Today's Topic in Focus: Sodium & Health [03:42]
In this episode Danny and Alan discuss the current evidence base related to sodium intake and health, most notably cardiovascular disease. The episode walks through understanding diet-disease relationships, the epidemiology of sodium and health outcomes, the reasons for conflicting conlusions, sodium measurements in research, intervention trials, and more. Importantly, the claim that the sodium-CVD risk relationship exhibits a "J-shaped curve" (i.e. risk is low at moderate intakes and higher at both low and high intakes) is dissected, with recommendations given on how to reconcile all the available evidence.
- Engberink et al., 2017 - Use of a Single Baseline Versus Multiyear 24-Hour Urine Collection for Estimation of Long-Term Sodium Intake and Associated Cardiovascular and Renal Risk
- Intersalt, 1988 - an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion
- Cook et al., 2014 - Lower levels of sodium intake and reduced cardiovascular risk
- Graudal et al., 2014 - Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis
- Mente et al., 2016 - Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies
"I Have a Question!" [83:33]
This episode's questions from listeners:
- David asks: "How much sodium does it take to incease blood pressure? Does "natural salt", like Redmond brand salt, make a difference?
- Nick asks: "In the low carb/ketogenic diet community there is this notion (I believe it originates from Steven Phinney) that the kidneys excrete more sodium while in ketosis, thus increasing sodium requirements while on a ketogenic diet. This has led to some prominent members of that community suggesting that supplementing up to 10g of salt per day can be beneficial. Any comments?"
Quack Asylum [90:51]
Claims about the health-promoting effects of sodium from author of "The Salt Fix", James DiNicolantonio.
Random Recommendations [99:09]
Alan's Recommendation: The Cicero Trilogy - Robert Harris
Zen and the Art of Motorcycle Maintenance - Robert M Pirsig
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