Not everyone should restrict salt
This week, a report by the very prestigious Institute of Medicine commissioned
by The United States Centers for Disease Control and Prevention says that no
good reason exists for many Americans to drive their sodium consumption down
to the very low levels recommended in national dietary guidelines.
The guidelines recommend 1,500 (a half teaspoon of salt) to 2,300 milligrams
of sodium per day. The average North American takes in 3,400 milligrams a day.
Some people will have their blood pressures drop slightly when they restrict
salt. However, in one study, dropping salt intake in heart patients from an
average 2700 mg/day to 1800 mg tripled hospital readmission and doubled the
death rate (Clinical Science, 2008;114:221-230). Another study showed that
both high and low intake of salt increased risk for heart attacks and heart
attack deaths (JAMA, Nov 23, 2011;306(20):2229-38).
Who Needs to Restrict Salt?
People who have high fasting insulin levels and high blood pressure should
restrict salt, even if they are not diabetic. On the other hand, people who
are not diabetic and do not have high insulin levels will usually not be
helped, and some will be harmed, by restricting salt. People who spend a lot
of time exercising need to take extra salt to replace the salt that they lose
Some People Develop High Blood Pressure from Taking Too Much Salt
Thirty-five years ago, researchers first described people whose blood pressure
and weight rise when they take in extra salt. They are called "salt sensitive".
They gain weight because their kidneys cannot get rid of the extra salt. The
extra weight is caused by retaining extra fluid. Eventually, taking too much
salt can cause salt-sensitive people to suffer kidney damage as evidenced by
leaking protein (albumin) into their urine. (Diabetes Res Clin Pract,
April 1998;39 Suppl:S15-26).
Insulin Resistance Can Cause High Blood Pressure
Not everyone gets high blood pressure from taking in too much salt. The people
who are most likely to get high blood pressure from taking in too much salt
are those whose cells do not respond well to insulin, have high fasting blood
insulin levels, and are at high risk for becoming diabetic (Hypertension,
How to Tell If You Are Insulin Insensitive and Therefore Should Restrict Salt
People who are insulin insensitive usually have what is called metabolic
syndrome. You have metabolic syndrome if you have any three of the following:
* storing fat primarily in your belly
* having small hips
* being overweight
* having blood triglycerides (>150)
* having blood HDL cholesterol (<40)
* having a fatty liver
* having a fasting blood sugar >100 (HbA1c> 5.7)
* having high insulin levels
* having high blood pressure
Lifestyle Changes to Lower Blood Pressure
Get a blood pressure cuff and take your blood pressure just before you go to
bed each night. If your systolic blood pressure is above 120 much of the time,
you have high blood pressure and should check with your doctor to see if you
are salt sensitive and therefore, should restrict salt (and make other
lifestyle changes). All people who develop high blood pressure from excess
salt intake, are diabetic, or have high insulin levels, can use the following
lifestyle changes to prolong their lives, lower high blood pressure, and
prevent or treat diabetes: 1) Avoid overweight. 2) Do not take sugared drinks
in any form, including fruit juices, except during prolonged intense exercise.
3) Avoid foods with added sugar. 4) Avoid fried foods. 5) Eat large amounts
of fruits & vegetables. 6) Do not eat red meat (blocks insulin receptors).
7) Exercise. 8) Grow muscle. 9) Reduce body fat. 10) Keep blood levels of
hydroxy-vitamin D > 75 nmol/L.
How Salt Deficiency Can Cause High Blood Pressure
A low-salt diet can cause a deficiency of salt, particularly in exercisers
or in very hot weather.
* Your body tries to retain the salt that you have by your adrenal glands
increasing production of aldosterone and your kidneys making more renin.
* Both of these hormones constrict arteries to raise blood pressure to
increase risk for heart attacks and strokes.
People who exercise regularly usually need extra salt. You lose a lot of
salt through sweat, even when you swim.
The American Heart Association Stands Firm
The AHA feels that the high amount of salt in processed foods makes it
almost impossible for most North Americans to suffer a salt deficiency.
Therefore they still recommend severe salt restriction.
A Healthful Diet is Naturally Low in Salt
Most plants are low in salt and high in potassium. Meat, fish and chicken
have higher amounts of salt, and virtually all processed foods include
added salt. The most healthful diets are based on large amounts of fruits
and vegetables that help to protect you from excessive salt.