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BMJ. 2007 May 12; 334(7601): 967.
PMCID: PMC1867920
Reduced Salt Intake

Sodium reduction is enticing, but what is the full recipe?

Paul P Glasziou, professor of evidence based medicine

Reading the study of the long term effects of dietary sodium reduction on a Friday evening, I wondered whether it could help my hypertensive patients on Monday morning.1 Unfortunately not: the prescription for sodium reduction is not usable by my fellow general practitioners: “Individual and weekly group counselling sessions were offered initially, with less intensive counselling and support thereafter, specific to sodium reduction.”

How do I translate this vague description for my patients? Those rare clinicians diligent enough to track down reference 23 would find a fuller, but still insufficient, description.2 It still misses so many details that I (or a dietitian) would need that I don't know how to replicate it. But there is sufficient detail to show that this form of salt reduction is probably impractical in primary care.

The accompanying Editor's Choice says, “You might try talking salt in your next consultation,”3 but that does not seem viable on the basis of either this paper or the previous publications. That is a pity. As a fan of non-drug interventions, I'd like to be able to share them with my patients. But so often the description of what clinicians and patients need to do is so woefully inadequate that it is unusable. If authors are interested in uptake, they need to make interventions practical and provide sufficient details and materials. In the internet world, space limitations are no longer an excuse.

Notes

Competing interests: None declared.

References

1. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007;334:885-8. (28 April.) [PMC free article] [PubMed]
2. Hebert PR, Bolt RJ, Borhani NO, Cook NR, Cohen JD, Cutler JA, et al. Design of a multicenter trial to evaluate long-term life-style intervention in adults with high-normal blood pressure levels. Trials of hypertension prevention (phase II). Trials of Hypertension Prevention (TOHP) Collaborative Research Group. Ann Epidemiol 1995;5:130-9. [PubMed]
3. Godlee F. Time to talk salt. BMJ 2007; doi: 10.1136/bmj.39196.679537.47

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