Review

Sodium restriction and insulin resistance: A review of 23 clinical trials

James J. DiNicolantonio, James H. O'Keefe
Journal of Metabolic Health | Vol 6, No 1 | a78 | DOI: https://doi.org/10.4102/jir.v6i1.78 | © 2023 James J. DiNicolantonio, James H. O’Keefe | This work is licensed under CC Attribution 4.0
Submitted: 20 September 2022 | Published: 14 March 2023

About the author(s)

James J. DiNicolantonio, Department of Preventive Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, United States of America
James H. O'Keefe, Department of Preventive Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, United States of America

Abstract

Background: Many clinicians recommend low-salt diets for lowering blood pressure but there may be unintended consequences such as worsening insulin resistance.

Aim: This paper aimed to find human clinical studies looking at low-salt diets on markers of glucose and insulin.

Methods: We reviewed PubMed using the search terms ‘sodium’, ‘insulin’ and ‘insulin resistance’ and found 23 human clinical studies testing low-salt diets showing negative harms on insulin or glucose.

Results: Twenty-three human clinical trials have shown that low-salt diets lead to systemic or vascular insulin resistance, glucose intolerance, elevated fasting insulin and/or elevations in glucose and/or insulin levels after an oral glucose tolerance test.

Conclusion: We discovered 23 human clinical studies showing that low-salt diets worsen markers of insulin and glucose. Caution is advised when recommending salt restriction for blood pressure control as this may lead to worsening insulin resistance.

Contribution: This review has revealed that low salt diets can induce insulin resistance.


Keywords

salt; sodium; insulin resistance; insulin; hyperinsulinaemia; glucose

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