Lately the media has been reporting a lot on a recent Cochrane Review and suggesting that perhaps salt reduction isn’t all it’s cracked up to be – that it may not offer any cardiovascular benefit. Since diet advice on salt restriction is the cornerstone of many guidelines for the management of hypertension, these reports made dietitians across Canada sit up and take a closer look at the study. What if we can suddenly change all of our advice?
Well, the Cochrane Review doesn’t actually show that reducing salt has no benefit, it demonstrates that current dietary interventions are not effective in significantly reducing salt intake (and it reinforces the notion that the media sometimes misses the point when reporting on studies). Here is what the authors actually say:
Our findings are consistent with the belief that salt reduction is beneficial in normotensive and hypertensive people. However, the methods of achieving salt reduction in the trials included in our review, and other systematic reviews, were relatively modest in their impact on sodium excretion and on blood pressure levels, generally required considerable efforts to implement and would not be expected to have major impacts on the burden of CVD.
This is not a big surprise to those of us teaching about sodium reduction. We know that reducing sodium is tough because it is in our food supply – the majority of Canadians’ sodium intake comes from processed foods. And, to top it off, Campbell’s Soup Company recently made headlines announcing that they are putting salt back in their soups in their US market (not Canada thankfully)!
So where does that leave us? Well, I think it actually makes us need to sit up and look closely at how we give diet advice. And it reinforces the notion that just telling people to eat less salt is not enough – we need to reduce the sodium in our food supply to have long term change in dietary intake.
I certainly think we can continue to focus on eating fresh, unprocessed foods more often!