 years after an initial 24-hour diet recall questionnaire, CHF cases were recorded and sorted based on sodium intake.
Results: Over an average of 19 years follow-up, overweight subjects in the highest sodium intake category (113.6 mmol/day or more) were 1.43 times more likely to suffer CHF than overweight individuals with the lowest intakes (50.2 mmol/day or less). Sodium intake was not linked to CHF in normal-weight subjects.
The authors note that a "moderately low" intake of sodium of less than 2,400 mg/day is recommended by several government health agencies, because high sodium intake can also increase hypertension and cardiovascular-disease risks. This study demonstrates a link between sodium and CHF in overweight patients.
Utilizing the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, the authors of this study compared CHF cases in 5,233 normal-weight and 5,129 overweight (BMI over 25) subjects. Up to 21 years after an initial 24-hour diet recall questionnaire, CHF cases were recorded and sorted based on sodium intake.
Results: Over an average of 19 years follow-up, overweight subjects in the highest sodium intake category (113.6 mmol/day or more) were 1.43 times more likely to suffer CHF than overweight individuals with the lowest intakes (50.2 mmol/day or less). Sodium intake was not linked to CHF in normal-weight subjects.
The authors note that a "moderately low" intake of sodium of less than 2,400 mg/day is recommended by several government health agencies, because high sodium intake can also increase hypertension and cardiovascular-disease risks. This study demonstrates a link between sodium and CHF in overweight patients.
Low Sodium=High Mortality?
Population-wide restrictions of dietary sodium have been recommended, yet little evidence has shown a direct link between sodium intake and mortality. An observational study on the relationship of sodium intake to all-cause and cardiovascular disease in the general population found an inverse association of salt intake and mortality.
After adjustment for age and sex, the mortality rate from any cause was highest among those who reported the lowest sodium intake and lowest among the group with the highest sodium intake. Results showed significant differences across the four quartiles of sodium intake in mean age; blood pressure; body-mass index (women only); use of table salt; and history of cardiovascular disease or hypertension. Sodium and calorie intakes were closely related.
These findings do not justify any particular dietary recommendation, but may be valuable in relating sodium intake to mortality rather than an intermediate variable (i.e., blood pressure). The relationship of low vs. high levels of sodium to survival may be significant, but must be considered within the dietary context.
These findings do not justify any particular dietary recommendation, but may be valuable in relating sodium intake to mortality rather than an intermediate variable (i.e., blood pressure). The relationship of low vs. high levels of sodium to survival may be significant, but must be considered within the dietary context.
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