Palm Harbor, FL - US researchers say even a small reduction in the amount of salt in the daily diet would have a huge public-health impact. Dr Kirsten Bibbins-Domingo (University of California, San Francisco) and colleagues calculate that cutting just 1 g of salt a day would prevent a quarter of a million new heart-disease cases and 200 000 deaths from any cause over a decade [1].
Bibbins-Domingo told heartwire that "everyone would benefit, but certain groups gain more." These include African Americans, women, and those under 65, she noted. Americans currently eat 9 to 12 g of salt per day, an amount far in excess of the 5 to 6 g per day that is recommended by most health organizations, she said. She reported the new findings in a poster at the AHA 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention last week.
She feels strongly that regulatory efforts will be key to tackling this problem, because 80% of the salt in the US—and other Western nations' diets—comes from processed and prepared foods. "We can't just keep telling patients to get rid of the salt shaker, because that has very little effect."
With these very small changes . . . we will not change the taste of foods or the profit margins of the food industry, but it would be a great benefit for public health. "We think our study lends support to the idea that this is an area that's really a prime target for public-health types of intervention, including regulatory efforts to restrict salt or force labeling of foods based on their salt content. We hope this would encourage efforts on the part of industry to reduce salt. The experience in other countries suggests that with these very small changes we are describing, we will not change the taste of foods or the profit margins of the food industry, but it would be a great benefit for public health."
A 3-g daily reduction in salt would give same benefits as eliminating smoking
Bibbins-Domingo et al used the Coronary Heart Disease Policy Model, a computer simulation of heart disease in the US adult population, and an extension that assesses stroke, to evaluate the impact of hypothetical policy changes on the health of the nation.
They estimated the impact of an immediate reduction of daily salt intake by 0 to 6 g on the incidence of cardiovascular disease and deaths between 2010 and 2019. In that period, the model suggests that more than 800 000 life-years could be saved for each gram of salt lowered.
"Others have estimated the population benefits of salt reduction; our findings are consistent with these studies and extend them in important ways," she and her colleagues note.
A 3-g daily reduction in the amount of salt consumed would provide morbidity and mortality benefits "on the same order of magnitude as if we could eliminate smoking in the population, and that's a really important point to make," she told heartwire. Such a reduction would result in 6% fewer cases of new heart disease, 8% fewer MIs, and 3% fewer deaths.
Even larger health benefits are projected for African Americans, she says, who are more likely to have high blood pressure and whose blood pressure may be more sensitive to salt: new heart-disease cases would be reduced by 10%, MIs by 13%, and deaths by 6%. Other groups who would gain include women, because of reductions in stroke—as high blood pressure is the major risk factor for stroke—and young people (under 65), who would benefit from a reduction in premature death, because often high blood pressure is the only risk factor in this group, she notes.
Bibbins-Domingo says consumer awareness is also important, so that individuals make more effort to reduce salt in their diets. Experiences in other countries suggest that the combination of government regulations, labeling requirements, voluntary efforts on the part of industry, and increasing consumer awareness of the dangers of consuming too much salt can, in concert, achieve worthwhile improvements. In the UK, for example, a combination of the above managed to achieve a 10% reduction in salt intake, she notes.
"We have to appreciate the scope of this problem and realize that efforts are needed on all these levels," she concludes.
- Bibbins-Domingo, Chertow G, Moran A et al. Population reductions in coronary heart disease associated with modest increases in salt intake: projections from the CHD policy model. AHA 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention; March 10-14, 2009; Palm Harbor, FL. Abstract P51.
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