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Does salt intake in the first two years of life affect the development of cardiovascular disorders in adulthood?
P Strazzullo1, A Campanozzi, S Avallone
1Department of Clinical and Experimental Medicine, ESH Excellence Centre of Hypertension, Federico II University of Naples Medical School, Naples, Italy. strazzul@unina.it
Insights
Excessive salt intake affects infant blood pressure (BP) and cardiovascular health. Early life sodium consumption, starting from infancy, can influence later hypertension development.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Nutrition Science
Background:
- Excessive salt intake is linked to elevated blood pressure (BP) and atherosclerosis, increasing risks for stroke and cardiovascular diseases.
- The impact of dietary sodium begins in early life, with studies showing a direct association between infant sodium intake and BP within the first few months.
- Infants naturally avoid salt taste, developing a preference around age 2-3, which may correlate with future hypertension.
Purpose of the Study:
- To examine the early-life impact of sodium intake on blood pressure and cardiovascular health.
- To understand the developmental trajectory of salt preference in infants and its potential link to hypertension.
- To review current recommendations and intake levels for infant sodium consumption.
Main Methods:
- Analysis of two randomized controlled trials in newborn infants examining sodium intake and BP.
- Review of infant taste preferences and the influence of postnatal factors on salt aversion/preference.
- Comparison of national Reference Nutrient Intakes (RNI) and Adequate Intakes (AI) for sodium in infants and young children.
Main Results:
- A direct association between dietary sodium intake and BP was observed in infants from the first few months of life.
- Infant sodium requirements for growth are met through breast milk or low-sodium formula and complementary foods without added salt.
- While UK and US guidelines for sodium intake vary, average intake in US children approaches or exceeds recommendations after age 2.
Conclusions:
- Early-life dietary sodium exposure significantly influences blood pressure and cardiovascular health trajectory.
- Introducing complementary foods without added salt is crucial for healthy infant development and preventing future hypertension.
- Monitoring and adhering to age-appropriate sodium intake guidelines are essential for preventing long-term cardiovascular risks.
Abstract:
Excess salt intake impacts on blood pressure (BP) and the pathogenetic mechanisms of atherosclerosis predisposing to stroke and other cardiovascular disorders. The influence of salt starts early in life. Two randomized controlled trials in newborn infants suggest a direct association between dietary sodium intake and BP since the first few months of life. Newborn infants display aversion to the salt taste to develop a "preference" for salt only at age 2-3 years, in part in relation to post-natal events: this preference might be associated with later development of hypertension. The amount of sodium to be retained by an infant for proper physiological growth is largely covered by breast feeding (or low sodium formula milk) in the first six months, and later on by the gradual implementation of complementary feeding, without the need for any added salt upon food preparation. Given the lack of dose-dependence data, reference nutrient intakes (RNI) or adequate intakes (AI) for sodium have been established by national health institutions in various countries. The U.K. RNI was set at 242 mg a day for infants 0-6 months with gradual increase to 0.5 g up until age 3. The U.S. AI is somewhat lower for age 0-6 months but larger for age 1-3 years. According to a recent report, the average sodium intake in U.S. children is close to the AI up to age 2 years, to become progressively greater exceeding the Institute of Medicine recommendation later on.
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