The FDA has issued guidance about dietary salt intake. Their advice needs to be taken with a grain of salt – sorry, I couldn’t resist. The summary below conveys their intent and message. The whole report is below and can be downloaded.

This guidance supports the goal of reducing sodium intake as recommended by scientific consensus groups, by focusing on short-term reduction to 3,000 mg/day as a gradual approach to sodium reduction in the food supply. The guidance reflects the broad consensus among experts regarding the direct relationship between sodium and blood pressure, as well as the relationship between blood pressure and cardiovascular disease events. With average sodium intake in the U.S. over 3,400 mg/day, there is considerable work to do to reduce intake to the recommended limit of 2,300 mg/day in order to reduce the risk of hypertension and cardiovascular disease. Thus, the overall goal of this guidance is to support reduction of average sodium intake to 3,000 mg/day as we continue the dialogue on sodium reduction.

I’ve written on this subject before but, as the experts continue to offer advice devoid of nuance, it needs further amplification. The report knowingly lumps sodium in all its forms together when it’s salt (NaCl) that’s the issue. It views a sodium intake of 3 grams/day as a temporary waystation on a final destination to 2300 mg/day. It hopes manufacturers of processed food will decrease the sodium content of their products. Fine, let’s hope they do so without sacrificing flavor. But does everyone need to be on a restricted salt diet? The answer is a firm No! A reality that the experts ignore.

If you do not have hypertension or any edematous disease there is no benefit gained by restricting dietary salt. If your blood pressure rises to a level felt to be unhealthy by your physician or you develop heart, kidney, or liver disease then salt restriction is a good idea. At least half the population can tolerate an unrestricted sodium diet. There’s no reason to put the country on a diet that won’t benefit a lot of them. In order to keep things simple, I’ve avoided the issue of what constitutes treatable high blood pressure as there’s some disagreement as to the optimum level.

Every medical student is told early in his training that treatment regimens should be individualized. Blanket recommendations should not be proffered because those dispensing them think the public incapable of understanding the details and exceptions to such advice. There are no data showing that an individual who will develop hypertension when he’s 50 benefits from a low sodium diet when he’s 20.

You now have enough evidence to make an informed decision about your sodium intake. If you fall into one of the categories mentioned above, go easy on the salt. Otherwise shake away.