Dietary Salt (Sodium) Increases Stomach Cancer Risk

 

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“A critical weekly review of important new research findings for health-conscious readers”


DIETARY SALT (SODIUM) INCREASES STOMACH CANCER RISK

 

Cancer of the stomach occurs only about half as commonly today in the United States as it did 30 years ago, but it remains one of the “bad actor” cancers that are associated with a high likelihood of death.  On a global scale, stomach cancer remains the #2 cause of cancer-associated death, while in the United States, gastric cancer is currently the #7 cause of cancer-associated death.

Known risk factors for stomach cancer include chronic infection with the Helicobacter pylori bacterium (and other causes of chronic gastric inflammation), smoking, obesity, decreased acid secretion within the stomach, stomach ulcers, pernicious anemia, a family history of stomach cancer, certain inherited cancer syndromes, and other less common risk factors.  As with other GI tract cancers, diet also appears to play an important role in gastric cancer risk.  For example, gastric cancer is more common among people who eat a lot of processed meat and red meat, smoked foods, and salt-cured or pickled foods.  On the other hand, stomach cancer is less common among people who consume a large amount of fresh fruits and vegetables.

The role of salt in gastric cancer risk has been a subject of some debate, as clinical research studies have come to varying and contradictory conclusions regarding this issue.  However, a newly published public health study, which appears in the current issue of the British Journal of Cancer, appears to strongly link excess salt consumption with an increased risk of developing stomach cancer.  In this case-control study, 442 patients with stomach cancer, and 649 healthy patients without any clinical evidence of cancer, were evaluated.  Multiple previously validated dietary questionnaires were administered to all of the study volunteers, with particular attention to dietary salt intake. 

The results of this public health study indicated that the risk of stomach cancer was twice as common among patients who regularly consumed the highest amounts of salt, when compared to patients with the smallest amount of regular salt intake.  After adjusting for other risk factors known to be associated with gastric cancer risk (including Helicobacter pylori status, smoking history, and other known gastric cancer risk factors), increased salt intake was still associated with a doubling of gastric cancer risk. 

While case-control studies, such as this one, do not offer high-level clinical research evidence (unlike the “gold standard” prospective, randomized, blinded clinical research trials that provide “Level 1” clinical research data), the findings of this observational study nonetheless add to an increasing volume of data linking increased salt intake with gastric cancer risk.

Excessive salt intake has also been clearly linked to a significant increase in the risk of high blood pressure, stroke, and cardiovascular disease.  Most hypertension experts are currently recommending that we lower our average daily intake of sodium, from the current 3,500 to 4,000 milligram (mg) per day level in the United States, to somewhere around 1,500 mg per day.  At this level of sodium intake reduction, significant improvements in high blood pressure, and in the risk of stroke and cardiovascular disease, have been demonstrated by multiple high-quality clinical research studies.  (An excellent pamphlet on the topic of dietary sodium reduction, as part of a heart-healthy diet, has been published online by the National Institutes of Health.)    

As with many other dietary and lifestyle factors that have been shown to reduce cancer risk, reducing sodium intake, by reducing your dietary salt consumption, can pay big health dividends not only in terms of cancer risk reduction, but also in terms of reducing those other great global killers of mankind, cardiovascular disease and stroke!

 

 

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Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity




Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author




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Salt (Sodium) Intake, Stroke & Cardiovascular Disease

December 6, 2009 by Robert Wascher  
Filed under Nutrition, diet, health, heart disease, stroke

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”


 

Salt (Sodium) Intake, Stroke & Cardiovascular Disease

 

 

Table salt consists of the elements sodium and chloride, both of which are essential for life.  There is a great deal of clinical research suggesting that more than 5 to 6 grams of salt intake per day (which is equal to 2 to 2.4 grams of sodium)  is associated with a significant increase in the risk of developing high blood pressure which, in turn, is associated with a significantly increased risk of stroke and cardiovascular disease.  Unfortunately, in most countries, the average daily salt intake for adults is considerably greater than 6 grams per day.  Moreover, in many countries of the world, the average daily adult intake of salt is a whopping 12 grams per day, or almost 5 grams of sodium per day. 

 

In the United States, the American Heart Association (AHA) currently recommends no more than 2.3 grams of sodium intake per day (equivalent to 5 grams, or about one teaspoon, of salt per day).  At the same time, the AHA also states that the ideal daily intake of sodium should actually be about 1.5 grams per day but, in an acknowledgment regarding the high intake of salt-rich processed foods in the United States, the AHA considers the 2.3 gram per day dietary sodium target to be more “realistic” for Americans.

 

There is considerable public health research data suggesting that the reduction of average daily adult salt intake, to 6 grams per day, or less, would result in a significant lowering of blood pressure in both people with and without high blood pressure.  Based upon these research findings, some public health experts have predicted that lowering the average daily salt intake below 6 grams per day could reduce the incidence of stroke by almost 25 percent, and the incidence of cardiovascular disease by almost 20 percent.  Unfortunately, there have not been any large-scale prospective, randomized, placebo-controlled clinical research trials performed to validate these estimates.  On the other hand, there have been multiple short-term prospective public health trials that have followed groups (cohorts) of patients in terms of their dietary intake of salt and the incidence of stroke and cardiovascular disease events.  Now, a newly published research study, in the British Medical Journal, has performed a meta-analysis of 13 of these “prospective cohort” studies, encompassing a total of 177,025 patient volunteers, with average durations of patient follow-up ranging from 4 to 19 years.  (Meta-analysis is a method of combining the data from multiple different clinical studies into a single “super-study,” in an effort to improve the validity of the resulting data, as well as the conclusions that are reached from such data.)

 

Among these more than 177,000 patient volunteers, there were 11,000 “vascular events” observed, including stroke and heart attacks (myocardial infarctions).  When the incidence of these vascular events was analyzed, along with dietary salt intake, the patients with the highest daily salt intake were observed to experience a 23 percent greater risk of stroke, and a 17 percent greater risk of cardiovascular disease, when compared to the adults who consumed less salt on a daily basis.

 

The increasing consumption of salt-rich processed foods throughout both the developed and underdeveloped countries of the world has been pushing daily salt intake to ever higher levels, with many Western countries reporting average daily adult salt intake of nearly 10 grams per day.  In other countries, and most notably in Asia and Eastern Europe, dietary practices that include a high concentration of heavily salted foods have pushed daily salt intake into the 10 to 12 gram per day range for the average adult.

 

The World Heart Federation estimates that there are 5.5 million annual deaths from stroke across the globe, and an additional 17.5 million annual deaths from cardiovascular disease.  Based upon the increased incidence of stroke and cardiovascular disease predicted by this meta-analysis study, even a rather modest decrease in the average adult daily salt intake, to the World Health Organization’s target of 5 grams per day, should result in 1.25 million fewer deaths per year from stroke and nearly 3 million fewer annual deaths from cardiovascular disease around the world.  Needless to say, this is a tremendous potential public health dividend from a rather simple alteration in our dietary habits.  (On the surface, reducing our daily salt intake would appear to be a rather simple goal.  However, the more complicated reality is that to achieve even the World Health Organization’s rather liberal target of 5 grams of salt per day, our entire food chain would have to be comprehensively reexamined and overhauled.) 

 

The world’s increasing consumption of highly-processed foods, which often contain high levels of salt as a preservative, are largely responsible for the high levels of salt intake in the developed world (in addition to a preference for salt-cured foods in much of Asia and Eastern Europe).  In the United States, the sodium content of most processed foods is readily available on food packages.  Unfortunately, most restaurants in the United States have not been as forthcoming about the sodium content of the food on their menus (as well as other important nutritional information), and so it continues to be very difficult to determine the actual salt content of much of what we eat here in the United States and, indeed, throughout much of the world.

 

 

 

Note:  Weekly Health Update is currently undergoing an extensive upgrade to better serve its tens of thousands of health-conscious readers around the world.  Beginning in January 2010, newly archived columns will be available by selecting the “Archives” tab on the right side of your screen (all archived columns prior to January 2010 will continue to be available by selecting the “Archives 2007-2009” tab at the top of the screen.)


 


Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author

 

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