“Modern medicine diverted us from our evolutionary path when it decided that common salt was a toxic, addictive, non-essential nutrient additive. The seeds of this destructive myth were sown 1 hundred years ago, but nosotros are yet bearing the costs now.” (p.30)
“As is clear from the medical literature, every bit good every bit the population-based studies, low-salt guidelines are non ‘the ideal.’ They are non fifty-fifty innocuous. We may someday discovery that the low-salt guidelines created to a greater extent than core illness than they always prevented.” (p.89)
Those are some pretty hefty claims, as well as it would accept some pretty hefty question to dorsum them up. Fortunately, James DiNicolantonio, PharmD, has done the heavy lifting for us inward his novel book, The Salt Fix: Why the Experts Got It All Wrong--and How Eating More Might Save Your Life. That’s an ambitious title, but afterward reading the book, yous powerfulness discovery it difficult to refute.
Before I larn into the review, inward the involvement of total disclosure, allow me to declare that I received a courtesy re-create of this book. I also collaborated alongside Dr. DiNicolantonio on my really start peer-reviewed magazine article, so obviously, I observe him as well as his work. That existence said, if I thought the mass was lackluster, I’d tell yous so. Fortunately, that is non the case, so I tin give yous my honest assessment of the mass as well as yet rest inward my friend as well as colleague’s goodness graces.
On to the details!
If yous read my weblog because yous follow a depression carb, ketogenic, or Paleo-type diet (or are thinking nigh starting one), so yous likely already remove maintain an agreement of how we, every bit a society, were misled regarding the supposed dangers of dietary saturated obese as well as cholesterol. In fact, fifty-fifty alongside tons as well as tons of prove to the contrary, the medical powers that endure are still trying to convince us there’s something inherently deadly nigh saturated fat. (whole grains as well as polyunsaturated vegetable oils, as well as if nosotros were looking to lose weight, nosotros were inundated alongside advice to cutting calories, peculiarly from fat—more advice that failed countless numbers of us. Considering this unblemished rails tape of wrongness, nosotros remove maintain to inquire ourselves if “the experts” got it incorrect on sodium, too. Dr. DiNicolantonio for certain makes a strong example for just this.
If you’ve long since abandoned fears nigh consuming egg yolks, butter, as well as beef, but trepidation lingers nigh sodium as well as yous discovery yourself buying reduced sodium bacon or other low- as well as no-salt items, this mass is for you. And if yous remove maintain identify unit of measurement members alongside hypertension (high blood pressure) who’ve banished the common salt shaker from the kitchen tabular array nether doctor’s orders, this is fifty-fifty to a greater extent than for them!
(Note: going forward, I volition usage the damage sodium as well as salt interchangeably. They are non the same thing, though, every bit salt—that is, tabular array salt, or NaCl—is sodium as well as chloride. For the purposes of this weblog post, though, we’ll consider them every bit the same thing. Some foods naturally comprise sodium—even vegetables as well as fruit—but nosotros larn the vast bulk of dietary sodium from salt, whether it’s common salt nosotros add together piece cooking at home, or common salt used every bit a preservative or season enhancer inward packaged foods.)
Ooookay!
The start affair nosotros demand to flora is that sodium is an essential nutrient. Like magnesium, similar manganese, similar whatever other essential nutrient, nosotros remove maintain to eat some. We have to. I desire to say the argue salty foods are so delicious is that our bodies innately “know” that nosotros demand salt, as well as inward monastic say to brand sure nosotros larn plenty of it, it makes salty foods peculiarly palatable to us. Unfortunately, nosotros could usage the same logic alongside sugar, as well as say that sugary foods are darn close irresistible to us because, well, perchance our bodies demand glucose as well as fructose, as well as this is nature/evolution’s way of ensuring nosotros larn some. This is faulty logic, though, because nosotros know nosotros don’t “need” whatever dietary glucose at all. It’s yet a decent declaration for sodium, though, because here’s the deal:
Even though salty foods are delicious—and nosotros could say the same for foods that are high inward poly peptide as well as fat, similar a ribeye steak or a obese pork chop—we eventually compass a call for where nosotros don’t desire anymore. When you’ve had plenty meat as well as plenty common salt inward the shrewd setting, yous don’t desire whatever to a greater extent than of them, as well as yous powerfulness fifty-fifty larn actively repulsed past times the thought of eating more. (You yet like these foods, but yous don’t desire to eat whatever to a greater extent than of them at the moment.) But this doesn’t hand off alongside sugar. You tin eat as well as eat as well as eat, and move along eating. You never genuinely compass a “shutoff” call for similar yous do alongside salt, fat, as well as protein. (In fact, fifty-fifty when you’ve reached that call for alongside obese meat, as well as yous experience similar you’d vomit if yous had to eat some other steak, if someone laid a slice of chocolate cake or peach pie inward forepart of you, yous could likely discovery room for a few bites all of a sudden!) I could eat roughly an entire package of chocolate chip cookies, as well as the solely argue I’d eventually halt is because I’d endure inward physical hurting or larn overwhelmed past times self-loathing, or both. But I don’t genuinely experience satisfied. Not so alongside salt! When your trunk needs sodium, common salt volition gustatory modality goodness to you. But yous do eventually compass a call for where yous don’t demand whatever to a greater extent than inward that moment, as well as salty foods volition gustatory modality too salty. They volition non endure desirable to you. The human trunk is really goodness at regulating its sodium intake, every bit Dr. DiNicolantonio emphasizes throughout the book, as well as bad things—very bad things—happen when nosotros override our natural instincts as well as intentionally trim down our sodium intake.
There’s a argue animals move to neat lengths to discovery common salt deposits as well as common salt licks, as well as why ancestral populations made sure to remove maintain a steady provide of salt, whether from marine animals as well as plants as well as evaporated saltwater, or from a land-based source.
The 2d affair to know—and hopefully yous already do—is that adequate sodium intake is perchance even to a greater extent than important for people on depression carb as well as ketogenic diets. I’ve written nigh this before: the number 1 contributor to hypertension is hyperinsulinemia, non common salt intake. Insulin influences the way the kidneys reabsorb sodium. Higher insulin leads to greater sodium retention. And there’s a maxim inward human physiology: “Water follows sodium.” Meaning, if high insulin is causing the kidneys to retain sodium, so to a greater extent than H2O has to endure retained every bit well, inward monastic say to move along the concentration of sodium inward the blood at a salubrious level. More H2O inward the blood way a greater blood volume, as well as if nosotros remove maintain a greater mass of blood flowing through the same amount of blood vessels, so the pressure level goes up—especially if the blood vessels remove maintain already been made rigid as well as unaccommodating due to glycation from constant hyperglycemia. You tin run across forthwith why a newspaper Dr. DiNicolantonio co-wrote has 1 of my favorite titles on this subject: The incorrect white crystals: non common salt but refined saccharify every bit aetiological inward hypertension as well as cardiometabolic disease. “The incorrect white crystals!” Classic!
(“Hyponatremia,” or likewise low a blood sodium concentration, tin endure fatal. It happens during marathons, when people imbibe likewise much H2O without adequate electrolyte replenishment, as well as also inward college fraternity hazing, where idiots convince other idiots to imbibe ungodly amounts of champaign H2O inward a really curt amount of time.)
When yous are on a depression carb or ketogenic diet—and your insulin levels are presumably really depression most of the time—you demand more sodium inward your diet, because your kidneys are inclined to larn rid of it. Low common salt intake is the osculation of decease on a depression carb diet. Feeling fatigued, lightheaded, dizzy, getting weaker at the gym, or only champaign feeling “blah?” Lots of things could endure at function here, but the start as well as easiest affair to do: GET MORE SALT. You’ll also demand a chip to a greater extent than common salt if you’re a caffeine junkie, similar I am. Diuretic beverages don’t only even out water; they even out electrolytes, too. I’ve genuinely started adding a pinch of common salt to my honey coffee, as well as I know it sounds weird, but I remove maintain to say, it’s delicious.
Hypertension deemed “idiopathic”—meaning, there’s no obvious campaign for it—is most oft due to chronically elevated insulin, which is why it’s 1 of the criteria for diagnosing metabolic syndrome (which should endure renamed insulin resistance syndrome).
We’ll larn dorsum to issues alongside sodium, itself, inward a sec, but here’s an excerpt that volition endure of neat involvement to readers of my blog:
“When yous start restricting your common salt intake, your trunk volition do anything to endeavour to handgrip onto it. Unfortunately, 1 of the body’s defense forcefulness mechanisms is to growth insulin levels. […] Also, think that when a person’s intake of dietary common salt is on the paltry side, hormones that compensate to assist the trunk retain common salt (such every bit renin, angiotensin, as well as aldosterone) are released inward greater amounts. Well, these hormones destination upwards increasing obese absorption, too. In essence, compared to someone who hasn’t slashed his or her common salt intake, a low-salt diet may campaign yous to absorb twice every bit much obese for every gram yous consume.” (p.91)
Wait, WHAT?
Not eating plenty sodium could genuinely cause higher insulin secretion as well as weight gain?
It seems so. I remove maintain to admit, for someone who’s hyperinsulinemic as well as obese, increasing dietary sodium wouldn’t endure my start recommendation, as well as I wouldn’t human face it to brand much of a dent if this individual is yet consuming a high saccharide diet. We’ve got to cutting the carbs start as well as foremost. But if someone’s already doing a depression carb diet as well as isn’t quite getting the results they were hoping for, it’s possible that adding to a greater extent than common salt could larn things moving. (Maybe there’s a argue salty materials similar bacon as well as sausages seem to endure so neat on depression carb diets. It could endure our kidneys, rather than our gustatory modality buds, that are trying to tell us something, haha!)
It’s fifty-fifty possible that people alongside high blood pressure level could do goodness from more salt, rather than less. Influenza A virus subtype H5N1 “high” common salt intake is rarely the campaign of hypertension, but likewise low a sodium intake tin most definitely contribute. Since sodium is so essential for a multitude of biochemical processes, when intake is inadequate, the trunk volition overcompensate in monastic say to ensure it has plenty of this most critical electrolyte, as well as this overcompensation tin final result inward elevated blood pressure. As the quote inward a higher identify says, in that place are other hormones that larn activated when the trunk needs sodium, as well as if dietary intake is peculiarly low, these hormones larn secreted inward higher amounts inward monastic say to hang onto every final molecule that is consumed. But belongings onto sodium isn’t the solely chore these hormones have. Just similar alongside insulin, or thyroid hormone, or growth hormone, hormones remove maintain multiple jobs, so whatever other things these salt-retaining hormones do volition also be done, as well as endure done more, when levels are elevated. So yous tin endure whatever unpleasant as well as potentially harmful effects come upwards from this, or, every bit Dr. DiNicolantonio suggests, yous could usage your natural inclinations every bit a guide as well as eat plentiful salt, hence sparing your trunk from having to activate this arsenal of emergency-situation hormones.
DiNicolantonio quotes Robert Heaney, MD, from a newspaper titled Making Sense of the Science of Sodium: “Demonizing sodium is non solely unsupported past times prove but is counterphysiological every bit well, every bit it ignores sodium’s most basic business office inward mammalian bodies.” (p.70) Heany recommends a sodium intake of 3000-5000mg per day. This is far higher than typical U.S.A. authorities guidelines as well as guidelines for those who already remove maintain hypertension or T2 diabetes (usually 1500-2300mg/day).
Dr. DiNicolantonio cites information from several populations who eat to a greater extent than sodium than a typical North American intake, as well as far more than is recommended for people alongside hypertension, yet these groups remove maintain much lower incidence of hypertension as well as core illness than nosotros do. Many of them eat to a greater extent than potassium than nosotros do, which is also a factor. (Like calcium & magnesium, as well as iron, coper & zinc, sometimes problems arise non when nosotros remove maintain “too much” or “too little” of them inward absolute amounts, but rather, when they’re out of residuum alongside a nutrient they function inward concert with. In the example of sodium, it’s potassium.)
So how did nosotros always come upwards to believe that common salt was bad for us? The writer provides a prissy overview of the history of common salt science, consummate alongside closed-minded researchers as well as authorities authorities who thought they were doing the correct thing. The parallels to the saturated obese as well as cholesterol stories are so striking that Eric Sodicoff, MD, said The Salt Fix is “like a salty version of The Big Fat Surprise.” Considering what a phenomenal mass The Big Fat Surprise is, that is high praise, indeed, as well as I agree. It turns out much of the common salt fearmongering is based on really small-scale studies from a long fourth dimension ago, as well as larger as well as to a greater extent than recent studies remove maintain pretty much exonerated common salt of crimes against humanity:
“The truth is, a small-scale number of emphatically held assumptions derailed scientific progress for decades—if non generations.” This was accomplished because of “a few researchers’ false assumptions” as well as “through a lethal combination of inertia, publication bias, as well as nefarious interests motivated past times the nutrient industry…” (p.32)
Ah, yes, Good ol’ inertia. Wrote nigh that here, alongside regard to saturated fat.
You know what? Back inward the day, I used to purchase unsalted pretzels as well as unsalted fries, thinking I was doing my trunk good. I felt so self-righteous, form of similar how I bought frozen fries as well as breaded chicken tenders as well as baked them inward the oven instead of frying them inward oil, since that was sooo much healthier! (LOL…I’m sure many of yous remove maintain similar stories of life earlier depression carb.) Honestly, I’m non a large common salt fiend. I bask salty foods, yes, but when I ate those unsalted versions, I wasn’t longing for the salt. I didn’t immature lady it. Maybe I was getting plenty sodium from other sources. (Probably the ketchup!)
I’ll destination alongside a quote from this highly recommended book:
“It’s fourth dimension to laid the tape direct nigh the health-protecting, lifesaving nature of common salt cravings—and drib the guilt for good.”
P.S. I wrote nigh the common salt tilt for my solar daytime gig alongside Designs for Health. You tin cheque it out here: Low Sodium Diets – Are They All They're Cracked Up to Be? (It’s short, I promise!)
Disclaimer: Amy Berger, MS, CNS, NTP, is non a physician as well as , LLC, is non a medical practice. The information contained on this site is non intended to diagnose, treat, cure, or preclude whatever medical status as well as is non to endure used every bit a substitute for the attention as well as guidance of a physician. Links inward this post service as well as all others may direct yous to amazon.com, where I volition have a small-scale amount of the purchase toll of whatever items yous purchase through my affiliate links.
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