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Heart disease: Could your salt-shaking habits predict your risk?

A new study suggests that how frequently you sprinkle salt on your food can predict your cardiovascular (CVD) health.

The study found that the less often you add salt to your food, the lower your risk of cardiovascular disease in general, and especially heart failureTrusted Source and ischemic heart diseaseTrusted Source.

These findings align with previous research on the health impact of salt on cardiovascular health.

The current study was led by Dr. Qi Lu, director of Tulane University’s Obesity Research Center in New Orleans, Louisiana. The researchers analyzed data encompassing the salt-shaking habits and CVD outcomes for 176,570 participants in the UK Biobank database.

Individuals were ages 37 to 73 years when they began participating in the database from 2006 to 2010. The UK BioBank continues to collect data today.

The study also tracked CVD outcomes for people on a DASHTrusted Source diet who added less salt at the table.

People who infrequently added salt and also followed the SALT diet had the lowest risk of unwanted CVD outcomes compared to being on the DASH diet alone.

The study is published in the Journal Of The American College Of Cardiology.

What is new about this study?

The study is based on the idea that adding salt may provide a more accurate indicator of one’s salt intake than the method commonly employed for such research.

In other studies, researchers analyze individuals’ salt intake by estimating their 24-hour salt excretion based on urine samples.

The problem with this method is that it is difficult to know whether the last day’s worth of information represents a typical level of salt, or if there might be something unusual about that particular time period.

In addition, “Tracking our dietary salt intake can be tricky because most of the time, the food we are served, and we cook will have added salt in it,” Dr. Sara Ghoneim told Medical News Today. Dr. Ghoneim is a fellow at the University of Nebraska Medical Center in Lincoln, NE, and wrote an editorial accompanying the study’s publication.

“Adding salt to foods is a common eating behavior directly related to an individual’s long-term preference for salty taste foods and habitual salt intake, and less likely to be affected by the substantial day-to-day variations. Therefore, adding salt to foods provides a unique assessment to evaluate the association between habitual sodium intake and health outcomes.”
— Dr. Qi Lu

Although expressing concern regarding the self-reported nature of the data in the study, Dr. Ghoneim adds that this methodology opens new avenues for potential interventions aimed at lower salt consumption.

Why too much salt is a problem

We need an estimated 500 mg of sodium each day to help conduct nerve impulses, maintain our water and mineral balance, and help in the contracting and relaxing of muscles.

The average American, according to the Harvard T.H. Chan School of Medicine, consumes about a teaspoon and a half of salt each day, or about 3,400 mg of sodium—much more than we require for our health.

Getting too much salt can lead to high blood pressure, heart disease, stroke, and result in a loss of calcium, leading to osteoporosis, although researchers sometimes reach contradictory conclusions. Salt has also been implicated in cancer and chronic kidney disease.

Less salt’s impact on heart failure

The authors of the study found the strongest association between a lower frequency of adding salt and CVD risk for heart failure.

People who never or rarely added salt to their food reduced their risk of heart failure by 37% compared to people who said they always added salt.

Low-frequency salt-sprinklers also had a 26% lower risk of ischemic heart disease, and a 23% reduction in risk for CVD in general.

When people on a DASH diet never or rarely add salt, the diet’s CVD benefit increased, the researchers found.

People who strictly follow a DASH diet and never or rarely add salt lower their risk of CVD by 36%, their risk of heart failure by 54%, and their risk of ischemic heart disease by 35%.

“So, if you add salt once a week to any particular meal, you might do better from a heart-health standpoint than someone who adds salt three or more times,” said Dr. Ghoneim.

The study surprisingly found no significant association between less salt-shaking and stroke, although the authors suggest that this finding should be treated with caution since there were a limited number of stroke cases in their study population.

Who adds the least and most salt?

The analysis revealed that the people most likely to never or rarely add salt to their food were white women with a low BMI.

They were also physically active, were unlikely to smoke, and drank alcohol only in moderation. Many also followed the DASH diet.

Medically, people who added less salt had a higher occurrence of hypertension and chronic kidney disease but less often had cancer.

Smokers and people with a lower socioeconomic status tended to be those most likely to more frequently add salt to their food.

Previous researchTrusted Source suggests that a greater desire for salty tastes is linked to people with low socioeconomic status.

What is the DASH diet?

DASH stands for “Dietary Approach to Stop Hypertension,” and as its name implies, was originally formulated to lower the risk of high blood pressure and, thus, stroke, kidney failure, and heart disease. It also lowers LDL, or “bad” cholesterol.

The DASH diet promotes foods that are low in saturated and trans fats and that are rich in calcium, potassium, protein, and fiber. It also recommends a daily limit of 2,300 mg of sodium — this is roughly the equivalent of a level teaspoon of table salt.

The diet emphasizes fruits, vegetables, and whole grains, along with lean sources of protein such as fish, chicken, and beans.

Eating red and processed meats and added sugar is discouraged.

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