Wednesday, December 12, 2012

Is Dietary Sodium Just a Marker For A Crappy Diet?

I once referred to salt as a "dietary red herring", whereby I wondered whether or not in modern first world nations the risks extended to high dietary sodium consumption might be indirect whereby high dietary sodium consumption serves as a marker for the consumption of nutritionally awful, highly processed garbage which in turn confers the risk.

A paper published online just 2 days ago in the journal Pediatrics fits that narrative.

In it authors looked at the dietary recall data from 4,283 Australian children between the ages of 2 and 16 (obviously the younger ones' data came from their parents). They explored the relationship between reported dietary sodium consumption and the consumption of sugar sweetened beverages.

Unfortunately that's pretty much all they looked at diet wise. The quality and quantities of macronutrients weren't explored or controlled, nor was where the food was purchased (restaurant vs. home made). This of course makes real conclusions impossible. But that said, they found that kids who consumed more dietary sodium also consumed more sugar sweetened beverages.

The authors postulated that dietary salt intake might be increasing physiologic thirst and that consequently the saltier the food, the more soda they drink.

Yup, possible.

Also possible is that kids who eat the saltiest foods are the ones with the worst overall dietary patterns. More restaurants, more processed foods, and yes, more soda pop.

Whatever the mechanism, when it comes to dietary sodium reduction, and things like regulations and task forces, it may be worth looking beyond the usual debate about blood pressure and also consider whether or not sodium has a unique role in driving hyper-palatable and junk food consumption, or whether or not it really is just a red herring and that folks who are found to consume a great deal of sodium, just have crappy diets.

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  1. If we were to eat a primarily whole foods based diet, it would be much harder to reach the RDI for Sodium. Furthermore, this would prevent the inclusion of all kinds of other junk in our diets as well! Whole foods are the way to go!

    I've been following Stefan Guyanet for a while, and his whole area of study is around the neuroregulation of appetite and the hyperpalatability of food. I'm sure you've read him before, but it seemed like you guys are definitely speaking about the same issue!

  2. Anonymous10:36 am

    Interesting. I like your hypothesis that dietary sodium intake is a proxy marker for intake of processed foods, and it's the latter that really causes problems. I would guess it's almost impossible to consider sodium as a truly independent variable, in much the same way as it's difficult to make correlations between things like education level and race, without the confounding factors of socio-economic status.

    In-fact, there might even be some solid evidence for a disconnect between sodium and health within certain ethnic and cultural populations. For example, in traditional home-cooked Italian food there is a large amount of sodium (salt in the pasta water, salt in the parmesan cheese, salt cured olives and meats). As such, Italians have a very "healthy" diet and a low cardiovascular risk, but they consume a ton of sodium.

    Regarding whether elevated dietary salt drives the consumption of sugar-sweetened beverages, that's a hard one to prove. No doubt the two are correlated, but cause/effect is unlikely. Probably the correlation has a lot more to do with the two things being sold next to each other. Think when was the last time you ate at a fast food restaurant and were NOT offered a combo deal with a free drink? Think about why the snack foods section of the supermarket is right next to the pop aisle.

  3. Have you ever looked at the salt content of pops? As much salt as can be added, with enough sugar to cover the taste of the salt. Salt to make one thirsty? But with high sugar, the kidney re-uptake is effected, and high sugar naturally become a high salt life.