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See ARTICLE page 1129. Until recently, the salt debate remained dominated by a select group of highly vocal global leaders whose goal is to impose their views through an unbalanced interpretation of so-called compelling evidence. Sailing against the tide, in this issue of the Journal, Graudal and colleagues published a comprehensive review of the literature 1 that complied with the highest possible quality standards as proposed by the Meta-analysis of Observational Studies in Epidemiology group. 2 Data from 23 cohort studies and 2 follow-up studies of randomized controlled trials (n = 274,683 participants) showed that the risks of all-cause mortality or cardiovascular disease were higher at low and high vs. usual sodium intake, congruent with a U-shaped association between health outcomes and salt intake. 1 The hazard ratios of total mortality and cardiovascular disease for low vs. usual sodium intake were 1.10 (95% confidence interval (CI) = 1.01–1.22) and 1.11 (95% CI = 1.01–1.22), respectively. The corresponding hazard ratios for high vs. usual sodium exposure were 1.16 (95% CI = 1.03–1.30) and 1.12 (95% CI = 1.02–1.24). 1 Cardiovascular endpoints and 24-hour urinary sodium

Systematic Review of Health Outcomes in Relation to Salt Intake Highlights the Widening Divide Between Guidelines and the Evidence