Abstract
Among the various strategies to reduce the incidence of non-communicable diseases reduction of sodium intake in the general population has been recognized as one of the most cost-effective means because of its potential impact on the development of hypertension and cardiovascular diseases. Yet, this strategic health recommendation of the WHO and many other international organizations is far from being universally accepted. Indeed, there are still several unresolved scientific and epidemiological questions that maintain an ongoing debate. Thus what is the adequate low level of sodium intake to recommend to the general population and whether national strategies should be oriented to the overall population or only to higher risk fractions of the population such as salt-sensitive patients are still discussed. In this paper, we shall review the recent results of the literature regarding salt, blood pressure and cardiovascular risk and we present the recommendations recently proposed by a group of experts of Switzerland. The propositions of the participating medical societies are to encourage national health authorities to continue their discussion with the food industry in order to reduce the sodium intake of food products with a target of mean salt intake of 5–6 grams per day in the population. Moreover, all initiatives to increase the information on the effect of salt on health and on the salt content of food are supported.
Highlights
The role of sodium in human physiology has been recognized more than two thousand years ago, but the importance of maintaining an equilibrated sodium balance in order to maintain body volumes and blood pressure (BP) has been demonstrated essentially by the pivotal publications of Claude Bernard in the 1850’s on the regulation of the ≪ milieu intérieur ≫ and the fantastic work of the physiologist Arthur Guyton and his studies on BP regulation and the kidney (Guyton et al, 1980)
Today it is well-accepted that an excessive salt intake is deleterious for health mainly because a high salt intake favors the development of essential hypertension and its cardiovascular and renal complications (Whelton et al, 2012; He et al, 2013; Kotchen et al, 2013; Mozaffarian et al, 2014)
Despite the accumulation of experimental, epidemiologic and clinical data confirming a causal association between salt intake and the risk of developing hypertension and cardiovascular complications with recent data obtained in very large sets of population (Mente et al, 2014; Mozaffarian et al, 2014) the issue of salt intake in the population remains a matter of an intensive scientific and political debate which is going on for several decades (He et al, 2013; Kotchen et al, 2013; Mente et al, 2014)
Summary
The role of sodium in human physiology has been recognized more than two thousand years ago, but the importance of maintaining an equilibrated sodium balance in order to maintain body volumes and blood pressure (BP) has been demonstrated essentially by the pivotal publications of Claude Bernard in the 1850’s on the regulation of the ≪ milieu intérieur ≫ and the fantastic work of the physiologist Arthur Guyton and his studies on BP regulation and the kidney (Guyton et al, 1980). Today it is well-accepted that an excessive salt intake is deleterious for health mainly because a high salt intake favors the development of essential hypertension and its cardiovascular and renal complications (Whelton et al, 2012; He et al, 2013; Kotchen et al, 2013; Mozaffarian et al, 2014)
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