ESTIMATED I .65 MILLION GLOBAL CARDIOVASCULAR DEATHS EACH LINKED TO HIGH SODIUM CONSUMPTION
More than 1.6 million
cardiovascular-related deaths per year can be attributed to sodium consumption
above the World Health Organization's recommendation of 2.0g (2,000mg) per day,
researchers have found in a new analysis evaluating populations across 187 countries.
The findings were published in the August 14 issue of The New
England Journal of Medicine
"High sodium
intake is known to increase blood pressure, a major risk factor for
cardiovascular diseases including heart disease and stroke," said first
and corresponding author Dariush Mozaffarian, M.D., Dr.P.H., dean of the
Friedman School of Nutrition Science and Policy at Tufts University, who led
the research while at the Harvard School of Public Health. "However, the
effects of excess sodium intake on cardiovascular diseases globally by age,
sex, and nation had not been well established."
The researchers
collected and analyzed existing data from 205 surveys of sodium intake in
countries representing nearly three-quarters of the world's adult population,
in combination with other global nutrition data, to calculate sodium intakes
worldwide by country, age, and sex. Effects of sodium on blood pressure and of
blood pressure on cardiovascular diseases were determined separately in new
pooled meta-analyses, including differences by age and race. These findings
were combined with current rates of cardiovascular diseases around the world to
estimate the numbers of cardiovascular deaths attributable to sodium
consumption above 2.0g per day.
The researchers found
the average level of global sodium consumption in 2010 to be 3.95g per day,
nearly double the 2.0g recommended by the World Health Organization. All
regions of the world were above recommended levels, with regional averages
ranging from 2.18g per day in sub-Saharan Africa to 5.51g per day in Central
Asia. In their meta-analysis of controlled intervention studies, the
researchers found that reduced sodium intake lowered blood pressure in all
adults, with the largest effects identified among older individuals, blacks,
and those with pre-existing high blood pressure.
"These 1.65
million deaths represent nearly one in 10 of all deaths from cardiovascular
causes worldwide. No world region and few countries were spared," added
Mozaffarian, who chairs the Global Burden of Diseases, Nutrition, and Chronic
Disease Expert Group, an international team of more than 100 scientists
studying the effects of nutrition on health and who contributed to this effort.
"These new findings inform the need for strong policies to reduce dietary
sodium in the United States and across the world."
In the United States,
average daily sodium intake was 3.6g, 80 percent higher than the amount
recommended by the World Health Organization. [The federal government's Dietary
Guidelines for Americans recommend limiting intake of sodium to no more than
2,300mg (2.3g) per day.] The researchers found that nearly 58,000
cardiovascular deaths each year in the United States could be attributed to
daily sodium consumption greater than 2.0g. Sodium intake and corresponding
health burdens were even higher in many developing countries.
"We found that
four out of five global deaths attributable to higher than recommended sodium
intakes occurred in middle- and low-income countries," added John Powles,
M.B., B.S., last author and honorary senior visiting fellow in the department
of public health and primary care at the University of Cambridge.
"Programs to reduce sodium intake could provide a practical and cost
effective means for reducing premature deaths in adults around the world."
The authors
acknowledge that their results utilize estimates based on urine samples, which
may underestimate true sodium intakes. Additionally, some countries lacked data
on sodium consumption, which was estimated based on other nutritional
information; and, because the study focuses on cardiovascular deaths, the findings
may not reflect the full health impact of sodium intake, which is also linked
to higher risk of nonfatal cardiovascular diseases, kidney disease and stomach
cancer, the second most-deadly cancer worldwide.
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