If you listen to what mainstream media and health authorities tell you, you probably believe that salt is a demonic entity that, with the smallest ingestion, will cause your blood pressure to rise so quickly your arteries explode from it. The American Heart Association, the Heart Foundation of Australia and even the WHO constantly advise the general population to reduce their salt intake to very low levels in order to prevent heart disease and general ill health, because clearly we need to be protected against this horrible white substance. There’s kind of a big issue at play here though…
The data does not in any way support this recommendation.
That’s right. Salt, like saturated fat and eggs, has been a nutritional boogeyman for decades now, because advice given by the authorities does not keep pace with what research actually says. To understand where these recommendations around salt intake come from, we need to go back to 1962, when Lewis Dahl and his associates were convinced that they had a clear ability to induce high blood pressure with salt. They conducted an experiment where they fed two groups of rats a high salt diet. One group, the salt sensitive rats, developed severe hypertension. The non-sensitive rats did not.
We also know that around 25% of humans can be salt sensitive, whereby decreasing salt intake (to a point, we’ll get to that later) can decrease blood pressure. Of those 25%, however, just over half maintain normal blood pressure. Let’s get back to the rat experiment though, because there’s a big kicker, and it’s mind blowing. Regardless of whether or not the rats were salt sensitive, guess how much salt they were given?
They were fed the human equivalent of just over one kilogram of salt per day.
The average salt intake of an American is, in comparison to this study, a paltry 9 grams. That’s two teaspoons.
So despite the fact that this study featured a diet fed to rats that was so ludicrously high in salt a human couldn’t actually replicate it, it’s formed the basis of the guidelines around salt consumption provided to us by health authorities. That’s not to mention that lab rats are all pretty much the same size. Humans differ greatly in size — it makes no sense that a 50kg female is advised to eat the same amount of salt as a man that is twice that size.
Fast forward to 2010, and The Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products. Even right now as of 2020, the American Heart Association recommends only a teaspoon of salt per day. That’s despite a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension in 2011 which found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure.
In fact, cutting your salt intake can actually be detrimental, depending on how much you currently consume. Recent data actually shows that current recommendations to get your sodium intake below 1000mg per day actually cause more problems than going to the extreme of ingesting over 7000mg.
Your body actually needs salt
I’m not going to weigh you down with biochemistry (you can really get into that in the links I provide at the bottom if you like), but it’s sufficient to say that salt is an important part of the electrolyte balance in your body and when you sweat, you lose it. As you drink more water in summer and continue to sweat, you’re replacing the water in your body but not the salt. The result is cramping and feelings of exhaustion. The same issue arises when an athlete (or any person) cleans up their diet and stops eating processed, packaged food. All of a sudden their sodium intake plummets, which becomes detrimental to their performance and overall levels of alertness, especially in summer when you sweat more.
Interestingly, a couple of years ago after doing this research, I began experimenting with my own sports drink. Gatorade and the major brands talk a lot about their “scientific formula”, but the reality is that they contain a paltry 51mg of sodium. I changed the ratios and amounts of salt and sugar (the drink I made had 500mg of sodium) to make it more accurate for optimal hydration. This wasn’t a scientific study, but the results were interesting. I gave it to a bunch of my fellow strongman competitors to try while we were training during the hot Australian summer (temperature was around 100 degrees), and not only did it keep their performance consistent during their training, but they found that they were recovering much more effectively as well.
Between my own research and testing these things, it’s become very clear to me that far from being detrimental to your health, salt is a performance enhancer.
But I’m not an athlete, how does this affect me?
You’re still a human, and you inhabit the same body. The problem is that the advice on salt isn’t given in a vacuum. We also have this recommendation that you see in popular media and online that you need to drink a gallon of water a day. There is literally no evidence that we as humans need to drink a certain amount of water considering our differences in size and the amount of water we consume through food. That doesn’t stop people from walking around the office with one of those freaking jugs, like they’re trying to show off how much water they consume.
So let’s say you’re one of those people, smashing yourself with water, and you eat most of your meals as fresh food with no salt on them. Now you’re constantly depleting the sodium level in your body without replenishing it. And you wonder why you’re tired despite getting enough sleep and living so healthy.
There is, as always, far more to the story
The war on salt would appear to be yet another case of the health authorities giving us one size fits all recommendations without hard evidence, but based on a logical progression that if high blood pressure is a risk factor for heart disease, and salt increases blood pressure (in rats mind you), then reducing salt intake would reduce the risk of heart disease. Unfortunately as noted above, the Cochrane review actually found an increase in risk when following a low sodium diet such as that recommended by the American Heart Association.
Fructose consumption increases the uptake of sodium by the kidneys, and by reducing consumption of fructose by 350ml (an average small bottle of soda or juice) blood pressure lowers. Potassium intake is also a factor, with research indicating that the ratio of potassium to sodium a more important marker than absolute level of sodium. So if you eat a diet that mostly consists of fresh, whole foods (not packaged or processed) and don’t eat fruit or drink fruit juice, the insistence that one must reduce salt intake is ludicrous and most likely detrimental.
The take home message once again is that one size certainly does not fit all, and we need specialized recommendations based on our individual makeup, lifestyle, diet, and genetics instead of messages like “you must cut saturated fat to 20g and reduce sodium intake at all costs.”
Health advice needs to be better thought through
This is where the health authorities continue to fail us. They make initial knee jerk reactions to science that is far from settled and advise everyone to do the exact same thing, regardless of lifestyle factors. Then, when more sophisticated research shows initial recommendations were incorrect, they stick their head in the sand and act like it didn’t happen, continuing with their initial advice.
That’s not good enough. If you’re a doctor and appointed to a health authority, interpreting research for the public should be your bread and butter. You’ve failed in your job when you act like new findings haven’t happened, because policy and guidelines should be up to date, not stuck with research from 40 years ago.
The bottom line
From all of the reading I have done on the subject — and I preface this by saying I’m not a doctor or a researcher, just a passionate health and fitness guy, keeping hypertension in check is more a matter of trying a few very simple things as opposed to eliminating salt:
- Cut down your consumption of fruit juice and soda.
- Eat as little as possible out of a box or packet.
- Keep the fast food to a minimum.
- Salt the food you cook at home to taste.
That’s all supported by the evidence I’ve linked to in this piece. I’d be willing to bet that if health authorities gave those kinds of recommendations, people would be a lot more willing to consider it. That’s because we know we shouldn’t drink too much juice or soda, or eat all our foods from a packet. We know we should keep the fast food to a minimum. Those kinds of changes are going to be so good for the average person that a drop in blood pressure will just be an added bonus.
And then, you don’t even have to worry about guidelines for salt intake.
But hey, don’t take any of my words here as gospel. Read the links I’ve provided in and at the bottom of this article. See for yourself and ask the question: is what I’m being told actually in line with the science?