Cutting sodium consumption: A major public health priority

Reducing sodium intake is a major public health priority that must be acted upon by governments and nongovernmental organizations to improve population health, states an article http://www.cmaj.ca/press/cmaj090361.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca.

Higher blood pressure is a risk factor for cardiovascular disease and a diet high in sodium has been linked to high blood pressure, vascular and cardiac damage, stomach cancer, osteoporosis and other diseases. Almost 1 billion adults worldwide have hypertension, and 17-30% of these cases can be attributed to excessive sodium consumption.

In developed countries, almost 80% of sodium intake is from processed food. Regulation of the food industry by government will bring about the most effective change, although immediate voluntary action is desired.

The recommended intake in Canada ranges from 1,000 mg/day sodium for people aged 1-3 years to 1,500 mg/day for those aged 9-50. Average daily sodium intake in Canada is more than double the highest recommended level.

"A population-wide reduction in sodium intake could prevent a large proportion of cardiovascular events in both normotensive and hypertensive populations," write Dr. Kevin Willis, Canadian Stroke Network and coauthors. "For example, a population-wide decrease of 2 mm Hg diastolic blood pressure would be estimated to lower the prevalence of hypertension by 17%, coronary artery disease by 6% and the risk of stroke by 15%, with many of the benefits occurring among patients with normal blood pressure."

National public health policy should be focused on reformulating processed food, educating consumers, labelling food clearly and setting timelines to meet these targets. Nongovernmental groups should lobby the food industry to change practice and partner with governments to mount public education campaigns.

As well, health care professionals should to counsel patients about healthy choices in reducing sodium consumption. Training to do this should be incorporated into curricula.

September 14, 2009