BY STEVE BORN
Thought to be the first study of its kind—a unique population-based study cohort—Swedish researchers found a connection between excess sodium intake and both carotid and coronary atherosclerosis [1].
Over 10,000 participants in the Swedish Cardiopulmonary bioImage Study (SCAPIS) were involved in this study. The average age was 58, comprised of 52% women and 48% men. Values for sodium consumption among participants with valid urinary data were calculated using estimated 24-hour sodium excretion. The results showed that rising sodium excretion levels were linked to increased occurrence of carotid plaques, coronary artery calcium, and the narrowing of the coronary arteries.
According to study researcher Dr. Jonas Wuopio, Ph.D., “The study is the first to examine a potential link between high dietary sodium intake and atherosclerosis in coronary and carotid arteries. The association was linear, meaning that each rise in salt intake was linked with more atherosclerosis. The findings applied even at normal blood pressure levels, suggesting that salt could be damaging even before the development of hypertension.”
Atherosclerosis is the process of plaque build-up, primarily of cholesterol, fats, and calcium, in and on the artery walls. Coronary artery disease—the number one killer of Americans—occurs when the plaque build-up causes the inside of the arteries to narrow over time, blocking optimal blood flow to the heart.
Carotid atherosclerosis (carotid artery disease) is the build-up of plaque and narrowing/hardening in the carotid arteries in the neck, the ones that deliver blood to the brain. Carotid atherosclerosis is a major risk factor for stroke, and when considered separately from other cardiovascular diseases, stroke ranks fifth among all causes of death in the United States.
With this eye-opening research and a wealth of other research detailing the health issues associated with excess sodium intake, it's no wonder the World Health Organization (WHO) is vigorously campaigning to reduce the global population's salt intake by an average of 30% by 2025. With a 30% reduction in global salt intake, the World estimates that 2.5 million deaths could be prevented yearly [2]. In the United States, with coronary artery disease and stroke ranking 1st and 5th in terms of death rates—much of which is due to excess sodium consumption—a reduction is not just a wise strategy; it's a necessity!
REFERENCES:
[1] Wuopio J, Ling YT, Orho-Melander M, Engström G, Ärnlöv J. The association between sodium intake and coronary and carotid atherosclerosis in the Swedish population. Eur Heart J Open. 2023;3:oead024.
[2] https://hammernutrition.com/blogs/endurance-news-weekly/reduce-sodium-in-processed-packaged-foods
7 comments
I have not yet read this study in full. But, unless the individuals were also screened and sorted for dietary preferences and history, these results are likely of limited value. Since high sodium levels are known to be associated with highly processed foods, it is reasonable to draw the conclusion that anyone who consumes large amounts of highly processed foods will also present high levels of sodium. So, which, if either, is actually causal? I appreciate the linear nature of the findings, but that would also be expected if the source of the sodium was highly processed food consumption, and some other aspect of those foods was causal.
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Hammer Nutrition replied:
Thank you for your feedback, though I’m not sure why this study’s results are “likely of limited value.” What Dr. Wuopio states is, IMO, straight forward and reason enough to lower salt intake no matter the source, which would certainly include highly processed foods (see https://hammernutrition.com/blogs/endurance-news-weekly/reduce-sodium-in-processed-packaged-foods). His direct comment 1
“The results show that the more salt people eat, the higher the burden of atherosclerotic plaques in the arteries of the heart and neck. The increase in blood pressure due to a high salt intake seems to be an important underlying mechanism for these findings. Interestingly, the results were consistent when we restricted our analyses to participants with normal blood pressure (below 140/90 mmHg) or to those without known cardiovascular disease. This means that it’s not just patients with hypertension or heart disease who need to watch their salt intake.”
My opinion is that no matter what the source of salt may be, this study (and many others) clearly indicates that we ALL would do well to identify those sources and reduce consumption of them.
REFERENCE:
1 High salt diet associated with hardened arteries even in people with normal blood pressure. European Society of Cardiology. Published March 31, 2023. Accessed April 3, 2023. https://www.escardio.org/The-ESC/Press-Office/Press-releases/high-salt-diet-associated-with-hardened-arteries-in-people-with-normal-blood-pressure
So if Sodium is so bad for us and potassium is so good for us, why do Endurolytes have 3 times more sodium than potassium on a DV basis??
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Hammer Nutrition replied:
Athletes need to remember that sodium intake during exercise does not count toward dietary sodium intake. The reasons are because your body is using—and thus depleting—sodium and other electrolytic minerals to perform the during-exercise functions that they are responsible for, and also because you’re losing/depleting these minerals via sweat. Listing the DV of minerals on our products, including our electrolyte replenishment products, is required by the FDA. However, the DV%, though listed on the labels of the Endurolytes products, is not applicable in terms of dietary amounts/percentages.
As I have mentioned before, we all need to reduce our sodium intake in our daily diet, getting it as close to the 2300 mg/day amount that the American Heart Association recommends. When we do that—and when we increase our dietary potassium intake—the results are quite phenomenal. This is discussed in the article “Potassium: A Key to Longevity—-Increase Potassium, Decrease Sodium: Live a Longer Life” at https://cdn.shopify.com/s/files/1/0617/9192/8555/t/19/assets/e69caa00ca27—ENissue111-2f3b4e.pdf#page=52). What is most interesting about the results of the study is that not only did the participants in the “lower sodium/higher potassium” group have a lower risk of cardiovascular disease and ischemic heart disease (aka artery disease or "hardening of the arteries”), they had a decreased risk of dying from ANY cause. In other words, a higher sodium intake was related to greater risk of dying from any cause, while a higher potassium intake and reduced sodium intake was associated with a lower mortality risk. When you read the article, you’ll see a list of foods that are high in potassium. A conscious effort to reduce our sodium intake while increasing potassium intake is an excellent way to reduce your risk for heart disease.
All this said, the reasons why the Endurolytes Extreme products exist are because of these primary conditions and circumstances:
1) If an athlete consumes a high-sodium diet. The high-sodium diet athlete will deplete their bodily stores of sodium more rapidly and in higher amounts compared to the athlete who is consuming a low-to-modest sodium diet. That athlete’s body, because of his low-sodium dietary practices, will be much more efficient at using its stores of sodium, losing less via sweat and allowing the body to recycle and thus conserve its stores of sodium. High sodium diet = more sodium lost in sweat. Low sodium diet = normal sodium loss in sweat and more sodium available from the body’s stores of this mineral. Until the “high-sodium diet” athlete lowers his/her intake of sodium in their diet—which we want the athlete to do because it’s undeniably healthier—they will need an electrolyte replenishment product that contains more salt/sodium to compensate for their higher-than-normal losses.
2) If the athlete is exercising in conditions that are significantly hotter than they’re acclimated to. At these times, more sodium and potassium will be lost via sweat as compared to the athlete who lives in an area where those conditions exist and is thus much better acclimated to them.
3) If the athlete is “physiologically predisposed” to cramping . For reasons that cannot be fully explained, some athletes have cramping problems even after following our fluid and electrolyte replenishment recommendations, which consistently work for the overwhelming majority of athletes. For example, we have a few clients who, due to their unique physiology, need to take 6 or more “regular” Endurolytes capsules hourly—even under mild weather conditions—or they experience cramping problems. Athletes who have unusually high, “buckets of sweat” losses (which means higher-than-normal sodium losses as well) also fall into this category.
What is the daily sodium intake for women 125lbs in age of 70s?
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Hammer Nutrition replied:
Research*** from The Institute of Medicine recommends the following “adequate intakes” (AI) per day:
* 1,000 milligrams (mg) for children aged 1 to 3 * 1,200 mg for children aged 4 to 8 * 1,500 mg for people aged 9 to 50 * 1,300 mg for adults aged 51 to 70 * 1,200 mg for seniors over 70 years of age.
Institute of Medicine. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride and Sulfate. Washington, DC: National Academy Press, 2004.The “lowest amount” recommendations from the American Heart Association is 1500 mg/day for sodium, which is also an appropriate amount for you.
Bottom Line: 1200 mg – 1500 mg per day of sodium—which is what is found in 3000 mg to 3750 mg of salt—is a good range for you to aim for on a daily basis.
Not the result I wanted to read the week I started drinking electrolytes in the morning!
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Hammer Nutrition replied:
Remember that sodium intake during exercise does not count as dietary sodium intake. The reasons are because your body is using—and thus depleting—sodium and other electrolytic minerals to perform the during-exercise functions that they are responsible for, and also because you’re losing/depleting these minerals via sweat. Taking any of the Endurolytes products (https://hammernutrition.com/collections/electrolytes) during exercise simply replenishes what your body has been using/losing to allow optimal exercise performance to continue.
With that in mind, we all need to reduce our sodium intake in our daily diet, getting it as close to the 2300 mg/day amount that the American Heart Association recommends. When we do that—and when we increase our dietary potassium intake—the results are quite phenomenal. I discuss this in the article “Potassium: A Key to Longevity—-Increase Potassium, Decrease Sodium: Live a Longer Life” at https://cdn.shopify.com/s/files/1/0617/9192/8555/t/19/assets/e69caa00ca27—ENissue111-2f3b4e.pdf#page=52). What is most interesting about the results of the study is that not only did the participants in the “lower sodium/higher potassium” group have a lower risk of cardiovascular disease and ischemic heart disease (aka artery disease or "hardening of the arteries”), they had a decreased risk of dying from ANY cause. In other words, a higher sodium intake was related to greater risk of dying from any cause, while a higher potassium intake was associated with a lower mortality risk. When you read the article, you’ll see a list of foods that are high in potassium. A conscious effort to reduce our sodium intake while increasing potassium intake is an excellent way to reduce your risk for heart disease.
Another relevant heads up Mr. Born. Although I question the integrity of the WHO organization, they are getting this one right. To bad they were compromised on the Co-Vid vaccine.
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Hammer Nutrition replied:
Thank you for the positive feeback, John! We appreciate it!