EFSA provides advice on adverse effects of sodium

The Scientific Panel on Dietetic Products, Nutrition and Allergies (NDA) of the European Food Safety Authority (EFSA) published today an opinion concerning the establishment of a Tolerable Upper Intake Level (UL) for sodium. While sodium is an essential nutrient, the habitual intake of sodium (mainly as salt) for populations in Europe is high and exceeds nutritional requirements. Following review of scientific evidence, the Panel advised that current levels of sodium consumption are associated directly with increased blood pressure, a risk factor for cardiovascular and renal diseases. Panel experts concluded that it is not possible to determine an intake level of sodium, above the recommended dietary intake, which is unlikely to pose a risk of adverse health effects. This is due to the continuous relationship between sodium intake and blood pressure and the many factors which can modulate blood pressure response to dietary sodium. The Panel is currently reviewing dietary recommendations for sodium as part of a new mandate for setting nutrient recommendations for the European Union.

EFSA’s NDA Panel has continued the work of the former Scientific Committee on Food (SCF) related to the establishment of tolerable upper intake levels of individual vitamins and minerals. The definition of nutrient levels for which daily intakes are unlikely to pose a risk of adverse health effects is a task requested by the European Commission in relation to the safe use of nutrients in fortified foods and food supplements. Sodium belongs to one of the 12 remaining vitamins and minerals for which EFSA has been asked to provide scientific advice in support of the European Commission’s legislative work in this domain.

While sodium is an essential nutrient, dietary intakes in Europe today far exceed nutritional requirements. Although this mineral is present in foods as a normal constituent at low levels, its main source in the diet (about 70-75% of total intake) is processed foods. Sodium is added to foods mainly as sodium chloride, commonly known as salt.

Elevated blood pressure has been identified to be the major adverse effect associated with increased sodium intake. Higher blood pressure in turn has been directly related to the development of cardiovascular and renal diseases which are major causes of morbidity and mortality in Europe.

The effect of sodium is linked to that of chloride as the rise of blood pressure is affected by the increased consumption of salt (sodium chloride); hence the relevance of the opinion on Tolerable Upper Intake Level of Chloride also published today by the NDA Panel. While blood pressure rises with increasing sodium consumption, this effect can be modulated by a range of factors such as the overall composition of the diet, body weight, level of physical activity, age, gender and genetic factors. Given the continuous relationship between sodium intake and blood pressure and the many and interrelated factors which can affect blood pressure response to dietary sodium, panel experts concluded that it is not possible to determine a level of sodium intake, beyond the recommended dietary intake, which does not have an adverse effect.

While it was not in the remit of this evaluation, to provide dietary advice regarding sodium and salt intakes, the NDA Panel is currently undertaking such work as part of a new mandate on “Population Reference Intakes.” In this context, the Panel will define nutrient recommendations for the EU as well as guidance on the development of food-based dietary guidelines.

Notes to editors

Mean daily sodium intakes of populations in Europe range from about 3-5 g (about 8-11 g salt) and are well in excess of recommended dietary intakes (about 1.5 g sodium/day in adults equivalent to 3.8 g salt). 

A number of national and international bodies have set targets for reduction of average salt intake levels in the population (to 5-7 g salt per day) in order to reduce blood pressure, and related risk of cardiovascular and other diseases. Such targets are not based on a “no effect” level with respect to blood pressure but have been set by public health authorities as realistic goals to achieve, taking into account current levels of intake which are well in excess of dietary needs.

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