Our bodies require small amounts of salt to function, however most people consume much more than that. Health professionals within the cardiovascular field have tried to tackle this problem for more than decades but contradicting research studies have muddied the waters as to what are safe levels of salt intake. And also are there any material difference to be made for the healthy individual versus the individual at risk of heart failure?. The debate seems to be ongoing especially when it comes to determining the role of salt intake in relation to heart failure. Recently, Harvard Health Publishing debated the matter followed by opposing debates from colleagues at Queen Mary University in London. It seems as there is somewhat of a consensus associating salt with worsening of water retention complications and increased blood pressure, both risk-factors of cardiovascular complications that can lead to Heart Failure. Also, over the past decades cardiologists have recommended salt restricting diets to patients and as good practitioners of evidence based medicine we should only recommends restrictions when needed. For sure, a restricted salt intake will not worsen the disease progressions, but is it beneficial for individuals who are at risk of heart failure to be on salt-restricted diets?. Reviewing the scientific literature I find contradicting studies, and it is therefore hard to say that there is enough evidence to state generalized salt restrictions relating to diagnosed heart failure. Whether it is beneficial for individuals at risk of heart failure is another open question. This leads me to question whether it is better to be safe than sorry, or to which extend it is worth taking the patient’s life quality into consideration. What do you think? The Dietary Guidelines recommend a restricted salt-intake of about 2,000 mg of salt per day, which is also what most physicians recommend. An amount that is almost impossible to stick to. It is very hard to stick to less than 1 tea-spoon of salt a day and I am guessing that only very few patients can abide by this restriction, because sodium is in almost everything we consume- this can therefore have a direct effect on the life quality of patients who are already struggling through their medical condition.
A teaspoon of salt contains about a bit more than 2,000mg sodium. In cured meats, as for example a salami or pepperoni there are about 0,500mg of sodium in one ounce, which is about 3 slices. I find it a little though provoking that The World Health Organization recommend a daily sodium intake of less than 5g ̴ 2,000mg when healthy americans consume twice as much on average.
A recent review published in JAMA Internal Medicine describes that only limited and inconsistent evidence support the benefits of a salt-restricted diet. Likewise, the ongoing debate is based on how comprehensive and how beneficial salt-restricted diet is. Do we have enough clinical evidence based data available on current sodium restriction in general? in heart failure? Just think if some patients could be more sensitive to salt intake than others and whether a one-sizefits-all approach is the road forward? Either way, excesses in intake over long time is also never good for anyone, – in the end it is all about making informed choices for health.
