Is the Salt in our Diets Killing Us?

Updated: Nov 19, 2020

In recognition of American Heart Month, I wanted to a few topics related to heart health. Much of the conversation about healthy eating focuses on optimizing physiques, not reducing the risk of heart disease and increasing the lifespan. It's assumed that the same diets that promote weight loss are also beneficial for overall health. This isn't always true. When dieting for weight loss, some people actually increase the amount of seasoning in their foods to compensate for the loss of flavor in low fat versions of their favorite meals. This addition of sodium could have detrimental effects.

Salt is a less attractive topic likely because it doesn't have much of an effect on physical appearance. Excessive salt intake doesn't cause significant weight gain, but this compound does have major effects on our bodies internally. Regular consumption of foods high in sodium increase blood pressure and the risk of stroke, heart failure, and heart disease. This was highlighted by a recent meta-analysis (collection of many research studies over the years) published in the Lancet that investigated the leading causes of diet-related deaths worldwide. Their results might be shocking. The Global Burden of Disease trial showed that of the 11 million diet-related deaths worldwide in 2017, high-salt diets were the cause of more than half. In fact, high-salt diets were the #1 cause of all diet-related deaths worldwide and most of these deaths were caused by heart disease, the leading cause of death globally.

The #2 cause of all diet-related deaths was diets low in whole grains followed by #3, diets low in fruits. Diets high in trans-fats, sugar-sweetened drinks, processed meat or other popularized dietary culprits, didn’t make the top 5 (but were among the top 10). Lastly, red meat consumption was the least prevalent cause of all diet-related deaths though some promote the restriction of red meat as a means of improving heart health. There are often discrepancies between media messaging and science and studies often don’t support common health beliefs.

The Academy of Nutrition and Dietetics recommends limiting sodium consumption to less than 2,300 milligrams or 1 teaspoon of salt per day for adults but most Americans exceed this amount daily consuming over 1,000 milligrams more. Food we eat out at restaurants and processed, frozen, and canned foods are loaded with sodium already so it’s possible to reach or even exceed the recommended amount without salting your food at all. The problem of excessive salt intake spans racial and socioeconomic lines as people of African, Latin, Asian, and European descent all have a tendency to over-consume.

People with high blood pressure should limit their sodium intake even more according to the American Heart Association which recommends a limit of 1,500 milligrams daily for those whose systolic blood pressures (top number) are at least 120 and whose diastolic blood pressures are at least 80. This is less than half of the 3,600 milligrams consumed by most Americans so major dietary changes are needed to achieve this.

All sodium isn’t bad as our bodies require sodium for many cellular and organ functions. Depending on your exercise training status, you might be able to consume the recommended amount or even more if you’re an endurance athlete as people who sweat a lot tend to lose more sodium. This isn't the case for most of the population as very few individuals regularly train at the level of an endurance athlete. If sodium concentrations in the body get too low, this can lead a medical emergency requiring hospitalization as was shown by a study in which someone developed hyponatremia after a hot yoga class and had to be admitted to intensive care.

Citrus, herbs, and other salt-free seasonings are good alternatives to salt. Also, limiting your salt to a small sprinkle per meal and limiting your consumption of processed foods, condiments, and salty snacks can help you stay within the recommended range. The DASH diet is a also a popular diet for lowering blood pressure that consists of foods low in sodium and high in potassium like fruits and vegetables.

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