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More Spice on the Salt Debate

Myron H. Weinberger, MD
Arch Intern Med. 1997;157(21):2407-2408. doi:10.1001/archinte.1997.00440420025003.
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JUST AS the names "Star Wars" and Strategic Defense Initiative piqued interest and emotions in the 1980s, the terms salt war1 and salt saga2 and a recent editorial entitled "A Salty Issue"3 discussing a series of articles published in the British Medical Journal have elicited debate in the 1990s. The medical community and the lay public rarely have been as confused and polarized about a health issue as they are concerning the role of sodium chloride in human health and disease. Thus, it seems appropriate to examine the evidence, devoid of emotionalism and innuendo.

Epidemiological evidence has established a direct relationship between the level of sodium intake and the prevalence of hypertension and its cardiovascular consequences in various societies throughout the world.4 Despite the limitations of many of these observational studies, they have demonstrated that in societies in which habitual sodium chloride intake exceeds 50 to


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