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To the Editor: In examining the relationship of dietary sodium intake and health outcome, Dr He and colleagues¹ have refined and extended our earlier analysis² of the long-term mortality experience of the National Health and Nutrition Examination Survey (NHANES) participants. Their findings support our prediction that the nature of this relationship would be affected by other patient characteristics. Indeed, He et al now report that, in the obese minority of a subset of the entire NHANES population, increased sodium intake was associated with increased mortality. This was not true in the majority (72%) who were not obese.

There were meaningful differences in the methods of the 2 studies. In seeking to understand universal recommendations for sodium intake, we included all respondents with data on sodium and mortality in this national sample. By contrast, He et al arbitrarily excluded the 1470 (13%) participants reporting a low-salt diet or a history cardiovascular . . . [Full Text of this Article]

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Dietary Sodium Intake and Subsequent Risk of Cardiovascular Disease in Overweight Adults
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