Too Little Sodium Just As Bad As Too Much, Study Says

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After years of being told to watch our salt intake, now a study says that less may not be better.

Researchers examined 25 studies and concluded that eating 2,645 to 4,945 milligrams (mg) of sodium daily (the amount most Americans consume) was associated with about the same risk of death as those eating less than 2,645mg.

This is way higher than current dietary guidelines for Americans, which recommend that adults consume no more than 2,300mg of sodium a day (and no more than 1,500mg daily if you are 51 years of age or older, are African American, or have high blood pressure, diabetes, or chronic kidney disease). These recommendations were based on the hypothesis that lowering sodium intake would reduce blood pressure and decrease risk for heart disease.

Niels Graudal, M.D., the study's lead author, says their findings are an extension from the 2013 Institute of Medicine’s (IOM) report, which cast doubt on the current CDC recommendations. In 2004 the IOM defined a tolerable upper sodium intake level (UL) of 2,300mg a day and an adequate intake level (AI) of 1,200 to 1,500mg daily.  However, based on the IOM’s own definition of AI—“the approximate intake found in apparently healthy populations”—Graudal concluded that the values should have been closer to where the majority of Americans presently fall, between 2,700mg and 4,900mg daily. Furthermore the authors noted that the IOM stated that the evidence for an UL for sodium is presently insufficient.  

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Confusing as this all is, considering that many individuals aren’t following current recommendations, to encourage a greater intake wouldn’t be the best message. And since I have a private practice and work with a lot of women, I can’t help but think about excess sodium and bloating. I certainly couldn’t imagine telling my patients to pump up their sodium intake, especially around their menstrual cycle.

Instead, I will still suggest consuming a diet mostly from whole foods instead of overly processed ones. And when you buy packaged, read the label closely and choose those products with the least amount of ingredients. This way you avoid excess sodium and other less-healthy ingredients.

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