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

Area of Science:

• Nutrition Science
• Cardiovascular Health
• Public Health

Background:

• Excessive salt intake is a primary dietary factor contributing to elevated blood pressure and hypertension.
• A significant portion of sodium consumption originates from "hidden salt" in processed and ultra-processed foods.
• This necessitates comprehensive strategies beyond simple salt shaker reduction.

Purpose of the Study:

• To summarize the scientific evidence on the impact of sodium/salt intake on blood pressure and cardiovascular risk.
• To highlight the role of "hidden salt" in processed foods and the limitations of single-focus interventions.
• To discuss associations with other health outcomes and current controversies regarding sodium intake.

Main Methods:

• Review of robust scientific evidence and observational studies on sodium intake and health outcomes.
• Analysis of the effectiveness of salt reduction strategies.
• Consideration of factors influencing sodium intake estimation and potential confounding variables.

Main Results:

• Strong evidence indicates that reducing sodium/salt intake lowers blood pressure, particularly in individuals with hypertension and salt-sensitive profiles.
• Associations with other health outcomes like gastric cancer and cognitive decline are reported but require cautious interpretation due to heterogeneous findings.
• Observational data suggest potential non-linear associations and a modifying role for potassium, complicated by sodium intake estimation challenges.

Conclusions:

• The most effective approach to managing salt intake involves integrated individual and population-level measures.
• Prioritizing reduction of "hidden salt" in processed foods is crucial.
• Promoting healthy dietary patterns, culinary strategies for palatability, improved label reading, and product reformulation are key components of effective interventions.