Posted on 02/27/2023 10:57:22 AM PST by Red Badger
According to a new meta-analysis presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology, individuals suffering from heart failure may not receive any additional benefits from limiting their dietary sodium intake below the recommended maximum level of approximately 2.3 grams per day. In fact, the analysis of nine randomized controlled trials suggests that such restriction may even raise the risk of death.
Cutting sodium below current recommendations could be counterproductive, research finds.
For people with heart failure, restricting dietary sodium intake to levels below the standard recommended maximum of about 2.3 grams per day does not bring additional benefits and may increase the risk of death, according to findings from nine randomized controlled trials in a new meta-analysis presented at the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology.
“Limiting sodium is still the way to go to help manage heart failure, but the amount of restriction has been up for debate. This study shows that the focus should be on establishing a safe level of sodium consumption instead of overly restricting sodium.” — Anirudh Palicherla, MD
Heart failure, in which the heart muscle becomes too weak or stiff to pump blood effectively, is a chronic condition affecting over 6 million adults in the U.S. Physicians recommend a low-sodium diet to reduce blood pressure and avoid common symptoms such as fluid buildup and swelling. However, previous studies have reported mixed results regarding the optimal maximum daily sodium intake for people with heart failure.
“Our findings showed that restricting dietary sodium to less than the usual recommendation was counterproductive in the management of heart failure,” said Anirudh Palicherla, MD, an internal medicine resident at Creighton University School of Medicine in Omaha, Nebraska, and the study’s lead author. “This was in line with a recent randomized controlled trial suggesting that restricting sodium more than what we do now doesn’t necessarily lead to better outcomes.”
The U.S. Dietary Guidelines for Americans recommends that most adults limit dietary sodium intake to 2.3 grams per day or less, equivalent to about one teaspoon of table salt. The average American consumes over 3.4 grams of sodium per day.
In the study, researchers analyzed nine randomized controlled trials that assessed different levels of sodium restriction for people with heart failure and included data on rates of death and hospitalization. Most of the studies were conducted between 2008-2022, except for one earlier study published in 1991. Together the trials enrolled nearly 3,500 heart failure patients in total.
Analyzing outcomes across all studies, researchers found that patients following a diet with a sodium intake target below 2.5 grams per day were 80% more likely to die than those following a diet with a target of 2.5 grams per day or more. The sodium limits varied from about 1.2-1.8 grams per day in the more restrictive study arms. The analysis did not show a trend toward increased hospitalizations among patients following more restrictive diets.
“Limiting sodium is still the way to go to help manage heart failure, but the amount of restriction has been up for debate,” Palicherla said. “This study shows that the focus should be on establishing a safe level of sodium consumption instead of overly restricting sodium.”
The researchers said that there was significant variability in the study designs used in the clinical trials, including different participant baseline characteristics, different health care settings and different methods for tracking sodium intake and health outcomes. Some studies required participants to restrict their fluid intake in addition to their sodium intake, while other studies did not. However, Palicherla said that the number of studies and total number of participants gives the researchers a high level of confidence in the overall findings.
Future studies could help clarify the optimal targets for dietary sodium or identify subgroups of heart failure patients who might benefit from more or less restriction, researchers said. To limit sodium intake, experts recommend eating more fresh fruits and vegetables and cooking with basic ingredients rather than processed, boxed and canned foods and sauces that often contain high amounts of sodium. When eating out or buying prepared foods, ask for nutrition information or read the food labels and choose items with the lowest amounts of sodium.
Palicherla will present the study, “Sodium Restriction in Heart Failure: A Meta-Analysis of Randomized Trials,” on Sunday, March 5, at 11:15 a.m. CT / 17:15 UTC in Heart Failure and Cardiomyopathies Moderated Poster Theater 11, Hall F.
Unless you’re eating straight raw vegetables you’re probably getting a sufficient amount of sodium. Especially if you’re eating chicken that’s been injected, processed meats, cheese, olives, pickles, chips, there’s no need to hit the salt shaker thinking that you’re not getting enough. If you look up the allowable amounts for a healthy diet it’s basically a teaspoon worth.
“Americans eat on average about 3,400 mg of sodium per day. However, the Dietary Guidelines for Americans recommends adults limit sodium intake to less than 2,300 mg per day—that’s equal to about 1 teaspoon of table salt!”
And if you’re not buying on salted beans or whatever or you’re not reading the labels you’re probably way over anyway. It’s interesting to track it for a while because a lot of the food we eat from spaghetti sauce to spam and beyond it’s a helluva lot.
Put simply, sodium is a metal that the body needs in order to drive it’s electrical processes.
Basically agree, but there are a fair number of vegans and quasi-vegans (aka idiots, IMO) who are eating pretty much nothing but fruits and vegetables. It’s unclear to me how they’re getting enough protein let alone sodium.
I sometimes mix salt with a small amount of water, drink it, and after that, drink a glass of water.
Potatoes, beans, have a lot of protein. There are other vegetables that have a lot of protein.
The world: “Salt is bad.”
Jesus: “Salt is good” (Mark 9:50).
I’ll go with Jesus.
Terrific article. I was diagnosed with congestive heart failure a few weeks ago and am limiting salt. Not that I use much anyway, but I have been buying yucky salt-free chips. Expensive. So I’ll just eat a few salted chips, enjoy them with nightly pre-dinner Kombucha, and forget to feel guilty.
A lot of those vegans are pretty informed, they’re taking supplements and they’re also eating things like rice and peas which has an amino acid affect but it’s not as concentrated or as effective as say, an egg.
What’s wrong with me it’s time to make my baked potato salad then maybe I’ll put some hard boiled egg in there too. I think I could get by on cheese and eggs pretty easily but I do like chicken and I do like a piece of beef however my beef consumption unless it’s a full-on celebratory meal is pretty much directed towards flavoring the dish with strips of meat like Asian food. That’s plenty
I don’t need to eat a 16 oz to steak, a portion would be about the size of a pack of cigarettes a day. And at my age and my level of activity most days, portions are probably a good idea for me.
There is a study about the relationship between sodium consumption and how long people live. If I recall correctly, the people who live longest are those who consume a lot more than the recommended amount of sodium.
Someone said that the component of salt that increases blood pressure is chlorine. If so, people could drink water with sodium.
Thanks. I always have to adjust recommendations because I am small, weigh 116, don’t need as much as some big fat guy. Same with water consumption. Drink half as much as recommended. And a little less now, because with congestive heart failure, water is not so great. Trying to work out what really works for me.
If you’re worried about heart disease look into excess iron.
Women who can have children don’t have excess iron.
Woman who can’t have children and consume chocolate or meat consume more iron than they need. If the body has more iron than it needs, the body puts it in the heart, liver, and pancreas.
I donate blood every two years.
If a person’s blood ferritin is less than 70 ng/ml, the person has an iron deficiency.
Many people have excess retinol. I don’t take multivitamins and wouldn’t take one that has retinol even with more reasons.
Ask your dentist about their health. I was shocked at what the dentist said, but it’s what we already knew. Bioavailability.
Himalayan salt? Or iodized?
Excellent info, thanks. I don’t take iron and eat beef once a week, if that, a 1/4 pound burger I make myself from great pasture-raised beef. I don’t like chocolate.
Also don’t take multivitamins. A lot of supplements though, not including A.
02/26/2023 3:02:19 PM PST · by ConservativeMind · 19 replies
Medical Xpress / American College of Cardiology's Annual Scientific Session ^ | Feb. 23, 2023 | Anirudh Palicherla, MD et al
https://freerepublic.com/focus/f-chat/4134122/posts
If you have a question about if you are or are not getting enough sodium then get a blood test.
Most Americans get a blood test or two a year. I was referring to in between the blood test if you’re really concerned about it.
Himalayan salt is pink because it has iron oxide in it. Iodized salt was invented because the medical community wanted to thwart the growing problem of goiters in Americans.
I’m torn, but I do understand the need for iodine for the thyroid. I don’t need to add any more rust by way of salt I usually get plain salt, or sometimes sea salt or kosher salt whatever that is, but I’m pretty sure it’s mined.
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