For decades we’ve been told that salt produces a blood pressure problem only for a minority of people, that the majority can eat even normal U.S. levels without problems. The primary caveat was that if our BP starts to rise as we get older, we may need to cut back on salt. Let’s examine recent analyses of the topic to see what may have changed or what greater details reveal, because . . . we’re all getting older!
An outspoken leader in the war against excess salt is our usual, idealistic friend, the Center for Science in the Public Interest, aka CSPI. They’re backed up by many trials reported and evaluated by the National Heart, Lung, and Blood Institute, the NHLBI. Right out of the gate they condemn salt with statements to the effect that a) salt is harmful to people who are sensitive to it, and b) there is no practical way to determine who is sensitive to it. Sounds a) circular and b) maybe pointless, but it comes straight from the research, which comes straight from the government (which may explain a lot).
The research sounds convincing, but the Salt Institute offers an ostensibly strong defense against it at http://www.saltinstitute.org/pubstat/cspi.html. Of course, the Salt Institute is biased towards the salt industry, so their comments should be taken with a grain of . . . naaaah, that’s too easy. But then CSPI is biased towards an ideal diet, which is a nice goal but sure can mess up a good pig-out. Let’s dig deeper to help find a compromise we can live with . . . literally.
Some sound bites from both sides:
- The worldwide research linking salt intake and BP is overwhelming.
- The Salt Institute references many studies which they say show no link between salt and BP.
- CSPI claims and explains why those studies are all flawed.
- The National Heart, Lung, and Blood Institute says 400 Americans die each day due to salt’s impact on blood pressure.
- 30% of Americans have pre(borderline)-hypertension, 30% have hypertension, and 90% of American 75-year-olds have hypertension. It goes with the territory in industrialized nations, where salt reigns.
- Hypertension is almost guaranteed as we achieve Social Security age.
- Fortunately, as we age our response to salt reduction improves.
- Big salt intake reductions drop BP by very small amounts, but
- Very small BP drops have big impacts on heart attack and stroke rates. Just cutting restaurant and prepared food salt by 50% would cut 5 points off the higher BP number and cut annual U.S. deaths by 150,000. If one of those lives is in your family, that’s important.
- BP meds help, and salt reduction doubles their effectiveness.
- Better yet, salt reduction can get many people off BP meds, and may prevent half of BP patients from needing the meds in the first place.
- Few doctors know how to reduce your salt intake, so they’re likely to just prescribe drugs, but
- They’re unlikely to know that half their patients stop taking their meds within a year.
- Think you don’t eat too much salt? A ‘burger or a big bowl of cereal often comes with more salt than we should eat all day.
- Think an occasional salt binge is harmless? Sorry, but salt is an acquired habit, and binges reinforce it.
My personal bottom line is that if I can clear my dual cancer hurdle for a couple of years, I’ll cut back on salt even if my BP remains fine. Those of you with lesser immediate health threats really should reduce your salt to 2,000-3,000 mg even if your BP is under 120/80 – the maximum we should feel comfortable with. Then when you can achieve that, you need to reduce it further to 1,500 mg – less than the amount in most restaurant entrees or cans of vegetables. It is likely to significantly reduce your odds of a heart attack or stroke, an effect further enhanced by weight control and lots of exercise, fruits, and vegetables.
How do we reduce our salt? Hypertension patients should:
- Avoid restaurants
- Read food labels and stop eating foods with enough salt to drive daily intake over 1.3 grams.
- Avoid fast food joints.
- Rinse the salty juices off high-salt canned foods. Unfortunately, this depletes their water-soluble nutrients, so it’s better to buy the salt-free free versions.
- Throw away the salt shaker.
The rest of us should:
- Eat out very seldom. Once a week is plenty. (You were doing that anyway, weren’t you?). Tell your favorite restaurants to cut their salt by 50%.
- Read food labels and cut way back on salty foods.
- Avoid fast food joints. (Really, folks, no one should eat at fast food joints.)
- Rinse the salty juices off high-salt canned foods.
- Leave the salt shaker in the cupboard and use it sparingly when cooking.
Potassium chloride-based salt substitutes help only by reducing salt intake; they add little to our potassium needs (most of us are deficient in it) and upset many people’s stomachs. Highly motivated hypertension patients may be able to go cold turkey, but most of us will probably have more success trying to drive down our salt consumption more gradually as we lose our acclimatization to it. There are many seasonings which liven up food without salt. (See http://www.mrsdash.com/, for example.)
You’ll find many more details at these links: