CASH Calls for Diabetics to Reduce Salt Intake

The new research is published in the journal Hypertension (‘Modest salt reduction lowers blood pressure and albumin excretion in impaired glucose tolerance and Type 2 diabetes mellitus’).

 

This is the first time that this finding has been so conclusively demonstrated.

 

Therefore, CASH is now calling for ALL patients with Type 2 diabetes and glucose intolerance to be shown how to reduce their salt intake to prevent further deaths.

 

The study was a carefully conducted 12 week randomized double-blind, crossover study of 46 individuals with Type 2 diabetes or impaired glucose tolerance and normal or mildly raised blood pressure (~134/82 mmHg). Patients were asked to reduce their salt intake to ~5g/day and continued on this reduced salt intake for the duration of the study.
After 2 weeks, they were randomized either to take salt tablets (5g salt/day), or the equivalent number of placebo tablets (0g salt) for 6 weeks. At the end of the 6-week period the participants crossed over to take the opposite tablets for a further 6 weeks. Blood pressure was measured before entry to the study and at the end of each 6-week period.

 

At the end of the 6-week crossover, salt intake fell by 2.9g/day (from 9.7g to 6.9g) and with this reduction in salt intake, blood pressure fell significantly from 135.5±2.0 / 81.3±1.1 mmHg with salt to 131.2±1.9 / 79.7±1.2 mmHg with placebo (P<0.01).

 

CASH is a group of specialists concerned with salt and its effects on health. It is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high salt diet, and bring about a reduction in the amount of salt in processed foods as well as salt added to cooking, and the table.

 

Dr Rebecca Suckling, Consultant Nephrologist at St Helier Hospital and lead author of the research said: “This study is the first and largest study of dietary salt intake in patients with Type 2 diabetes or impaired glucose tolerance early on in their disease and has shown that lowering salt intake reduces blood pressure and the urinary albumin level, both important risk factors for cardiovascular disease and kidney failure.”

 

“Reducing blood pressure through lifestyle changes is recommended by all national and international guidelines but patients do not consistently receive any advice on lowering salt intake. This study highlights that all patients with Type 2 diabetes and impaired glucose tolerance should be given advice on lowering salt intake to levels at least less than 6g a day.”

 

Currently, the number of people diagnosed with diabetes in the UK is estimated to be 3.5 million, 90% of which have Type 2 diabetes.  This number is set to rise worldwide as the prevalence of overweight and obesity increases, and will continue to do so until preventive measures are carried out. Worldwide, it is predicted that there will be a global rise in the number of people with diabetes mellitus from 171 million people in 2010 to 366 million by 2030.

 

Raised blood pressure is one of the most important risk factors in Type 2 diabetes, with at least a twofold increased risk in developing cardiovascular disease compared to those who do not have Type 2 diabetes or glucose intolerance. This study clearly demonstrates that a modest reduction in salt intake causes a significant reduction in both blood pressure and albumin excretion, which will reduce their risk of developing strokes, heart attacks and heart failure as well as being likely to reduce the risk of kidney disease.

 

Graham MacGregor, Professor of Cardiovascular Medicine at Queen Mary University of London and Chairman of CASH said: “This study clearly demonstrates that salt reduction is effective in lowering blood pressure in patients with Type 2 diabetes or glucose intolerance. This is the first time that this has been so conclusively demonstrated and it is important now that all patients with Type 2 diabetes or glucose intolerance are given appropriate advice on how to reduce their salt intake.”

 

“This study also has public health implications in that it is vital that we continue to reduce salt intake in the UK by getting the food industry to take out the huge and completely unnecessary amounts of salt that they put into our food (80% of our current intake). Currently, the world leading UK salt reduction strategy has been stopped whilst David Cameron dithers on his Childhood Obesity Strategy to tackle obesity and Type 2 diabetes. This plan will apparently also contain a new strategy to reduce salt intake but we have been waiting for Cameron to decide for almost over a year".