Shaping sodium guidelines

A convergence of scientific advances and policy recommendations has set the stage for renewed, aggressive, and hopefully effective efforts to reduce dietary sodium intake in the general population. A large and compelling body of evidence has documented that a reduced sodium intake lowers blood pressure. Supporting evidence includes results from animal studies, epidemiologic studies, migration studies, randomized trials (including dose-response studies), and meta-analyses of clinical trials. In the United States, advice to reduce sodium intake has been in place for decades, despite highly aggressive and persistent attempts by commercial interests to roll back recommendations. The 2005 US Dietary Guidelines recommended an upper limit of sodium intake of 100 mmol (2300 mg)/day in the general population and 65 mmol (1500 mg)/day in persons who are especially sensitive to the adverse effects of sodium (blacks, middle- and older-aged individuals, and persons with hypertension, diabetes or chronic kidney disease). Because those groups comprise ~70% of US adults, the American Heart Association and the 2010 US Dietary Guidelines Scientific Advisory Committee lowered the recommended intake to 65 mmol(1500 mg)/day. The benefits of population-wide sodium reduction are substantial. Furthermore, in contrast to other preventative strategies, economic analyses suggest cost-savings. In this setting, efforts to promote population-wide reduction in sodium intake are warranted and should be a high national priority.