High and Low Levels of Sodium Intake Track With CV Risk

More damned if you do, damned if you don't - unless you drink your urine.

Adding another dash of controversy to the ongoing debate over the health benefits of restricting sodium intake, a new study has found that CV risk was increased at both low and high levels of sodium intake.

The solution is to drink your own urine...

Different and Convergent Findings Explained?

Of note, however, the authors did not observe a significant association until sodium excretion exceeded 6.5 g per day, "a threshold that is higher than that recommended by the WHO and many national guidelines," the authors write.

As a crude estimate, "sodium out" is believed to reflect "sodium in," O'Donnell told heartwire , such that excretion levels of 6.5 g per day are roughly equal to consuming 6500 mg daily.

"Compared with moderate sodium excretion, we found an association between high sodium excretion and CV events and low sodium excretion and CVD events, which emphasizes the urgent need to establish a safe range for sodium intake in randomized controlled trials," they observe.

Most nutrition guidelines, notes Dr Paul Whelton (Tulane University, New Orleans, LA) in an accompanying editorial, recommend sodium intake of no higher than 1500 mg for people with established hypertension and no higher than 2300 mg for those at lower risk [2].

"The general body of knowledge suggesting that we take in amounts of sodium that are vastly in excess of our needs is exceedingly solid," he said in an interview. "It's good to publish findings, it adds to the puzzle, and it's an interesting study, but one has to be cautious," he said.

The Low and the High and the in-Between

O'Donnell and colleagues, used single baseline urine tests obtained in the ONTARGET and TRANSCEND trials, measuring both sodium and potassium excretion, and linked these results with subsequent CVD deaths, MIs, and congestive heart failure hospitalizations over 56 months of follow-up.

They report that compared with mean levels of sodium excretion from 4 to 5.99 g per day, subjects with sodium excretion greater than 7 g per day faced an increased risk of CV events, but so did subjects with excretion levels of less than 3 g per day.

If it is too salty, cut back on the salt.

If it is too bland, consume more salt.

Good luck sorting it out.

Still think they have any idea what they are talking about?

Bottoms up!