Twelve moderately obese middle-aged male out-patients with untreated mild hypertension reduced their sodium intake by about 120 mmol/day during 4-6 weeks. The low sodium diet period was followed by a period of energy reduction as well as sodium restriction for 15 weeks. Mean body mass was then reduced by 7.5 +/- 1.0 kg. Intraerythrocyte sodium (IeNa), sodium influx (Na-influx) and sodium efflux rate constant (Na-efflux rate), were measured before intervention, during salt restriction and during salt and energy restriction. Plasma renin activity (PRA) and urinary excretion of aldosterone (U-Aldo) and noradrenaline (U-NA) were also determined during the three observation periods. During sodium restriction there was a significant increase in PRA and U-Aldo, but no change was seen in IeNa, Na-influx or Na-efflux rate constant. During sodium restriction there was a significant positive correlation between PRA and both Na-influx and Na-efflux rate constant. When energy reduction was combined with sodium restriction, PRA and U-NA both diminished significantly. Na-influx and Na-efflux rate also exhibited a significant decrease while IeNa did not change. Sodium restriction caused a significant fall in mean arterial blood pressure and a tendency to a further decrease was seen when energy intake was also reduced. No significant correlation could be found between the fall in blood pressure and changes in cellular sodium transport. These data indicate that the renin-angiotensin-aldosterone system and sympathetic activity influence the regulation of erythrocyte sodium turnover during sodium and energy restriction in obese hypertensive men.