Reducing average adult population sodium intake to the recommended 2,300 mg per day would reduce hypertension cases by 11 million and save $18 billion in health care, a new study estimates.
Researchers from the non-profit research organization RAND wanted to calculate the potential benefit of achieving certain levels of reduction in population-level sodium consumption. Study results were published in the current issue of the American Journal of Health Promotion.
The Institute of Medicine (IOM) recommends that adults consume no more than 2,300 mg of sodium daily. Using data from National Health and Nutrition Examination Survey (NHANES 1999-2004), researchers estimated that Americans consume an average of 3,400 mg of sodium daily. Only one-third of the population consumes less than 2,300 mg per day.
Excess sodium intake raises blood pressure and leads to hypertension (defined as 140/90 mm Hg or greater). Although death rates from cardiovascular disease and stroke had decreased by 50 percent since 1970, hypertension rates have increased since 1991. High blood pressure can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure and blindness.
Using a statistical model, researchers estimated that by reducing the daily average sodium intake from 3,400 mg to 2,300 mg, the number of hypertension cases would drop by 4.9 points from 32.9 percent to 28 percent.
If further reductions were made to 1,200 mg of sodium intake daily, hypertension prevalence would drop even further to one-quarter of the population, representing a reduction of 17.7 million cases from the current level. This would equate to $28.3 billion in direct health care cost savings.
In addition to calculating reduced high blood pressure cases and health care savings, researchers calculated QALYs – a wellness measure called quality-adjusted life years. This takes into account the value to an individual in avoiding a chronic disease or condition.
By reducing the average sodium consumption to the IOM target, over 300,000 life years could be saved. This number is significant when compared to quality-of-life savings from other public health initiatives such as increasing breast cancer screening and influenza vaccine rates (about 100,000 life-years each). In monetary terms, the value of these life-years is $32 billion.
This study was the first of its kind to equate savings in healthcare associated with behavior that is largely modifiable.
Based on the study findings, adults are nowhere near reaching the objective of Healthy People 2010† to have 65 percent of the population consuming less than 2,400 mg of sodium daily.
The problem for most Americans is how to cut out the extra sodium in the diet. Most do not get the extra sodium by adding salt at the table. Packaged and processed foods are the primary culprit. Restaurants and take-out food is usually no better. In 1995, the government estimated that the sodium content of restaurant food was 1,873 mg per 1,000 calories.
“It is apparent that widespread changes in the food environment, in tandem with continued efforts by clinicians to give appropriate individual advice on sodium intake, are needed to make any progress toward the Health People 2010 objectives”, said study authors.
†Healthy People 2010 is a set of health objectives for the nation to achieve over the first decade of the new century. Two major goals are to increase quality and years of healthy life and eliminate health disparities.
The Bottom Line
In the past week, two studies have issued a wake-up call to public officials, healthcare professionals and the public that Americans are consuming far too much in added sugars and sodium.
Excess sugars and sodium leads to a number of health problems and raises the risk for cardiovascular and other diseases. Both involve behaviors that are largely modifiable.
A simple way to reduce the amount of sugars and sodium in the diet is by cutting back on processed, packaged foods. By shopping the perimeter and not the “bowels” of the supermarket, you can ensure that your basket is loaded with fruits, vegetables and lean-meats and not highly processed foods loaded in these unhealthy compounds.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.