Reduced salt diets cause premature death. Wait wait, I’m doing it again. Let’s slow down.
Sodium chloride (NaCl) is of course table salt, either mined as rock salt, when we call it Halite, or separated from oceanic salt water. Chemically, salts are usually ionic, formed commonly via hydrogen replacement metals in a bond following an acid/base you’ve already stopped reading. (1,7)
“Salt” is not sodium, because of the chlorine weight, among other factors; approximately triple the sodium to get the “salt” content on a food packet, if you are so inclined. Likewise, divide “salt content” for “sodium” – multiply by about 0.3. Food science is not a science after all.
But we do need it, is the point, don’t we? Or is it more like the Gypo’s: can be fun, but ultimately dangerous and questionable if we actually ‘need’ need them? I mean it! It. (2)
Well according to Harvard and the CDC (and just about every other research source that no one actually reads), we do. (4)
It is estimated 1500mg is required to replace the amount lost during a days average activity – more if you are an athlete. People, of course, do intake many times this requirement with effects on atherosclerosis and a mystery effect on increasing blood pressure … or is there? (3.4).
No, there is not.
That is why the mechanism is always taught to us as a “mystery”. But since that matches most of medical science, we go along with it.
From the BMJ:
“There is no relationship between sodium and hypertension; in fact, those who ate the most salt had a LOWER median blood pressure” (13)
Sodium is used by all communicating cells: all cells I can think of, actually. It is in part responsible for allowing water intake to keep us hydrated. But that isn’t why I decided to look into this one.
I am just INCREDIBLY suspicious about things that everyone just “knows”, as I am equally (or more greatly) suspicious about climate change, as well, on similar grounds. Other examples include the lipid hypothesis against saturated fats (no longer recommended after 50 yrs of us being banged over the head with it), or vitamin C benefits; or many antioxidants thought DEFINITELY of benefit (now the research is in – not only don’t they work: TOXIC)! And many others. Ask me, I dare you.
The examples are numerous and the only thing they all have in common is their fame and popularity, given from authority and passed on mostly (almost exclusively) by people with no training in research or with a book to sell. (5)
Yet what of common sense; we have all had the experience of cramping muscles, and a vague awareness that salt is required to STAY hydrated. This is why salt is added to the water bottles of athletes. And these people are running further and faster than you are: I believe them. (6)
The editor of JAMA, during the height of the “reduce salt” controversy, is quoted as saying the health education establishment had:
“made a commitment to salt [reduction] education that goes way beyond the scientific facts.” (6)
Similarly, the NIH recommended reduced salt before any link was made to morbidity or mortality experimentally; rather only a vague theory existed at the time. Though, to be fair, there was also a highly confounded observational study and a rat study where, true to all animal research (as if they don’t have enough intrinsic problems); they fed the rat 6’000% more than a human could consume and drew some conclusions. As they do with illicit drug research; the opposite for a pharm (*Whoa! Hey there now! Shhh. Nearly started on pharm research).
Yes, that’s science – even today. Don’t get me started. (6)
The truth is, as far as we can tell, we do need sodium, a lot of it, and it isn’t harmful; though this isn’t spoken about (not uncommon, once industry is involved. One salt reduced butter can be all it takes …).
When you hit the literature, even the Cochran reviews finds zero link between morbidity or mortality – except possibly in the “wrong” direction. There have been several major meta/reviews of all the literature on the topic, that I know of, of which the conclusions were:
” … there is insufficient evidence to confirm the predicted reductions in people dying prematurely or suffering cardiovascular disease.”
”…little evidence for long-term benefit from reducing salt intake”
“… we do not know if low salt diets improve or worsen health outcomes.”
Oops. Hang on. J Clinical Science:
”Low-sodium diets result in WORSE clinical outcomes for people with congestive heart failure, due to “detrimental kidney and neurohormonal effects.” ”
”Lower sodium diets led to HIGHER mortality” (15,14,16,8,6,9).
In fact, like all poisons: it is the dose stupid.
Dose range, high or low, causes cascade events like transcription activation, receptor number and function changes, hormone level alterations, excretion rate alterations (often used as a marker).
For example: “sodium excretion of greater than 7 g per day was associated with an increased risk of all CV events, and a sodium excretion of less than 3 g per day was associated with increased risk of CV mortality” (8)
In fact, mortality (DEATH) appears to increase when you have LESS salt. Yep. The New England Journal published theory goes like this:
1) Less salt, the higher their levels of angiotensinogenase excreted by the kidneys.
2) Excess angiotensinogenase secretion sets off a physiological cascade event.
3) Cascade event result in increased heart disease, and you die prematurely. (11)
So sprinkle that on your steak and snort it. The whole steak. One nostril. (8,9)
Yep. here is another:
”The magnitude of the effect in Caucasians with normal blood pressure does not warrant a general recommendation to reduce sodium intake.” (9)
And low salt diets may help CAUSE patients to develop insulin resistance and diabetes melitus. Interesting since it is on the rise and so too is everyone told to reduce sodium. Probably unrelated; like how nothing is working since I got windows 8: that is probably unrelated too. (10,11)
Yes, while we swallow American dietary recommendations from books, fads and TV hook line and salt-shaker;
European researchers study both the drawbacks and potential benefits of high, low & no salt diets. Then using DATA (I know, crazy) come to very different conclusions. ~100’000 people in more than 30 countries, consume double what is considered the safe upper limit for Americans – LESS DIABETES, LESS HEART DISEASE, *LONGER LIFE (*from approximate similar background conditions). (9)
Is it really that hard to understand that any individual body needs a different amount? What is wrong with you people.
This isn’t priests, printing presses in locked windmills and Latin; you can read this stuff. Why does nobody look into ANYTHING they are told? The science has always been there, as usual.
This isn’t even research theory – I mean do you all look exactly the same? Do the same things? Blood volume? Body size? Activity level? These, and a range of other things, make cut offs arbitrary at best. Why that is not clear to everyone prima facie I don’t understand. Similarly … oh NM.
I nearly started talking about the thyroid – but you’d just start crying. You are not hypothyroid, lets just leave it there for now.
For the fun stuff, researchers at Iowa U have found there are antidepressant effects of salt; with deficiency causing depression. Fun huh? Reading. (17)
And I didn’t even address how much gets into the body, versus what is on the packet, or in your stomach, or research design.
Just think yourselves lucky. ❤ ;D
Now, go to bed. Go on, off you go. You have school and work in the morning: and that is important.
J(J) Raphael, hc Lsc (A03-1-Q/C/M) & AJ Casper, (GSI A04WA). (2014).”Sodium & Niobium (Nb) in the Human Frame”. Chronicle of Letters. 2 (15). Ed5.
(1) Halite (CEB Acc 2014) http://tinyurl.com/jvoqj8d
(2) Gervais (2011) tt1783772/
(3) Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, National Academies Press (2004).
(4)Harvard CDC Report: Sodum Requirements – http://tinyurl.com/ke5283o
(5) JChronLttSc Inex ~
(6) Taubes (2012) ~ Robert Wood Johnson Foundation Independent Investigator in Health Policy Research.
(7) Princeton Chemistry “Salts” ~ https://www.princeton.edu/~achaney/tmve/wiki100k/docs/Salt_%28chemistry%29.html
(8) JAMA (2011). Urinary Sodium and Potassium Excretion and Risk of Cardiovascular Events, http://tinyurl.com/k3lt6ch
(9) Cochrane (2002). Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.:CD004022.
(10) Low-salt diet increases insulin resistance in healthy subjects (2011), Metabolism – Clinical and Experimental, 60 (7).
(11) Dietary Salt Intake and Mortality (Death) in Patients With Type 2 Diabetes. (2011) ADA:New England Journal of Medicine (2001).Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet”. 10.1056/NEJM200101043440101.
(13) BMJ (1988). International study of … sodium and potassium excretion. PMC1834069
(14) Cochrane (2009). Reduced salt intake compared to normal dietary salt, or high intake
(15) Am J Med (2006).Sodium intake and mortality in the NHANES II follow-up study Mar;119(3):275.e7-14.
(16) J Clin Sci (2008). Normal-sodium diet compared with low-sodium diet. 114(3):221-30.
(17) U Iowa. (Ac 2014). Salt Might Be ‘Nature’s Antidepressant’. ScienceDaily. Org 2009.