Review
Sodium restriction and insulin resistance: A review of 23 clinical trials
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 AmericaJames 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
Metrics
Total abstract views: 13855Total article views: 68857
Crossref Citations
1. Dietary recommendations for people with diabetes in special situations: a position statement report by Arabic Association for the Study of Diabetes and metabolism (AASD)
Amin Roshdy Soliman, Mona Hegazy, Rabab Mahmoud Ahmed, Shereen Abdelghaffar, Mohammed Gomaa, Sahar Alwakil, Dina Soliman, Lobna Sedky, Inass Shaltout
Journal of Health, Population and Nutrition vol: 43 issue: 1 year: 2024
doi: 10.1186/s41043-024-00619-y
2. Specifically formulated ketogenic, low carbohydrate, and carnivore diets can prevent migraine: a perspective
Angela A. Stanton
Frontiers in Nutrition vol: 11 year: 2024
doi: 10.3389/fnut.2024.1367570
3. The Effect of Increased Sodium Intake with a Carbohydrate-Rich Meal on Glucose Homeostasis in People without Diabetes after Roux-en-Y Gastric Bypass: a Proof-of-Concept, Randomized, Open-Label, Crossover Study
Stanislava Katsarova–Harrison, Gráinne Whelehan, Joseph Henson, Louisa Y. Herring, David Bowrey, Alice E. Thackray, David J. Stensel, Iskander Idris, Oluwaseun Anyiam, Anjali Zalin, Alan Askari, David R. Webb, Tom Yates, Melanie J. Davies, Dimitris Papamargaritis
Obesity Surgery vol: 36 issue: 1 first page: 215 year: 2026
doi: 10.1007/s11695-025-08420-4
4. Empowering Pharmacists in Type 2 Diabetes Care: Opportunities for Prevention, Counseling, and Therapeutic Optimization
Sarah Uddin, Mathias Sanchez Machado, Bayan Alshahrouri, Jose I. Echeverri, Mario C. Rico, Ajay D. Rao, Charles Ruchalski, Carlos A. Barrero
Journal of Clinical Medicine vol: 14 issue: 11 first page: 3822 year: 2025
doi: 10.3390/jcm14113822
5. Salt Sensitivity of Blood Pressure and the Role of the Immune System in Hypertension
Jackeline Flores, Camilo Pena, Kenneth Nugent
Cardiology in Review year: 2024
doi: 10.1097/CRD.0000000000000834
