Eat Less Salt - and Die?

I'm being sarcastic, right? The official health wisdom — the wisdom everybody knows is right (because all the top health officials repeat it over and over again) — is that if you "restrict" the salt in your diet, you'll live longer.

That's because (once again, according to those official pronouncements) your blood pressure will be lower, putting you at less risk for a heart attack or stroke, the #1 and #3 causes of death in the U.S.

There's only one problem with that widespread "health wisdom," as I've been telling my patients and readers for many years. It's not true! And a recent article in the May 4, 2011 issue of the Journal of the American Medical Association is the latest evidence to run counter to the medical (and mistaken) myth of "Low Salt Good, High Salt Bad."

Low-Salt Diet = 4X Death Rate from Heart Disease

The study was conducted by researchers at the University of Leuven in Belgium. First, they measured the urinary sodium levels of 3,681 healthy people in their 40s. Then they tracked their health for the next eight years. The folks with the highest urinary sodium levels — a sign of a higher dietary intake of salt — had the lowest risk of developing heart disease. Looked at another way, the low-sodium folks had four times the rate of dying from heart disease, compared to the high-salt folks.

The conclusion of the researchers was straightforward: "Our current findings refute the estimates…of lives saved and health care costs reduced with lower salt intake. They do not support the current recommendations of a generalized and indiscriminate reduction of salt intake."

The recommendations they're talking about are those from the American Heart Association (AHA), which suggests you limit your intake of salt to 1,500 milligrams (mg) per day — way down from the 4,000 or so mg most of us eat every day.

What did the study researchers have to say about the low-salt pronouncements of U.S. heart honchos? Yes, they agree, salt restriction may be a good idea if you already have high blood pressure or congestive heart failure. But for the rest of us? Previous scientific research has overestimated the effect of salt intake on healthy people, they say. And, they point out, hardly anyone actually achieves the level of salt restriction suggested by the AHA — a sign that the salt-needing body naturally triggers you to eat more salt when you try to cut back.

Of course, this isn't the first study to report that salt isn't bad for you. (And, in fact, it's good for you.) Many other studies say the same thing.

7 More Studies Throw Water on Salt Bashing

The Cochrane Library is a widely respected scientific organization that analyzes previous studies (a so-called meta-analysis) on a topic and reaches "evidence-based" conclusions about what's likely to work and not work in medical practice. In May of this year, they published a meta-analysis that looked at seven studies on salt and health involving more than 6,000 people. Their conclusion? "We didn't see big benefits" from salt restriction, said the lead author of the study, Professor Rod Taylor from the Peninsula College of Medicine and Dentistry at the University of Exeter. No lower risk of heart disease. No lower rate of early death.

Another recent study analyzed data from the government's National Health and Nutrition Examination Survey (NHANES) — one of the most respected (if not the most respected) nutritional databases in the country. It found the lower the intake of salt, the higher the risk of death!

So do take the advice to “restrict” the salt in your diet with a grain of salt — in fact, a lot of grains of salt! Now, I’m not saying that the insane amounts of salt added by food processing is a good thing — it’s not. But I am saying that of all the things we need to worry about for better health, salt isn’t that big of a deal — with the exception of people who already have high blood pressure or congestive heart failure.

Bottom line: let your taste buds be your guide to the right level of salt. If you want more salt, salt away!

Most importantly, for people with CFS and fibromyalgia, restricting salt is a setup for crashing and burning, and is very ill-advised — especially in summertime, when you sweat and have more salt loss.

Salt restriction is also a terrible idea if you have adrenal exhaustion. How do you know if you’ve got that problem? The symptoms include intense irritability when hungry, low blood pressure, and a tendency to collapse physically, mentally and emotionally when you’re under too much stress. Salt supports the adrenals.

And when I’m talking about salt, I’m not just talking about sodium chloride, or table salt. Saying sodium chloride is the be-all and end-all of salt is sort of like saying the human being is $5 worth of chemicals and nothing more. When you’re at home, consider using sea salt, which is a complex combination of minerals. I think it has many health benefits that are not yet understood by our current medical technology.

References

"European Project on Genes in Hypertension (EPOGH) Investigators. Fatal and nonfatal outcomes, incidence of hypertension, and blood pressure changes in relation to urinary sodium excretion." Stolarz-Skrzypek K, Kuznetsova T, Thijs L, Tikhonoff V, Seidlerová J, Richart T, Jin Y, Olszanecka A, Malyutina S, Casiglia E, Filipovský J, Kawecka-Jaszcz K, Nikitin Y, Staessen JA; Journal of the American Medical Association. 2011 May 4;305(17):1777-85.

"Reduced dietary salt for the prevention of cardiovascular disease." Taylor RS, Ashton KE, Moxham T, Hooper L, Ebrahim S.; Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011 Jul 6;7:CD009217.

"Sodium Intake and Mortality Follow-Up in the Third National Health and Nutrition Examination Survey (NHANES III)." Hillel W. Cohen, DrPH, MPH, Susan M. Hailpern, MS, DrPH, and Michael H. Alderman, MD.; J Gen Intern Med. DOI: 10.1007/s11606-008-0645-6