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Adding salt to foods and hazards of microvascular, cerebrovascular and cardiovascular diseases

European Journal of Clinical Nutrition volume 78, pages 141–148 (2024)Cite this article

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Abstract

Background

We aimed to examine the association of the frequency of adding salt to foods and the hazards of the incidence and mortality risks for a range of vascular outcomes, including microvascular, cerebrovascular, and cardiovascular diseases.

Methods

438,307 participants from the UK Biobank who completed the questionnaire on the frequency of adding salt to foods and were free of vascular disease at baseline were enrolled. Information on the frequency of adding salt to foods (do not include salt used in cooking) was collected at baseline through a touch-screen questionnaire. The primary outcomes included incident microvascular diseases, cerebrovascular diseases, and cardiovascular diseases, respectively. The secondary outcomes included: (1) each component of these vascular diseases (10 components in total), (2) first occurrence of fatal and non-fatal vascular diseases.

Results

During a median follow-up of 12.1 years, a total of 17,169 (3.9%), 10,437 (2.4%), and 48,203 (11.0%) participants developed microvascular, cerebrovascular and cardiovascular diseases, respectively. Overall, the hazards of incident microvascular, cerebrovascular and cardiovascular diseases increased with the increasing frequency of adding salt to foods (all P for trend <0.001). Similar trends were found for the secondary outcomes. Moreover, the positive association of always adding salt to foods with hazard of cardiovascular diseases was stronger among current-smokers (P-interaction = 0.010), younger participants (P-interaction <0.001), and those with lower body mass index levels (P-interaction = 0.003).

Conclusions

Higher frequency of adding salt to foods was associated with higher hazards of non-fatal and fatal microvascular, cerebrovascular and cardiovascular diseases, and each component of these vascular diseases.

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Fig. 1: The relationship of always adding salt to foods (vs never/rarely) with the risk of vascular diseases in various subgroups*.

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Data availability

The UK Biobank data are available on application to the UK Biobank, and the analytic methods, and study materials that support the findings of this study will be available from the corresponding authors on request.

Code availability

The software application or custom code that support the findings of this study will be available from the corresponding authors on request.

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Acknowledgements

This research has been conducted using the UK Biobank Resource under Application Number 73201. We specially thank all the participants of UK Biobank and all the people involved in building the UK Biobank study.

Funding

The study was supported by the National Natural Science Foundation of China (81973133, 81730019 to XHQ); the National Key Research and Development Programme (2022YFC2009600, 2022YFC2009605 to XHQ); the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2017J009 to XHQ); the National Natural Science Foundation of China (Key Programme) (82030022 to FFH); the Programme of Introducing Talents of Discipline to Universities, 111 Plan (D18005 to FFH); Guangdong Provincial Clinical Research Centre for Kidney Disease (2020B1111170013 to FFH); Key Technologies R&D Programme of Guangdong Province (2023B1111030004 to FFH).

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Author notes

  1. These authors contributed equally: Mengyi Liu, Ziliang Ye.

Authors and Affiliations

  1. Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Mengyi Liu, Ziliang Ye, Panpan He, Sisi Yang, Yanjun Zhang, Chun Zhou, Yuanyuan Zhang, Fan Fan Hou & Xianhui Qin

  2. State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China

    Mengyi Liu, Ziliang Ye, Panpan He, Sisi Yang, Yanjun Zhang, Chun Zhou, Yuanyuan Zhang, Fan Fan Hou & Xianhui Qin

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  1. Mengyi Liu
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Contributions

ML, FFH, and XQ designed and conducted the research; ML and ZY performed the data management and statistical analyses; ML and XQ wrote the manuscript. All authors reviewed/edited the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fan Fan Hou or Xianhui Qin.

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Competing interests

XQ reports grants from the National Natural Science Foundation of China (81973133, 81730019), the National Key Research and Development Programme (2022YFC2009600, 2022YFC2009605), and the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (2017J009); FFH reports grants from the National Natural Science Foundation of China (Key Programme) (82030022); the Programme of Introducing Talents of Discipline to Universities, 111 Plan (D18005); Guangdong Provincial Clinical Research Centre for Kidney Disease (2020B1111170013); Key Technologies R&D Programme of Guangdong Province (2023B1111030004); no other disclosures were reported.

Ethics approval and consent to participate

The UK Biobank was approved by the North West Research Ethics Committee (06/MRE08/65) and all participants signed an informed consent.

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Liu, M., Ye, Z., He, P. et al. Adding salt to foods and hazards of microvascular, cerebrovascular and cardiovascular diseases. Eur J Clin Nutr 78, 141–148 (2024). https://doi.org/10.1038/s41430-023-01354-z

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