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American Journal of Clinical Nutrition, Vol 65, 671S-677S, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

REVIEW ARTICLES

Adverse effects of short-term, very-low-salt diets in subjects with risk-factor clustering

BM Egan and KT Stepniakowski
Department of Pharmacology and Medicine, Medical University of South Carolina, Charleston 29425, USA.

Obesity is associated with risk-factor clustering, including risk factors for hypertension, hyperinsulinemia, resistance to insulin's lowering of glucose and fatty acid concentrations, and a complex dyslipidemia. Obese hypertensive subjects are presumed to be salt sensitive because of the antinatriuretic actions of insulin. However, in our studies obese hypertensive subjects aged < 45 y were not more salt sensitive than were lean individuals. Subjects with the greatest evidence for risk-factor clustering had higher renin and aldosterone concentrations, which increased with salt restriction. The greater rise of fatty acids and activation of the renin-angiotensin system may explain the larger elevations of blood pressure, insulin, and triacylglycerol with salt restriction in high-risk subjects than in low- risk subjects. Regardless of mechanism, the adverse effects of short- term, very-low-salt diets in high-risk subjects suggest that continued moderation in advice for universal salt restriction is appropriate.


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Copyright © 1997 by The American Society for Nutrition