Science of Salt: A regularly updated systematic review of salt and health outcomes studies (April to October 2018)

Abstract

The Science of Salt reviews identify, summarize, and critically appraise published studies on dietary salt and health outcomes according to pre‐specified methods. This review covers the period April 3 to October 30, 2018. Here, nineteen studies that fit pre‐specified criteria for review and summary are included. Three of these, one prospective cohort study, one randomized controlled trial, and a post hoc analysis of the Dietary Approaches to Stop Hypertension (DASH) sodium trial fulfilled the quality criteria for detailed critical appraisal, including risk of bias assessment, and commentary. Two trials demonstrated a positive association between salt intake and blood pressure. In a cohort of older Italians, increased risk of total mortality was observed with salt intake less than ~16 g/d (6300 mg sodium/d) at baseline; no association existed for incident cardiovascular disease (CVD) or CVD mortality. The paucity of published studies which met our criteria for methodological quality is of concern.

Further evidence that methods based on spot urine samples should not be used to examine sodium‐disease relationships from the Science of Salt: A regularly updated systematic review of salt and health outcomes (November 2018 to August 2019)

“…The findings of this eighth Science of Salt review are consistent with previous reviews in this series and show that most high‐quality studies report favorable health effects of sodium reduction and adverse effects of excess sodium intake 11‐17 . He et al 23 report that sodium intake, assessed by three to seven 24‐hour urine collections, is linearly associated with all‐cause mortality.…”

“…However, over one‐third of these studies were cross‐sectional (n = 10) and over half (n = 14) used low‐quality methods to assess sodium intake. The goal of the Science of Salt systematic reviews is to provide scientists, clinicians, and public health advocates with a regularly updated review of recent publications in the area of sodium and health outcomes, and only direct attention to studies that meet predefined criteria for outcomes assessed and methodology to assist in interpretation of this evidence base 10‐17 . In this field of study, poor methodological approaches have yielded results that contrast with evidence from studies using more rigorous methods 9 .…”

“…To keep scientific, clinical, and policy stakeholders up to date with the quantity and quality of publications in the rapidly growing area of sodium and health outcomes, regularly updated reviews and critical appraisals are published in the Journal 10 . The objective of this eighth Science of Salt health outcomes review is to build on previous reviews in this series 11‐17 and summarize published articles on sodium and health outcomes from November 1, 2018, to August 31, 2019, and to highlight and critically appraise articles that meet pre‐specified methodological criteria 14 …”

Primary stroke prevention worldwide: translating evidence into action

“…41 Issues for clinicians in primary stroke prevention at the individual level include the absence of digital decision-making tools 19 and scarcity of time to motivate, develop, and give tailored primary prevention recommendations to the patient. An example of a digital decision-making tool that can help to resolve all these issues is the desk-top multilanguage PreventS web app for clinicians, developed by the Auckland University of Technology (appendix pp [22][23][24][25][26][27].…”

Effects of physical and chemical properties on the dissolution of sea salt

“…Sodium is an essential nutrient for maintaining blood plasma, acid-base balance, transmit nerve impulses and participate in necessary functions for human cells 1,2 . Sodium is found naturally in many foods, such as milk, meat, and seafood.…”