Controlling blood pressure is complex and influenced by a variety of physiologic, dietary, and environmental factors. Dietary salt, or more specifically sodium chloride (NaCl), is an important effector of blood pressure regulation. In our current food environment, we are ingesting an amount of salt that is far above recommendations. A major issue in salt consumption is that much of it is involuntary and attributed to the increase in the consumption of packaged, processed, and restaurant foods. Although there is still debate regarding the role of sodium in the development of hypertension for all individuals, reducing the use of salt is warranted to decrease the risk for cardiovascular disease and stroke. It is important for individuals to take personal action, but it is equally essential that the food industry reduce the salt content of food so that consumers can have more control over their health.
Bronas, UG, Leon, ASHypertension: lifestyle modifications for its prevention and management. Am J Lifestyle Med. 2009;3:425-439.
2.
US Department of Health and Human Services, US Department of Agriculture.Dietary Guidelines for Americans 2005. 6th ed. Washington, DC: US Department of Health and Human Services, US Department of Agriculture; 2005. http://www.health.gov/dietaryguidelines/dga2005/document/pdf/dga2005.pdf . Accessed July 16, 2009.
3.
Food and Nutrition Board, Institute of Medicine.Sodium and chloride. In: Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC : Food and Nutrition Board, Institute of Medicine; 2004.
4.
American Heart Association.Sodium recommendations . http://www.americanheart.org/presenter.jhtml?identifier=538 . Accessed July 16, 2009.
5.
World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. http://www.who.int/dietphysicalactivity/Salt_Report_VC_april07.pdf. Accessed July 16, 2009.
6.
National Health and Nutrition Examination Survey (NHANES).Centers for Disease Control and Prevention: National Center for Health Statistics . Atlanta, GA. http://www.cdc.gov/nchs/nhanes.htm . Accessed July 14, 2009.
7.
US Department of Agriculture, Agricultural Research Service.What we eat in America. http://www.ars.usda.gov/services/docs.htm?docid=15044. Accessed July 16, 2009.
8.
American Dietetic Association.Evidence analysis library. What evidence suggests a relationship between sodium intake and blood pressure in healthy and hypertensive adults?http://www.adaevidencelibrary.com/conclusion.cfm?conclusion_statement_id=250636. Accessed July 16, 2009.
9.
American Medical Association.Medical library. Nutrition basics: what is food and what are the essential nutrients?http://www.medem.com/medlib/article/ZZZLWSKI9CC. Accessed July 16, 2009.
10.
Mattes RD, Donnelly D.Relative contributions of dietary sodium sources. J Am Coll Nutr. 1991;10(4):383-393.
11.
Appel LJ, Moore TJ, Obarzanek E., et al; DASH collaborative study group.A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med. 1997;336:1117-1124.
12.
Obarzanek E. , Proschan MA, Vollmer WM, et al. Individual blood pressure responses to changes in salt intake: results from the DASH-Sodium trial. Hypertension. 2003;2(42):459-467.
13.
Weinberger MH, Miller JZ, Luft FC, Grim CE, Fineberg NSDefinitions and characteristics of sodium sensitivity and blood pressure resistance. Hypertension. 1986; (8 suppl II):127-134.
14.
Franco V., Oparil S.Salt sensitivity, a determinant of blood pressure, cardiovascular disease and survival. J Am Coll Nutr. 2006;25(3):247S-255S.
15.
Weinberger MH, Fineberg NS, Fineberg SE, Weinberger M.Salt sensitivity, pulse pressure, and death in normal and hypertensive humans. Hypertension. 2001;(37 pt 2):429-432.
16.
Morimoto A. , Uzu T., Fujii T., et al. Sodium sensitivity and cardiovascular events in patients with essential hypertension. Lancet. 1997;350:1734-1737.
17.
Akita S., Sacks FM, Svetkey LP, Conlin PR, Kimura G.; DASH-Sodium Trial Collaborative Research Group.Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension. 2003;42(1):8-13.
18.
Page LB, Damon A., Moellering RC Jr.Antecedents of cardiovascular disease in six Solomon Islands societies. Circulation. 1974;49(6):1132-1146.
19.
Beauchamp GK , Cowan BJ, Moran M.Developmental changes in salt acceptability in human infants. Dev Psychobiol. 1986;19:17-25.
20.
Cowart BJ, Beauchamp GKThe importance of sensory context in young children’s acceptance of salty tastes. Child Dev. 1986;57:1034-1039.
21.
Beauchamp GKOntogenesis of taste preference. In: Walcher DN, Kretchmer N, eds. Food, Nutrition and Evolution: Food as an Environmental Factor in the Genesis of Human Variability. New York, NY: Masson; 1981;49-57.
22.
Filer LJ Jr.Studies of taste perception in infancy and childhood. Pediatric Basics. 1978;12:5-9.
23.
Bertino M., Beauchamp GK, Engelman K.Long-term reduction in dietary sodium alters the taste of salt. Am J Clin Nutr. 1982;36:l134-l144.
24.
Beauchamp GK , Bertino M., Engelman K.Modification of salt taste. Ann Intern Med. 1983;98(5 pt 2):763-769.
25.
Mattes RDThe taste for salt in humans. Am J Clin Nutr. 1997;65(suppl):692S-697S.
26.
Food Standards Agency.Salt reduction targets. May 18, 2009. http://www.food.gov.uk/healthiereating/salt/saltreduction. Accessed July 13, 2009.
27.
Pietinen P., Valsta LM, Hirvonen T., Sinkko H.Labelling the salt content in foods: a useful tool in reducing sodium intake in Finland. Public Health Nutr. 2008;11(4):335-340.
28.
Jacobson M.Presentation to FDA public hearing on sodium reduction (November 29, 2007) . http://cspinet.org/new/pdf/fda-salt-hearing-oral-testimony-11-27-07.pdf . Accessed July 14,2009.
29.
Code of Federal Regulations, Title 21, Vol 2, § 101.61. Nutrient content claims for the sodium content of foods. US Food and Drug Administration. Washington, DC. Revised April 1, 2008.
30.
American Medical Association.Report 10 of the Council on Science and Public Health (A-06). Promotion of healthy lifestyles I: reducing the population burden of cardiovascular disease by reducing sodium intake. http://www.ama-assn.org/ama/no-index/aboutama/16413.shtml . Accessed July 16, 2009.
