[Dietary sodium intake: evidence, controversies and practical recommendations]

Excess salt intake is one of the relevant dietary determinants of elevated blood pressure and hypertension, with a direct impact on cardiovascular risk. In today's food environment, a substantial proportion of sodium comes from "hidden salt" added to processed and ultra-processed foods, which limits the effectiveness of interventions focused exclusively on the salt shaker and reinforces the need for combined strategies. The most robust scientific evidence shows that reducing sodium/salt lowers blood pressure, with a greater effect in people with hypertension and in salt-sensitive profiles. Although associations have been reported with other outcomes, such as gastric cancer, kidney stones and bone mineral balance, or cognitive decline, study findings are more heterogeneous and require cautious interpretation. Part of the current controversy arises from observational results suggesting non-linear associations and a potential modifying role of potassium, together with limitations in estimating sodium intake. Overall, the most effective approach integrates individual and population-level measures: promoting overall healthy dietary patterns, prioritizing reductions in hidden salt, using culinary strategies to preserve palatability, improving label reading, and supporting product reformulation and monitoring.