Claim: Medicines should be labeled for salt content

This is junk science because…

Most of the press releases have confused ‘sodium’ with ‘salt’ in their coverage. This dumming down has resulted in misinformation.

Nowhere in the paper do the authors talk of salt in pharmaceutical formulations. They refer to sodium only. This is because they are referring to sodium bicarbonate, sodium carboxymethylcellulose, sodium benzoate, sodium citrate, etc.

It will be interesting to see if this confusion is cleared up by the authors. Their reference to the flawed projected death models, the disputed Intersalt study, Dahl’s work (largely discredited) and the IOM report supporting salt reduction (not the latest IOM report) leads me to believe that they do not mind the erroneous confusion of sodium compounds used in drugs with salt. The other issue of not knowing total sodium intake (no knowledge of dietary sodium intake) makes this study close to useless.

Potassium intake may be a more important issue here. Since it is known that potassium intakes are chronically low, pharmaceuticals containing high levels of it can dramatically improve outcomes (unlike its use as a salt replacer, the bitterness is not noted).

The issue of sodium in pharmaceuticals is not a new issue and calls for labeling were previously published.

[h/t Salt Guru]

The media release is below.

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High salt levels in common medicines put patients at increased risk of cardiovascular events

Researchers call for salt content of medicines to be labeled in same way as foods

Researchers at the University of Dundee and University College London found that taking the maximum daily dose of some medicines would exceed the recommended daily limits for sodium, without any additional dietary intake.

They say the public “should be warned about the potential dangers of high sodium intake from prescribed medicines” and that sodium-containing formulations “should be prescribed with caution only if the perceived benefits outweigh the risks.”

They also call for the sodium content of medicines to be clearly labelled in same way as foods are labelled.

Numerous studies have shown that excess salt is harmful to heart health. Many commonly prescribed medicines have sodium added to improve their absorption into the body, but the effect of this is unknown.

The team, led by Dr Jacob George, Senior Clinical Lecturer and Honorary Consultant in Clinical Pharmacology at the University of Dundee, compared the risk of cardiovascular events (non-fatal heart attack, non-fatal stoke, or vascular death) in patients taking sodium-containing effervescent, dispersible and soluble medications with those taking non-sodium versions of the same drugs between 1987 and 2010.

Over 1.2 million UK patients were tracked for an average of just over seven years. During this time, over 61,000 incident cardiovascular events occurred.

Factors likely to affect the results, such as body mass index, smoking, alcohol intake, history of various chronic illnesses and use of certain other medications, were taken into account.

Overall, the researchers found that patients taking the sodium-containing effervescent, dispersible and soluble medications had a 16% increased risk of a heart attack, stroke or vascular death compared with other patients taking the non-sodium versions of those exact medications .

Patients taking the sodium-containing drugs were also seven times more likely to develop high blood pressure and overall death rates were also 28% higher in this group. These events are largely driven by an increased risk of hypertension and stroke.

The authors acknowledge that there is still some controversy regarding the relation between dietary sodium and cardiovascular events, but say their findings “are potentially of public health importance.”

They conclude: “Prescription of these sodium-containing formulations should be done with caution, and patients prescribed them should be closely monitored for the emergence of hypertension.”

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3 responses to “Claim: Medicines should be labeled for salt content

  1. Salt got a bad name for the same reason that labels and epithets are used by demagogues as rhetorical tools to silence their opponents or critics.

    Ignorant people thought that because people with kidney or heart disease had to decrease salt intake to avoid edema water overload, that somehow reducing salt intake would prevent disease. Sorry–chicken egg fallacy.

    There are people who have salt intolerance because of disease, salt is essential for livining things, which are made up of a lot of salty fluid. The major electrolyte in the extracellular fluids of the body is salt, the resuscitation fluid of choice for dehydrated people and people who have lost blood and need to expand circulating blood volume is Normal Saline until you can get some blood. Dehydrated people get a water and sodium chloride mix resuscitation fluid. We add some potassium if we are going to give a lot of fluids because potassium is a major intracellular and and minor extracellular cation.

    This crummy paper by deceitful people is intended to join the big parade of salt scare charlatans. Shame on them. Salt restriction is important for some special patient groups, not the the general population. We excrete salt if we get too much. Eat your potato chips, they are part of the real world food pyramid.

    Did you know that cured meats are treated with salt preparations to prevent things like Botulism poisoning? Botulinum poison is one of the most potent killer poisons on the planet. Just a little can send you to the other side. Reducing salt in Ham preparation could kill somebody. These salt nannies need to get a job or spend more time with their families.

  2. The ‘study’ may be totally worthless, but the title looks good on a CV.

  3. Should “wellness studies” be required to label the BS content?

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