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Mediterranean Diet not just for Mediterranean people
 There's another misconception that I run into frequently, however, and it's that because the peoples around the Mediterranean Sea are mostly white (debatable), its benefits haven't been adequately established for non-whites or people who don't live in the countries around the Mediterranean Sea.

Even More Reason to Hold the Salt
When scientific studies are reported on in the media they can appear far more conclusive than they really are. For example, many clinical studies in humans have shown a link between high sodium (salt) intake and high blood pressure.

Finding a direct link from sodium to heart disease
I like to tell my medical students that "medicine is not math." Remember that Transitive Property of Equality you might have learned about in Algebra? Where if A = B and B = C, then A always equals C? Medicine is not like that. (Would that it were!) In medicine, sometimes A = B and B = C, but A has no relation to or effect on C.


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Sodium and Stroke

The United States Department of Agriculture recommends that Americans limit their sodium intake to less than 2400 milligrams per day. The American Heart Association, however, recommends a limit of 1500 milligrams per day. We know that high levels of sodium in the diet are linked to high blood pressure and thus to the risk of stroke, but until recently many studies have not tried to link sodium and stroke more directly.

In a well-designed study recently published in the journal Stroke (2012;43(5):1200-1205), researchers at the University of Miami and Columbia University in New York City collaborated to use information gathered through a multiethnic study of diet and stroke based in Northern Manhattan. The over 2,600 participants in the researchers' analysis were between 50 and 80 years of age and had not previously experienced a stroke at the start of the ten-year study. Over half of the participants (53%) were Hispanic, while 21% were white and 24% black.

At the start of the study the participants answered a detailed dietary questionnaire to help determine their daily sodium intake. Every year thereafter the participants were recontacted to discuss their current health, including any hospitalizations, medication changes, or changes in stroke risk factors (such as smoking).

Interestingly, only 12% of the participants were meeting the American Heart Association recommendation of less than 1500 milligrams of sodium per day. Slightly more than one third of the participants were under the USDA recommendation of less than 2400 milligrams per day, while 21% were consuming over 4,000 milligrams of sodium per day.

The researchers then compared the sodium intake of those who experienced stroke of any kind or a heart attack with those who did not. They found that compared to those meeting the AHA recommendation, those who were consuming over 4,000 milligrams of sodium per day were more than 2 and a half times more likely to have a stroke. In fact, every increase of sodium intake of 500 milligrams per day increased the risk of stroke by 17%: an intake of 2500 milligrams per day meant a 34% increase in risk; 3,000 milligrams per day was a 51% increase in risk, and so on.

What this means for you

While the USDA recommends 2,400mg/day for most Americans, it further recommends that those over 50, black, or suffering from diabetes, high blood pressure or kidney disease limit their intake to 1500mg/day. This study certainly supports the American Heart Association's recommendation that all Americans reduce their intake to under 1500mg/day. You can get started reducing your sodium intake with our low sodium recipes, which are designed to keep your intake under the 2400 milligram per day target. Find the low sodium recipes at

First posted: June 27, 2012