Salt intake and Cardiovascular Disease.

Reducing sodium intake has emerged as one element within a comprehensive strategy for cardiovascular (CV) prevention, based on the curvilinear relationship between sodium intake and blood pressure. The chief source of sodium in the diet is salt (sodium chloride), which is consumed from discretionary (e.g. salt on table or added during cooking) and non-discretionary sources (included within food manufacturing). Clinical trials report that a reduction in sodium intake of 1.76 g/day reduces blood pressure by 3.39/1.54 mmHg, which is more marked in those with hypertension ( 4.06/2.26 mmHg) than those without hypertension ( 1.38/0.58 mmHg). Reducing sodium intake, therefore represents an attractive approach to reducing CV disease (CVD), particularly in lowand middle-income countries, where lower-cost population-level interventions are required. Current guidelines recommend low sodium (salt) intake in adults. For example, the World Health Organization (WHO) recommends sodium intake of less than 2 g/day (5 g of salt) in the entire population. Current mean sodium intake in a global population is about 4 g/day, which will mean a dramatic reduction in sodium intake to achieve current targets. This has not been achieved in any population outside a few short term and small clinical trials. Targets in these guidelines are especially influenced by the small and short term phase II DASHSodium trial, which reported a reduction in blood pressure with reductions in sodium intake to less than 1.5 g/day, in a diet-controlled environment over a 30-day intervention period in a fewer than 100 people. The current proposal for low sodium intake in the entire population has been challenged, primarily based on three considerations.