Less salt on food could reduce heart disease risk

According to a new study published in the Journal of the American College of Cardiology, salting foods more sparingly is linked to a lower risk of heart disease, heart failure, and ischemic heart disease. Even among people who consume a diet similar to the DASH, behavioral treatments to cut back on salt consumption could enhance heart health.

A significant risk factor for cardiovascular disease, high blood pressure, is demonstrated to be correlated with high sodium intake. Due to a lack of useful techniques for determining long-term dietary sodium intake, epidemiological studies looking into this connection have produced contradictory results. According to recent research, a person's individual sodium intake over time may be predicted by how frequently they salt their food.

"Overall, we found that people who don't shake on a little additional salt to their foods very often had a much lower risk of heart disease events, regardless of lifestyle factors and pre-existing disease," said Lu Qi, MD, Ph.D., HCA Regents Distinguished Chair and professor at the School of Public Health and Tropical Medicine at Tulane University in New Orleans. "We also found that when patients combine a DASH diet with a low frequency of adding salt, they had the lowest heart disease risk. This is meaningful as reducing additional salt to food, not removing salt entirely, is an incredibly modifiable risk factor that we can hopefully encourage our patients to make without much sacrifice."

In the current investigation, 176,570 participants from the UK Biobank were examined to see whether the frequency of salting foods was associated with an increased risk of incident heart disease. The DASH diet and the frequency of salting foods were also investigated in relation to the risk of heart disease.

To gather information about how frequently people salt their food--excluding salt used in cooking--the study used a baseline questionnaire. Along with being asked if they had changed their diet significantly in the previous five years, participants also had to complete one to five rounds of 24-hour dietary recalls over a three-year period.

By minimizing the consumption of red and processed meats and emphasizing vegetables, fruit, whole grains, low-fat dairy, nuts, and legumes, the DASH-style diet was created to avoid hypertension. While a recent clinical investigation indicated that the DASH diet combined with sodium reduction was more advantageous for some cardiac biomarkers, including heart damage, strain, and inflammation, it has been shown that the DASH diet has benefits in connection to lowering cardiovascular disease risk. The seven foods and nutrients that were either highlighted or deemphasized in the DASH-style diet were used to create a modified DASH score that did not take sodium consumption into account.

Data on heart disease episodes were gathered through medical history, information on hospital admissions, a questionnaire, and information from the death register.

Overall, study participants who added less salt to their food were more likely to be women, white, have a lower body mass index, drink moderate amounts of alcohol, be less likely to smoke now, and be more physically active. In addition, they were more likely to have chronic kidney disease and high blood pressure, but less likely to develop cancer. Additionally, compared to those who added salt to their food more frequently, these participants were more likely to follow a DASH-style diet and consume more fruits, vegetables, nuts, and legumes, whole grains, and low-fat foods, but fewer sugar-sweetened beverages, or red/processed meats.

Researchers discovered that participants with lower socioeconomic status and current smokers had a greater correlation between salting food and the chance of developing heart disease. A lower risk of heart disease events was correlated with a higher modified DASH diet score.

Sara Ghoneim, MD, a gastroenterology fellow at the University of Nebraska Medical Center, stated in a related editorial comment that the study is encouraging, builds on prior findings, and makes reference to the potential effect of long-term salt preferences on overall cardiovascular risk.

"A major limitation of the study is the self-reported frequency of adding salt to foods and the enrollment of participants only from the UK, limiting generalizability to other populations with different eating behaviors," Ghoneim said. "The findings of the present study are encouraging and are poised to expand our understanding of salt-related behavioral interventions on cardiovascular health."