Seven Facts about Salt Your Doctor Won’t Tell You

Salt affects blood pressure.  If you are deficient in sodium, your blood pressure can drop too low! However, if you regularly consume salty and sodium-rich processed foods, you can increase your risk for five other medical conditions besides hypertension!  Find out which conditions. Discover what lifestyle habit overrides the benefit of a low sodium diet for high blood pressure.

How to Make Low-Sodium Diets Ineffective

Many individuals who have high blood pressure are salt sensitive. They retain more sodium than normal. Sodium and salt restriction help to reduce blood pressure levels in these individuals. Right? Correct, unless they are engaged in shift work or follow an irregular schedule. Evidence please! Blood pressure usually decreases when we sleep. When researchers fed a low-salt diet to mice that had a disturbed sleep-wake cycle (circadian rhythms), the low sodium diet was ineffective in reducing blood pressure. It actually caused narrowing of their blood vessels.¹ This is early evidence but it suggests that sometimes disturbed circadian rhythms can nullify some benefits of therapeutic diets.

Low potassium intake is another factor that sabotages the beneficial effect of a low-sodium diet on hypertension. Indeed, potassium intake is just as important as sodium-restriction in helping to reduce an elevated blood pressure. Additionally, a potassium-rich diet improves the ability of the kidneys to excrete water and sodium.² Fresh and frozen fruits and vegetables are rich in potassium. The more they are processed, the more they lose the beneficial potassium-to-sodium ratio.

Moderate Versus Strict Restriction

Moderate salt/sodium restriction is safer than severe salt restriction especially in individuals who have heart failure in which the heart cannot pump effectively to meet all of the body’s demand.³

Many years ago I greeted Mrs. Smith in our hospital. Over the years I nursed her daughter and son. Mrs. Smith had a history of high blood pressure. She was prescribed a low-sodium diet and diuretics. She was feeling weak and nauseated. Half-way through my shift, she became very confused and incontinent. Stroke? No. A low-sodium level was her problem. She was given sodium by IV and returned to her normal self. Anyone taking diuretics and eating a low-sodium diet should be aware of the signs of low sodium: fatigue, nausea, weakness, muscle spasm, headaches, and confusion. One needs sodium and salt to live. Salt is not a poison. Excess amounts are detrimental and can encourage many problems.

Salt & Autoimmune Disease

Excessive salt could increase your risk for autoimmune disease.  Fifty million Americans have an autoimmune condition in which the immune system attacks the tissues and organs of the human body. The incidence of autoimmune disease is rapidly rising. Ordinary salt reduces the number of certain lactic acid bacteria in the gut of mice and humans. A high salt diet kills off a species of good bacteria in the gut (lactobacilli ) and increases the number of Th-17 immune cells even in healthy men.⁴ These immune cells,– when overactive or in excess,– are linked to hypertension and autoimmune diseases.

 Salt & Your Risk for Diabetes

Excessive sodium intake has been linked to increased risk for both type 2 diabetes and Latent Adult Autoimmune Diabetes (LADA). LADA is a class of type 1 diabetes in which an autoimmune process destroys the insulin -producing cells in the pancreas. Unlike the typical type 1 diabetes, it occurs in adulthood instead of childhood. A significant study found that excess sodium intake was linked to a 58% increase in the risk of developing type 2 diabetes for each extra gram of sodium (equivalent to 2.5 extra grams of salt) consumed per day compared to those who consumed the lowest amount of sodium. We should add that this study adjusted for a lot of confounding factors such as age, obesity, smoking, physical activity, alcohol, total number of calories consumed, potassium, and even family history of diabetes.

The effect of sodium intake on the risk of developing LADA was even more pronounced: a 73% rise for each gram of sodium consumed per day. Those individuals who were genetically predisposed for LADA, and whose sodium intake was classed as ‘high’ (over 3.15 g/day), were almost four times more likely to develop the disease than those consuming the lowest intake (under 2.4 grams/day).⁵

After adjusting for possible confounders, Researchers in one study, found that an almost doubled increased risk of type 2 diabetes was determined in subjects who add salt to prepared meals.⁶

Diabetes increases the risk for heart and blood vessel disease. Individuals who have type 2 diabetes and consume a high-sodium diet double their risk for cardiovascular events.⁷

Bones and Stones!

Too much salt and processed foods (loaded with extra sodium) can set you up for osteoporosis and kidney stones. How? When too much sodium is consumed, the kidneys try to remove it. When this happens, calcium is removed too. This makes it easier for calcium-containing stones to form. Consuming excessive amounts of sodium on a regular basis lowers the level of calcium and thins the bone matrix.⁸

Salt & Dementia?

Habitual and excessive salt might increase your risk of dementia. One study found that a high-salt diet reduces resting blood flow to the brain and causes dementia in mice because extra salt reduces the ability of blood vessels to dilate. Consequently, this reduces blood flow by 25% to two important areas within the brain for memory and learning. In this study the decreases in blood flow worsen cognitive performance to the extent of dementia.⁹ Another consideration. As we age, the kidneys do not eliminate extra sodium as effectively.¹⁰ Older individuals could be more sensitive to the adverse effects of consuming a high-sodium diet.

Salt & Your Risk for Obesity

Consumption of a salty meal increases appetite.¹¹ Several studies found that a high salt diet is linked to a greater risk of obesity in children and adults. For example, a 2015 study reports that children who increased their salt consumption by one gram a day increased their risk for obesity by 28%. In adults the risk was increased by 26%.¹²

How to Reduce Sodium Intake

How to reduce sodium intake:
Ready-to-eat foods account for 75% of the sodium in the American diet.
Rinse canned beans and vegetables to remove some of the sodium.
Use frozen or fresh vegetables in place of canned vegetables.
Use unsalted, unroasted nuts and seeds.
Add a splash of fresh lemon or lemon juice to soups and salads.
Use garlic and onions.
Basil substitutes well for black pepper.
Make your own condiments.
Bragg’s coconut aminos have 90 mg of sodium per teaspoon, while traditional soy sauce contains about 280-293 mg of sodium in the same serving size. Soy-based liquid aminos have slightly more sodium than soy sauce, containing 320 mg per 1 teaspoon serving.

Caveat:

Please be aware that Himalayan and Celtic salt do not have the recommended daily allowance of iodine. This is potentially serious because you need iodine to make thyroid hormone. Iodine deficiency is the major cause of hypothyroidism world wide. Too little and excessive amounts of iodine increases the risk for diabetes and thyroid cancer. Adults and teens need 150 micrograms a day. Children ages 1-8 need 90 mcg and children 9-13, 120 mcg of iodine per a day. Pregnant women and nursing mothers require 200 micrograms of iodine daily. The content of iodine in seaweed is highly variable. Kelp or brown seaweed has excessive amounts where as red and green seaweed may contain between 30-200 micrograms per a serving.

1. R. D. Rudic. Time Is of the Essence: Vascular Implications of the Circadian Clock. Circulation, 2009; 120 (17): 1714 DOI:10.1161/CIRCULATIONAHA.109.853002[↩]
2. Alicia A. McDonough. Cardiovascular benefits associated with higher dietary K versus lower dietary Na Evidence from population and mechanistic studies. American Journal of Physiology – Endocrinology And Metabolism, 2017; ajpendo.00453.2016 DOI:10.1152/ajpendo.00453.2016[↩]
3. Konerman M. Sodium Restriction in Heart Failure: Benefit or Harm? www.ncbi.nlm.nih.gov/pmc/articles/PMC3947770/[↩]
4. Max Delbrück Center for Molecular Medicine in the Helmholtz Association. “Gut bacteria are sensitive to salt: Link to autoimmune disease and hypertension.” ScienceDaily. 15 November 2017.[↩]
5. Diabetologia. “Sodium (salt) intake is associated with a risk of developing type 2 diabetes.” ScienceDaily., 14 September 2017. www.sciencedaily.com/releases/2017/09/170914210621.htm[↩]
6. Radzeviciene, L., & Ostrauskas, R. (2017). Adding Salt to Meals as a Risk Factor of Type 2 Diabetes Mellitus: A Case-Control Study. Nutrients, 9(1), 67. https://doi.org/10.3390/nu9010067 [↩]
7. Chika Horiakwa. Dietary Sodium Intake and Incidence of Diabetes Complications in Japanese Patients with Type 2 Diabetes – Analysis of the Japan Diabetes Complications Study (JDCS).The Journal of Clinical Endocrinology & Metabolism, 2014; jc.2013-4315 DOI:10.1210/jc.2013-4315[↩]
8. University of Alberta Faculty of Medicine & Dentistry. “Diets high in salt could deplete calcium in the body.” ScienceDaily. ScienceDaily, 24 July 2012. www.sciencedaily.com/releases/2012/07/120724131604.htm[↩]
9. Giuseppe Faraco. Dietary salt promotes neurovascular and cognitive dysfunction through a gut-initiated TH17 response. Nature Neuroscience, 2018; DOI: 10.1038/s41593-017-0059-z[↩]
10. Hong Ji. Aging-related impairment of urine concentrating mechanisms correlates with dysregulation of adrenocortical angiotensin type 1 receptors in male Fischer rats. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology, 2015; ajpregu.00131.2015 DOI: 10.1152/ajpregu.00131.2015[↩]
11. Max Delbrück Center for Molecular Medicine in the Helmholtz Association. “Mission control: Salty diet makes you hungry, not thirsty: New studies show that salty food diminishes thirst while increasing hunger, due to a higher need for energy.” ScienceDaily. 17 April 2017.[↩]
12. https://www.webmd.com/diet/obesity/news/20170501/salt-weight-connection[↩]