Pelo pouco que já li sobre o tema, tenho a impressão que essas visões mais divergentes (sal não importa/reduzir é um risco), embora estritamente "corretas" (talvez seja melhor dizer, "
ardilosamente corretas"), na prática são algo com quem ninguém tem que se preocupar, ou, ninguém que não tenha um cozinheiro trabalhando cozinheiros sob
as instruções rígidas de um nutricionista a instrução de reduzir o consumo de sódio ao máximo absoluto, e talvez alguém para fazer as compras nesses parâmetros de redução máxima de sal. Já para a vasta maior parte da população, "deficiência de sódio", não deverá ser uma preocupação racional, por mais que a pessoa tente se esforçar em reduzir o consumo.
Até porque alguns fabricantes FDPs farão esforços FDPs em tentar te enganar, como colocar as informações nutricionais correspondentes a meio macarrão lamen num pacote.
Sobre o tema:
https://sciencebasedmedicine.org/salt-more-confirmation-bias-for-your-preferred-narrative/
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When it comes to health, it’s the hard outcomes we care about. We pay attention to measures like high blood pressure (hypertension) because of the relationship between hypertension and events like heart attacks and strokes. The higher the blood pressure, the greater the risk of these events. The relationship between the two is well established. So when it comes to preventive health, we want to lower blood pressure to reduce the risk of subsequent effects. Weight loss, diet, and exercise are usually prescribed (though often insufficient) to reduce blood pressure. For many, drug treatment is still required.
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There is reasonable population-level data linking higher levels of salt consumption with higher blood pressure. From a population perspective, interventions that dramatically lower salt intake result in lower blood pressure. Not everyone responds in the same way — many people with normal blood pressure can regularly consume a high salt load without any apparent change in blood pressure. But not everyone, and not forever. Salt sensitivity seems to increase with age and is more pronounced in some ethnic groups, as well as in those with salt-sensitive conditions such as kidney disease. And chronic high levels of salt consumption may be associated with the subsequent emergence of hypertension. There may be additional effects, unrelated to blood pressure, too. However, the causality between salt consumption, and all of these negative effects, is less clear.
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And that’s where the recommendations to cut salt come from. The vast majority of the salt we eat (75%) is from processed foods. Restaurants are a large source, too. Few foods in their original state are naturally high in salt, and in general, we don’t add that much at the table. Interestingly, when foods are reduced in sodium, we don’t tend to add the same amount back at the table. So public health initiatives have concentrated on a few strategies: education on how to reduce your own salt consumption, and putting pressure on packaged food manufacturers to reduce the amount of sodium that they use in their products. But reducing salt may hurt sales: if we’re accustomed to eating salty foods, low-salt foods taste unpalatable. Just last week Campbell Soup Company announced that it’s raising the salt content in its products in an attempt to boost sagging sales.
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The authors did not conclude that reducing salt consumption is ineffective. They concluded that interventions such as dietary advice, do not result in substantial reductions in consumption. As expected, blood pressure didn’t change much as a consequence. This finding should not be a surprise. Given the vast majority of salt is consumed via processed foods, it should come as no surprise that dietary approaches are modestly effective at reducing consumption.
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A mim isso ainda tem um pouco um cheiro daquelas de "cientistas de aluguel"* fazendo lobby para indústrias, embora de maneira não tão grotesca quanto os lobbies "não há 100% de certeza de que fumo causa câncer," "não há 100% de certeza que CFCs aumentam o buraco na camada de ozônio", e "não há 100% de certeza que há aquecimento global, ou que CO2 antropogênico seja um fator".
* Ou, provavelmente, na maior parte, grupos ideológicos/lobbies/ativistas pró-mercado irrestrito/anti-regulação, fazendo uma apresentação estrategicamente seletiva de pesquisa científica relacionada, mas sem formação ou atividade relacionada à saúde.
Eu particularmente acho que um nicho interessante de apelo análogo ao natureba/orgânico, porém com maior embasamento científico e relevância palpável para a saúde, seria de um cardápio/coisas com reduzido teor de sódio, como até usando aquele "sal light" (combinado a cloreto de potássio), e outros "truques" variados. Tirando margarina "sem sal", acho que praticamente nunca vi nada assim, o que acho até meio estranho. Talvez pelo sal ter um efeito conservante. Mas também acho curioso que não seja mais "alardeado" como positivo em embalagens, como de ervilhas, milho, congelados, em vez de enlatados.
Os riscos de "deficiência de sódio" parecem mais ligados a rápida desidratação esportiva do que a dieta, e na dieta, o mais significativo parecem ser coisas como consumo insuficiente de proteínas/consumo excessivo de cerveja. É a única ocorrência de "dieatary" no artigo, tirando a relativas ao tratamento de síndrome de secreção inapropriada de hormônio antidiurético (SIHAD), e a explicitamente dizer que sódio insuficiente na dieta é "muito raramente" causa de deficiência:
https://en.wikipedia.org/wiki/Hyponatremia
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Hyponatremia is one of the most commonly seen water–electrolyte imbalances.[5][6] It occurs in about 20% of those admitted to hospital and 10% of people during or after an endurance sporting event.[2][4] Among those in hospital hyponatremia is associated with an increased risk of death.[4] The economic costs of hyponatremia are estimated at $2.6 billion in the United States.[9]
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Causes
The specific causes of hyponatremia are generally divided into those that occur with high fluid volume, those with normal fluid volume, and those with low fluid volume. Too little sodium in the diet alone is very rarely the cause of hyponatremia.
High volume hyponatremia[edit]
Both sodium and water content increase: Increase in sodium content leads to hypervolemia and water content to hyponatremia.
- cirrhosis of the liver
- congestive heart failure
- nephrotic syndrome in the kidneys
- massive edema of any cause
Normal volume hyponatremia
There is volume expansion in the body, no edema, but hyponatremia occurs[15]
- states of severe pain or nausea
- in the setting of trauma or other damage to the brain
- SIADH (and its many causes)
- Hypothyroidism
- Glucocorticoid (steroid) deficiency
Low volume hyponatremia
The hypovolemia (extracellular volume loss) is due to total body sodium loss. The hyponatremia is caused by a relatively smaller loss in total body water.[15]
- any cause of hypovolemia such as prolonged vomiting, decreased oral intake, severe diarrhea
- diuretic use (due to the diuretic causing a volume depleted state and thence ADH release, and not a direct result of diuretic-induced urine sodium loss)
- Addison's disease and congenital adrenal hyperplasia in which the adrenal glands do not produce enough steroid hormones (combined glucocorticoid and mineralocorticoid deficiency)
Prolonged periods of exercise may be a cause, known as exercise-associated hyponatremia (EAH).[4][16] It is common in marathon runners and participants of other endurance events.[17] The use of MDMA can result in hyponatremia.[18] This likely occurs as a result of fluid loss via sweating and replacement with water without electrolytes.
Other causes
Miscellaneous causes of hyponatremia that are not included under the above classification scheme include the following:
- factitious hyponatremia (due to massive increases in blood triglyceride levels, extreme elevation of immunoglobulins as may occur in multiple myeloma, and very high level of blood glucose)
- Hypothyroidism and adrenal insufficiency (both thyroid hormone and cortisol are required to excrete free water)
- Beer potomania and other malnourished states where poor dietary protein intake leads to inadequate urine solute formation thereby impeding the kidney's ability to excrete free water
- Primary polydipsia and water intoxication (where the amount of urine solute required to excrete huge quantities of ingested water exceeds the body's ability to produce it; this typically occurs when 12 or more liters of water are ingested per day)
Potomania, also known as beer potomania, beer drinker's potomania, and beer drinker's hyponatremia, is a specific hypo-osmolality syndrome related to massive consumption of beer, which is poor in solutes and electrolytes.
<![CDATA[<a href="https://www.youtube.com/v/Y1H6rohqMJE" target="_blank" class="new_win">https://www.youtube.com/v/Y1H6rohqMJE</a>]]>Essas recomendações gerais ainda levam em consideração uma pessoa artificial de um dado volume. Acho que talvez fosse interessante desenvolverem uma tabela de acordo com altura. Mas não sei...
Relationship between height and blood pressure in Japanese schoolchildren.
Fiquei curioso quanto às perspectivas "paleodietéticas" quanto ao sódio. Certamente nossos ancestrais do paleolítico não exploravam minas de sal.
Aparentemente se dividem em uma postura mais religiosa contra o sal por essas linhas bem estritas de paleo-mímica, enquanto outros vão pela linha de "ceticismo" contra o mainstream, também comum nesse meio, e são mais liberais com o sal, ignorando seletivamente os princípios paleo-dietéticos. Possivelmente com toda variação possível entre os dois.
Tópico: Consumo de Sal (Lida 886 vezes)