Dr. Mercola did an article about sodium in the diet months ago but most of you don’t have access to his website so I am reviewing the literature now to give you a different perspective on salt. I don’t have to do any new studies…the research is there for anyone to review. You have been told for years that a low salt diet is better for your health and that salt is the main cause of hypertension, strokes, and heart attacks. Turns out, when you evaluate the latest and best research…your salt shaker has gotten a bad rap. The diuretic medications patients take for edema, heart failure and hypertension work, in part, by causing you to excrete salt (sodium chloride) via your kidneys.
Caffeine is also known to be a potent stimulus for salt excretion. Four cups of coffee in a day would cause you to lose an estimated 2,300 mg of sodium…that’s about a teaspoon of salt. If you are restricting your salt intake a gradual imbalance will result in a chronic salt deficiency.
In April 2022 the results of the SODIUM-HF trial were reported and there was no statistical difference in any important markers between patients with significant heart failure and either a restricted salt or regular diet. This was a six country, six year, 26 site trial which suggests the results are likely valid. As the Lancet commented, “in ambulatory patients with heart failure, a dietary intervention to reduce sodium intake did not reduce clinical events.” Interestingly enough, all cause mortality was slightly higher in the low sodium group but it didn’t achieve statistical significance.
The Mercola review pointed out that historically salt use was much much higher as it was a primary way of preserving food before refrigeration. Both the Japanese and South Koreans have among the longest life expectancies and also consume the highest amounts of salt.
James DiNicolantonio Pharm. D. wrote a book called “The Salt Fix; Why the Experts Got It All Wrong – and How Eating More MIght Save Your Life.” He points out that a number of medical conditions also can increase sodium loss such as inflammatory bowel diseases, sleep apnea, adrenal insufficiency, kidney diseases, and hypothyroidism. Any of these might suggest you need to increase your sodium intake.
The Dr. Mercola article pointed out a metric I have not used before but will pay more attention to now. Apparently the way to normalize your blood pressure is to get the right sodium/potassium rate. Most Americans consuming the standard processed food diet get much more sodium than potassium but the ideal ratio is a 5:1 ratio potassium: sodium. Dr. Mercola has a customized version of the free nutrient tracker, cronometer. com that you can use to calculate your sodium to potassium ratio automatically based on the foods you enter.
Part of the problem with a low sodium diet is that it causes changes in your hormone system that are not necessarily healthy for you. Your blood pressure will go down more with carbohydrate restriction than with salt restriction but the carbohydrate restriction doesn’t disturb your body’s systems like salt restriction does. Low sodium diets cause elevation in insulin levels and triglyceride levels…both undesirable. Also low sodium causes the body to pull magnesium and calcium from your bones in order to try to normalize your levels and that’s undesirable too. It’s not just lab abnormalities, patients with hyponatremia can experience muscle fatigue, muscle cramps, heart palpitations, lethargy and confusion. I have had to hospitalize patients with low sodium but rarely these days have I had to hospitalize anyone with a high sodium level in their bloodwork. In today’s world it’s much easier to have low sodium in your blood work…with all its attendant problems than it is to have high sodium in your blood work.
Below are some links addressing this issue. Of course, don’t make any changes without consulting your health care professional but don’t be so quick to just accept the party line. It’s perfectly okay to challenge your doctor to back up his or her recommendations with real data…not just some statement drawn from the “guidelines.” You are forging a relationship with your provider and it’s okay for you to ask about certain tests and procedures and supplements etc.
Until next month….get well and stay well.
https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2022/04/01/03/02/SODIU M-HF