July 8, 2024 — Reducing salt intake is probably not the most effective idea for everybody with heart problems. Although it is understood that salt restriction can lower blood pressure, the query stays whether salt restriction really helps individuals with heart problems. Heart failure. Could these patients sprinkle some salt and never worry a lot?
A recent review from the European Journal of Clinical Investigations suggests that is true. Researchers examined studies between 2000 and 2023 and located that there isn't any clinical evidence that strict salt restriction advantages patients with heart failure. They also found that restricting sodium consumption didn't result in fewer deaths or hospitalizations.
Restricting salt intake in heart failure is widely really helpful based on traditional teachings relatively than solid randomized data, says Deepa M. Gopal, MD, assistant professor of cardiovascular medicine on the Chobanian and Avedisian School of Medicine at Boston University.
“The idea that we need to limit our salt intake comes mainly from acute decompensated heart failure (worsening of symptoms such as labored breathing And extreme tirednessrequiring immediate medical attention) patients,” said James DiNicolantonio, PharmD, a cardiovascular researcher and creator of The Salt Fix“However, if the situation is stable and Diuretics (Medicines that help the body eliminate excess salt and fluid). Often these people turn out to be worse once they restrict their salt intake an excessive amount of.”
It's normal for our bodies to retain fluid when we eat a particularly salty meal. But when you're suffering from heart failure, your body can't remove the fluid as easily, Gopal said. This can lead to fluid and salt buildup in your feet, ankles and lungs, as well as other organs, and can raise your blood pressure.
However, DiNicolantonio said patients with stable heart failure can generally consume between 2,300 and 3,000 milligrams of sodium per day (or 1 1/3 teaspoons of salt). About 25% of patients with heart failure have low blood sodium levels, so salt intake recommendations should be individualized to the patient, especially since many take diuretics, he said.
As with most health-related issues, a balanced approach to salt consumption is often most effective.
With Gopal's patients, “I attempt to have them discover and eliminate or minimize very high-salt foods themselves to essentially allow them to optimize a eating regimen that offers them quality of life and joy, keeps them healthy, but can be sustainable for years to return,” she said. While severe salt restriction can lead to health problems in some cases, so can a high-salt diet. Gopal advises avoiding extremes. One way to monitor your sodium intake is to pay attention to foods you didn't prepare yourself, like those found in restaurants or fast-food places, DiNicolantonio said. Spicy dishes like ramen noodles, cheeseburgers and pizza are notoriously high in salt. Chips, cold cuts and seasoning mixes are also high-sodium foods to watch out for, says Gopal.
“When decompensation occurs in patients with heart failure and we discover high-salt foods as a part of the trigger, I feel it may well be very reassuring for patients to know that they've control over how you can feel and behave higher by reducing their salt intake,” Gopal said.
Experts advise patients with heart failure to monitor their sodium intake, but not to restrict it too much or to avoid family meals or social gatherings. They also don't need to eat bland meals all the time, notes Dr. Maya Guglin, former chair of the American College of Cardiology's Heart Failure and Transplant Council.
“In the absence of strong evidence, I see no point in reducing the standard of lifetime of our patients and pushing them to limit their sodium intake to the purpose where food becomes tasteless,” she said.