Heather Bedard, C.H.E.
Salt has become very controversial due to a lot of poorly done studies and conflicting information. Salt is made of sodium and chloride ions. The chloride is used by the body for many things, but the sodium ions are used by every cell in your body. Salt helps to maintain the fluid balance between the cells and plays a part in how the nerves signal allowing them to be transmitted around the body.
The World Health Organization (WHO) recommends 2,000 mg (2 grams) of sodium per day. (1) However, the Centers for Disease Control (CDC) states that most Americans consume at least 3,400 mg per day. (2)
One of the reasons for suggesting a lower sodium intake is the increased risk of cardiovascular events due to high blood pressure. A recent study, with quality design, found that in areas where the average intake was higher than 5 grams per day there was a higher risk of cardiovascular events, however, this did not exist in areas where the average intake was higher than the WHO’s recommendations of 2 grams, but below 5 grams. (3) In other words, there is a risk of cardiovascular events if you have less than 2 grams or more than 5 grams. The sweet spot appears to be between 2-5 grams.
Another study that compared high sodium intake with patients who had hypertension (high blood pressure) with those who had low sodium intake and no hypertension found that restricting sodium intake to under 3,000 mg per day had the same effect of increased risk of cardiovascular events and death in those with low sodium intake as those who had hypertension and too much salt.
In other words, eating a low-salt diet increased the risk of heart attack or stroke 26% for those without hypertension as well as increasing 34% for people with hypertension – meaning high blood pressure. Eating too much salt increased the risk of heart attack or stroke by 23% for people with hypertension, but not at all for people who did not have hypertension. (4)
Interesting, huh?
One other thing to keep in mind when addressing the sodium issue is the role that sodium and potassium play in connection with each other. Many people in the west consume a lot more sodium and a lot less potassium which is found in fruits and vegetables. This leads to a concerning twist in the high sodium debate. Low potassium exacerbates the symptoms of high sodium intake such as cardiovascular disease which makes determining the cause even that much more difficult. Raising the amount of potassium through whole fruits and vegetables can help to eliminate this issue. (5)
So with all this being said, the type of salt you consume matters. You consume sodium naturally in whole foods such as celery and beets as well as in baked goods containing baking soda. If you consume most of your salt from highly processed and preserved foods, this is where you can get into trouble. Unless you need to restrict your salt intake because of salt sensitivity you don’t need to spend a lot of time counting and tracking. Symptoms of salt sensitivity include higher blood pressure when you consume sodium and water retention.
Many brands of table salt are fortified with iodine which is much more beneficial if you consume as part of a whole food. Most people in the US are not iodine deficient and consuming too much can cause many health problems including thyroid disease. As with any isolated nutrient, your body was not designed to use it in that form and is much more effective in its whole, natural state.
Salt found in nature is generally not pure white. As it is processed, many table salts are bleached and other additives are supplemented such as fluoride, dextrose, and aluminum. Additionally, it is heated to 1200 degrees to remove impurities and this also damages much of its natural components. Sea salt and Himalayan salt are processed much more naturally and left in their original state such that no, or less, anti-caking agents are used and more of the naturally occurring minerals are left behind. I would recommend this as an alternative to traditional table salt.
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WHO. Guideline: Sodium intake for adults and children. Geneva, World Health Organization, 2012. https://www.ncbi.nlm.nih.gov/books/NBK133309/
Mente A, O’Donnell M, Rangarajan S et al. “Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study.” Lancet 2018 Aug;392(10146):496-506
Mente M, Rangarajan S, Dagenais G et al for the PURE, EPIDREAM and ONTARGET/TRANSCEND Invstigators. “Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies.” Lancet Published online 20 May 2016
Morris R, Schmidlin O, Frassetto L, Sebastian A. “Relationship and interaction between sodium and potassium.” J Am Coll Nutr 2006 Jun;25(3 Suppl):262S-270S