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Benefits of very-low-sodium diet questioned

WASHINGTON -- A surprising new report questions public health efforts to get Americans to sharply cut back on salt, saying it's not clear whether maintaining super-low levels is worth the struggle.

Make no mistake: Most Americans eat way too much salt, not just from the shakers but because of sodium hidden in processed foods and restaurant meals.

So yesterday's report still stressed that the nation needs to ease back on the sodium for better heart health.

But there's no good evidence that eating very low levels -- below the 2,300 milligrams per day that the government recommends for most people -- offers benefits even though national guidelines urge certain high-risk patients to do just that, the Institute of Medicine concluded.

Also, there are some hints, albeit from studies with serious flaws, that eating the lowest levels might harm certain people -- those who are being aggressively treated for serious heart failure, the report added. The prestigious group, which advises the government about health, urged more and better research to settle the best target range.

"We're not saying we shouldn't be lowering excessive salt intake," said Dr. Brian Strom of the University of Pennsylvania, who led the IOM committee. But below 2,300 mg per day, "there is simply a lack of data that shows it is beneficial," he said. The average American consumes more than 3,400 mg of sodium per day, equivalent to 11/2 teaspoons.

U.S. dietary guidelines say most people should limit themselves to the 2,300 mg, but certain people -- those older than 50, African-Americans, and people with high blood pressure, diabetes or chronic kidney disease -- should aim for just 1,500 mg.

The report sparked an immediate outcry from health organizations that have long battled to lower the nation's salt consumption. The American Heart Association said it stood by its own stricter recommendations that everyone eat no more than 1,500 mg of sodium per day.

Debating how little salt is too little is a moot point, said nutritionist Bonnie Liebman of the Center for Science in the Public Interest. "The average American is still in the red zone, the danger zone," she said.