Chances are your doctor has told you to cut back or even eliminate this ingredient from your cooking. Maybe a loved one grabs it from your hands at the dinner table to save your life. No doubt you’ve read about how it leads to heart disease, stroke and death.
It’s been called the deadliest ingredient in the food supply.
But here’s the thing… We would all die without this essential mineral.
What is this alleged killer?
Everyone “knows” you should cut back on salt to lower blood pressure. Doctors tell you a high sodium diet leads to hypertension and heart disease, right?
But what if it’s not true? What if salt doesn’t cause high blood pressure? Or heart disease?
Busting the Myth that Salt Raises Your Blood Pressure
The link between salt and hypertension is a theory that’s been debated for 40 years.
But it’s just a theory. And more and more scientific studies are showing that it may not be true.
Take the recent Belgian study in the Journal of the American Medical Association. It found that, contrary to government recommendations and all the advice you’ve heard, there was no association between higher sodium levels and increased blood pressure.
In fact, they concluded that lower sodium is actually associated with an increased risk of cardiovascular death.1
Another study from the prestigious Cochrane Collaboration concluded that moderate reductions in the amount of salt people eat doesn’t reduce their likelihood of dying or experiencing cardiovascular disease. In fact, one study found that a reduced sodium diet significantly increased the number of heart failure deaths.2
There are now a multitude of studies documenting that low-salt diets don’t improve blood pressure, hypertension or heart disease, and may in fact increase the risk of diabetes, heart disease and death.
And there’s even evidence that a low-sodium diet can lead to diabetes… and more.
A 2011 study from Harvard Medical School clearly links reduced sodium to increased insulin resistance. Researchers put healthy people on a low-salt diet and found that they developed insulin resistance within just 7 days.3
So it’s possible that cutting back on salt could contribute to the current epidemic of diabetes.
It could also contribute to weight gain and obesity. How? We may consume more calories just to satisfy our innate need for salt. We’ve seen it happen before with low-calorie and low-fat foods. We may overindulge in low-salt foods because we are not getting what we crave or need.
Other studies show that even when low salt diets lower blood pressure, they can also raise cholesterol and triglyceride levels as well as other hormones that increase heart disease risk.4
And low salt diets may be particularly dangerous for the elderly. They can lead to a mild sodium deficiency (hyponatremia), the most common form of electrolyte imbalance in older people. Hyponatremia is associated with walking problems, attention deficits and a much higher rate of falls and fractures.5
How Much Salt Do You Need?
The Centers for Disease Control and Prevention recommends that healthy adults get less than 2,300 mg of sodium per day.
They reduce that number to only 1,500 mg if you:
- have high blood pressure,
- are over 51,
- have diabetes or kidney disease, or
- are African American.
That means the CDC wants almost 70% of Americans to take in no more than 1,500 mg per day.
However, Dr. Michael Alderman, a professor of medicine and epidemiology at Albert Einstein College of Medicine in New York, disagrees. He thinks higher sodium levels are healthier.
In an article published in the American Journal of Hypertension, Alderman reviewed all of the scientific studies on the relationship between cardiovascular deaths and dietary sodium.6
Based on 23 studies that covered 360,000 patients, Alderman concluded that too little sodium is just as bad as too much.
He found that sodium intake above 6,000 mg/day or below 2,500 mg/day is associated with increased cardiovascular risk.
Dr. Alderman advises that as long as your sodium intake is around 3,500 mg/day, there is no evidence that cutting the amount of salt in your diet will improve your health.
In fact, Dr. Alderman did not even find support for the idea that people with hypertension should restrict their salt. Instead, he found that low salt diets were associated with an increased risk of death and disease, even if people successfully reduced their blood pressure.
Potassium: The Other Side of the Salt Story
Instead of cutting sodium, increasing potassium in your diet could contribute significantly to improving your blood pressure.
In fact, adding potassium to your diet might get you the same results as cutting your table salt in half.
The balance between sodium and potassium is so critical to our wellbeing that it’s been dubbed the “vitality ratio.”
Here’s why. Potassium and sodium work together to maintain your body’s optimal fluid levels. When your sodium levels drift up, your body retains fluid putting pressure on your blood vessels.
Potassium helps excrete the excess sodium in your urine. It also relaxes blood vessel walls helping to relieve the pressure.
But most of us aren’t getting enough potassium. Researchers in the Netherlands recently looked at potassium consumption in 21 countries.7 They found that average potassium intake varies between 1,700 and 3,700 mg a day. That’s much less than the recommended 4,700 mg a day.
The researchers believe that increasing potassium to the recommended level would have the same effect on blood pressure as decreasing salt consumption by 4,000 mg per day.
So how do you get more potassium into your diet?
Here are 10 of the best potassium sources from fruits and vegetables.
- Baked potato with skin
- Coconut water
- Acorn squash
- Lima beans
- Prunes, raisins
So worry a little less about your sodium, and pay a little more attention to your potassium, to maximize your vitality ratio.
1 Stolarz-Skrzypek K, Kuznetsova T, Thijs L, et al, Fatal and nonfatal outcomes, incidence of hypertension, and blook pressure changes in relation to urinary sodium excretion. JAMA. 2011 May 4;305(17):1777-85.
2 Rod S. Taylor, Kate E. Ashton, Tiffany Moxham, Lee Hooper and Shah Ebrahim, Reduced Dietary Salt for the Prevention of Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials (Cochrane Review) American Journal of Hypertension 24, 843-853 (August 2011) | doi:10.1038/ajh.2011.115 http://www.nature.com/ajh/journal/v24/n8/full/ajh2011115a.html
3 Garg R, Williams GH, Hurwitz S, Brown NJ, Hopkins PN, Adler GK, Low-salt diet increases insulin resistance in healthy subjects. Metabolism. 2011 Jul;60(7):965-8. Epub 2010 Oct 30. http://www.ncbi.nlm.nih.gov/pubmed/21036373
4 Niels A. Graudal, Thorbjørn Hubeck-Graudal and Gesche Jürgens, Effects of Low-Sodium Diet vs. High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol, and Triglyceride (Cochrane Review) American Journal of Hypertension (2012); 25 1, 1–15. doi:10.1038/ajh.2011.210 http://www.nature.com/ajh/journal/v25/n1/abs/ajh2011210a.html
5 Michael H. Alderman and Hillel W. Cohen, Dietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved? American Journal of Hypertension 25, 727-734 (July 2012) | doi:10.1038/ajh.2012.52 http://www.nature.com/ajh/journal/v25/n7/full/ajh201252a.html
7 Linda A. J. van Mierlo; Arno Greyling; Peter L. Zock; Frans J. Kok; Johanna M. Geleijnse. Suboptimal Potassium Intake and Potential Impact on Population Blood Pressure. Archives of Internal Medicine, 2010; 170 (16): 1501-1502 DOI: 10.1001/archinternmed.2010.284
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