Low Sodium
As
a writer of recipes and cookbooks, I am often chastised by readers for including salt in my ingredients lists. “It’s poison!” they say. “I never add salt to my food.” These people are abetted by many doctors, who advise their patients to reduce their sodium intake as a way to reduce their risk of cardiovascular disease and early death. But as Sloan puts it: “Those doctors are just wrong. They are saying what they are told to say.” The low- sodium gospel is based on two sets of evidence: One tells us that high sodium intake is associated with high blood pressure ( although the diff erence between the high- sodium consumers and the low- sodium consumers is surprisingly small, according to Sloan). The second maintains that high blood pressure is associated with cardiovascular disease and strokes, two of the leading causes of death in the western world. You would think, then, that it would be a simple thing to prove that lowering your sodium intake reduces your risks and extends life expectancy. You would be wrong. Large studies involving tens of thousands of people consistently fail to show any benefi t. Some, but not all, people’s blood pressure does go down when they cut out the salt, but that doesn’t seem to reduce the overall risk of catastrophic illness. In fact, a study involving 14,000 Americans found that the people who consumed the least sodium were 20- per- cent more likely to die of heart disease than people who ate the most sodium ( National Health and Nutrition Examination Survey, Lancet, 1998). Researchers writing in the British Medical Journal last year found that medications containing sodium increased blood pressure, but not heart failure. They noted the near- universal frustration of researchers in this area: “The association between sodium intake and heart failure is not as clearcut as one might assume.”