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The Lancet weighs in on JAMA’s salt study

A study published May 4 in the Journal of the American Medical Association made headlines for its surprising finding that excess sodium consumption might not raise risk of cardiovascular disease after all.

The British medical journal The Lancet is having none of that.

The JAMA study, in short, found that among 3,681 subjects, those who excreted the least sodium in their urine (the standard measure of sodium intake, as sodium consumed in a day is mostly excreted in that day’s urine) were more likely than those with the most sodium in their urine to experience adverse cardiovascular events. Meaning that, contrary to common wisdom, low sodium intake was associated with higher cardio risk.

Many took that to mean that the federal government’s ongoing campaign to get people to consume less sodium is misguided. Since the 1970s Americans have been urged to cut back on salt as a means of reducing incidence of cardiovascular disease (CVD) and related deaths. Cardiovascular disease is the leading cause of mortality in the U.S.

But critics of the study were quick to point out that its sample size was too small and the number of cardiovascular events it documented too tiny for it to serve as the basis for any big conclusions.

The Lancet editorial neatly summarizes that stance: “At a time when CVD is the world’s leading cause of death and excess dietary sodium has convincingly been shown to be a serious public health hazard, the results of this work should neither change thinking nor practice.”

The debate will no doubt continue. Does the back-and-forth about this issue influence your own decisions about how much salt to consume?

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