Take a Grain of Salt With That Salt Reduction Advice

by Heidi Stevenson

2 February 2010

It's taken as a matter of fact, something so obvious that everyone knows it. Good health and avoiding heart attacks requires low salt intake—and, of course, nearly everyone eats too much. There's just one problem. It's not true. Studies have not shown that lower salt intake reduces death from heart attacks or anything else. In fact, most studies have shown the opposite.

Rich nations are terribly concerned about their citizens' salt intake. Both the US and UK are actively trying to get people to cut back. The United States agency, the National Heart Lung and Blood Institute (NHLBI) pushes Americans to reduce their salt intake. The United Kingdom is quite delighted that its campaign against salt has reduced consumption by about 10 percent—and has tightened its food industry salt targets even further. The upscale supermarket, Marks and Spencer, proudly advertises throughout its stores that it has cut salt in all its prepared foods.

Who could possibly doubt that salt is a terrible evil? The refrain from nearly every direction says salt kills. Your doctor says it. Your employer may say it. Your spouse harrasses you about it. Less salt in products is a major selling point.

A Brief History of Salt's Persecution in Modern Times

Salt was one of the most valued substances throughout most of history, so valuable that it's incorporated into some of our most ingrained lingo. "He's the salt of the earth." As a necessary nutrient for life, it's not surprising. Then, sometime during the 20^th century, it was discovered that decreasing salt in the diet often eased edema (water retention). So, in severe disease, severely restricting salt intake was found to be beneficial.

In 1949, Walter Kempner's research showed that people with severely high blood pressure in conjunction with deadly kidney or heart disease could decrease their blood pressure by severely limiting salt intake and eating virtually no fat. The requisite diet was impossible for almost anyone to follow for more than a few days, at most a week or two, but a connection between less salt and lower blood pressure—in a severe disease state—had been made.

In the 1960s, Lewis Dahl developed a strain of mice that was exceptionally sensitive to salt. He compared these mice to others and found that the new strain was far more likely to develop hypertension (high blood pressure) when fed a high-salt diet. This seemed to prove that some people will respond badly to a high-salt diet. That makes sense, except that his salt-sensitive mice required a dose of salt equivalent to about a pound (over 500 grams) a day in a human.

On the basis of Dahl's research, the US set about its campaign to reduce salt intake in US citizens. A major study, INTERSALT (International Studies of Salt and Blood Pressure) was put in place to try to prove that high salt intake causes heart disease. The reported results initially appeared to support salt as a deadly toxin. However, the official results proved to be the result of cherry-picking data.

INTERSALT's conclusion was that higher blood pressure resulted from higher salt intake. 52 societies had been examined. INTERSALT included only 48 in its results. A reanalysis that included the other four societies found no relationship between high blood pressure and salt intake. Though the four societies not originally included had low salt intakes, they also had low stress, ate diets high in fiber and unprocessed-unprepared foods, and less obesity. They were also primitive groups of people who usually died long before heart disease shows itself.

The next major pro-salt study was the National Health and Nutrition Examination Survey (NHANES), which tracked 20,279 Americans starting in 1971 and first reporting in 1999. It reported significantly more deaths associated with salt: 89% more from strokes, 44% more from heart attacks, and 39% more deaths from all causes. That sounded so definitive. But it was nothing but statistical lies.

When the data was analyzed by independent researchers, a completely different picture emerged. They found that only the obese experienced higher rates of death with higher salt intake, and that there was no relationship between higher salt intake and deaths in anyone else.

Nonetheless, the notion that salt is bad for you and that everyone needs to restrict its intake not only continues, but is accelerated and institutionalized to the point where even questioning it is virtual heresy. Sadly, if you really want to enjoy good health today, heresy is your lot.

Why You Need Salt

Salt is a critical nutrient. It's the primary sources of sodium ions necessary in the sodium-potassium pump, which is the transfer of sodium ions out of cells and potassium ions into cells.

If there isn't adequate sodium for the sodium-potassium pump to function, the body cannot possibly function properly. In nerve cells, it creates the electrical imbalance required to transmit messages. Sodium movement in epithelial cells of the intestines and kidneys creates an osmotic gradient that allows water absorption. The movement of glucose and other nutrients into cells is achieved through the sodium-potassium pump. Sodium is absolutely necessary to normalize insulin levels.

More specifically, salt is required for a wide array of critical body functions, including:

• Stabilizing heart beat rate.
• Acting an antihistamine, so helps prevent allergy attacks.
• Preventing muscle cramps.
• Absorbing nutrients through the digestive system.
• Clearing sinus congestion.
• Clearing mucous plugs and sticky phlegm—critical in cystic fibrosis and asthma.
• Preventing varicose veins.
• Balancing sugar levels in the blood—critical for diabetics.
• Transmitting nerve signals.
• Preventing gout.
• Extracting excess acidity from cells.
• Regulating sleep.
• Maintaining sexuality and libido.
• Maintaining bone structure—critical in preventing osteoporosis.

Salt Heresy

The simple fact is that no study has shown any benefit in a low-salt diet in anyone but the obese. Studies have shown that death rates from cardiovascular disease and all other causes increase in people who adhere to the recommended maximum intake of salt—2,400 mg. of sodium per day. Certainly, some people are eating too much salt—but how much is too much is unknown, and as in most other things, it's probably different in each person.

One thing is certain: The emphasis on a low salt diet is misguided. Studies show that, rather than being healthy, it leads to severe health problems in most people. Unfortunately, the focus on trying to get people to lessen their salt intake is distracting from doing studies that might help determine what a truly optimal salt intake would be.

However, until research money is spent to find out how much salt really is optimal, the fact is that most people's salt intake is just fine or too low. To be healthy, you need to ignore the knee-jerk pressure to lessen salt intake. You need to become a salt heretic.

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