A little more salt, please

In the push to reduce the often-high level of sodium in the average American diet, have we gone too far?

A handful of recently published studies suggests that restricting intake may be less beneficial than thepublic thinks and in fact might actually be harmful for some people.

I think I hear a rumbling of approval from the Salt Institute.

The trade group has been working for years to counteract the sodium-is-bad-for-you message so prevalent in the national conversation about health and nutritional standards. The Salt Institute’s latest salvo: a Facebook campaign asking the public to “fight for salt freedom” by leaving online comments for five federal agencies charged with finding strategies to reduce American salt consumption.

The Salt Institute also delivered a 17-page letter in October to the USDA, asking the government to withdraw new federal dietary and school lunch guidelines that call for more restrictions on sodium. The group argues that the sodium provisions are “arbitrary and capricious”, based on “inadequate medical and scientific evidence” and deeply flawed.

Biased much?  Of course. The Salt Institute, after all, does represent the industry. At least they’re up front about it; their letter to the USDA is pretty open in pointing out that when salt is unfairly disparaged, it “adversely impact[s] the market for dietary salt, and caus[es] concern for inappropriate regulatory and litigation initiatives.”

But don’t be too quick to dismiss the Salt Institute’s position as one of mercenary self-interest, because it contains a kernel of truth: Humans need a certain amount of salt in their diet, and too little can have health consequences.

The latest study to draw this conclusion appeared a couple of weeks ago in the Journal of the American Medical Association. The study involved an international group of nearly 29,000 adults over age 55 who were at high risk of heart disease and whose salt intake was tracked for three years.

The findings confirmed what medical experts have known all along: Too much sodium led to a significantly greater chance of heart problems. But too little sodium was almost as bad. The individuals in the study who consumed the least salt were more likely to be hospitalized with congestive heart failure or die from a stroke or heart attack.

Other studies have reached similar conclusions about the health risks of reducing sodium too aggressively. For instance, a small-scale study published earlier this year in the journal Metabolism found that low-salt diets may promote insulin resistance and lead to diabetes in some people.

Another study, this one appearing in August in the American Journal of Hypertension, analyzed seven previous studies and concluded that reducing dietary salt did little to lower the risk of premature death.

It’s not clear what to make of all this. In some respects, the debate might be purely academic because for most Americans, the issue isn’t too little salt; it’s too much. New guidelines issued by the federal government this past year call for adults to consume no more than 2,300 milligrams of sodium per day. This daily limit is even lower – 1,500 mg – if you’re older than 51, African-American or have high blood pressure, diabetes or kidney disease.

In view of the fact that the average American adult gets 3,400 mg of sodium per day, much of it from processed foods, there’s obviously room for improvement. But how low can the threshold go? More to the point, how low should it go? Many nutrition experts say that for most people, cutting their sodium intake in half to meet the new dietary guidelines is likely to be very, very difficult and perhaps not achievable for some. And if, as the research suggests, too little salt might be harmful (or at least not all that beneficial), it raises the question of how far we can go before reaching the point of diminishing returns.

I don’t think I’m going to stop buying low-sodium bacon any time soon. It’s still pretty clear that a diet heavy in sodium is undesirable. But it would seem that a little more moderation is called for in the discussion. Perhaps it’s time for a more honest and realistic look at where the bottom limit of sodium consumption should be.

Photo: Wikimedia Commons

5 thoughts on “A little more salt, please

  1. Wise up PEOPLE!!!! There is a BIG difference in what Kind of salt you consume on a daily basis!! The typical table salt purchased in the grocery store is actually toxic to the human body in large quantities, that is because it is so refined. All of the precious minerals,etc. are taken out of it in the refining process,actually the chemicals used to do this is the problem, To be healthy the body needs salt! Purchase the regular coarse ground SEA SALT that contains essential trace minerals and is labeled as UNREFINED. May I suggest you read the book called SALT YOUR WAY TO HEALTH by DR. DAVID BROWNSTEIN

  2. Hey Anne,

    Would the amount of sodium one needs also depend on their level of activity? I’ve done three half marathons and simple hydration doesn’t seem to be enough. Sometimes I really need Gatorade (along with its dose of sodium) or my body lets me know (difficulty sleeping, for example).

    Shane

    • Physical activity does make a difference, because sodium is an electrolyte that is depleted through sweating. Drinking a lot of water to stay hydrated during intense activity can further dilute your sodium levels; sports drinks help by replenishing this. I found more information here: http://bit.ly/uagTWU

  3. I am with the Salt Institute. Get over it. There is not a single statement we put out that is not based on an independant peer-reviewed study in a respected medical journal. I suggest you Look at the latest study by O’Donnell in JAMA that states we are currently eating salt at the ideal level and that the Dietary Guideline recommendation of 1,500 – 2,300 mg sodium per day is smack in the middle of the danger zone for increased mortality. Melody Tilbury’s comment on sea salt would have more credibility if she could quote a single peer-reviewed study in a respected medical journal to back up the health claims for sea salt – if not the claim is strictly anecdotal.

  4. I recently had an experience of diuretics flushing electrolytes. The dosage has since been lowered to a more electrolyte friendly level. I now carry packets of salt with me–just in case. Multiple lab testing showed my low salt symptoms would begin as my sodium approached the lower end, but remained within, the “normal” range. Salt loading to get my levels back into mid-range relieved my symptoms.

    Each person has their own optimal level of salt. I clearly need more than my husband does to maintain the same level of functionality even though he’s on a higher dose of the same diuretic. Perhaps we need to begin thinking more in terms of individual “optimal” levels instead of trying to herd everyone into a generic prescribed intake.

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