Ignored critique
This page is a non-comprehensive archive of published criticisms regarding the flawed methodology on which claims are made by the PURE Salt Study and those studies that employed their methodology.
| ORIGINAL PAPER | COMMENTARY |
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Yan D, Gao D, Yuan M. A cross-sectional study of urinary sodium, cardiac remodeling, and the mediating role of insulin-like growth factor-1: Insights from the UK Biobank. Medicine 2025; 104(50): e46528, DOI: 10.1097/MD.0000000000046528 |
Campbell NRC, Cappuccio FP. Flawed method of assessing dietary sodium makes health outcome associations unreliable. Medicine 2026; on-line (Jan 29) |
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Lundeberg JE, Wuopio J, Mente A, et al. Estimated sodium intake and premature ventricular complexes: data from the population-based Swedish CArdioPulmonary bioImage Study. Heart 2025; 111: 300-305. Johnson LS, Lundeberg JE, Wuopio J, Mente A, Healey JS, JÄG Engström. Response to: Correspondence on ‘Estimated sodium intake and premature ventricular complexes: data from the population-based Swedish CArdioPulmonary bioImage study’ by Campbell. Heart 2025; 111: 1-2
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Campbell NRC. Correspondence on ‘Estimated sodium intake and premature ventricular complexes: data from the population-based Swedish CArdioPulmonary bioImage study’ by Economou Lundeberg et al. Heart 2025; 111: 741-741. Campbell NRC, Guichon J, Cappuccio FP. Scientific and Ethical Concerns. Correspondence on “The Authors’ Reply” by Johnson et al. (letter). Heart 2026; Jan 19; (on-line) |
| Wuopio J, Ting L-Y, Dekkers KF, et al. The metabolic signature of salt intake: a cross-sectional analysis from the SCAPIS-study. Nutr Metab 2025; 22: 104 | Campbell NRC, Cappuccio FP. Research on dietary sodium with invalid methods does not advance scientific understanding. Nutr Metab 2026; 23: 17. https://doi.org/10.1186/s12986-025-01057-1 |
| Peng Y, Li W, Wang Y, Chen H, Bo J, Wang X, et al. Validation and assessment of three methods to estimate 24-h urinary sodium excretion from spot urine samples in Chinese adults. PLoS One 2016; 11:e0149655 | McLean RM, Song J, Wang C, He FJ, Cappuccio FP, Campbell NRC, MacGregor GA. Formula-led methods using first morning fasting spot urine to assess usual salt intake: a secondary analysis of PURE study data. J Hypertension 2024; 42(11): 2003-10. DOI: 10.1097/HJH.0000000000003831 |
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Hogas M, Statescu C, Padurariu M, et al. Salt, not always a cardiovascular enemy? A Mini-Review and modern perspective. Medicina 2022; 58(9): 1175. Hogas M, Statescu C, Padurariu M, et al. Reply to Campbell et al. Comment on "Hogas et al. Salt, not always a cardiovascular enemy? A mini-Review and modern perspective. Medicina 2023; 59(1): 51 |
Campbell NRC, Cappuccio FP, McLean RM, He FJ, MacGregor GA. Comment on Hogas et al. Salt, Not Always a Cardiovascular Enemy? A Mini-Review and Modern Perspective. Medicina 2023; 59(1): 51 |
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Muiesan ML, Buso G, Agabiti Rosei C. Less sodium and more potassium to reduce cardiovascular risk. Eur Heart J Suppl 2023; 25: B108-B110
doi: 10.1093/eurheartjsupp/suad084Link opens in a new window |
Campbell NRC, He FJ, McLean RM, Cappuccio FP, MacGregor GA. Less sodium and more potassium to reduce cardiovascular risk and the PURE study. Eur Heart J Open 2023; 3: 1-2 |
| Du Toit JD, Kapaon D, Crowther NJ, Abrahams-Gessel S, Fabian J, Kabudula CW, et al. Estimating population level 24-h sodium excretion using spot urine samples in older adults in rural South Africa. J Hypertens 2023; 41: 280–287. |
Heagerty AM. The end of spot urine analysis as a reseaerch tool for salt intake. J Hypertens 2023; 41 (5): 708. Cappuccio FP, D'Elia L, Rakovac I. Spot urine samples and estimation of population salt intake: the return of the phoenix? J Hypertens 2023; 41: 869-71 |
| Tsirimiagkou C, Karatzi K, Argyris A, et al. Levels of dietary sodium intake: diverging associations with arterial stiffness and atheromatosis. Hellenic J Cardiol 2021; 62(6): 439-446. https://doi.org/10.1016/j.hjc.2021.02.005. | Campbell NRC, He FJ, Cappuccio FP, MacGregor GA, McLean R. Levels of dietary sodium intake: diverging associations with arterial stiffness and atheromatosis. Concerning about the evidence review and methods. Hellenic J Cardiol 2022; 63: 92-93 |
| Kurtz TW, Pravenac M, Di Carlo SE. Will Food and Drug Administration Guidance to reduce the salt content of processed foods reduce salt intake and save lives? Hypertension 2022; 79(4): 809-812 | Campbell NRC, Cappuccio FP, McLean RM. Concerns about estimating the health impact of salt targets for foods. Hypertension 2022; April 22; Comment |
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Liu X, Bai Y, Li S, O’Donnell M, Mente A, Yin L, et al. Associations of estimated 24-h urinary sodium excretion with mortality and cardiovascular events in Chinese adults: a prospective cohort study. J Hypertens 2021; 39: 484–493. Liu X, Yusuf S, O'Donnell M, Li W. Reply. J Hypertens. 2021; 39(7): 1467-1469. |
Campbell NRC, He FJ, McLean RM, Woodward M, MacGregor GA, Cappuccio FP. Dietary sodium and cardiovascular disease in China: concerns about the methods, conclusions, and evidence review. J Hypertens. 2021; 39(7): 1466-1467. Campbell NRC, He FJ, McLean RM, Cappuccio FP, Woodward M, MacGregor GA, Guichon J, Mitchell I. Dietary sodium and cardiovascular disease in China: addressing inaccurate, scientifically unsupported and repeated statements and claims about reducing dietary sodium. J Hypertens 2022; 40: 1831-1836. |
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O’Donnell M, Mente A, Alderman MH, Brady AJB, Diaz R, Gupta R, et al. Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake. Eur Heart J. 2020; 41(35): 3363–3373 Mente A, Dehghan M, Yusuf S. Diet and health: the need for new and reliable approaches. Eur Heart J. 2020; 41(28): 2641–2644. Lechner K, Schunkert H. Recommendations on sodium intake for cardiovascular health: conviction or evidence? Eur Heart J. 2020; 41(35): 3374–3375. Mente A, O’Donnell M, Yusuf S. Sodium and health: another challenge to the current dogma. Eur Heart J. 2021; 42(21): 2116–2118 Messerli FH, Hofstetter L, Syrogiannouli L, Rexhaj E, Siontis GCM, Seiler C, et al. Salt consumption at a population level remains remarkably steady over time. Eur Heart J. 2021; 42(21): 2134. Messerli FH, Hofstetter L, Syrogiannouli L, Rexhaj E, Siontis GCM, Seiler C, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J. 2021; 42(21): 2103–2112. Adedinsewo DA, Pollak AW, Carter RE. Dietary sodium and mortality: how much do we really know? Eur Heart J. 2021; 42(21): 2113–2115. Yan Y, Mu J. Salt intake paradox: the estimation method matters. Eur Heart J. 2021; 42(21): 2133 |
Cappuccio FP, Campbell NRC, He FJ, Jacobson MF, MacGregor GA, Antman EM, Appel LJ, Arcand JA, Blanco-Metzler A, Cook NR, Guichon JR, L'Abbè MR, Lackland DT, Lang T, McLean RM, Miglinas M, Mitchell I, Sacks FM, Sever PS, Stampfer M, Strazzullo P, Sunman W, Webster J, Whelton PK, Willett WC. Sodium and health: old myths, and a controversy based on denial. Curr Nutr Rep 2022; 11: 172–184 |
| Swanepoel B, Schutte AE, Cockeran M et al. Monitoring the South African population’s salt intake: spot urine v 24 h urine. Public Health Nutrition 2018; 21(3): 480-488 | Cappuccio FP, D'Elia L. Evaluating population salt reduction programs worldwide: the risk of cutting corners! Public Health Nutrition 2018; 21(12): 2161-3 |