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Sodium Intake in Populations: Assessment of Evidence (2013)

Chapter: Appendix E: Literature Search Strategy

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Suggested Citation:"Appendix E: Literature Search Strategy." Institute of Medicine. 2013. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press. doi: 10.17226/18311.
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Appendix E

Literature Search Strategy

A literature search strategy was conducted to select the scientific literature published after 2003 for the committee’s review and answer the question in the statement of task related to the potential associations of sodium intake and health outcomes. The online databases usedfor these search were Cochrane Database of Systematic Reviews, Embase, MedLine, PubMed, and Web of Science. A broad search to include all health outcomes and a number of searches targeted at specific outcomes identified by the committee were conducted. The specific outcomes were cardiovascular disease, heart failure, hypertension, myocardial infarction, diabetes, mortality, stroke, bone disease, fractures, falls, myocardial infarction, headaches, kidney stones, chronic kidney disease, skin reactions, immune function, thyroid disease, and cancer. Table E-1 presents the search conducted in the MedLine database. The searches were conducted in consultation with the staff librarians at the George E. Brown Jr. Library of the National Academies.

Suggested Citation:"Appendix E: Literature Search Strategy." Institute of Medicine. 2013. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press. doi: 10.17226/18311.
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TABLE E-1 Example (MedLine) of Searches to Identify Relevant Literature on Sodium Intake and Health Outcomes


Search No. Search Terms Number of Hits

1 Sodium, Dietary/or Sodium Chloride, Dietary/or Diet, Sodium-Restricted/ 4,022  
2 1 and (health or disease$ or condition$). mp. [mp=title, abstract, original title, name of substance word, subject heading word, protocol supplementary concept, rare disease supplementary concept, unique identifier] 1,936  
3 1 and hypertension/ 1,445  
4 1 and (cardiovascular diseases/or coronary disease/or death, sudden/) 289  
5 1 and heart failure/ 130  
6 1 and mortality/ 10  
7 1 and stroke/ 80  
8 1 and (fractures, bones/or accidental falls/) 1  
9 1 and myocardial infarction/ 22  
10 1 and headache/ 3  
11 1 and kidney calculi/ 17  
12 1 and skin manifestations/ 0  
13 1 and thyroid diseases/ 28  
14 1 and immunity/ 0  
15 1 and diabetes mellitus/ 21  
16 1 and (kidney failure, chronic/or kidney diseases/) 242  
17 1 and neoplasms/ 13  
Total 2,687  
Total without animal or in vitro studies 1,938  

 
Suggested Citation:"Appendix E: Literature Search Strategy." Institute of Medicine. 2013. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press. doi: 10.17226/18311.
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Page 143
Suggested Citation:"Appendix E: Literature Search Strategy." Institute of Medicine. 2013. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press. doi: 10.17226/18311.
×
Page 144
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Despite efforts over the past several decades to reduce sodium intake in the United States, adults still consume an average of 3,400 mg of sodium every day. A number of scientific bodies and professional health organizations, including the American Heart Association, the American Medical Association, and the American Public Health Association, support reducing dietary sodium intake. These organizations support a common goal to reduce daily sodium intake to less than 2,300 milligrams and further reduce intake to 1,500 mg among persons who are 51 years of age and older and those of any age who are African-American or have hypertension, diabetes, or chronic kidney disease.

A substantial body of evidence supports these efforts to reduce sodium intake. This evidence links excessive dietary sodium to high blood pressure, a surrogate marker for cardiovascular disease (CVD), stroke, and cardiac-related mortality. However, concerns have been raised that a low sodium intake may adversely affect certain risk factors, including blood lipids and insulin resistance, and thus potentially increase risk of heart disease and stroke. In fact, several recent reports have challenged sodium reduction in the population as a strategy to reduce this risk.

Sodium Intake in Populations recognizes the limitations of the available evidence, and explains that there is no consistent evidence to support an association between sodium intake and either a beneficial or adverse effect on most direct health outcomes other than some CVD outcomes (including stroke and CVD mortality) and all-cause mortality. Some evidence suggested that decreasing sodium intake could possibly reduce the risk of gastric cancer. However, the evidence was too limited to conclude the converse—that higher sodium intake could possibly increase the risk of gastric cancer. Interpreting these findings was particularly challenging because most studies were conducted outside the United States in populations consuming much higher levels of sodium than those consumed in this country. Sodium Intake in Populations is a summary of the findings and conclusions on evidence for associations between sodium intake and risk of CVD-related events and mortality.

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