Do You Really Have to Cut Back on Salt?

A new report calls the current sodium guidelines into question

Beth Fontenot, MS, RD, LDN
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It was widely accepted in 2005 when the IOM report came out that when people ate less salt, they had a slight drop in blood pressure. But more rigorous studies since then showed that sodium consumption produced a number of negative effects in people who had mid-to-late stage heart failure and that there was little evidence that low sodium intake helped the subgroups of the population who are encouraged to keep their intake down to the 1,500 mg/day level.

The new IOM report concludes that, “Studies on health outcomes are inconsistent in quality and insufficient in quantity to conclude that lowering sodium intake levels below 2,300 mg/day either increases or decreases the risk of heart disease, stroke, or all-cause mortality in the general US population. ” In fact, some recent studies suggest that sodium intake might affect the risk of heart disease via pathways other than high blood pressure.

“These studies make clear that looking at sodium's effects on blood pressure is not enough to determine dietary sodium's ultimate impact on health. Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways,” Dr. Brian Strom, chairman of the IOM committee, said in a statement.

Americans should still limit their sodium intake to 2,300 mg/day, as there is good evidence that this level decreases the risk of heart disease. The new report does not recommend a “healthy” range; more research is needed to determine an association between low sodium intakes (1,500 and 2,300 mg/day) and health outcomes.

Not a License to Salt

The new recommendations are not a signal that it's OK to stock up on chips. The American Heart Association disagrees with the conclusion of the IOM report and stands by its 1,500 mg/day recommendation, and the Center for Science in the Public Interest, a nonprofit organization, said they hope this report will not stop the government, food industry, health professionals, and consumers from pushing for lower sodium levels.

Another committee will take on the task of revising the Dietary Guidelines for Americans. New recommendations will be released in 2015. Perhaps by then we will better understand the biology behind the contradictory findings.

Regardless of what numbers ultimately evolve, the majority of Americans consume significantly more sodium than the 2,300 mg/day recommendation. While it is useful to continue to question and revise nutritional recommendations in light of new research, for most of us, using less salt on our food and paying attention to the sodium content of processed foods, eating out less often, and eating more fresh fruits and vegetables, meat, poultry, and fish, beans and peas, unsalted nuts, eggs, and low-fat or fat-free dairy is likely to be more important than setting a number that the average consumer probably won’t understand or pay attention to anyway.

Reviewed by Albert Einstein College of Medicine. This story originally appeared on

Photo courtesy of Deyan Georgiev/

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