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Salt: Is it Good or Bad?

Salt: Is it Good or Bad?

Lowering salt is common dietary advice but doing so could actually increase blood pressure and diabetes risk.

Conventional wisdom on salt is that most Americans need to reduce their salt intake; this is the view put forth by the federal government’s Dietary Guidelines for Americans as well as others. The truth is more complicated, particularly with the most up-to-date science. We will untangle some of these threads below, but the main takeaway is one that is common throughout integrative medicine: the healthy way to incorporate salt into your diet is dependent on your own individual biology and needs—there isn’t a one-size-fits-all solution.

The advice for most people to reduce salt is based on the notion that a reduction in salt decreases blood pressure and incidence of hypertension, which in turn leads to a reduction in mortality from cardiovascular disease.

But there is reason to be skeptical of such broad claims. For one, the results of the largest trial to date looking at salt reduction and incidence of heart failure were released earlier this month. The trial found that reducing salt intake did not lead to fewer emergency room visits, hospitalizations, or deaths for patients with heart failure.

The truth is that salt affects people differently. Some people can eat salt with no effect on their blood pressure; other people are “salt sensitive” and even a slight increase in sodium intake can increase blood pressure and harm the kidneys’ ability to regulate fluid.

This is why integrative practitioners often tell us to be wary of “low salt diets.” Lowering salt intake may be appropriate for some “salt sensitive” individuals to lower blood pressure. But for others with normal blood pressure, some evidence demonstrates that lowering salt intake is just as likely to increase blood pressure as to reduce it. And even if cutting salt reduces blood pressure, it may not be a good thing, because it activates salt-retaining hormones which can stiffen arteries. Animal studies have shown that low salt diets can accelerate atherosclerosis. Low salt diets can also elevate insulin levels, meaning lowering salt may increase your risk of becoming overweight or obese (insulin is a fat-storing hormone).

Additionally, not all salt is created equal. Most of the salt people eat tends to come from ultra-processed junk foods that contain refined salt. These foods should be eaten sparingly, if at all. Refined salt has been chemically treated to improve the product’s shelf life; chemicals are added that contain anti-caking, free flowing, or conditioning agents, such as sodium ferrocyanide, ammonium citrate, and aluminum silicate. Unrefined salt, like sea salt, contains over 80 natural minerals and elements that have myriad health benefits.

The campaign to reduce excess salt intake may have had the unintended consequence of making many of us iodine insufficient or deficient. Typical Western diets are low in iodine, so table salt was iodized decades ago to prevent goiters. Iodine is essential for thyroid function, and inadequate iodine has also been linked to cancers, fatigue, and weight gain. Note that you can get sufficient iodine from your diet by eating foods like fish and seaweed.

The main point is, like most health issues, there is no one, simple answer. We all need to assess our own health to determine what level of salt intake is appropriate.

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8 thoughts on “Salt: Is it Good or Bad?

  • A 1970 study at the University of Hawaii indicated that while salt restriction could slightly reduce hypertension in some individuals, it had the greatest effect on those with only mildly elevated BP. After weeks of a no-added-salt diet, during which my BP climbed from 140/90 to 150/92 and I had to endure constant accusations of noncompliance from my MD, I began acupuncture and my BP returned to the normal range. I have since learned that my BP is quite sensitive to emotional disturbance (including being berated or even terrorized by doctors), and that the common BP drugs, including calcium blockers and beta blockers, cause significant side effects, including tachycardia ( like 40 BPM heart rate). the Heartmath protocol has helped immensely, but I found out about it through my own research, augmented by suggestions from an integrative cardiologist.

  • abinico warez

    ANH, you are so wrong on this. Salt your food to taste – your body will tell you if something is too salty, or not salty enough.

  • Frank Maxant

    Following my cardiologist’s advice to go onto a low salt diet was one of the most harmful things I’ve done for my health. After 3+ years, I finally realized the harm.
    Now, after >a year back to normal, my food tastes good again (which improves my state of mind & improves my outlook on everything). My body feels more “solid”, I am more energetic & alert. My libido is back, which is great for my ego & sense of “self”.
    I show no sign of fluid retention, & no appreciable change in my BP.
    I hadn’t noticed how un-salty my tears & nasal mucous had become. Now, they are back to normal, which restores my body’s defenses against infections through my eye sockets and my respiratory system.
    I WONDER: How many of us old farts die of some sort of pneumonia? –How many of us are on low salt diets, reducing our bodies’ natural defenses against these infections?

    NEXT: trying to get off my diuretics. I tried twice while on the low salt diet. Both times, after a couple of weeks symptoms emerged, principally fluid retention (but NOT in my lower extremities, but in my large muscles, the body’s natural reservoir!) and shortness of breath. Seeing (above) that salt affects (indirectly, maybe) our kidneys’ ability to regulate fluid encourages me to try again, now that my body is otherwise back to normal. Of course, diuretics interfere w/our kidneys’ function, almost certainly causing some sort of harm.

  • Michael Cone

    I hope someone reads this and can appreciate the implications of what I’m about to share. In 2004 I began to experience elevated blood pressure (140’s/90’s). My research led to an East Indian doctor and the results of his salt water therapy for a wide variety of illness, and I don’t mean bathing in it, I mean drinking it. As per his instructions, I put a tablespoon of grey sea salt(I now use Himalayan salt) into a gallon of filtered water and drank a gallon a day. By the end of the second day my blood pressure was back in the 120’s/70’s and it’s never gone back up. I also lost my taste for alcohol after a few months. I’m seventy-one now and I still drink a gallon of salt water everyday(actually it should be called(“Salt Minerals Water”). I’m getting 84 essential minerals in the water I’m drinking. Could so many health problems be linked to mineral deficiency? And this is as about as all natural as it gets! So, let me know your thoughts.

  • Daz wazlle

    Excellent article but I wanted to point out 1 thing. You CAN get adequate Iodine levels from seaweed, but NOT from fish! Research has shown that a person needs 12.5mg Iodine/day to maintain saturation. that is 50 times higher than the avg American gets, even with iodized salt(sea salt doesnt have iodine but IS better for you but if you use it you MUST get another source of iodine, like Dr Lugols solution[10% inorganic iodine]) You cannot eat enough seafood to get 12.5 mg. Research has also shown it takes 50mg/day for 3 months for the Avg. American to reach saturation(excreting 90% of it in the urine). You literally are soaking it up like a sponge because every cell in the body has a receptor for iodine and the thyroid, ovaries mammary glands and testicles concentrate iodine. iodine is anti- viral, bacterial and fungal. it has been credited for the fact that Japanese living in japan have almost no cancer(they get 50mg/day from Kelp). Iodine will also , in conjunction with selenium strengthen a weak heart and reverse gout from right sided heart failure.

    • daz wazlle

      Extrathyroidal Benefits of Iodine, American Journal of Physicians and Surgeons
      Iodine- Dr Brownstein(book)
      In case I didnt make it clear, one cannot get 12.5mg/day iodine, from iodized salt use.

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