High-Salt Diet Doubles Heart Risk in Type 2 Diabetes

People with Type 2 diabetes who eat a high-sodium diet have twice the risk of developing cardiovascular disease as those who consume less salt, according to new research published in The Journal of Clinical Endocrinology and Metabolism. Cardiovascular disease and stroke are the leading causes of death among people who have diabetes.


Many guidelines recommend that people with Type 2 reduce their sodium intake, but few studies have explored the link between sodium intake and diabetes complications in this population. To evaluate this relationship, researchers in Japan surveyed 1,588 subjects ages 40–70 from the Japan Diabetes Complications Study who had been diagnosed with Type 2 diabetes and who had an A1C level (a measure of glucose control over the previous 2–3 months) of 6.5% or higher.

The participants filled out a Food Frequency Questionnaire about their diets, including sodium intake, and were then followed for eight years to determine their risk of various diabetes complications, including cardiovascular disease, kidney disease, eye disease, and all-cause death.

Dividing the participants into four groups based on their sodium consumption, the researchers found that those who ate the highest amount of sodium — an average of 5.9 grams a day, or roughly 2 1/2 teaspoons of salt — had double the risk of developing cardiovascular disease as those who ate the lowest amount of sodium — an average of 2.8 grams a day, or slightly more than one teaspoon of salt. They additionally found that every 1-gram increase of salt per day was associated with an increased risk of heart and blood vessel disease.

Further breaking the groups down according to blood sugar control, the researchers found that heart risk was significantly higher for people eating the most salt compared to those eating the least salt if they had an A1C level greater than 9%.

The risk of kidney disease, eye disease, and all-cause death was not found to be associated with sodium intake.

“To reduce the risk of developing cardiovascular disease, it is important for people who have Type 2 diabetes to improve their blood sugar control as well as watch their diet. Our findings demonstrate that restricting salt in the diet could help prevent dangerous complications from diabetes,” noted study author Chika Horikawa, RD, MSc, CDE, of the University of Niigata in Japan.

For more information, read the article “High-salt diet doubles threat of cardiovascular disease in people with diabetes” or see the study’s abstract in The Journal of Clinical Endocrinology & Metabolism. And to learn more about reducing your salt intake, read the article “Cutting Back on Sodium: Are Salt Substitutes the Answer?” by registered dietitian Julie Licthy Balay.

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  • MJ

    I would be interested in knowing what type of sodium – was this regular table salt? What other kinds of foods were the participants eating? What was the quality of the food in their complete diet? I don’t see how you can pinpoint all these adverse health problems as being directly related to sodium intake. It’s not like they are eating sodium in a vacuum with no other input into their health (or lack thereof).

    I looked at all of the links provided and could not find any information in regards to any of my questions.

  • Kathy

    Salt, Sodium, Sea Salt
    Following my husband’s stroke in July 2012, the salt shaker was placed in the back of the cabinet. We use garlic powder, onion powder, etc., and Mrs. Dash seasonings for adding flavor to foods. We learned that all food already contains Sodium and there is no need to add salt. For canned goods we buy No Salt Added items or if using regular canned vegetables we drain & rinse before use. Sure the food tastes a bit different, but a healthier lifestyle calls for change.

  • Chandan Khan

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