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Do You Have to Cut Back on Salt If You're Healthy?

Here's what the latest evidence has to say

En español | True or false: Eating too much salt is bad for you.

If you answered true, you'd be wrong.

If you answered false, you'd be wrong, too.

But if you said, "Why are you asking me? Even the experts can't decide," you'd be a lot closer to the truth.

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Several shakers containing varying amounts of salt. Sodium intake can contribute to high blood pressure.

Safe salt intake depends on the health of the person taking it in. — Photo by Rita Maas/Getty Images

The debate over the dangers of a high-salt diet, particularly for older Americans, is nothing new. It's been raging for decades, but a spate of conflicting studies in the past few months has many saying "enough already."

Last month's article in Scientific American basically summed it up with the exasperated headline, "It's time to end the war on salt." The writer — who looked at the research behind our salt fears — argued that the long, zealous campaign to get all of us to reduce our salt consumption has little basis in science.

And some notable experts agree.

Cardiologist Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic, says there's no question that those with high blood pressure or heart problems should cut back on salt. But the quality of scientific evidence is still too weak for policymakers to insist that low sodium is right for everyone, regardless of their overall health.

"The evidence is observational. It's not based on randomized clinical trials that are the gold standard," he says. "So we're in the dark. We don't have good quality data, so we just don't know."

Michael Alderman, M.D., of the Albert Einstein College of Medicine in New York and former president of the International Society of Hypertension, also has repeatedly argued for caution in the nation's push to reduce sodium.

In medical journal commentaries over the past decade, Alderman has detailed the seesawing results of studies investigating the link between salt and heart disease.

He explains the reasoning behind the country's low-salt push this way: If reducing sodium reduces blood pressure — a medical fact — and high blood pressure causes strokes and heart attacks — another truism — then obviously reducing sodium will reduce heart problems and deaths.

But that kind of leap-of-faith assumption is problematic, Alderman writes.

Despite decades of research, no study has clearly proved that lowering salt consumption will save lives. For every study that seems to show that high-sodium leads to poor health, another one disputes it.

A perfect example of this occurred just last month. An analysis by British researchers of seven studies involving 6,250 people found no strong evidence that reducing salt reduced the risk of dying or getting heart disease. The study was published in the American Journal of Hypertension.

Next: Does everyone benefit by reducing his or her salt intake? >>

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