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Story at-a-glance |
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Salt is an essential nutrient required for blood
pressure regulation, transportation of nutrients
into and out of your cells, ion exchange, and
brain-muscle communication.
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Decades of scientific research have failed to
show the benefits of a low-salt diet, and in
fact tend to show the opposite. Low-salt (DASH)
diets are associated with higher cardiac risk
across multiple studies.
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The primary original study responsible for the
"sodium myth" did not control for fructose
consumption, which is a major factor
contributing to heart disease.
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All salts are not equal, in terms of their
impact on your health.
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The idea that salt is bad for you and contributes to heart
disease is an idea that has become more or less cemented as
dogma in the West. Where did this idea come from? And more
importantly, is
it true?
My intention today is to show you the fallacy of the notion
that salt is generally bad for you, and how salt has been
indicted by so-called nutritional "experts," as well as by
government regulators, without a fair trial. When you look
at what the research actually says, I believe you will be
convinced that salt is not only relatively benign but is a
major nutritional goldmine, IF you consume the right kind.
You have probably had the benefits of a low-salt diet
drummed into your head for years.
However, decades of scientific research have failed to prove
ANY benefits of a low-salt diet, and in fact tend to show
the opposite. Studies have also failed to prove salt's
connection to heart disease. I will show you where this
mistaken idea originated… and the sound you hear may be
cardiologists' hearts breaking across the globe.
Salt is an Essential Nutrient
Salt is essential for life—you cannot live without it. Salt
has always been important to human life on this planet. Even the
word "salary" comes from the root "sal,"because
Romans were paid in salt. African and European explorers
traded an ounce of salt for an ounce of gold—salt was
literally worth its weight in gold. Unrefined natural
salt is important to many biological processes, including:
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Being a major component of your blood plasma, lymphatic
fluid, extracellular fluid, and even amniotic fluid
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Carrying nutrients into and out of your cells
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Maintain and regulate blood pressure
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Increasing the glial cells in your brain, which are
responsible for creative thinking and long-term
planning.
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Helping your brain communicate with your muscles, so
that you can move on demand via sodium-potassium ion
exchange
More than 80 percent of
the salt most people consume is from processed foods.
Indeed, there is far too much sodium in processed foods. But
you shouldn't be eating those foods anyway—sodium is just
one of MANY ingredients in packaged foods that will
adversely affect your health. The salt added to these
convenience foods is mostly sodium—as opposed to natural
salt, which is much lower in sodium. I'll be discussing more
of the
differences between natural and refined salt shortly.
DASH-ing the Sodium Myth: Salt as the Scapegoat for Sugar
If you repeat something long enough, people will believe
it's true. And this seems to be the case with salt. The
genesis of the sodium myth lies with one study that seemed
to show a link between salt and
hypertension.
Yes, just ONE study.
In 1997, the DASH-sodium
study was
conducted to determine whether or not a low-salt diet would
control hypertension. The DASH
diet consists largely of fresh vegetables and fruits,
lean protein, whole grains, and low-fat dairy, and is very
low in salt. But
it's ALSO low in sugar/fructose. So,
while people on DASH diets do show reduced hypertension, the
reason for this is not the reduction in salt, but the
reduction in fructose.
Hypertension is actually promoted more by excess fructose
than excess salt.
Researchers were so eager and personally invested in proving
their salt theory that they completely overlooked other
factors, thereby drawing the wrong conclusion altogether.
This is where the sodium myth really gained its footing.
Salt got the blame for the damage sugar was causing in a
monumental rush to judgment.
The amount of salt Americans eat pales in comparison to the
amount of fructose they consume on a daily basis, and I'm
convinced that sugar/fructose—rather than salt—is the major
driving force behind our skyrocketing hypertension rates. Gary
Taubes is an
investigative science and health journalist and author of
several books, including Good
Calories, Bad Calories.
In his classic 1988 article "The
(Political) Science of Salt," Taubes
wrote:
"While the government has been denouncing salt as a
health hazard for decades, no amount of scientific
effort has been able to dispense with the suspicions
that it is not. Indeed, the controversy over the
benefits, if any, of salt reduction now constitutes one
of the longest running, most vitriolic, and surreal
disputes in all of medicine….
The data supporting universal salt reduction have
never been compelling, nor has it ever been demonstrated
that such a program would not have unforeseen negative
side effects… After decades of intensive research, the
apparent benefits of avoiding salt have only diminished.
This suggests either that the true benefit has now been
revealed and is indeed small, or that it is nonexistent,
and researchers believing they have detected such
benefits have been deluded by the confounding influences
of other variables…"
Blood pressure drops as much in low-sugar studies as it did
in the DASH-sodium study, but this fact has been
conveniently
ignored. Even though researchers have repeatedly failed to
prove the salt/heart disease link, agencies like the
National Institutes of Health (NIH) and the U. S. Department
of Agriculture (USDA) climbed aboard the anti-salt train,
and salt has been painted as "Public Enemy Number One" ever
since.
But why?
One reason could be because it directed attention away from
the real culprit
behind high blood pressure and heart disease—specifically,
excess sugar and grain carbohydrates. Whether or not that
culprit is known by these agencies is up for debate, but by
restricting salt, at least they maintain the appearance that
they're doing something to address the increasing
cardiovascular disease epidemic. Once the notion of salt's
evilness became lodged in the mind of the public, very few
bothered to check the facts, and this medical myth became
accepted as truth.
The Link Between Fructose and Cardiovascular Disease
Let's review how excess dietary sugar and refined
carbohydrates can set you up for developing cardiovascular
disease. Hypertension is the common thread linking obesity,
type 2 diabetes, gout, heart disease and stroke. But there
is ANOTHER common denominator among those diseases: insulin
resistance. And what do we know causes insulin
resistance? Sugar and refined carbohydrates—primarily
fructose.
Sugar and refined carbohydrates raise your insulin levels,
which in turn raise your blood pressure and promote storage
of body fat, obesity, diabetes and heart disease. The reason
fructose does this more than any other sugar is that your
body produces uric acid as a byproduct of fructose
metabolism, and increased uric acid levels drive up blood
pressure. No one explains this more clearly than Dr. Richard
Johnson, and I recommend you listen to my
interview with him if
you want to really understand this basic physiological
phenomenon.
What the science shows is very clear. It isn't the salt
doing this—it's the fructose. The preponderance of evidence
shows that sodium
intake does NOT affect blood pressure unless you are
especially sodium-sensitive. But there is an added
problem with salt-restricted diets.
Can Your Sodium Ever be TOO Low?
Yes it can!
You may not be aware of this, but your risk for health
problems increases significantly if your sodium is too low,
a condition known as
hyponatremia.
Sodium is an electrolyte responsible for many critical
biological processes, including regulating the amount of
water that's in and around your cells, so if your blood
becomes too low in sodium, your body's fluid levels rise and
your cells begin to swell. This swelling can cause a number
of health problems, from mild to severe.
According to the Mayo
Clinic:
"A low-sodium, high-water diet can sometimes disturb
the proper balance between sodium and fluids in your
blood."
Other causes of hyponatremia include medications, drinking
too much water during exercise, dehydration, and certain
diseases, including those affecting the function of your
liver, kidneys, and thyroid gland. At its worst,
hyponatremia can be life threatening, leading to brain
swelling, coma and death. Premenopausal women appear have
the highest risk of hyponatremia-related brain damage due to
how female hormones affect women's ability to regulate
sodium levels. But mild to moderate hyponatremia has more
subtle effects that you or your healthcare provider may not
even connect with an electrolyte problem. Hyponatremia can
present with the following signs and symptoms:
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Nausea, vomiting, and changes in appetite |
Headache |
Confusion |
Hallucinations |
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Loss of energy |
Fatigue |
Urinary incontinence |
Nervousness, restlessness and irritability, and other
mood changes |
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Muscle weakness, spasms or cramps |
Seizures |
Unconsciousness |
Coma |
Changes in mood and appetite are among the first noticeable
manifestations of sodium deficiency, yet the cause is often
missed. Yet, in order to stave off heart disease, the advice
you are likely receiving is, "drink lots of water, exercise
vigorously, and cut back on your salt." Talk about a setup
for electrolyte disaster! There is evidence that low sodium
levels can damage your health in other ways. Consider the
following scientific studies:
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A 2009
study of
large-bone fractures in the elderly found the incidence
of hyponatremia in patients with fractures was MORE THAN
DOUBLE that of non-fracture patients. They postulated
the reason for the sodium deficiency might have been the
use of selective serotonin receptor inhibitors (SSRIs),
a type of antidepressant drugs.
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A 1995
study by
the AMA, published in the journal Hypertension,
found low urinary sodium associated with an increased
risk of heart attack.
Twenty-Five Years of Scientific Evidence Fails to Show Any
Benefit of a Low-Salt Diet
To help you access relevant research, I have assembled a
chronological list of the main research studies about
low-salt diets from the past three decades. As you will see
from the table that follows, the benefits of low-salt diets
have been quite "underwhelming" in the scientific
literature.
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J Chronic Dis 1987: The number of people who
experience drops in blood pressure after eating
high-salt diets almost equals the number who experience
blood pressure spikes; many stay exactly the same. |
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Intersalt study, BMJ 1988: Conclusion: There is no
relationship between sodium and hypertension; in fact,
those who ate the most salt had a LOWER median blood
pressure than those who ate the least salt. |
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DASH-sodium study, NEJM 1997: Conclusion: "A diet
rich in fruits, vegetables, and low-fat dairy foods and
with reduced saturated and total fat can substantially
lower blood pressure. This diet offers an additional
nutritional approach to preventing and treating
hypertension." (Related
Mercola article) |
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NHANES I, Lancet 1998: Conclusion: "These results do
not support current recommendations for routine
reduction of sodium consumption, nor do they justify
advice to increase salt intake or to decrease its
concentration in the diet." (Related
Mercola article) |
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Cochrane review 2003: Conclusion: "There is little
evidence for long-term benefit from reducing salt
intake." |
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NHANES II, Am J Med 2006: Conclusion: Lower sodium
diets led to HIGHER mortality rates among those with
cardiovascular disease, which "raised questions
regarding the likelihood of a survival advantage
accompanying a lower sodium diet." |
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Rotterdam Study, Eur J Epidemiol 2007: Conclusion:
"From this and other epidemiological studies we conclude
th effect of dietary salt on clinical cardiovascular
endpoints and overall mortality within the range of
intake commonly observed in Western countries has not
yet been established." |
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Clin Sci (Lond) 2008: Low-sodium diets result in
WORSE clinical outcomes for people with congestive heart
failure, due to "detrimental kidney and neurohormonal
effects." |
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Cochrane review 2011: Conclusion: Cutting down on
the amount of salt has no clear benefits in terms of
likelihood of dying or experiencing cardiovascular
disease. |
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Rotterdam Study, JBMR 2011: Conclusion: "Mild
hyponatremia in the elderly is associated with an
increased risk of vertebral fractures and incident
nonvertebral fractures, but not with bone mineral
density. Increased fracture risk in hyponatremia also
was independent of recent falls, pointing toward a
possible effect on bone quality." |
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JAMA 2011: Conclusion: "Systolic blood pressure,
but not diastolic pressure, changes over time aligned
with change in sodium excretion, but this association
did NOT translate into a higher risk of hypertension or
cardiovascular disease complications. Lower sodium
excretion was associated with higher cardiovascular
disease mortality." |
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Meta-Analysis AJH
2011: Conclusion: "Despite collating more event data
than previous systematic reviews, there is still
insufficient power to exclude clinically important
effects of reduced dietary salt on mortality or
cardiovascular disease morbidity." |
The second to last study in the table above deserves some
explanation. This recent study followed 3,681 middle-aged
healthy Europeans for eight years. The participants were
divided into three groups: low salt, moderate salt, and high
salt consumption. Researchers tracked mortality rates for
the three groups, with the following results:
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Low-salt group: 50 people died
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Moderate salt group: 24 people died
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High-salt group: 10 people died
In fact, the risk for heart disease was 56
percent higher for
the low-salt group than
for the group who at the most salt. So the only reasonable
conclusion the researchers could make was, the
less salt you eat, the
more likely you will die from heart disease. This
absolutely flies in the face of conventional views.
In an article in Newswise,
Dian Griesel, Ph.D., co-author of the book TurboCharged:
Accelerate Your Fat Burning Metabolism, Get Lean Fast and
Leave Diet and Exercise Rules in the Dust, explains:
"The optimal level of salt in our diets has been a
controversial subject for at least 20 years. There is no
disagreement that high blood pressure (even moderately
high) is a risk factor for heart disease and stroke.
However, salt consumption does not seem to have the same
effect on everyone. In addition, there is usually no
distinction on the type of salt used."
He is absolutely right. All forms of salt are not equal.
Type of Salt Matters
Today's table salt has practically nothing in common with
natural salt. One is health damaging, and the other is
healing. Natural salt is 84 percent sodium chloride, and
processed salt is 98 percent. So,
what comprises the rest?
The remaining 16 percent of natural salt consists of other
naturally occurring minerals, including trace minerals like
silicon, phosphorous and vanadium. But the remaining two
percent of processed salt is comprised of man-made
chemicals, such as moisture absorbents, and a little added
iodine.
You might be tempted to think "salt is salt," but even the
structure of processed salt has been radically altered in
the refining process. Refined salt is dried above 1,200
degrees Fahrenheit, and this excessive heat alone alters the
natural chemical structure of the salt. What remains after
ordinary table salt is chemically "cleaned" is sodium
chloride,
The processed salt is not pure sodium chloride but is only
97.5 percent sodium chloride and anticaking and flow agents
are added to compromise about 2.5 percent. These are
dangerous chemicals like ferrocyanide and aluminosilicate.
Some European countries, where water fluoridation is not
practiced, also add fluoride to table salt. In France, 35
percent of table salt sold contains either sodium fluoride
or potassium fluoride and use of fluoridated salt is
widespread in South America.
Salt as Nature Intended it: Himalayan Crystal Salt
The more you can move toward a diet of whole
organic foods in their natural state, the healthier
you'll be—whether it's veggies, meat, dairy products, or
salt.
Given that salt is absolutely essential to good health, I
recommend switching to a pure, unrefined salt. My favorite
is an ancient, all-natural sea salt from the Himalayas.
Himalayan salt is very special. It is completely pure,
having spent many thousands of years maturing under extreme
tectonic pressure, far away from impurities, so it isn't
polluted with the heavy metals and industrial toxins of
today. And it's hand-mined, hand-washed, and minimally
processed. Himalayan salt is only 85 percent sodium
chloride, the remaining 15 percent contains 84 trace
minerals from our prehistoric seas. These trace minerals are
important for, among other things, good
bone health, as explained by Dr. Robert Thompson in his
book The
Calcium Lie.
It's also the most delicious salt you'll ever find—so much
so that I always caution people before they use it because
once most people taste it, they have a very difficult time
ever using conventional salt again. That is one of the
reasons why so many gourmet chefs exclusively use this salt.
So, please, relax and salt your food to taste, provided the
salt you're using is natural and unrefined. If you are
exercising heavily, or in the middle of a heat wave, you may
require more salt than on a cool day when you're relaxing.
And remember, the more processed foods you consume, the
higher your sodium will be, as it is hidden is just about
everything that comes in a box or can. And of course, this
is NOT the kind of salt your body needs.
So there you have it, the sodium myth debunked.
To learn even more about this and other health myths, sign
up for the 2011 Weston A. Price conference, which will take
place in Dallas, Texas, from November 11 to November 13. The
conference will feature a long list of prominent health
experts, including yours truly.
To sign up, please see the Weston
A. Price conference page.
Sources:
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