There is “no strong evidence” to conclude that cutting down the amount of salt consumed every day reduces the likelihood of normal people or those with hypertension dying or experiencing cardiovascular diseases (CVD). This is the finding of a Cochrane Review published recently in the American Journal of Hypertension (AJH). The study was based on a meta-analysis of seven randomised controlled trials involving 6,250 participants who were followed up for at least six months. The meta-analysis covered people with normal blood pressure, hypertension, and those with heart failure. The finding, which comes in a line of dubious studies published in reputed medical journals, flies in the face of an overwhelming body of evidence showing a clear link between reduced salt intake and health benefits. Unsurprisingly, the results attracted wide publicity in the electronic and print media. But a comment published in The Lancet (“Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials,” by Feng J He and Graham A MacGregor) exposes the limitations of the Cochrane Review study and tries to undo the damage. It shows that the paper by Rod Taylor of the University of Exeter and others in the AJH is scientifically flawed on major counts. The data of normal and hypertensive patients that enabled Taylor to arrive at the conclusion were not statistically powered; in fact, a re-analysis of the combined data by He and MacGregor revealed that there was a significant 20 per cent reduction in cardiovascular events when the daily salt intake was reduced by 2.0-2.3 grams. Another major flaw was the inclusion of the trial involving heart failure patients without undertaking the necessary adjustments.
It is well known that increased salt intake poses a major challenge to the kidneys' ability to flush out the sodium. Greater salt intake leads to increased water retention in the body, which is one of the major factors in the development of hypertension. The evidence of a salt-BP link comes from a variety of sources — animal studies, human genetic, epidemiological, migration, population-based intervention, and treatment studies. According to a 2008 paper in the Journal of Human Hypertension, elevated blood pressure alone is responsible for 62 per cent of strokes and 49 per cent of coronary heart disease worldwide. Denial in the face of all this evidence is dangerous. All efforts should be aimed at following the World Health Organisation's recommendation that people should cut down the daily salt intake to 5 grams, eat more fruits and vegetables, and exercise regularly.
Keywords: heart disease, hypertension, salt and heart disease
I don't think that there should be no doubt that taking more salt is harmful to the health. There are lots of scientific evidence for that. But at the sametime individual has the right to make their own choice to eat or not to eat more salt. Eventhough it is well known that belief in God and superstitious things are more harmful than doing any good the individual has the right ro worship god. In any society well informed adult has the right to indulge in any activities until it interfers with the freedom of the other individual.
These studies pro and con were all done in foreign countries in the
West where for multiple centuries the human metabolism is not used to
large quantities of salt. Such is not the case in India where salt
intake has been relatively high. Salt is essential as a preservative.
Sambar or Dhall made at 8 AM will spoil by 8 PM but for salt (forget
refrigeration for now). We have been on a high salt diet since time
immemorial. Differently, the Inuit people in the arctic area live
their entire lives without eating single vegetable or fruit (forget
modern food drops by air). Their metabolisms have developed ways to
adjust. Therefore the alarmist warnings about the cutting down salt
should be - pardon me - taken with a pinch of well, salt.
Research by definition is an effort to upgrade the present level of knowledge to the next higher level.Given the fact that the papers published in high impact journals undergo rigorous and blind peer review, the only way out to counter any theory is to publish with scientific evidence another research paper.There will be always murmur against stock beliefs.
But reduced salt intake should be resorted to on the Doctor's advice. Just a few months' agao my sodium level was found to be low by my Neurologist. As I am a Trigeminal Neurolgia patient (age 74 years), the Doctor advised to increase the salt intake in my diet and take a test after 15 days. Luckily sodium level(salt) came to 'normal', again by a test and I was asked to go slow on salt. So, it is better to leave it to Doctor.
Its a great job to talk on the topics which affects health of the millions.And Hindu editorials always touch touch such type of topics. I agree with the views expressed by Hindu. We know from such a young age that intake of more salt causes hypertension and our grandparents and parents always insist us to avoid salty things. The faulty research studies who merely want to publish their paper must be looked over-cautiously. People are now fond of conducting different studies without considerable sample size and uniform sample and neglect various confounding factors. Publishers when publishing papers must exhaustively examine the studies before publishing it. Because the results published can affect the life of common public. By pointing out the flaws in the paper,, Hindu has done a great job.
Why salt is bad. The amount of salt you eat has a direct effect on your blood pressure. Salt makes your body hold on to water. If you eat too much salt, the extra water stored in your body raises your blood pressure. So, the more salt you eat, the higher your blood pressure. The higher your blood pressure, the greater the strain on your heart, arteries, kidneys and brain. This can lead to heart attacks, strokes, dementia and kidney disease. Also, eating too much salt may mean that blood pressure medicines (such as diuretics) don't work as well as they could. It is a common sense that people having BP, heart trouble are advised to reduce salt in -take based on elaborate research on the ill effects of salt.Even normal persons are advised moderation in salt in-take and also spicy and oily foods.I agree fully with the views expressed in the editorial which very few dare to write!
I really appreciate The Hindu for such a good editorial. The breadth of the topics that are provided in the editorial columns is astounding. It has a done a good job one more time by highlighting the blatant faults in the studies published in a major journal. Reducing salt intake by low consumption of of pickles, salted foods helps our body to function better.
Very nice and sharp edit. Congrats once more. I agree with the previous reader (Mr Kutty) in that the Hindu is different from other newspapers. May I request this newspaper to similarly raise awareness about wearing helmets (by two wheeler riders) and helmets (in cars)? This will drastically reduce the unnecessary deaths and disability in the country. Please, do something about this also.
The article makes an interesting reading as it is concerned with our health and well being. Though any curry without salt is tasteless, but excessive amounts of salt intake would prove to be dangerous as the connection between our blood pressure and salt intake has been well established by many studies. As the Indian food among others mainly consist of pickles, papad, dry fish, etc. a high quantity of salt is used as preservative to store these food items for a long time. As pointed out in the editorial, an elevated blood pressure alone is responsible for 62 per cent of strokes and 49 per cent of coronary heart disease worldwide, it is indeed alarming and a wake up call. The Govt and NGOs should take this issue seriously and launch campains to bring about greater awareness on the ill effects of excessive intake of salt and also to stick to the WHO's recommendations to maintain good health. Hindu also published a similar article sometime back. Thanks a lot to The Hindu.
It is inherent in human nature to show more inclination towards options that are easier to take. Salt has been a preferred ingredient of cuisines, world over, for ages. Any proof, it is natural, suggesting that one should cut down on it will face resistance. Similarly any proof suggesting otherwise will be met with open arms. As the editorial has correctly pointed out, there is a definite link
between salt intake, over a period of time, and hypertension, via water
retention in blood vessels. The fact which cannot be ignored.
I fully agree with the opinion expressed in the editorial.A discussion with lots of nephrologists has underscored the importance of reducing salt intake (especially in the form of pickles, papads,tin foods, dry fish etc)for reducing kidney problems and arresting elevated blood pressure. I salute The Hindu for writing editorials on such important topics. This clearly shows how The Hindu is different from other dailies. KEEP IT UP.
The 'salt' debate underlines how the findings of research based on small or big samples are vulnerable to different interpretations. The debate also indicates that there is an overriding need to make far more serious efforts to find the truth. Medical research about radiation effects of mobile hand sets and mobile towers has also been a matter of controversy. Vested interests have always found ways to distort facts and confuse ordinary people. One hopes that at least medical research, which impacts our lives, is kept free from such distortions.
This type of misinformation by reputed journals and other media channels leads laymen to believe it is true. It is good that your paper has highlighted the dangers involved in such propaganda and the risk of not seeking proper medical advice. It is always safe to go by the medical opinion of the family doctors.
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