Journal Club - Low Sodium Diet might not Cut Clinical Events in Heart Failure Trial

Sodium is an essential mineral involved in many important bodily functions, including cellular function, fluid regulation, electrolyte balance and maintaining blood pressure. Because this mineral is vital to life, your kidneys tightly regulate its levels based on the concentration (osmolarity) of bodily fluids. Sodium is found in most foods you eat — though whole foods like vegetables, fruits and poultry contain much lower amounts. Plant-based foods like fresh produce generally have less sodium than animal-based foods, such as meat and dairy products. Sodium is most concentrated in processed and packaged foods like chips, frozen dinners and fast food where salt is added during processing to enhance flavor. Another major contributor to sodium intake is adding salt to food when preparing meals in your kitchen and as a seasoning before eating. 

Healthcare professions typically recommend these diets to treat conditions such as high blood pressure or heart disease. Although there are variations, sodium intake is generally kept to less than 2–3 grams (2,000–3,000 mg) per day. 

A low-sodium diet was not associated with a reduction in future clinical events in a new study in ambulatory patients with heart failure. But there was a moderate benefit on quality of life.

The results of the SODIUM-HF trial were presented at the American College of Cardiology (ACC) 2022 Scientific Session. They were also simultaneously published online in The Lancet.

The study found that a strategy to reduce dietary sodium intake to less than 1500 mg daily was not more effective than usual care in reducing the primary endpoint of risk for hospitalization or emergency department visits due to cardiovascular causes or all-cause death at 12 months. SODIUM-HF was a pragmatic, multinational, open-label, randomized trial conducted in six countries, which included 809 patients (median age, 67 years) with chronic heart failure who were receiving optimally tolerated guideline-directed medical treatment. They were randomly assigned to usual care according to local guidelines or a low-sodium diet.

Hence, when following a low-sodium diet, foods high in sodium must be limited or completely avoided to keep your sodium intake under the recommended level.