Hi Zeid

You will find an answer here :

Effects of low sodium diet versus high sodium diet on blood

pressure, renin, aldosterone, catecholamines, cholesterol, and

triglyceride.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004022.pub4/epdf/standard

Greetings

Khaled

Thanks Meghit.

This is a great review and meta-analysis. I recommend everybody with interests in sodium diet to read.

Sodium is everywhere present in all food products. At the present time there is no risk of a small amount of sodium in the diet but is too much. Sodium, besides being naturally occurs, is added to many food products in large quantities - meat, rennet cheese.

Sodium is the most important extracellular ion & plays an important role in maintaining BP . In tropical countries , sweating is a mechanism to maintain body temperature & salt loss can be considerable . Low salt diet can lower BP in hot weather & lead to other complications .

If its high, it has a toll on one's blood. Yet, when it low it affects the diet.

Common Symptoms

• weakness.
• fatigue or low energy.
• headache.
• nausea.
• vomiting.
• muscle cramps or spasms.
• confusion.
• irritability.

A Low-Salt Diet May Be Bad for the Heart. People with high blood pressure are often told to eat a low-sodium diet. But a diet that's too low in sodium may actually increase the risk for cardiovascular disease, a review of studies has found. ... “But low sodium intake may be harmful,”

It turns out there is a huge debate in the literature when it comes to low salt diet in the healthy and nonhyoertensive. There is strong evidence that it is harmful with increased cardiovascular mortality. This is not final. The debate continues. Most studies are criticized for many reasons.

Clinically we find that table salt's additives increase blood pressure. Unadulterated sea salt lowers B/P in low insulin resistant patients. We see an increase in B/P that parallels increasing fasting insulin. In fact, a blood pressure of 140/90 in an indication of insulin resistance

First of all, it is very difficult to have a very low sodium diet as many foods are naturally rich in this mineral and most of us consume processed foods, which as you know are very high in sodium. Secondly, a very low sodium diet can be harmful as it might cause a decline in blood pressure and bring about weakness, fatigue, lethargy etc. This is because low blood content of sodium along with too much water intake can bring about hyponatremia, especially in people, who are physically active and are heavy sweaters. Extreme hyponatremia can even be life threatening. Thirdly, if you restrict consumption of table salt to limit sodium ingestion instead of processed foods you might experience iodine deficiency, which will lead to many clinical conditions we call iodine deficiency disorders.

I agree with the above comments but my point that I was trying to show is that low salt diet has been linked with CV mortality in two land mark studies published in NEJM 2014 and the Lancet in 2016 as well as in a meta-analysis last year. Any thoughts?

The remarks about the elderly are important. I've been trying to use

How much sodium you need does depend on climate and occupation. If you lose a lot of sodium through sweat, you need to replace it.

Sodium should be consumed in plain salt, like sea salt, not salt with additives, that may themselves cause problems. Sodium and potassium compete . So those consuming lots of vegetables can have more salt.

Low sodium diets might increase the risk of the development of insulin resistance. This is because limited sodium intake decreases the content of body water, which is usually compensated by increased epinephrine, renin, and angiotensin levels, all of which inhibit the action of insulin and increase insulin resistance. As you are all aware, insulin resistance is linked to many metabolic diseases, including cardiovascular disorders, type 2 diabetes mellitus, cancer etc. Overall, we just have to be careful with under-consumption of sodium, which I regard at the level of less than 1 g (1000 mg) per day.

Hi Khitan,,, high sodium intake is positively correlated with increased risk of hypertension and cardiovascular mortality. But low sodium intake may not be always helpful in these regard and it may be harmful in some patients of hypertension, heart failure and diabetes. There is a beautiful article published in August 2014 in NEJM in this topic... Thanks

In tropical countries , low salt diet in patients with Chronic Kidney Disease ( CKD ) can cause hypovolemia & decline in GFR causing Acute Kidney Injury ( AKI on CKD ) . This is common in CKD due to salt wasting renal diseases , such as chronic interstitial nephritis . In addition , low salt diet with excess water can cause Hyponatremia . Salt restriction would benefit in volume overload diseases with edema , such as cardiac failure , chronic liver disease or CKD due to glomerular disease .

Article PURE is not so pure when it comes to dietary sodium and card...

Considering that minimum intakes can be 200 mg per day with no adverse health outcomes (https://www.nap.edu/read/10925/chapter/8), and it is nearly impossible to reach such intakes consuming even a healthy diet (leafy greens contain significant sodium quantities compared with other foods, 126 mg alone from 1 cup of cooked spinach), it is unlikely that you will be under such intakes. Typically, without added sodium in the diet, naturally occurring sodium in food will inherently result in roughly ~500mg of sodium consumed per day.