Salt Restriction: Good In Theory, But Impossible to Implement?
Reducing salt intake might be a good idea, but it may not matter since our bodies have irresistible physiologic mechanisms to defend a higher level of salt intake, according to a new report in the Clinical Journal of the American Society of Nephrology.
Another push to lower salt (actually, sodium) intake in the American public started a few years ago. The idea is that sodium restriction will lower blood pressures, leading to fewer heart attacks and strokes. That proposition itself is debatable. The medical/nutrition community hotly debated it 20 years ago. There are reasonable arguments on both sides.
The authors of the study at hand don't address whether sodium restriction would be healthful. They question whether any measures at the public health level can even work. Their answer: probably not.
The Institute of Medicine in 2003 recommended 2,300 mg/day as the upper limit of dietary sodium. The USDA's 2005 Dietary Guidelines recommend 1,500 mg/day for people at risk of hypertension.
The authors conclude that the average person has powerful physiologic mechanisms working to keep sodium intake around 3,000 mg/day, at least.
They studied the salt consumption of widespread, diverse populations, including those who were carefully instructed and motivated to reduce salt intake. In this case, it seems you just can't fight Mother Nature.
I think perhaps two of every 10 people may have blood pressures sensitive to salt intake. Let's try to identify and target them for intervention rather than attempting sweeping societal changes that affect us all.
If I had elevated blood pressures, I'd make an attempt to reduce my sodium intake over a two or three month trial and note the effect. You can calculate and monitor your sodium intake with NutritionData's "My ND/My Tracking" feature. I'd also start exercising regularly and lose my excess body fat.
-Steve Parker, M.D.
Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physician before making any dietary or exercise changes.
References: McCarron, David, et al. Can dietary sodium intake be modified by public policy? Clinical Journal of the American Society of Nephrology. 4 (2009): 1,878-1,882.
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Posted by: Ron | Oct 19, 2009 12:26:11 AM
It's not Mother Nature you're fighting, it's human culture. If you eat a completely salt-free diet for about a month, your body makes a neuroadaptation, and you no longer crave it. I've done it. Get off salt (gradually), and your body retains more sodium when you sweat. If you get sufficient sodium and chlorine from vegetables and other foods, and you eat sea veggies or other foods for iodine, salt has no nutritional benefit. Salt is a risk factor for stroke even when blood pressure is normal.
When the Yanomami Indians were studied, they ate no salt. This was in a hot, humid rain forest. Their blood pressure was low, and didn't rise as they aged.
http://cspinet.org/salt/saltreport.pdf
www.worldactiononsalt.com
Posted by: Steve Parker, M.D. | Oct 19, 2009 8:10:15 AM
Ron-
I'm glad it worked for you. McCarron et al would say your are the exception to the rule. And you're not the only one.
-Steve
Posted by: Steve Parker, M.D. | Oct 19, 2009 11:32:10 AM
Here's a quote from the introductory paragraph of the McCarron article:
"For thousands of years, salt's high value has made it the foundation of a society, a currency of trade, and cause for wars."
Ever heard of someone being "worth his salt"? The phrase harkens back to the days in certain societies in which workers were paid with salt.
-Steve
Posted by: Ron | Oct 20, 2009 12:12:45 AM
Yes, salt has value culturally. The word "salary" comes from salt. But it may be that anybody can lose the preference for salt. Once you go a month or so without it, the sodium content of vegetables satisfies the desire for it. Before modern times, salt, sugar, and fat were all harder to come by, so our taste preferences for them induced us to eat healthfully. Now we have an overabundance of salt, sugar, and fat all around us, so those taste preferences harm us. Try going salt-free for a month, and then eat something salty you used to enjoy!
Posted by: Alan Anderson | Nov 2, 2009 5:08:16 PM
Here is an easy way to keep track of sodium intake: try never to eat a food that has more calories than mg of sodium. Assuming some food has little or no sodium and most people eat around 2000 calories, you end up under 2,000 mg of sodium per day. This is the best way to determine if a food is high in sodium: make sure the sodium is less than the calories. I have been trying to get doctors to consider this but I guess it is too simple.
Posted by: E. J. Martin | Nov 2, 2009 7:14:43 PM
I reduced my sodium intake on my own and found I not only felt better, but the fluid retained in my legs decreased to the point that pain in the knees and ankles was greatly reduced. I now find prepared foods in restaurants and fast food establishments grossly over salted. This can't be good for anyone, healthy or with problems. Sorry Dr. Steve....I think it can be done and should.
Posted by: shan | Nov 4, 2009 12:19:45 AM
I reduced my blood pressure several points by using a mixture of around 4 parts of "no salt" substitute, made from potassium, and ammonium chloride (salt is sodium chloride) with 1 part of sea salt. In that proportion, I find it tastes like normal salt, when cooking, where the substitute tasted bitter, if used straight.
Posted by: john | Nov 5, 2009 1:33:55 AM
has anyone here ever taken the time to read the "vital function of salt in the body" I reduced my blood pressure from 150/80 to 118/62 & no longer have asthma, all due to the application of the correct balance of natural salt & the correct hydration & water intake. It is worth the research!
