How is sodium intake associated with mortality outcomes? : Study

Sodium is an essential nutrient for normal physiologic function, but excessive intake is associated with adverse health outcomes. For health promotion and disease prevention, the 2020 to 2025 Dietary Guidelines recommend less than 2300 mg of sodium per day.

Excessive sodium consumption has been linked to elevated blood pressure, a major risk factor for cardiovascular disease (CVD), and can directly affect multiple target organs and tissues, including the brain, heart, kidneys, and bones, contributing to increased mortality hazards. A report from the National Health and Nutrition Examination Survey (NHANES) found 46% higher CVD mortality among people with high-sodium diets.

In the cohort study, participants aged 40 to 79 years from the Southern Community Cohort were recruited from 2002 to 2009. Analyses were conducted between March 2022 and June 2023. Dietary sodium intake was assessed using a validated food frequency questionnaire at baseline. Multivariable-adjusted regression was used to estimate hazard ratios for mortality outcomes, i.e., all-cause, cardiovascular disease [CVD], coronary heart disease [CHD], stroke, heart failure, cancer, and others, associated with sodium intake.

The results revealed that compared with the recommended level of less than 2300 mg/d, higher sodium intake was associated with increased mortality. A 1000-mg increase in daily sodium intake was associated with a 3% higher risk of death from all-cause, a 7% higher risk from total cardiovascular disease, 8% higher risk from coronary heart disease. No significant dose-response associations were observed for any other mortality outcomes.

The findings suggested that high sodium intake can promote oxidative stress, endothelial dysfunction, and increased arterial stiffness and further lead to an imbalance in immune homeostasis and a persistent proinflammatory state, all of which are significant predictors of CVD and hypertension.

More importantly, developing effective dietary modification strategies tailored to the population is urgently needed to promote health.

Reference: Hyung-Suk Yoon, PhD, MPH; Qiuyin Cai, MD, PhD; Jae Jeong Yang, PhD, MPH; et al; Sodium Intake and Cause-Specific Mortality Among Predominantly Low-Income Black and White US Residents; Journal: JAMA Network Open; doi:10.1001/jamanetworkopen.2024.3802