Adding salt to foods and hazard of premature mortality

European Heart Journal: Published: 10 July 2022

Adding salt to foods (usually at the table) is a common eating behavior directly related to an individual's long-term preference to salty taste foods and habitual salt intake. Indeed, in western diet, adding salt at the table accounts for 6–20% of total salt intake.

In addition, the commonly used table salt contains 97–99% sodium chloride, minimizing the potential confounding effects of other dietary factors including potassium. Therefore, adding salt to foods provides a unique assessment to evaluate the association between habitual sodium intake and mortality.

In this study, authors analyzed the association between the frequency of adding salt to foods and the hazard of premature mortality and life expectancy.

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In this prospective study of 501,379 UK Biobank participants, a dose-dependent increased risk of all-cause mortality was observed with increasing frequency of adding salt to food.

Authors found that higher frequency of adding salt to foods was significantly associated with a higher hazard of premature mortality and lower life expectancy, independent of diet, lifestyle, socioeconomic level, and pre-existing diseases.

Compared with participants who reported to never/rarely adding salt to foods, those who always added salt to foods had a 1.50- and 2.28-year lower life expectancy at the age of 50 years in women and men, respectively.

An increased intake of fruits and vegetables significantly attenuated the hazard of premature mortality in a dose-dependent fashion.

In conclusion, this study indicates that the higher frequency of adding salt to foods is associated with a higher hazard of all-cause premature mortality and lower life expectancy. High intakes of potassium-rich foods, such as vegetables and fruits, may attenuate the association between adding salt to foods and mortality.

These findings suggest that addition of salt to food is associated with a dose-dependent increase in premature mortality.

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Abstract

Aims: Authors analyzed whether the frequency of adding salt to foods was associated with the hazard of premature mortality and life expectancy.

Methods and results: A total of 501 379 participants from UK biobank who completed the questionnaire on the frequency of adding salt to foods at baseline. The information on the frequency of adding salt to foods (do not include salt used in cooking) was collected through a touch-screen questionnaire at baseline. Authors found graded relationships between higher frequency of adding salt to foods and higher concentrations of spot urinary sodium or estimated 24-h sodium excretion. During a median of 9.0 years of follow-up, 18 474 premature deaths were documented. The multivariable hazard ratios of all-cause premature mortality across the increasing frequency of adding salt to foods were 1.00 (reference), 1.02 (0.99, 1.06), 1.07 (1.02, 1.11), and 1.28 (1.20, 1.35). Authors found that intakes of fruits and vegetables significantly modified the associations between the frequency of adding salt to foods and all-cause premature mortality, which were more pronounced in participants with low intakes than those with high intakes of these foods. In addition, compared with the never/rarely group, always adding salt to foods was related to 1.50 and 2.28 years lower life expectancy at the age of 50 years in women and men, respectively.

Conclusions: Our findings indicate that higher frequency of adding salt to foods is associated with a higher hazard of all-cause premature mortality and lower life expectancy.

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