German and US researchers report that cognitive ageing could be delayed by up to 2.5 years in elderly people who eat greater amounts of blueberries and strawberries, flavonoid-rich berries. Flavonoids are compounds found in fruits, nuts and vegetables that have been linked to disease prevention through their antioxidant and anti-inflammatory properties. Berries are particularly high in a subclass of flavonoids called anthocyanidins, which can cross the blood–brain barrier and localise in areas of learning and memory. The research used data from the Nurses’ Health Study – a cohort of 121,700 female, registered nurses who since 1980 have been surveyed every four years regarding their frequency of food consumption. Between 1995 and 2001, cognitive function was measured in 16,010 subjects over the age of 70 years, at two-year intervals.

The study shows that women who had higher berry intake delayed cognitive aging by up to 2.5 years. The authors caution that while they did control for other health factors in the modelling, they cannot rule out the possibility that the preserved cognition in those who eat more berries may be also influenced by other lifestyle choices, such as exercising more.

 Feel free to use these quotes in your stories.  Any further comments will be posted on our website at here. If you would like a copy of the research or to speak to an expert, please don’t hesitate to contact us on (08) 7120 8666 or by email.

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Dr Bryce Vissel is Head of the Neurodegeneration Research Laboratory at the Garvan Institute of Medical Research

“Cognitive decline is often a sign of the onset of dementia and Alzheimer’s in the elderly. There are currently no known therapies that slow the dementia disease process. The results of this study by Dr Devore et al in the USA suggest that significant berry intake may delay cognitive aging by up to 2.5 years. Their research suggests that this may be due to the flavonoid content of the berries. The public policy implications of this research are sufficiently important to merit further study. However, the implications are further reaching, as they show that research offers the possibility to identify ways to slow dementia. Most importantly, if research can show that lifestyle affects cognitive decline, then it seems logical to suggest that research will also deliver effective treatments that slow cognitive decline, given the chance.  

The potential implications of this type of research are that simple berries could potentially reduce the time before elderly people may need care. However, the broader point is that more research is needed and it is needed urgently.”

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Professor Peter Howe is a Research Professor in Nutritional Physiology at the University of South Australia

“Flavonoids are not simply antioxidants – they can have very specific effects on mechanisms involved in circulatory function and inflammation as well as potentially acting on the nervous system. This large scale prospective study has been able to drill down and show that a specific class of flavonoids, the anthocyanidins (that are coming predominantly from strawberries and blueberries) are able to improve cognitive function. There are other sources of flavonoids like tea and cocoa that have also been shown to have cognitive benefits. (Some of the best work in this area has been done by Andrew Scholey at Swinburne’s Centre for Human Psychopharmacology.)

 The flavonoids appear not only to influence cognitive function but also visual function. Research in Canada is showing how the consumption of blueberries can enhance visual acuity, and there is also evidence for similar effects with the cocoa flavanols.

 What I think is happening here, which is not considered in this paper, is that the flavonoids are acting on the blood vessels in the brain and the eyes to improve the circulation. We’re conducting research at the Nutritional Physiology Research Centre looking at how foods rich in flavonoids, like the ones present in these berries, are able to improve blood flow in the brain, because that may be the key to their cognitive benefits. We’re leading that particular line of research at the moment. And we’re doing that in collaboration with our colleagues at Swinburne University.”

Prof Howe will give a presentation on this topic at the Canadian Nutrition Society’s annual meeting next month in Vancouver.

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Associate Professor Shawn Somerset is Associate Professor of Public Health at the Australian Catholic University in Brisbane

 “My previous work has shown that in elderly Australians the most likely source of flavonoids is wine. Berries are expensive, and there are other good sources of anthocyanadins, eg. aubergine (eggplant). Australian intake of vegetables is inferior to fruit, therefore vegetable consumption needs to be promoted above fruit consumption. The most sensible advice is to consume a wide range of flavonoids (rather than large amounts of specific ones, since excessive amounts of some are problematic). This translates to consuming a range of vegetables and fruits, not just one type.”

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 Comments from the UK SMC:

Dr Eric Karran, Director of Research at Alzheimer’s Research UK, said:

“Population studies like this can provide useful clues about the effects of lifestyle and diet on cognition, but we must be sensible when interpreting the results. The study suggests a link between eating berries and slower cognitive decline, but there could be many factors at play.

“It is not possible to say whether the increased consumption of berries resulted in an increased, beneficial level of flavonoid antioxidants in the brain. Further research will be needed to conclude whether antioxidants in berries are beneficial in the brain and we can’t assume that simply eating berries could protect against cognitive aging or dementia.

“Understanding the factors that affect our memory and thinking as we age can help us to understand possible risk factors for dementia. Previous evidence has shown that eating fruit as part of a healthy diet in midlife could help to reduce our risk of dementia and so eating a healthy balanced diet is something we should all be thinking about. With 820,000 people in the UK living with dementia, there is an urgent need to understand more about how to reduce the risk.”

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 Carol Brayne, Professor of Public Health Medicine, University of Cambridge, said:

“Broccoli, blueberries, Mediterranean diet, Sudoku…..it is very difficult indeed to be sure that this is not residual confounding as these kinds of dietary patterns are associated with many other positive attributes, which themselves are associated with healthier ageing.

“Blueberries have been of interest for many years and it’s certainly worth further investigation, but for definitive evidence we have to await well designed trials as this is another observational study.”

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 Derek Hill, CEO of IXICO and Professor of Medical Imaging Sciences, University College London, said:

“Later this year, two major drug trials targeting the proteins in the brain associated with Alzheimer’s Disease will announce their results. Many experts fear these drugs will be added to the long list of potential dementia treatments that fail to demonstrate conclusively that they slow cognitive decline.  

 “This latest research suggesting that a diet high on berries can slow cognitive decline in the elderly population is therefore especially welcome. It is a large and well-designed study that significantly strengthens the evidence that changes to diet may be able to delay onset of dementia symptoms. This suggests that we can take further steps to tackling the scourge of dementia in society while we await the arrival of effective new medicines.”

 ———–

* ‘Dietary Intakes of Berries and Flavonoids in Relation to Cognitive Decline’ by Devore, E. et al. will be published in Annals of Neurology at 2pm AEST on Thursday 26th April, which is also when the embargo will lift.

The guidelines are now available online at www.eatforhealth.gov.au.

These guidelines contain updated dietary advice based on the latest scientific evidence. A news briefing was held in Canberra on Monday 12 December. Below experts comment on the guidelines.

Feel free to use these quotes in your stories. If you would like to speak to an expert, please don’t hesitate to contact us on (08) 7120 8666 or by email.

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Dr Amanda Lee, Chair of the Dietary Guidelines Working Committee

“To answer the question: ‘What should Australians eat?’ the NHMRC reviewed systematically and rigorously the body of scientific evidence related to food, diet and health outcomes. The results confirm previous advice, but this is now underpinned by stronger scientific evidence.

Most Australians need to increase our intake of vegetables (particularly different types and colours), fruit, whole grain cereal foods, and milk products- especially reduced fat varieties. But if we are to tackle obesity and diet-related chronic disease like type 2 diabetes, heart disease, stroke and some cancers, we also need to reduce excessive intake of energy-dense nutrient-poor foods and drinks which are high in saturated fat, salt and added sugar, particularly sugar sweetened drinks. Foods high in saturated fat should be replaced by those containing polyunsaturated and monounsaturated fats. It is also important to be physically active and to check weight regularly. Some population groups need to eat more of some food groups and less of others. For example, while some adult males may need to reduce their consumption of red meat, young women and pregnant women who consume an omnivore diet may benefit from eating more lean red meat. Evidence of the health benefits of breastfeeding for both infants and mothers has also strengthened. To avoid food borne illness, it is also important to care for our food and store it safely.

The Dietary Guidelines help cut through all the misinformation about diet, and should help Australians enjoy health and wellbeing, achieve a healthy weight and reduce risk of chronic disease.

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Professor Manny Noakes is Research Program Leader in Food, Nutrition and Health Science at CSIRO Food and Nutritional Sciences and co-author of the CSIRO’s “Total Well Being Diet” book.

“I think that the NHMRC have done an enormous amount of work in reviewing the scientific literature and have developed a comprehensive set of dietary recommendations that are based on good scientific evidence. It is vital to continue to review new scientific findings and modify recommendations accordingly. The new guidelines confirm the previous guidelines and that very little has changed with regard to major dietary advice. The key messages are about focussing primarily on healthy foods such as fruits, vegetables, whole grains, low fat dairy foods, and lean meats, fish, eggs and other protein foods. The important next step will be to translate these guidelines into practical advice that can help Australians put them into everyday practice.”

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Professor Jennie Brand-Miller is a researcher on carbohydrates and the glycaemic index of foods at the Boden Institute, University of Sydney

“The NHMRC have done a fantastic job in a really difficult area. They’ve walked a fine line between giving practical versus overly scientific advice.

If I had to split hairs, then I would say that there is not enough scientific evidence to say that solid foods that contain added sugars are any more harmful than foods that contain refined starch. They assume that starch, in all forms, does no harm. However, my area of research is in the glycaemic index (GI) and I think that high-GI starch is worse than added sugars.

In an earlier version, they recommended eating grains, preferably wholegrains, whereas now they are saying eat mostly wholegrains. I would have liked to see them come out a little stronger and say that we really should just be eating wholegrains as there is mounting evidence that refined grains cause harm.

I am 95 per cent happy with what has been said and think there is some incredibly helpful advice, particularly to those wanting to manage heart disease and diabetes.”

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Professor Peter Clifton is a visiting scientist at CSIRO’s Preventative Health Flagship. He is also Affiliate Professor of Medicine and Biomedical Science at the University of Adelaide and Laboratory Head, Nutritional Interventions at the Baker IDI Heart and Diabetes Research Institute.

What has changed for the better?

“The advice to ‘eat plenty of’ has now been restricted to the vegetable/fruit group.”

What is missing?

“The report acknowledges that the NRV for fat recommends 4-10% of energy from n6 fat but only recommends in guideline 2 ‘include small amounts of foods that contain unsaturated fat’.  This is essentially a continuation of the low fat diet recommendation. The report does not deal with the recent controversy on saturated fat where only replacement of saturated with polyunsaturated fat was associated with reduced risk of CVD. Replacement with carbohydrate or monounsaturated fat was not protective.  It does not deal with the Mediterranean diet and the protection it provides from a wide variety of diseases.  Although it deals with some elements of the diet including legumes and vegetables it is silent on recommending abundant olive oil- the cornerstone of the Mediterranean diet.”

What is controversial?

“The statement that low fat dairy foods are associated with protection from coronary heart disease and colorectal cancer, Walter Willett of the Nurses’ Health Study would not agree with. Improved bone mineral density with dairy is not a well proven statement. The report says ‘To meet recommended food group intakes for adults consumption of milk, yoghurt and cheese products would need to approximately double overall…’ This is not a well-founded recommendation.”

“Suggesting that cola drinks reduce bone strength is going way beyond current evidence which is very patchy.”

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Prof Colin Binns is the John Curtin Distinguished Professor of Public Health at the Faculty of Health Sciences, Curtin University, Perth. He was also deputy chair of the Dietary Guidelines Working Committee

On the benefits of good nutrition:

“Good nutrition is important for health and development across the whole of the lifespan. For the past three decades the Dietary Guidelines have made available to the Australian public the best advice on nutrition for a healthy lifestyle. They have been developed by the National Health and Medical Research Council and the Department of Health with the advice of committees of experts. The Australian population is one of the healthiest in the world with an average life expectancy of 79.3 years for men and 83.9 years for women. In the past two decades there has been an average increase of five years. The trend in improved health has been evident for more than a century and one of the important factors has been improved nutrition and the quality of the food supply for all age groups. Nutrition still offers the opportunity of further improvements in our health as we tackle more recent problems such as obesity.

A recent study from the UK shows that 40 per cent of cancer cases could be prevented by improvements in lifestyle. After cessation of smoking, improved nutrition provided the best opportunities for cancer prevention, including reducing obesity, eating more vegetables and fruit, reducing alcohol and breastfeeding. Similarly, in Australia, most of the major causes of death and disability have some nutritional component in their cause, such as heart disease, diabetes, cancer, osteoporosis etc.

The new dietary Guidelines are the result of almost three years of planning and hard work. More effort has been put into updating the science in this set of guidelines than for any previous nutrition documents. The review of thousands of scientific papers provides a database second to none on which to base the guidelines. But given the complexity of the modern diet and our food supply it has not been possible to cover all areas of nutrition leaving further scope for future reviews.

While understanding of nutrition science has advanced, the recommendations made by the committee are remarkably consistent with previous Australian dietary guidelines. The introduction to the new Dietary Guidelines states ‘evidence from Western societies confirms that dietary patterns consistent with current guidelines recommending relatively high amounts of vegetables, fruit, whole grains, poultry, fish, and reduced fat milk, yoghurt and cheese products may be associated with superior nutritional status, quality of life and survival in older adults’.  The consistency of the New Guidelines with previous advice confirms the quality of nutrition advice that has previously been given to the Australian public by the NHMRC.

For this edition of the Dietary Guidelines the different age groups have been combined as many of the general nutrition principles apply to one or more age groups. This makes for a concise document where it is easier to find information. The disadvantage is that there is less information available about specific age groups and in particular the rapidly expanding older population.

At the beginning of life the emphasis remains on promoting breastfeeding for as many infants as possible. Breastfeeding offers the most nutritional benefits including lower rates of infection, less obesity and higher IQ.

The New Dietary Guidelines will be accompanied by a number of specific consumer documents that will help Australians to enjoy good nutrition, reduce obesity and live healthy and productive lives.”

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Assoc. Prof. Catherine Itsiopoulos is Head of Department of Dietetics at the Faculty of Health Sciences at La Trobe University, Victoria.  Catherine had no involvement with the writing of the guidelines

“The revised (2011) NHMRC’s Australian Dietary Guidelines are a critically important suite of recommendations for healthy eating specifically targeted at the health priorities of the Australian population, and the needs of individual high risk groups within the population. The guidelines represent a monumental body of work by key experts who have developed these guidelines based on the highest level of scientific evidence over the past decade.

Prevention and management of nutrition-related chronic diseases such as heart disease, stroke, and diabetes are a major challenge for health professionals in Australia. Despite some improvements with heart disease and stroke rates in Australia, conditions such as diabetes and obesity continue to rise reaching epidemic proportions. Healthy eating and physical activity should form the basis of tackling these health issues however the public are often confused by misinformation and the lack of practical advice on how to follow a healthy diet. The availability of up to date guidelines based on accurate information is critical to enable effective health services for the Australian public. The revised guidelines provide a summary of the latest scientific evidence for easy use by health professionals.

The accompanying Australian Guide to Healthy Eating is a detailed practical guide with quantities of different foods recommended for different groups of the population, and includes pictorial food information represented on a plate providing the image of nutritional balance. There is a very good effort to include foods relevant to different cultural / ethnic groups within Australia and issues of food sustainability and food security are addressed.

The focus on foods rather than nutrients is a strength of the revised guidelines, and ensures they are likely to be more effectively used by health professionals and better understood by the general public.”

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BRIEFING FOR JOURNALISTS - Mon 12 Dec at 11.30am AEDT in Canberra (ALSO ONLINE)

Diet is a hot topic, positively and negatively for Australians. Poor nutrition is responsible for around 16% of the total burden of disease and is implicated in more than 56% of all deaths in Australia. Obesity alone is estimated to cost the economy in excess of $8 billion per year. And yet, many Australians are still not following recommended daily intakes of the major food groups and rely too heavily on high energy, low nutrition foods.

A draft of the revised dietary guidelines was released for public comment on Tuesday 13 December  by the National Health and Medical Research Council (NHMRC). These guidelines contain updated dietary advice based on the latest scientific evidence.  The guidelines are available at www.eatforhealth.gov.au

The revised guidelines will help reduce the risk of Australians developing chronic diseases such as heart disease and stroke, type 2 diabetes and some cancers.

A briefing was held in Canberra on Monday 12 December 2011 for journalists in advance of the public release. A Roundup of reaction is also available here.

The speakers provided an opportunity to discuss the science behind the guidelines and the processes NHMRC undertakes to produce such a resource.

Topics discussed included:

• How the draft guidelines differ from earlier versions, and why they have been revised
• A brief overview of the science sitting behind the revised guidelines
• How Australians need to change their food choices
• How Australians can provide feedback on the draft guidelines before a final version is released

A full recording of the presentation is available here.   Audio only is also available, along with a copy of the powerpoint.

SPEAKERS:

• Professor John McCallum, Head of the Research Translation Group, National Health and Medical Research Council
• Dr Amanda Lee, Chair of the Dietary Guidelines Working Committee

BRIEFING DETAILS:

DATE: Monday 12 December
START TIME: 11.30am AEDT
DURATION:  48 min
VENUE: Canberra and online

For further information, please contact the AusSMC on 08 7120 8666 or email us.

International researchers have investigated a link between taking dietary supplements and an increased risk of death in older women. Data was used from the Iowa Women’s Health Study to examine the link between vitamin and mineral supplementation, including multivitamins and iron, and death rate in over 38,000 older women with an average age of 62 years. Commentary available.

Feel free to use these quotes in your stories.  Any further comments will be posted here. If you would like to speak to an expert, please don’t hesitate to contact us on (08) 7120 8666 or by email.

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Professor Mark Wahlqvist is Visiting Professor at the National Health Research Institute (NHRI) in Taiwan and Zhejiang University in China and Emeritus Professor at Monash University in Melbourne

“The Iowa Women’s Health Study reporting on dietary supplements adds to growing concern about the safety of their use in Western society – usually more so, curiously, among the more socio-economically advantaged. Such people might be expected to out-perform the less advantaged, and indeed they do, unless they have unhealthy behaviours. It now seems that dietary supplementation is an unhealthy behaviour. The problem is partly that the people who use them are the ones who need them least.

Nevertheless, the problem is also seen among the world’s poor where well-meaning supplementation is given to those at risk of overwhelming infection with, for example, malaria or tuberculosis, as with iron supplementation for infants in Pemba (Tanzania) where mortality increased.

The safest way to achieve optimal nutrient intake is from food, and to have a diet which is diverse. This is the consistent finding in studies we and others have published on the Mediterranean diet in various locations, including Melbourne (Australia) and, this year, in people of Chinese ancestry and food culture in Taiwan. The more diverse the diet, the better the survival. This may be seen for small changes in the diet, as with a small 20g daily serving of beans or a serving of fish a week. With careful food choice these dietary practices are affordable and sustainable – and certainly much more so than buying supplements at inflated prices. Food is too complex to be simulated by pills.”

(All the studies referred to in this comment are available by contacting the AusSMC)

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Below is a comment collected by our friends at the UK Science Media Centre:

Dr Glenys Jones is Nutritionist in the Department of Diet & Population Health at MRC Human Nutrition Research in Cambridge

“This observational study is interesting, but it does not show that supplement use causes women to die earlier. The study does not take into account whether the women using the supplements are doing so in response to illness, for example using iron supplements in response to anaemia (which is estimated to affect around 10-20% of women in this age group). Whereby it is most likely the illness that is the cause of the women dying, not the supplement use. Research in this area to date has had inconsistent findings, and what is needed to determine whether supplement use actually causes an alteration of mortality rate is a number of well controlled intervention studies that can then be brought together and reviewed.”

* Dietary Supplements and Mortality Rate in Older Women: The Iowa Women’s Health Study, Mursu et al., Archives of Internal Medicine, 171(18), 10 October 2011

A review of scientific literature suggests moderate reductions in salt intake don’t lead to reduced risk of a person suffering cardiovascular events or dying prematurely.

The original review has been published in The Cochrane Library. A paper will also appear in the American Journal of Hypertension today, based on the study published in The Cochrane Library.

Below are comments compiled by our colleagues at the New Zealand and UK Science Media Centres.

Feel free to use these quotes in your stories.  Any further comments will be posted here. If you would like a copy of the paper(s) or to speak to an expert, please don’t hesitate to contact us on (08) 7120 8666 or by email.

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COMMENTS FROM THE NEW ZEALAND SMC:

Robert Beaglehole, Emeritus Professor, University of Auckland and former World Health Organisation Director of the Department of Chronic Disease and Health Promotion comments:

“I agree that there is not yet sufficient evidence on hard outcomes, though there is plenty of evidence that salt reduction reduces blood pressure. A decent mortality study is still required. In the meantime, we should be doing all we can to reduce salt intakes – current high levels serve no useful purpose and are probably very harmful. Further, the real problem is that giving advice to reduce salt intake doesn’t work. We need to reduce the amount of salt in manufactured food”.

Professor Robert Walker, Head of Department, School of Medicine, University of Otago, comments:

“An interesting analysis. I think the important issue is that it is from a relatively small number of studies 7 in total but only 2 were in groups that would be deemed at moderate risk – the more hypertensive group.

“Lowering salt intake has clear cut evidence for reducing blood pressure. However blood pressure is not the only cardiovascular risk and therefore it has to be seen in the global context of reducing risk not as the sole intervention to reduce heart attacks.

“In addition, the impact of salt is not solely on blood pressure, elevated salt intake also has direct effects on blood vessel function independent to that of blood pressure. This may be more critical to the risk of stroke or kidney damage, rather that heart attack, which the meta-analysis did not address.

“Therefore in the context of general good health, it is not appropriate to go out and reload the salt shaker. Dietary reduction in salt for those at risk of cardiovascular disease should still be encouraged and placed in the same context as exercise, healthy diet and smoking cessation.”

Elaine Rush, Professor of Nutrition, Auckland University of Technology, comments:

“Cutting down on salt does not reduce the likelihood of dying or experiencing cardiovascular disease.

Facts:

“Both the elements of “common salt”, sodium and chloride, are essential for animal life. Sodium is also found in food as sodium bicarbonate, monosodium glutamate and food additives. The daily intake of sodium is exquisitely balanced by the body through excretion in urine and sweat.

“Higher blood pressure is associated with high intakes of sodium and also obesity and existing high blood pressure. There is a genetic predisposition for risk high blood pressure in some families and ethnic groups. Across the lifecourse all the environmental pressures that drive obesity also drive hypertension

What we do not know:

“The authors state that there is insufficient data to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity.

“For the studies reported ethnicity, socioeconomic status, gender, menopausal status, age were not included in the overall analysis. Most of the participants were white and male. The percentage female is not reported.

What we should consider:

“Hypertension does not just happen, as we age blood pressure increases. Relatively high blood pressure in young children and adolescents is a risk factor for high blood pressure in later life. Reducing salt intake may help, but increased physical activity, less stress, losing extra weight and improving the nutrient quality of the foods eaten also help reduce blood pressure and improve health.

“Putting the spotlight on single nutrient trials and generalizing dietary advice for a single nutrient, in this case to reduce salt intake, is not helpful. What is helpful is for the food industry to reformulate products to reduce sodium AND increase the nutrient quality of foods by using real ingredients.

“Junk food and marketing to children are elephants in the room. Changes in our attitudes to these would markedly reduce salt consumed, shift consumption to real foods and be more friendly to health and the environment – long term.”

Delvina Gorton, National Nutrition Advisor, Heart Foundation, comments:

“The Heart Foundation welcomes the Cochrane Collaboration’s robust review of the effect of moderate salt reduction. As the author’s acknowledge, however, there was simply not enough data to allow them to draw firm conclusions around whether moderate salt reduction has an effect on risk of heart attack or death.

The authors estimated they needed 18,000 participants to draw firm conclusions – substantially more than the 6,489 participants in the seven studies included in the review. Reduced risk ratios suggested a beneficial effect from moderate salt reduction but the sample size was too small for the trend to be conclusive.

Other types of research have conclusively linked moderate salt reduction with reduced risk. The Heart Foundation maintains its position of advocating salt reduction for all New Zealanders and will continue to support the food industry in reducing salt levels in pre-prepared foods.”

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COMMENTS FROM THE UK SMC:

Professor Francesco Cappuccio, Head of the WHO Collaborating Centre for Nutrition at the University of Warwick, said:

“This is a surprisingly poor piece of work under the Cochrane banner. The analysis bears little relevance to policy. The results are in keeping with a protective effect of salt reduction but due to the very small number of events, they do not reach statistical significance. Furthermore the conclusions in patients with heart failure are based on a single questionable small clinical study in very sick hospitalised patients treated with extreme doses of water tablets, a practice not recommended by international guidelines.

“This study does not change the priorities outlined worldwide (NICE, WHO, PAHO, IOM, Ministry of Canada) for a population reduction in salt intake to prevent heart attacks and strokes, the greatest killers in the world.  What is important is not whether to reduce salt intake but how to do so to save lives. The published study confirms that individual choices may have little effect because salt is added to food before it is sold. Voluntary and regulatory reformulation of food by the food and catering industries must be implemented. Governments have an obligation to act to facilitate this process.”

Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool said:

“This is a disappointing and inconclusive meta-analysis, with mixed data and small numbers of events. It is fronted by a potentially misleading press release from the American Journal of Hypertension.

“The main Cochrane message is that advice to individuals only succeeds in getting them to reduce their salt intake a little.

“This is not a new finding.

“Crucially, it does not change the public health consensus from the WHO, PAHO, NICE etc, which is that:

1.         Dietary salt raises blood pressure (this is bad),

2.         Reducing dietary salt intake lowers blood pressure (this is good),

3.         Government actions are far more effective and cost saving at reducing dietary salt intake, than is advice to individuals.”

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* Reduced Dietary Salt for the Prevention of Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials (Cochrane Review), Taylor et al., American Journal of Hypertension, doi:10.1038/ajh.2011.115, July 6, 2011

(A more detailed review has been published and will be updated in the Cochrane Database of Systematic Reviews [Taylor RS, Ashton KE, Moxham T, Hooper L, Ebrahim S. Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database of Systematic Reviews (CDSR) 2011, Issue 7] Available in The Cochrane Library)