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The World Health Organization recommends an intake of less than 2.0g of sodium per day to reduce the risk for cardiovascular disease.  A value yet to be achieved by any country.  The American Heart Association recommends less than 1.5g/day.  A prospective epidemiological cohort study called PURE published in The Lancet, August 2018, finds that if you don’t have heart disease, moderate consumption of sodium may not be so bad.  The 21-country study from McMaster University looked at 95,700 people, from 255 communities around the world who did not have heart disease and tracked their sodium excretion for 8 years.  In 80% of the countries, half the people consumed an average of 3-5grams of sodium per day and no associated increase in cardiovascular risk .  Sodium intake was associated with cardiovascular disease and strokes only in communities where mean intake was greater than 5 g/day such as in China.    It is also notable that in communities where the sodium intake was very low there was an increase risk of cardiovascular events which indicates that consuming too little sodium, an essential nutrient, is also dangerous.

In addition, the researchers found that as potassium intake increased, the risk of cardiovascular events decreased.  Foods that are rich in potassium include fruits and vegetables such as potatoes, tomatoes, oranges, squash, nuts and seeds and dairy products.  Encouraging an increase in consumption of these healthy foods rather than focusing on the reduction of a single nutrient may be more important when it comes to heart health.  The researchers found that there is no reason for people with normal blood pressure to restrict salt intake. It is important to note that this is an observational study and that a clinical trial would be necessary to change current dietary guidelines.  The best defence against heart disease and hypertension is to maintain a healthy body weight, exercise regularly and eat a healthy diet.

For those individuals with hypertension a low sodium DASH diet is still recommended.  This diet is rich in fruits and vegetables, nuts and seeds, fish, whole grains and low-fat dairy.  Sodium consumption below 1.5g and above 5 g per day is associated with increased cardiovascular disease risk.