Excessive consumption of dietary sodium likely was responsible for up to 30% of cardiovascular disease-related deaths among mostly low-income participants in a large cohort study conducted by Vanderbilt University Medical Center.
More than 80% of the participants exceeded by a large margin the recommended daily intake of sodium, according to a report published March 28 in JAMA Network Open, a journal of the American Medical Association.
“These findings suggest that approaches to lower sodium intake among underserved populations need to be established as the primary public health priority,” the researchers concluded.
The research included 64,329 participants in the Southern Community Cohort Study, ages 40 to 79, who were recruited at community health centers in 12 southeastern states between 2002 and 2009. Nearly 83% reported annual household incomes less than $25,000.
Average sodium intake estimated from the diets reported by white participants exceeded the national guideline–less than 2,300 milligrams per day–by about 1,740 milligrams, while average sodium consumption by Black participants was nearly double the recommended level—exceeding 4,500 milligrams a day.
The study analyzed 17,811 deaths, including 5,701 deaths from cardiovascular disease, which occurred among the participants since they joined the cohort. After controlling for confounding factors, the researchers estimated that excessive sodium intake accounts for 10% of deaths from all forms of cardiovascular disease, and 30% of deaths from heart failure.
High sodium consumption is a well-known risk factor for cardiovascular disease, but it has been largely overlooked in marginalized populations, especially among Black and low-income individuals who experience food insecurity and have limited healthy food options, the researchers noted.
“Providing accessible healthy diet resources and increasing knowledge on the potential harms associated with high sodium intake would be the first steps in reducing racial, ethnic and socioeconomic disparities in everyday diets and health outcomes,” they concluded.
The paper’s first author, Hyung-Suk Yoon, PhD, is assistant professor of Surgery at the University of Florida and a former postdoctoral fellow at VUMC. Xiao-Ou Shu, MD, PhD, Ingram Professor of Cancer Research, and professor of Medicine in the Division of Epidemiology at VUMC, is the paper’s corresponding author.
VUMC co-authors are Qiuyin Cai, MD, PhD, Loren Lipworth, ScD, Hui Cai, MD, PhD, Danxia Yu, PhD, Deepak Gupta, MD, MSCI, William Blot, PhD, and Wei Zheng, MD, PhD.
The research was supported in part by National Institutes of Health grants T32CA160056, R01CA092447, and U01CA202979, the Vanderbilt-Ingram Cancer Center and University of Florida Health Cancer Center. The Southern Community Cohort Study is funded by the National Cancer Institute.