One pediatrics professor makes the argument that low-sodium diets aren't helping those diagnosed with high blood pressure.

By Zee Krstic
December 17, 2018
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If you struggle with cardiovascular health issues, there's a good chance your doctor has recommended a low-sodium diet. Plus, the American Heart Association currently recommends reduced sodium intake for issues like high blood pressure. But a new opinion piece in the New York Times suggests there isn't enough evidence to support the medical industry's reliance on low-sodium diets as a comprehensive solution for heart health issues.

Aaron Carroll, a pediatrics professor at Indiana University's School of Medicine and author of The Bad Food Bible: How and Why to Eat Sinfully, highlighted a new report published in JAMA Internal Medicine to support his claims that low-sodium diets may not be the key to cardiovascular health. In this report, researchers reviewed nine previously published studies involving patients who were prescribed reduced sodium intake in order to treat heart failure.

The report suggests data from these studies showed that salt restriction neither reduced mortality or cardiac disease, nor did it affect if the patient returned to the hospital (or how long they stayed there). Out of the four outpatient studies reviewed in this report, two suggested reduced sodium actually improved heart function—while another two did not.

Given that heart failure affects nearly 6 million people in the United States, low-sodium diets are often used as treatment methods alongside prescription drugs that either strengthen the heart or dilute blood. But Carroll says that health professionals need more data before they can solely rely on low-sodium diets to fix the issue. He also names a few ongoing studies and efforts, like this trial by University of Michigan which randomly assigned 66 patients a low-sodium meal delivery plan after being discharged from the hospital to study the effect on overall health.  

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Should health professionals ask patients to focus on other dietary recommendations instead? Carroll calls upon evidence from the Agency for Healthcare Research and Quality that suggests increasing potassium in a diet could also lower blood pressure levels naturally—maybe even more so than lowering sodium. His report also includes references to a British Medical Journal meta-analysis that illustrates increased fiber intake as being associated with a lower risk of heart disease.

Carroll makes it clear that more research is needed to determine the best preventative methods of lowering blood pressure. But if dieters—especially those suffering from poor cardiovascular health—aren't counting sodium levels, what should they focus on?

Brierley Horton, MS, RD, says that home cooks need to maintain healthy levels of a host of nutrients beyond sodium—regardless of the latest research. If you're dealing with any kind of heart condition, optimizing your diet to increase a few nutrients might actually be the key to heart health.

"Saturated fat, which is found in fattier cuts of meat and fuller-fat dairy products, and cholesterol are two to be mindful of if you have a history of a heart condition or are at risk of developing one," Horton says. "Potassium and fiber are two nutrients to really try to up the ante on in your diet. Potassium helps offset sodium and fiber in general has heart health benefits. Plus, potassium and fiber are two nutrients most Americans don't get enough of.”

While more evidence is needed before major health organizations update their current recommendations, it could be that the best solution for optimal heart health may not be so salt-less. After all, many healthcare providers will tell you that each patient is different—so a "one-size-fits-all" recommendation like a low-sodium diet may not be as cut and dry as professionals once thought.

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