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Cappuccio FP, Campbell NRC, He FJ, Jacobson MF, MacGregor GA, Antman E, Appel LJ, Arcand J, Blanco-Metzler A, Cook NR, Guichon JR, L'Abbè MR, Lackland DT, Lang T, McLean RM, Miglinas M, Mitchell I, Sacks FM, Sever PS, Stampfer M, Strazzullo P, Sunman W, Webster J, Whelton PK, Willett W. Sodium and Health: Old Myths and a Controversy Based on Denial. Curr Nutr Rep 2022; 11:172-184. [PMID: 35165869 PMCID: PMC9174123 DOI: 10.1007/s13668-021-00383-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The scientific consensus on which global health organizations base public health policies is that high sodium intake increases blood pressure (BP) in a linear fashion contributing to cardiovascular disease (CVD). A moderate reduction in sodium intake to 2000 mg per day helps ensure that BP remains at a healthy level to reduce the burden of CVD. RECENT FINDINGS Yet, since as long ago as 1988, and more recently in eight articles published in the European Heart Journal in 2020 and 2021, some researchers have propagated a myth that reducing sodium does not consistently reduce CVD but rather that lower sodium might increase the risk of CVD. These claims are not well-founded and support some food and beverage industry's vested interests in the use of excessive amounts of salt to preserve food, enhance taste, and increase thirst. Nevertheless, some researchers, often with funding from the food industry, continue to publish such claims without addressing the numerous objections. This article analyzes the eight articles as a case study, summarizes misleading claims, their objections, and it offers possible reasons for such claims. Our study calls upon journal editors to ensure that unfounded claims about sodium intake be rigorously challenged by independent reviewers before publication; to avoid editorial writers who have been co-authors with the subject paper's authors; to require statements of conflict of interest; and to ensure that their pages are used only by those who seek to advance knowledge by engaging in the scientific method and its collegial pursuit. The public interest in the prevention and treatment of disease requires no less.
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Affiliation(s)
- Francesco P Cappuccio
- University of Warwick, W.H.O. Collaborating Centre for Nutrition†, Warwick Medical School, Gibbett Hill Road, CV4 7AL, Coventry, UK.
| | | | - Feng J He
- Wolfson Institute of Population Health, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Michael F Jacobson
- Author, 'Salt Wars, The Battle Over the Biggest Killer in the American Diet', Washington, DC, USA
| | - Graham A MacGregor
- Wolfson Institute of Population Health, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Elliott Antman
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | | | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Adriana Blanco-Metzler
- Costa Rican Institute of Research and Teaching in Nutrition and Health, San José, Costa Rica
| | - Nancy R Cook
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | | | - Mary R L'Abbè
- Temerty Faculty of Medicine, University of Toronto, W.H.O. Collaborating Centre On Nutrition Policy for Chronic Disease Prevention, Toronto, Canada
| | | | - Tim Lang
- Centre for Food Policy, City, University of London, London, UK
| | - Rachael M McLean
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Marius Miglinas
- Santaros Klinikos Hospital, Vilnius University, Vilnius, Lithuania
| | | | - Frank M Sacks
- Harvard T.H. Chan School of Public Health, Boston, USA
| | | | - Meir Stampfer
- Harvard T.H. Chan School of Public Health, Boston, USA
| | | | - Wayne Sunman
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jacqui Webster
- The George Institute for Global Health, W.H.O. Collaborating Centre On Salt Reduction†, Sydney, Australia
| | - Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
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O'Donnell M, Mente A, Yusuf S. Low sodium intake and cardiovascular health: an unanswered question. Response to: Letter from Dr N. Campbell, 'Dissidents and dietary sodium. Concerns about the commentary by O'Donnell et al.'. Int J Epidemiol 2018; 46:367-369. [PMID: 28039380 DOI: 10.1093/ije/dyw297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Martin O'Donnell
- HRB-Clinical Research Facility, NUI Galway, Galway, Ireland.,Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Andrew Mente
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
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