A low-sodium diet or a high-sodium diet, that is the question. A question that seems to have many people, including the experts, unsure of the answer. Three new reports published this week in the New England Journal of Medicine have left many heads spinning.
One study focusing on blood pressure found that people with a moderate sodium intake—3,000 to 6,000 milligrams (mg) per day—didn't benefit from reducing their consumption as much as people eating more than 6,000mg daily. Another study looked at death and heart disease and concluded that diets with less than 3,000mg sodium a day may pose a risk of death and heart problems. And lastly a third study supported the current recommendations that there's a direct link between less sodium and better cardiovascular health.
There are skeptics of the low-sodium intake and increase for health risks findings. Elliott Antman, M.D., president of the American Heart Association, told Reuters, "The gold standard is 24-hour urine collection, and they didn't use it.” They collected sodium once per day. And Dariush Mozaffarian, M.D., dean of the Friedman School of Nutrition Science and Policy at Tufts University, and chief author of the third study stated, “When you have a single study like the PURE study, that's one study in the context of many."
Another skeptic—me—wonders what the participants in the study were actually eating overall. Did their diet include plenty of fruits, vegetables, whole grains, and low-fat dairy? Or was it filled with too much sugar, fat, and sodium? Were they exercising? Did they have healthy sleep patterns? There could possibly be many more reasons for an increase in heart disease than simply the amount of sodium they were consuming.
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Believe it or not, our bodies actually need sodium. Sodium is necessary for muscle contractions, nerve transmissions, maintaining pH balance, and hydration. Now, be that as it may, I am not suggesting more is better. And all the studies concur that too much sodium is not advised. But I for one think we should stop focusing on single nutrients, because our bodies function on a variety of nutrients, both micro and macro.
I will continue to support the current guidelines from U.S. government agencies, the World Health Organization, and the American Heart Association that set daily dietary sodium targets between 1,500 (for those defined as at risk) and 2,300mg. However, I will also continue to tell my patients that they need to focus on the big picture and adapt an overall healthy lifestyle. The more wholesome they eat and the more active they are is really the best advice I can give.