Please Don’t Pass the Salt – A Look at the Health Benefits and Risks of Dietary Sodium

Salt not as damaging to health as previously thought, says study | Science | The Guardian

In , the American Heart Association lowered its recommendations to mg a day for everyone. We thought that was good advice, but new evidence has muddied the waters. In the latest issue of The New England Journal of Medicine , three new studies about the role of salt in cardiovascular disease were published. Instead of providing clear answers, they raise more questions.

High blood pressure is a known risk factor for heart attacks and strokes. Numerous studies have shown a correlation between salt intake and blood pressure, but the correlation between salt intake and cardiovascular outcomes like stroke and death has not been so clearly established. Some systematic reviews of the literature have confirmed that association, others have not. A review in the British Medical Journal found that lower sodium intake was correlated not only with a lower risk of hypertension but also with a lower risk of stroke and fatal coronary heart disease.

Prospective cohort studies have shown inconsistent associations between sodium intake and cardiac risk.

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It was greatest in those ingesting over 6 grams of sodium a day, modest in those ingesting grams, and not significant in those ingesting less than 3 grams a day. They found an inverse relationship for potassium: Compared to a reference range of 4. Higher potassium excretion was associated with decreased risk. The authors reviewed studies on sodium consumption from 66 countries. Estimated mean global consumption was 3. The lowest risk was in the gram range. They used a computer model to estimate that 1. The rate ranged from 4 deaths per million adults per year in Kenya to 1, per million in Georgia.

We knew too much sodium was risky, but these studies raise concerns that too little sodium might be even worse. As the accompanying editorial points out,.

Salt not as damaging to health as previously thought, says study

They call into question the feasibility and usefulness of reducing dietary sodium as a population-based strategy for reducing blood pressure…the alternative approach of recommending high-quality diets rich in potassium might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction.

It may not be the potassium itself; diets rich in potassium are also rich in a lot of other healthy nutrients from fruits and vegetables. These studies were large and well designed. They gathered an immense amount of data, looked at a variety of associations, and did their best to rule out possible confounding factors. But epidemiologic studies like these are imperfect by nature.

The authors themselves pointed out several limitations of their studies, including the indirect way they measured sodium and potassium excretion. Notably, you may notice that not one of the countries with the highest salt intake is in the top twenty. Additionally, the countries with the highest prevalence of raised blood pressure are predominantly Eastern European.

Notably, the four Eastern Asian countries—China, Japan, Korea and Singapore—show a much lower rate of high blood pressure. Would these foods have a different effect compared to unhealthy processed foods loaded with salt? High blood pressure is the biggest risk factor for cardiovascular disease and stroke Although the studies do suggest an overall positive association between excessive salt and stomach cancer, the studies are very mixed.

Despite the potential dangers of a very high salt intake, that does not mean we should unnecessarily restrict salt. James DiNicolantonio and several other prominent researchers caution that low salt intake is more damaging than a high consumption. As with many things in the nutrition world, there is no uniform perfect amount of salt for every individual.

In truth, the optimal sodium intake per day will differ from person to person and depends on various lifestyle factors like activity level and current health. As of right now, the studies on salt are mixed. The best bet is likely somewhere in between. James DiNicolantonio puts the ideal amount of salt somewhere between 8 and 10 grams per day. Additionally, the Japanese are one of the healthiest nations in the world.

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It features over pages on the dangers of following a low salt diet, and the steps you can take to improve health. As has been noted, the author firmly believes that a lower salt intake is more harmful than a high salt diet is. Blame that on sugar — which is also a leading culprit in the etiology of diabetes, cardiovascular disease, and kidney disease.

Further, he claims that a healthy intake of salt offers us better immunity, and improves our physical and emotional wellbeing.

A danger to public health? Uproar as scientist urges us to eat more salt

Just eat non-processed foods and add the right amount of salt — by following your taste! First, the book offers a look at the history behind the dietary guidance on salt and how it developed. Somewhat similar to the demonization of saturated fat, salt too was an innocent bystander in the face of poor science.

With false accusations levied at salt, researchers would convince doctors and the general public on the necessity of reducing salt intake. Additionally, the book hypothesizes how eating more salt might even save your life. Offering a detailed explanation, the book focuses on how sodium deficiency affects important health markers.

I hope that after reading my book people will no longer fear the salt shaker and can finally start enjoying their food again. Personally, I have found potassium lowered my BP much more than both ace-inhibitors and beta-blockers. In fact, if you get used to salting by taste on homemade food, the processed stuff starts to taste awfully salty.

Also, there are a number of substitutes for salt itself, things like tamari or Parmesan, that can flavor up your foods in more interesting ways than just plain salt. Third, it is patently obvious that salt is a necessary nutrient. We evolved taste buds for it! Animals go to great lengths to obtain it; we used to also, before it became ubiquitous in processed foods.

Finally, the whole issue of which salt is best is something I addressed here: In an ideal world, the public health message would focus on the potassium-sodium ratio rather than overly simplified blanket advice to lower sodium. The stuff about processed food is definitely true — and that goes for sugar too. Ditto to tamari and Parmesan! Please log in again.