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Is a Low Salt Diet Really Good For You?

Is a Low Salt Diet Really Good For You?

Watch the salt, watch the salt, right? The findings of a new study in the Journal of the American Medical Association suggest otherwise. Researchers found that low-salt diets increased the risk of death from heart attacks and strokes and did not prevent high blood pressure.

These results run so counter to what has become standard nutritional advice that the Centers for Disease Control and Prevention have spoken critically of the study as flawed.

All the participants in the study were 3,681 middle-aged Europeans who did not have high blood pressure or cardiovascular disease. Researchers followed them for an average of 7.9 years. They assessed the subjects’ sodium content at the start and conclusion of the study by measuring the amount of sodium excreted in urine within 24 hours, the most precise way to measure sodium consumption as the body eliminates all sodium consumed within a day. Here’s what they found, as summarized in the New York Times:

The investigators found that the less salt people ate, the more likely they were to die of heart disease — 50 people in the lowest third of salt consumption (2.5 grams of sodium per day) died during the study as compared with 24 in the medium group (3.9 grams of sodium per day) and 10 in the highest salt consumption group (6.0 grams of sodium per day). And while those eating the most salt had, on average, a slight increase in systolic blood pressure — a 1.71-millimeter increase in pressure for each 2.5-gram increase in sodium per day — they were no more likely to develop hypertension.

“If the goal is to prevent hypertension” with lower sodium consumption, said the lead author, Dr. Jan A. Staessen, a professor of medicine at the University of Leuven, in Belgium, “this study shows it does not work.”

Dr. Peter Briss of the CDC raised the following concerns about the study:

…the study was small; that its subjects were relatively young, with an average age of 40 at the start; and that with few cardiovascular events, it was hard to draw conclusions. And the study, Dr. Briss and others say, flies in the face of a body of evidence indicating that higher sodium consumption can increase the risk of cardiovascular disease.

Dr. Briss points out that subjects who consumed the smallest amount of sodium also provided less urine, leading him to note that they may not have collected all of their urine on a 24-hour period. Other scientists, including Dr. Frank Sacks of the Harvard School of Public Health and Dr. Michael Alderman, the editor of the American Journal of Hypertension, hone in on the study’s flaws, while noting that the “medical literature on salt and health effects [is] inconsistent.” Dr. Alderman himself has done a study that found that, for those with high blood pressure, those most likely to die had a low-salt diet; he notes that the effects of a low-salt diet include insulin resistance, which can increase the risk of heart disease.

Scientists also are wary of the JAMA study’s results because it is an observational study rather than one involving randomized controlled clinical trial in which participants would be randomly assigned to follow a low-sodium diet or not over a period of years, and then have their health assessed and the deaths from cardiovascular disease noted. While some of the scientists argue that such a clinical trial is not feasible, Dr. Alderman (who, it should be noted, “once was an unpaid consultant for the Salt Institute but … [now does] no consulting for it or for the food industry”) says that doing such a clinical trial could be done, if public health researchers truly felt the need to do so.

Certainly it’s not easy to avoid eating a lot of salt if your diet includes a lot of processed and fast foods. The Recommended Daily Allowance (RDA) for sodium for an adult is to consume less than 2400 milligrams (mg) — about a teaspoon — of salt a day. Take a look at the ingredients for many items on the menus of McDonalds or for Mexican chains and your blood pressure might go up just seeing that more than a few items contain at least 1000 mg of sodium (and some far more). The body does need sodium so one doesn’t want to cut out all sodium from one’s diet, but it’s probably still a good idea not to go crazy with the salt shaker and to think twice before pouring out the soy sauce (914 mg in one tablespoon).

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Photo by SoraZG

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42 comments

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5:37AM PST on Dec 7, 2011

Everything in moderation. It's obvious, isn't it? We also need iron, potassium, calcium and many other minerals and nutrients, but in moderation. Too much water and we die, not enough, we die. Too much oxygen we die, not enough... Salt isn't "bad" for people in and of itself. it's potent stuff and we don't need too much sodium (table salt is sodium chloride, NaCl). It is not actually the sodium that raises blood sugar, but the chloride in table salt (studies show that calcium chloride- which is added to canned foods as a colour preservative, will also raise the blood-pressure of "salt-sensitive" people). I consume sodium bicarbonate every so often by the tablespoon in water to raise my internal Ph and my bp has always been very low (90/60 usually). Sodium bicarbonate (baking soda) does not contain chloride though. If your doctor is concerned about your "sodium" intake, he or she is almost certainly referring to sodium chloride, and you should avoid calcium chloride as well. Molecules interact with each other in the body, we are really just giant test tubes of chemicals. Also, unrelated, but North Americans consume more dairy than any other continent, but we have the highest osteoporosis rate. Magnesium and other minerals is necessary for calcium to be properly absorbed, and most North Americans are low on magnesium. Ok. Enough rambing.

6:05PM PDT on Oct 2, 2011

I think our bodies need a little salt. It's like anything else, don't over do it. My aunt used what I'd consider too much salt all her life and lived to be 92, experiencing very few medical problems along the way. She had a drink every day, too.

5:43AM PDT on Jun 5, 2011

everything in moderation except processed foods

4:13AM PDT on May 20, 2011

Thanks for the post, but it really isn't a large enough and wide-spread enough study to be absolutely sure what is really right! As many people say... it is most likely that until defnite evidence to the contrary is found to be true, it is wise to just eat salt in moderation. maybe sea salt would be slightly preferrable and there are salts that are mixed with herbs that give a different taste. It will be really good when enough studies are done so that there are no doubts about their validity.

12:22PM PDT on May 13, 2011

I never bought it, or the fat thing, at least not for me.

10:30AM PDT on May 13, 2011

i think it also depends on your heretity factors. as some people are more harmed by any amount over their threshold.i know i am so i use a minimal amount and i only use steam distilled water to drink and cook with and make teas. and that can take away any excess i might get but i use sea salt or and himalian pink salt. i feel i need a little

9:59AM PDT on May 8, 2011

A study that small is just a sampling and is not enough in itself to be noteworthy.

However, salt just tastes too damn good to eat a low salt diet unless it's really necessary. Eat sea salt and just use enough to flavor your food.

10:16AM PDT on May 6, 2011

At home we use small amounts of sea salt because the high pressure of my husband. From time to time I take more because my blood pressure is very low. People with low pressure need some salt to be in good condition. They need also a lot of water and coffee with sugar. And chocolate of course - if they have enough money.

After the socialistic era In Bulgaria the obesity is problem of the young people - old people have no money for fast food.

9:43AM PDT on May 6, 2011

Do you know the formula of happiness?
Everything in moderation - Happiness.
Something over - Sorrow...

9:06AM PDT on May 6, 2011

This study appears to have some flaws. Not sure it is worth noting.

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