4.7 Article

Sodium intake, life expectancy, and all-cause mortality

Journal

EUROPEAN HEART JOURNAL
Volume 42, Issue 21, Pages 2103-2112

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehaa947

Keywords

Sodium intake; Salt; Diet; Life expectancy; All-cause mortality; Cardiovascular disease; Hypertension; Blood Pressure

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Our study found a positive correlation between sodium intake and life expectancy worldwide and in high-income countries, but no correlation with death due to non-communicable diseases, and an inverse correlation with all-cause mortality. This suggests that dietary sodium intake may not be a culprit in shortening lifespan or a risk factor for premature death.
Aims Since dietary sodium intake has been identified as a risk factor for cardiovascular disease and premature death, a high sodium intake can be expected to curtail life span. We tested this hypothesis by analysing the relationship between sodium intake and life expectancy as well as survival in 181 countries worldwide. Methods and results We correlated age-standardized estimates of country-specific average sodium consumption with healthy life expectancy at birth and at age of 60 years, death due to non-communicable diseases and all-cause mortality for the year of 2010, after adjusting for potential confounders such as gross domestic product per capita and body mass index. We considered global health estimates as provided by World Health Organization. Among the 181 countries included in this analysis, we found a positive correlation between sodium intake and healthy life expectancy at birth (beta = 2.6 years/g of daily sodium intake, R (2) = 0.66, P < 0.001), as well as healthy life expectancy at age 60 (beta = 0.3 years/g of daily sodium intake, R (2) = 0.60, P = 0.048) but not for death due to non-communicable diseases (beta = 17 events/g of daily sodium intake, R (2) = 0.43, P = 0.100). Conversely, all-cause mortality correlated inversely with sodium intake (beta = -131 events/g of daily sodium intake, R (2) = 0.60, P < 0.001). In a sensitivity analysis restricted to 46 countries in the highest income class, sodium intake continued to correlate positively with healthy life expectancy at birth (beta = 3.4 years/g of daily sodium intake, R (2) = 0.53, P < 0.001) and inversely with all-cause mortality (beta = -168 events/g of daily sodium intake, R (2) = 0.50, P < 0.001). Conclusion Our observation of sodium intake correlating positively with life expectancy and inversely with all-cause mortality worldwide and in high-income countries argues against dietary sodium intake being a culprit of curtailing life span or a risk factor for premature death. These data are observational and should not be used as a base for nutritional interventions.

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