Back in 2003, the Cochrane Collaboration published its evidence-based review of the health outcomes of reducing dietary salt, concluding:
Intensive interventions, unsuited to primary care or population prevention programmes, provide only minimal reductions in blood pressure during long-term trials. Further evaluations to assess effects on morbidity and mortality outcomes are needed for populations as a whole and for patients with elevated blood pressure.
Coming from the inventors of the term "evidence-based medicine," this should have caused reconsideration of the entire approach of universal salt reduction. It also pointed the way to resolving the ongoing conflict among medical experts about whether salt restriction should be part of recommended dietary guidelines: it called for "further evaluations to assess effects on morbidity and mortality outcomes...."
Since then, several new studies have been published on the health outcomes of low-salt diets; they haven't confirmed a benefit.
So the Cochrane Collaboration has re-issued its 2003 Review, unchanged .
Proponents of evidence-based nutrition recommendations should use the 2008 version to counter the statistically-creative, substantively-deficient, blood pressure-centric arguments posited by proponents of the status quo. As this re-publication reminds us, it's time to sweep away opinion-based recommendations and replace them with sceince-based guidelines.
