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The health effects of salt are the conditions associated with the consumption of either too much or too little salt. Salt is a mineral composed primarily of sodium chloride (NaCl) and is used in food for both preservation and flavor. Sodium ions are needed in small quantities by most living things, as are chloride ions. Salt is involved in regulating the water content (fluid balance) of the body. The sodium ion itself is used for electrical signaling in the nervous system.[1]

The Centers for Disease Control and Prevention (CDC) states that excess sodium can increase blood pressure and the risk for a heart disease and stroke in some individuals.[2] Therefore, health authorities recommend limitations on dietary sodium.[3][4][5][6] The United States Department of Health and Human Services recommends that individuals consume no more than 1500–2300 mg of sodium (3750–5750 mg of salt) per day[2][7] depending on race, medical condition and age.[8] The World Health Organization recommends that adults consume no more than 5 g of salt per day.[9]

As an essential nutrient, sodium is involved in numerous cellular and organ functions. Salt intake that is too low, below 3 g per day, may also increase risk for cardiovascular disease and early death

Hypernatremia, a blood sodium level above 145 mEq/L, causes thirst, and due to brain cell shrinkage may cause confusion, muscle twitching or spasms. With severe elevation, seizures and comas may occur.[12][13] Death can be caused by ingestion of large amounts of salt at a time (about 1 g per kg of body weight).[14] Deaths have also been caused by use of salt solutions as emetics, typically after suspected poisoning.[15]

Hyponatremia, or blood sodium levels below 135 mEq/L, causes brain cells to swell; the symptoms can be subtle and may include altered personality, lethargy, and confusion. In severe cases, when blood sodium falls below 115 mEq/L, stupor, muscle twitching or spasms, seizures, coma, and death can result.[16] Acute hyponatremia is usually caused by drinking too much water, with insufficient salt intake.[17]

Long-term effects[edit]
Main article: Salt and cardiovascular disease
Although many health organizations and recent reviews state that high consumption of salt increases the risk of several diseases in children and adults,[18][19][20][21] the effect of high salt consumption on long term health is controversial.[22] Some suggest that the effects of high salt consumption are insignificant.[23][24]

Excess sodium consumption can increase blood pressure.[18] Most studies suggest a “U” shaped association between salt intake and health, with increased mortality associated with both excessively low and excessively high salt intake.[10][11][25]

Health effects associated with excessive sodium consumption include:

Stroke and cardiovascular disease.[26]
High blood pressure: Evidence shows an association between salt intakes and blood pressure among different populations and age range in adults.[27] Reduced salt intake also results in a small but statistically significant reduction in blood pressure.[22][28]
Left ventricular hypertrophy (cardiac enlargement): “Evidence suggests that high salt intake causes left ventricular hypertrophy. This is a strong risk factor for cardiovascular disease, independently of blood pressure effects.”[27] “…there is accumulating evidence that high salt intake can predicts left ventricular hypertrophy.”[29] Excessive salt (sodium) intake, combined with an inadequate intake of water, can cause hypernatremia. It can exacerbate renal disease.[13]
Edema: A decrease in salt intake has been suggested to treat edema (fluid retention).[13][30]
Stomach cancer is associated with high levels of sodium, “but the evidence does not generally relate to foods typically consumed in the UK.”[31] However, in Japan, salt consumption is higher.[32]
Kidney disease: A US expert committee reported in 2013 the common recommendation by several authorities “to reduce daily sodium intake to less than 2,300 milligrams and further reduce intake to 1,500 mg among persons who are 51 years of age and older and those of any age who are African-American or have hypertension, diabetes, or chronic kidney disease”, but concluded that there was no health-outcome-based rationale for reducing intake below 2,300 mg, and did not have a recommendation for an upper limit.[33]
One report stated that people excreting less salt (thus, presumably ingesting less) were at increased risk of dying from heart disease. However, a recent meta-analysis conducted by the Cochrane Hypertension group found this article was subject to methodological flaws, and urges great caution when interpreting their results.[34]

Another meta-analysis investigated the association between sodium intake and health outcomes, including all-cause mortality and cardiovascular disease (CVD) events.[11] Sodium intake level was a mean of <115 mmol (2645 mg), usual sodium intake was 115-215 mmol (2645–4945 mg), and a