The ‘low salt is best’ dogma may need to be reconsidered
in diabetes patients because high intakes of salt are linked
to lower mortality according to Melbourne researchers.
In a ten year follow-up study of 638 patients with long established type 2 diabetes doctors at the Endocrine Centre at Heidelberg Repatriation Hospital found that the highest mortality risks were seen in people with the lowest sodium intake and vice versa.
All cause mortality and cardiovascular mortality were
inversely related to sodium levels with a 28% lower mortality
seen for every 100mmol rise in sodium levels they found.
Writing in Diabetes Care the researchers say the presumed
benefits of a low sodium intake on hypertension may be outweighed by adverse effect of low sodium activating the renin-angiotensin system and also adverse effects on lipids catecholamine levels and insulin resistance. They say the assumption that low sodium intakes translates into less end organ damage in diabetes has been based on inconsistent research. The strength of the latest study is in the use of
multiple 24-hour urinary collection to measure sodium excretion whereas previous studies relied on dietary recall that may have underestimated salt intake.
The data call into question universal recommendations that all
adults should endeavour to reduce their salt intake.