What to do about salt
I am very confused about the recommendations around salt and sodium intake. Some things I see insist that too much salt is bad and that I need to drastically reduce my sodium intake, while others say not to worry so much about salt. So which is it??
This is a great question and something that can be very confusing to people. The recommendations for sodium can be all over the map and the research behind them has been mixed. As with most things related to nutrition, the best answer is that it depends on the person and their individual body and needs. But in general, I wouldn’t overly worry about sodium, especially if you don’t eat a lot of processed or restaurant food. In fact, if you follow a low carb diet and cook most of your meals at home, it is probably more likely that you are not getting enough sodium.
The guidance on salt intake and the restriction of sodium is mainly focused on preventing high blood pressure and reducing the risk for heart disease. High blood pressure affects nearly half of adults and can increase a person’s risk for a number of other major conditions such as heart disease, stroke, and kidney disease. The Dietary Guidelines for Americans 2020 – 2050 recommend that all Americans limit their sodium intake to 2,300 mg per day, yet the average American consumes over 3,000 mg of sodium per day. As noted, most sodium comes from processed food or meals consumed at restaurants and generally does not come from people simply adding their own salt while they are cooking at home.
A little bit more about sodium. Sodium is an essential mineral that has a number of important functions in the body - it allows cells to maintain proper fluid balance and contributes to blood pressure regulation. Part of the popularity of sodium restriction guidance is that it makes intuitive and logical sense. Sodium attracts water and eating more sodium will lead to more water in the bloodstream, which can increase the volume of blood and eventually increase blood pressure. However, as with most things related to the human body and the various, complex mechanisms at play, it is not quite that simple and there are complex interactions that can lead to different outcomes.
There is also an individual component to how people react to salt. Different people react in different ways to sodium and some people are salt sensitive (about 30% of the population) and some are salt resistant. Salt sensitive people experience an increase in blood pressure when they consume a high salt diet, as well as a decrease in blood pressure when they have low salt intake. On the other hand, those who are salt resistant do not experience changes in blood pressure when they have different levels of salt intake. It might be beneficial for someone who is salt sensitive to consume a low sodium diet if they have high blood pressure, but that same low sodium diet will not make much of a difference in the blood pressure of the salt resistant person.
The research on sodium and blood pressure and heart disease is decidedly mixed. There are some studies that point to the effectiveness of a low sodium diet, especially when it comes to lowering blood pressure. There are also a number of studies that show that the link between sodium, blood pressure, and heart disease is not conclusive. Overall, there is a lack of strong evidence that supports a big reduction in salt intake for everyone. There is also evidence that focusing on potassium is even more important when it comes to lowering blood pressure and the risk of heart diseases.
So what should you do? While this is not permission to go to town with the salt shaker, if you do not already have high blood pressure, then you can probably stop worrying about sodium so much, especially if you do not eat out a lot or consume a lot of processed food. And we all could focus a little more on potassium - found in sweet potatoes, spinach, broccoli, cucumbers, bananas, beans, lentils, cantaloupe to name a few.
