Sodium Intake in Populations: Assessment of Evidence by Brian L. Strom

Author:Brian L. Strom
Language: eng
Format: epub
ISBN: ISBN0309282985
Publisher: The National Academies Press

Outcome measure, confounders, and adjustments Outcomes measured were CVD mortality, all-cause mortality, coronary heart disease mortality, and cerebrovascular disease mortality. All analyses were adjusted for prior hypertension and systolic blood pressure, which may be in the causal pathway.

Direction and significance of effect For quartiles of sodium intake the lower sodium intake quartiles were not associated with CVD mortality (hazard ratio [HR]=1.31 [confidence interval (CI): 0.90, 1.89] p=0.14), 2 (HR=1.39 [CI: 0.91, 2.11] p=0.11), and 3 (HR=0.89 [CI: 0.64, 1.25] p=0.49). Similarly, no significant associations were found between sodium intake quartiles and all-cause or stroke mortality. However, when analyzed for intakes less than 2,300 mg per day compared to 2,300 mg per day or greater, lower sodium intake was statistically significantly associated with increased risk of all-cause mortality. Models of sodium density, expressed as a sodium-to-calorie ratio, showed a statistically significant inverse association with all-cause mortality (HR=0.89 [CI: 0.79, 1.00] p=0.05). In other words, lower sodium intake was associated with higher all-cause mortality. For dietary sodium intake measured as a continuous variable, a statistically significant inverse relationship was found between sodium intake and CVD mortality whether expressed as sodium per mg (HR=0.89 [CI: 0.80, 0.99] p=0.03) or as sodium per calorie (HR=0.80 [CI: 0.68, 0.94] p=0.008).

Interactions Although data were not shown, the authors reported that they found no evidence of interactions by age, race, or prevalence of diabetes or hypertension.

Cohen et al. (2008)

Population size and characteristics Cohen et al. (2008) analyzed data from participants in the NHANES III survey from the general U.S. population (n=8,699 participants 30 years of age and older). Individuals with self-reported preexisting disease, as well as those who reported being on a low-sodium diet for hypertension, were excluded.

Study design, purpose, and length This secondary analysis of NHANES data was carried out to assess the potential impact of dietary sodium on risk of CVD and all-cause mortality over a mean period of 8.7 years.

Sodium intake measure and method Energy-adjusted dietary sodium intake was estimated from one 24-hour dietary recall. Use of added salt was determined by the responses “does not add,” “adds some,” or “adds a lot.”

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