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Precise Guideline to Control Salt

A precise guideline to control your salt intake

"Salt restriction” with low salt diets used to be notoriously unpopular and unreliable, and drugs called diuretics took over, but there is a new way to do it without diuretics, and this page links you to a PDF about it.

It was hard work in the old days measuring portion sizes and adding up a cumulative daily total of the sodium that was coming from every portion of every meal.  You can imagine the welcome both doctors and patients gave to a drug that made the kidneys eliminate salt faster than normal, increasing urine production and relieving fluid retention without going on a diet.

After World War II, drug companies started producing “a pill for every ill” and in 1958 they released Chlotride (chlorothiazide), the world’s first synthetic diuretic.  Unfortunately we are now seeing “an ill for every pill”.  Diuretics—also called “fluid tablets” ("water pills" in the US)—have their own potential side effects (low blood sodium and potassium, high blood uric acid and gout, male impotence and glucose intolerance, with earlier onset of type 2 diabetes). To limit the side-effects doctors now prescribe low doses, which obviously remove less salt. Even low doses can still disturb the serum electrolyte balance, and a good way to restore the serum electrolyte balance to normal is to replace the diuretic with a low salt intake [1]. 
 
The Heart Foundation’s advice since 2008 is to remove the long-term side effects of both salt and diuretics—instead enjoy the long-term benefits of a healthier salt intake (the Heart Foundation recommends a maximum of 65 mmol/day) [2]. 
 

The PDF to which this page is linked explains how to take your 24-hour sodium excretion below 50 mmol/day if you follow it strictly, and the Heart Foundation’s 65 mmol for treating hypertension allows a comfortable safety margin for accidental mistakes.  The PDF is a long article [3] written for health professionals, but you should have no trouble understanding most of it, and your doctor can explain anything that is not clear.  Why not make another copy for your doctor—and why not ask for your doctor’s candid professional opinion of this article.

Note for health professionals:  Articles published in supplements are often not reviewed by referees, but this article was extensively revised and enlarged to accommodate the favourable and detailed comments of two referees [3].

Click here for the article. 

References 

1. Beard TC, Cooke HM, Gray WR, Barge R. Randomised controlled trial of a no-added-sodium diet for mild hypertension. Lancet. 1982;2:455–58.

2.  National Heart Foundation of Australia (National Blood Pressure and  Vascular Disease Advisory Committee). Guide to management of hypertension 2008.  Quick reference guide for health professionals. 2008.

3. Beard TC. The dietary guideline with great therapeutic potential. Australian Journal of Primary Health. 2008;14(3):120–31.

This article is published on the web with the permission of the Australian Journal of Primary Health (www.publish.csiro.au/journals/py). 

 

 

 


Page last modified on: Tuesday 16 Mar, 2010

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