salt

Is Salt Good or Bad? The Facts on the Health Effects of Salt

The truth about whether salt is good or bad depends on the individual.  Some people need more, while others need less.

saltThe Salt Controversy

A core problem with how we think is that we view all things as either good or bad. This thinking has lead me astray in the past.

Anytime there’s a controversy or a mix of opinions, you can bet that the good/bad paradigm is especially flawed.

People should realize that something can be good in one way and bad in another.

  • It could be good for one person and bad for another.
  • It could be good in one situation and bad in another.

The reason we think in these terms is because it causes us cognitive strain (or ‘dissonance’) to believe something we’re doing can be both harmful and helpful. We want the benefits, but we don’t want the harm.

Salt is one of those things that has no clear answers, but is dependent on the person and dose.

Just like with saturated fat and the controversies surrounding it, when we find out that salt isn’t as bad for us as we thought, it suddenly turns into a superfood and we start piling it on at each meal.

How Much Salt Do We Consume

Salt consists of sodium (40%) and chloride (60%), both essential nutrients needed by your body to function.

The average sodium included in the typical US diet is between 3,400-3,840 mg/day (R, R2).

It is estimated that salt intake in paleolithic times was less than 1 g/day (R), much less than our 9.6 g/day in the average American diet (R).

In fact, an article in the Journal of Cancer Detection and Prevention observes that from Paleolithic to modern times, man’s intake of potassium has significantly decreased, while sodium has significantly increased. The Sodium/Potassium ratio has been reduced by about 20X (R).

Where does our salt come from?

  • About 75% of our daily salt intake comes from processed foods (R).
  • Only 15% comes from knowingly adding salt (ie, cooking and table salt) (R).
  • The remaining 10% occurs naturally in whole foods (R).

Recommendations From The Health Establishment

shutterstock_324768497

Major United States health organizations advise limiting our sodium intake to under 2300 mg per day:

  • The United States Department of Agriculture (USDA), creator of the Food Pyramid and now the MyPlate says limit to 2300 mg per day (R).
  • The Academy of Nutrition and Dietetics (AND) recommends 1500 to 2300 mg (R).
  • The American Diabetes Association (ADA) also says 1500 to 2300 mg (R).
  • The American Heart Association (AHA): 1500 mg (R).

So the establishment says to try to keep sodium under 1500 mg per day and to never exceed 2300 mg. 

In normal, everyday measurements, that would involve aiming for less than 1 teaspoon per day.

The Bad: Potential Problems With Too Much Salt

Excess Salt May Worsen Inflammation

inflammation_233859859

One concern with excess salt is that it can raise the risk for autoimmune disease by increasing Th17-related inflammation (R).

When I increased my salt intake, I noticed more issues with inflammation, but maybe only because I was susceptible to Th17 inflammation.

Salt-induced inflammation has been found to be a factor in worsening Hypertension-related tissue damage (R), Congestive Heart Failure (R), and Asthma (R).

Excess salt can raise Aldosterone, which is implicated in many chronic diseases and can contribute to inflammation (R, R2).

In particular, aldosterone increases IL-6IL-1b (R), TNF (R) and induces Nf-kB, the master control switch of inflammation (R).

However, this study found no association between a higher sodium intake and systemic inflammation (R).

It may just be wise to limit salt if you have issues with Th17 inflammation or certain cancers (R).

Excess Salt May Raise Blood Pressure

Blood Pressure

According to the World Health Organization (WHO), high blood pressure is one of the most significant independent predictors of chronic disease (R).

Health professionals worldwide recommend restricting your sodium intake because it is believed to increase blood pressure, which is one of the strongest risk factors for heart disease and stroke (R).

And these are the top two causes of death in wealthier countries (R).

A 2013 Cochrane review found that in people with high blood pressure, reducing salt lowers blood pressure by 5.4 points systolic and 2.8 points diastolic. Individuals with normal blood pressure show a reduction of 2.4 and 1.0 (R).

Another study found that lowering sodium intake was more effective at reducing blood pressure in Black and Asian patients than in Whites (R).

It’s important to note that restricting salt has no direct effect on risk of death or cardiovascular disease, even in people diagnosed with high blood pressure (R).

Studies have actually found that salt consumption does not raise your risk of heart disease or death. So there is no reason to restrict salt due to concerns over cardiovascular health or longevity (R).

It may just be wise to restrict it if your blood pressure tends to be high, and you want to keep it within normal range.

However, it’s interesting that high insulin levels are associated with high blood pressure in multiple studies (R).

So, maybe take a look at your carbohydrate/sugar intake first, and then consider the salt.

Most of my clients have low blood pressure, and therefore salt may benefit these people.

So when it comes to salt, your individual biology is key.

Excess Salt May Increase Your Calorie Intake

High salt intake may cause you to consume more calories (11% more) than you would otherwise (R).

Excess Salt May Cause Headaches

headache_142814494

In a study of sodium consumption and headaches, people who ate foods high in sodium – around 8 g per day – had one third more headaches than those who ate foods low in sodium – around 4 g per day (R).

Additionally, it made no difference whether the volunteers ate the standard Western diet or the DASH (Dietary Approaches to Stop Hypertension) diet (R).

However, it could be that foods that have higher levels of salt may cause headaches.  These studies do not show causation.

Excess Salt May Cause Cognitive Decline

shutterstock_402621205

Excessive salt intake may contribute to cognitive issues.

In an animal study, a high salt diet led to a significant decrease in the naturally occurring antioxidants, and marked increase of damaging free radicals in the memory center of the brain (R).

A high-salt diet may accelerate decline in the elderly. In a rat study, older rats who were put on a high salt diet had significant worsening of blood pressure levels, memory, anxiety, and overall cognitive health (R).

But this is only one side of the story. See Potential Problems With Too Little Salt below…

Excess Salt May Cause Kidney Stones

Those who are prone to kidney stones may need to reduce their salt intake, as high sodium excretion also leads to a higher level of calcium excretion in the urine (R).

Again, evidence on this topic is mixed, but it has been demonstrated that if you consume excess sodium, you lose more sodium and calcium in the urine (R).

Subjects who consumed the most sodium tended to lose the most calcium in the urine.

Higher calcium excretion may lead to kidney stone formation, particularly if fluid intake is inadequate.

But again, it could be the foods that are typically high in salt may increase calcium excretion.

Excess Salt May Increase Bone Loss

Because of this increased calcium excretion with higher sodium intake, those with osteoporosis may benefit from a lower salt intake as well (R).

Increased losses of calcium in the urine, particularly in the context of low dietary calcium, could be problematic for those at risk for low bone density.

However, a high salt intake is not believed to cause osteoporosis, and the potential osteoporotic effects of a high salt intake can be offset with an adequate intake of calcium and potassium.

Excess Salt May Raise Your Risk for H. Pylori Infection

shutterstock_304789835

Higher salt intake may make you more susceptible to H. Pylori infections, which cause ulcers and can in some cases lead to stomach cancer (R).

Excess Salt May Raise Risk for Certain Cancers

A comprehensive meta-analysis detected a strong adverse effect between total salt intake and salt-rich foods on the risk of stomach cancer in the general population (R).

These studies show an association and it doesn’t necessarily mean that salt is the problem. It could be that the types of foods which people eat with a high salt diet is the problem.

Excess Salt May Raise Your Risk for Cataracts

An observational study performed in Australia found a clear association between high sodium intake and the occurrence of cataracts, a condition of cloudy vision associated with aging (R).

An earlier study conducted in Italy also found a significant association between high salt intake . However, a higher intake of meat, cheese, and certain vegetables (cruciferous vegetables, spinach, tomatoes, peppers) was protective (R).

Excess Salt May Worsen Sleep Apnea

In a study of 97 patients, high sodium intake worsened sleep apnea if high blood pressure and high aldosterone were present (R).

The Good: Potential Problems With Too Little Salt

Too Little Sodium Can Increase Cardiovascular Stats and Risk

A study published in the American Journal of Hypertension found that a low sodium diet raised LDL 4.6% and triglycerides 5.9% (R).

A sodium intake of under 3 g per day was associated with increased risk of dying from Cardiovascular disease and greater chances of hospitalization for Congestive Heart Failure (R).

Too Little Sodium Worsens Insulin Resistance & Diabetes

shutterstock_439996486

In a study by published in the Metabolism Journal, just one week on a low sodium diet caused onset of insulin resistance in a group of healthy volunteers (R).

In Type II diabetics, restricting salt raised risk of death from all causes, including cardiovascular disease (R).

Too Little Sodium Can Be Bad for the Brain

In a study of Dahl rats, salt restriction caused a decline in learning and memory (R).

So, excess salt is bad for the brain, and too little salt is also bad for the brain. It may be worth considering the role of other minerals needed for a healthy balance, such as potassium.

Too Little Sodium is Dangerous for Athletes and Those with Higher Vasopressin/Anti-Diuretic Hormone (ADH)

In athletes, a lower intake of sodium combined with a higher intake of water can cause hyponatremia (unnaturally low salt levels), which can lead to headaches, muscle cramps/weakness, or even seizures when severe (R).

If you have a condition that results in higher vasopressin/ADH release (low thyroid, low adrenal function, low pituitary, etc), you want to make sure to take in salt (R).

Inflammation and infections can increase vasopressin, so you should be mindful if your vasopressin is high or low.

You can check your Vasopressin directly and BUN as an indirect measure.

What To Do?

salt_377733145

Overall, you should not pay attention to a blanket statement anyone makes about salt — whether they claim that it is completely good/bad or healthy/unhealthy for everyone.

If you consume a whole-food diet with lots of fruits and veggies (potassium) and use salt (sodium) to taste, you’re probably fine.

However, in some cases more or less salt is better for you.

  • If you are healthy, then simply use salt to taste.
  • If you have chronic inflammation, figure out if that’s causing vasopressin to go up.
  • If you have an autoimmune issue that causes higher Th17 immune activation, then do experiments with higher or lower salt
  • If you have high blood pressure then it’s probably wise to use less rather than more.
  • If you are an athelete, sweating a lot, or exercising a lot in a day, then go for more salt.
  • If you have low blood pressure (under 110/70), experiment with more salt.

If you’re completely healthy and have normal blood pressure, then I see no reason to restrict salt. In this case, just consume it for optimal taste.

But in general, I think it’s one of those things that you should experiment with for yourself.

The most important thing is to pay attention to your body and ignore general recommendations.

Buy Healthy Salt

I use himalayan salt.  I like to use the powder and also the crystals with a salt shaker, which allows for more precision in the amount of salt that you want.

Comments

  1. My understanding, and I need time to dig out the links I saved on this, is:
    – salt (real salt, NaCl) is fine for you, we probably get too little (according to ADA), and it doesn’t increase blood pressure
    – table salt (pretty much just sodium with anti-caking agents) is bad for you, it poisons you, it does increase blood pressure

    I wonder if this should be more clear in the article? It reminds me of that article by Dr Jason Fung about the biggest nutrition mistake we have made – like just calling it “fat” without differentiating between good fat and bad fat, and all the problems that causes.

    Same with salt?

    Anyway, great article as always. Really appreciate your research.

      • Travelling at the moment so don’t have access to my links, sorry. Will check when I get back home – though can’t remember what I read and what I saved.

        Nature of many of those article was similar to what i have read for food colouring or for sweeteners like aspartame – some say they’re fine, others say they’re poison.

Leave a Reply