We’ve all heard the recommendation: Eat no more than a teaspoon of salt a day for a healthy heart. Health-conscious Americans have hewn to the conventional wisdom—that your salt shaker can put you on the fast track to a heart attack—and have suffered through bland but “heart-healthy” dinners as a result.
What if the low-salt advice is wrong?
Dr. James DiNicolantonio, a leading cardiovascular research scientist, has reviewed over 500 publications to unravel the impact of salt on blood pressure and heart disease. He’s reached a startling conclusion: The vast majority of us don’t need to watch our salt intake. In fact, for most of us, more salt would be advantageous to our health.
This all seemed too good to be true. So we asked Dr. DiNicolantonio a few questions to get to the bottom of “the salt fix.”
If a low-sodium diet isn’t good for us, how did it come to be so widely recommended?
Dr. James DiNicolantonio: All our dietary fallacies began with the publication of the 1977 Dietary Goals in the United States. There were six main dietary recommendations that were published, and they were all based on opinion not scientific fact. Unfortunately, these Dietary Goals became the 1980 U.S. Dietary Guidelines and the low-salt dogma has carried over into every five-year update of the U.S. Dietary Guidelines.
In fact, the 1977 Dietary Goals mainly relied on George Meneely and Harold Battarbee for recommending low-salt to all Americans. However, even these authors believed that salt restriction was only important in those who had a low intake of potassium and only in those who were genetically susceptible to the blood-pressure-raising effects of salt. In other words, even these authors never believed that all Americans should be given low-salt dietary advice.
What’s worse for our health—high intake of salt or high intake of sugar?
JD: By far and away a high intake of sugar is worse for our health. The underlying issue is almost never a high salt intake, it’s the underlying disease state that is causing certain individuals to have swelling or increases in blood pressure with salt. If you fix the underlying issue (such as insulin resistance, hyperaldosteronism, Cushing’s disease, Liddle syndrome, etc.) you can fix the “salt-sensitive” blood pressure. Many times cutting the sugar from the diet can fix people’s salt-sensitive blood pressure.
We should always remember that salt is an essential micronutrient, whereas sugar is a nonessential macronutrient. And unlike sugar, our taste receptors for salt “flip” when we eat too much providing us an aversion signal to stop eating salt. This doesn’t happen with sugar. In fact, the more we eat sugar, the more we crave it. The body controls our salt intake, whereas physiological dependence controls sugar intake.
What are some health benefits from eating salt?
JD: First and foremost, we wouldn’t have a blood pressure and adequate blood flow to organs if we didn’t consume salt. The heart wouldn’t beat, and our muscles wouldn’t be able to move without salt. Salt keeps our heart rate down and allows the blood vessels to be dilated and relaxed, rather than constricted when our blood volume is down after maintaining a low-salt intake.
Sodium (which is one of the essential micronutrients that makes up salt, chloride being the other) allows us to absorb biotin and vitamin C in the intestine. Sodium also allows vitamin C to get into the brain and bone. In other words, salt is very important for brain and bone health because it helps to maintain adequate vitamin C status in these tissues.
Eating more salt also helps to reduce hyperactivation of the brain’s reward system potentially reducing the risk of sugar and drug addiction. When we eat low salt, the brain’s reward system seems to become overactivated so that if we find salt in the diet we like it more and eat more of it. Unfortunately, if we find sugar while salt depleted this may provide us with an even greater reward and increase our risk of becoming dependent on sugar.
Salt is also extremely important for maintaining good blood flow to the kidneys and hence eating adequate amounts of salt helps to maintain kidney health. Salt is also important for preventing muscle cramps and twitching, heat stroke, circulatory collapse, and fatigue when we exercise.
Is all salt the same, or are some salts healthier than others (like pink Himalayan salt)?
JD: Pink Himalayan salt may contain some iodine and another 84 trace minerals that aren’t found in just plain table salt, but they are extremely low in quantity and are probably not worth the tenfold higher price point. What is good about Himalayan salt is that it comes from an ancient dried up ocean and may not have the pollutants like microplastics, etc., that can be found in sea salts from modern-day oceans. Himalayan salt is also in general less processed than table salt.
There’s one salt that I recommend the most. You can discover it in my book, The Salt Fix.
What are a few easy adjustments we can make to our diet to get a healthy dose of salt?
JD: Eat real food and salt to taste. Trust the signals that your body is sending you when it comes to salt cravings; they are generally leading you toward better health. Try to ignore those impulses for sugar, however.
Photo Credit: By Miro Novak/Shutterstock