Reducing dietary sodium: the case for caution.
JAMA. 2010 Feb 3;303(5):448-9
Authors: Alderman MH
QUOTE:
Multiple randomized clinical trials (RCTs) have established that reduction of sodium intake sufficient to lower blood pressure also increases sympathetic nerve activity, decreases insulin sensitivity, activates the renin angiotensin system, and stimulates aldosterone secretion.
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Low salt diets lead to:
Increased sympathetic nervous system activity – i.e. increased stress, increased anxiety and other mood disorders, increased insomnia, blood pressure, etc.
Increased insulin resistance and increased insulin signaling – leading to an increased risk for diabetes and obesity.
Activation of the renin-angiotensin-aldosterone system – i.e. increased blood pressure
Increased immune system proinflammatory cytokine signaling – i.e. increasing the risk of inflammatory illnesses and heart attacks and strokes.
In congestive heart failure, a low salt diet may be harmful.
Interestingly, in the large U.S. government studies (the National Health and Nutrition Examination Survey I (1998), II, (2006), and III (2008), lower salt intake was overall associated with an increase in cardiovascular events including heart attacks and stroke. With the above mechanisms, it is clear why a low salt diet can be associated with an increase in heart attacks.