A Grain Of Salt Restriction.

DeadlySalt Decades worth of anti-salt fear mongering has made sodium restriction a very common thing today, and unfortunately it is probably true that those who could benefit the most from increasing their intake, also tend to suffer the most from limitation.

Lack of convincing scientific evidence aside however (for any real benefit from low salt diets), it seems likely that recommendations to reduce salt intake – down to potentially dangerously low levels – will not be going away any time soon.

“The American Heart Association has recently emphasized goals to achieve “Ideal Cardiovascular Health” by 2020, and one of the dietary metrics is daily sodium intake of less than 1500 mg/d.”

This kind of daily sodium intake is well within the realms of what has been shown not only to be unsafe, but to also be associated with little in the way of real evidence of actual long term health benefits.

“There is no conclusive evidence that a low sodium diet reduces cardiovascular events in normotensive…or hypertensive individuals.”

On the contrary, experimental evidence suggests that in patients with heart failure or type 2 diabetes, a low sodium diet worsens cardiovascular prognosis, increasing the likelihood of death.

“In patients with type 2 diabetes…, a low sodium diet has been associated with increased cardiovascular and all-cause mortality.”

“The low sodium diet caused increased mortality and heart failure hospitalizations versus a normal sodium diet in patients with…heart failure. These results have been verified across multiple randomized controlled trials”

It has recently been confirmed that low sodium diets worsen cardiovascular disease outcomes – as well as increasing the risk of dying – and this was not seen to be dependent on issues relating to hypertension or blood pressure levels in general.

“In our analysis, the association between low sodium intake (<3 g/day) and increased cardiovascular disease and mortality was consistent, irrespective of baseline hypertension status and after further adjustment for blood pressure level indicating that mechanisms unrelated to blood pressure might be operational.”

From a more rational physiological perspective, it would appear that the theory behind the restriction of salt consumption as a means to lowering blood pressure (for the sake of health) is highly misleading and counterproductive.

“The idea that the blood pressure effect of sodium restriction can be extrapolated to a health benefit no longer retains scientific credibility.”

Insufficient dietary sodium intake stimulates the renin-angiotensin system, causing an increase in the production of aldosterone, which in turn reduces the amount of sodium lost in sweat and urine. This comes at the expense of an increased loss of the electrolytes potassium and magnesium (even calcium), contributing to inflammation and heart failure amongst other things.

“…in this study, we showed Na intake affected the balances of Na, K, Ca and Mg with an intake of about 55-65mg of Na per kg of body weight each day being required to maintain a positive balance of these minerals.”

“Thus, it seems that a normal sodium diet (4-6 g/d) in addition to a high potassium intake may be best for the general population…”

In fact, sodium restriction, by stimulating the production of aldosterone, causes constriction of blood vessels, likely leading to an increase in blood pressure. Rising levels of aldosterone have been shown to be connected to a variety of issues relating to metabolic interference.

“Emerging evidence supports a paradigm shift in our understanding of the renin–angiotensin–aldosterone system and in aldosterone’s ability to promote insulin resistance and participate in the pathogenesis of the metabolic syndrome and resistant hypertension.”

Rather than focusing obsessively on blood pressure and on misguided ideas regarding the limiting of salt intake, it makes far more sense to start considering the factors (especially those relating to diet) which promote stress and prevent proper thyroid function and healthy metabolic energy production.

“….even with the use of blood pressure as a surrogate marker of benefit…a focus on food and dietary patterns that provide adequate potassium, calcium, and magnesium create a more meaningful blood pressure effect and do not pose the potential harm of very low sodium intakes.”

An under active thyroid metabolism is usually accompanied with a rise in estrogen and both of these factors typically lead to a loss of salt as well as an abnormal increase in retention of water.

Increasing salt intake works with thyroid to improve energy systems, helping to stabilise blood sugar, lowering adrenalin as well as the associated stress substances (cortisol, estrogen and serotonin), helping your whole system work more efficiently and in a manner which is better able to protect against rapid aging and disease.

“These findings question any potential survival advantage with a low sodium diet and indicate caution for population-wide sodium restriction…”

It would appear as though those who might benefit most from an increased intake of sodium (beyond the requirements of a healthy population) – including the elderly and others exposed to high levels of stress and with under active metabolic function – are even more likely to be receiving misguided advice heavily promoting salt restriction.

“The recommended intakes….have direct implications for hospitalized patients, nursing home residents, and school feeding programs and other government-funded feeding programs that must adhere to these guidelines.”

“…enforcing very low sodium intakes will at best fail for most people and at worst cause harm for vulnerable or ill individuals…”

Insufficient salt intake in the context of conditions that increase sweating and promote the loss of far greater amounts of sodium than is likely the case under more regular conditions (up to as much as 30g/day) – and particularly when it is common for a lot of water to be consumed – can be exceedingly risky.

“…athletic trainers and other sports medicine professionals…need to recognize the potential for the vast range of sodium losses…so that individual fluid and electrolyte needs can be appropriately met.”

In order to meet what has been suggested by studies to be the minimum basic daily sodium requirements of between approximately 4-6 g/day – before even considering greater metabolic needs – one would have to consume the equivalent of 10-15g of salt over the day, or alternatively somewhere around 15-20g of sodium bicarb.

In the case of those with stress related issues and suppressed metabolic function – translating one way or another into an under performing thyroid metabolism where more sodium can be lost – extra salt (as much as 20-30 g/day sometimes more) can potentially be needed to help protect against stress and normalise energy systems.

A diet supplementing with sufficient amounts of salt and ensuring increased intake of potassium, calcium and magnesium – from dairy products, coffee, chocolate, sweet ripe juicy fruits and fruit juices – is one rational approach to improving metabolic function, as well as protection from the related diseases of inflammation and degeneration.

“Advising low sodium diets seems misguided and potentially dangerous and illustrates the problem of guidelines based on flawed studies using surrogate measures.”

Increased consumption of sodium can help to suppress stress, reducing inflammation and supporting improvement in thyroid function and the efficient production of metabolic energy. This can help with many different symptoms including mood related issues and sleep quality as well as general protection against the diseases of aging and degeneration, such as diabetes and heart disease. It has been shown to work so well, one might wonder why it is yet to be banned.

See more here

Dietary Sodium Restriction: Take It with a Grain of Salt

Beyond Blood Pressure: New Paradigms in Sodium Intake Reduction and Health Outcomes

Fatal and Nonfatal Outcomes, Incidence of Hypertension, and Blood Pressure Changes in Relation to Urinary Sodium Excretion

Beyond Blood Pressure: New Paradigms in Sodium Intake Reduction and Health Outcomes

Sweat Rates, Sweat Sodium Concentrations, and Sodium Losses in 3 Groups of Professional Football Players

Positive Correlation Between Dietary Intake of Sodium and Balances of Calcium and Magnesium in Young Japanese Adults–Low Sodium Intake Is a Risk Factor for Loss of Calcium and Magnesium–

Low Salt Diet Increases Insulin Resistance in Healthy Subjects

Low Sodium Intakes are Not Associated with Lower Blood Pressure Levels among Framingham Offspring Study Adults

Effect of dietary salt restriction on urinary serotonin and 5-hydroxyindoleacetic acid excretion in man.

Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis

Aldosterone: Role in the Cardiometabolic Syndrome and Resistant Hypertension

Dietary Salt Intake and Mortality in Patients With Type 2 Diabetes

Dietary Sodium Intake and Cardiovascular Mortality: Controversy Resolved?

Narrative Review: The Emerging Clinical Implications of the Role of Aldosterone in the Metabolic Syndrome and Resistant Hypertension

A novel combined glucocorticoid-mineralocorticoid receptor selective modulator markedly prevents weight gain and fat mass expansion in mice fed a high-fat diet.


Image: ArtOfTypH: “A Salt With A Deadly Weapon:W.I.P”

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