By Dr. Mercola
Salt has long been a treasured food staple. Far from being
harmful, high-quality salt is actually essential for
life, but in the United States and many other developed
countries salt has been vilified as a primary cause of high
blood pressure and heart disease.
According to preliminary research presented at an American
Heart Association meeting in New Orleans on March 21,1
excessive salt consumption contributed to 2.3 million
heart-related deaths worldwide in 2010; 42 percent from coronary
heart disease and 41 percent from stroke.
This includes sodium intake from commercially available table
salt and sodium found in processed foods and soy sauce.
According to the researchers, 40 percent of deaths were
premature, occurring in those under the age of 69. Sixty percent
of the deaths were in men; 40 percent were women.
To reach these conclusions, the researchers analyzed 247 food
surveys on sodium consumption collected between 1990 and 2010.
From these, they tried to determine how the various salt intakes
affected cardiovascular disease risks. The ideal salt intake was
determined to be less than 1,000 mg per day.
Kazakhstan had the highest average salt intake at 6,000 mg
per day. Kenya and Malawi had the lowest average intake at about
2,000 mg. Other salty regions included Central Asia, with an
average of 5,500 mg sodium per day; high-income countries in the
Asia-Pacific area, averaging 5,000 mg per day; and East Asia at
4,800 mg per day.
According to the featured article:2
“Global sodium intake from various sources such as
prepared food and soy sauce averaged nearly 4,000 milligrams
a day in 2010... In the U.S., the average intake was about
3,600 milligrams a day. While the World Health Organization
recommends sodium intake of fewer than 2,000 milligrams a
day, 181 of 187 countries representing 99 percent of the
world’s population exceeded the recommended level.”
You Need Salt, But Make Sure It’s the Right Kind
So is salt a dietary friend or foe? Salt is actually a
nutritional goldmine, provided you consume the right kind, and
maintain a proper salt-to-potassium ratio, which I’ll discuss in
a moment. Unfortunately, modern table salt has very little in
common with natural, unrefined salt.
Salt provides two elements – sodium and chloride – that are
essential for life. Your body cannot make these elements on its
own, so you must get them from your diet. Some of the
many biological processes for which natural salt is crucial
include:
Being a major component of your blood plasma, lymphatic
fluid, extracellular fluid, and even amniotic fluid |
Carrying nutrients into and out of your cells, and
helping maintain your acid-base balance |
Increasing the glial cells in your brain, which are
responsible for creative thinking and long-term
planning. Both sodium and chloride are also necessary
for the firing of neurons |
Maintain and regulate blood pressure |
Helping your brain communicate with your muscles, so
that you can move on demand via sodium-potassium ion
exchange |
Supporting the function of your adrenal glands, which
produce dozens of vital hormones |
However, not all salts are created equal. Natural salt
contains 84 percent sodium chloride, and 16 percent
naturally-occurring trace minerals, including silicon,
phosphorous and vanadium.
Processed (table) salt, on the other hand, contains 97.5
percent sodium chloride and the rest is man-made chemicals, such
as moisture absorbents and flow agents. These are dangerous
chemicals like ferrocyanide and aluminosilicate. A small amount
of iodine may also be added.
Some European countries, where water fluoridation is not
practiced, also add fluoride to their salt.3
In France for example, 35 percent of table salt sold contains
either sodium fluoride or potassium fluoride, and use of
fluoridated salt is widespread in South America.
Besides these basic differences in nutritional content, the
processing—which involve drying the salt above 1,200 degrees
Fahrenheit—also radically alters the chemical structure of the
salt. So, while you definitely need salt for optimal health, not
just any salt will do. What your body needs is natural,
unprocessed salt, without added chemicals.
Does Salt Really Cause Heart Disease?
Overindulgence in the typically used commercially processed
table salt can lead to fluid retention, high blood pressure,
swelling of your limbs, and shortness of breath. In the long
term, it is thought to contribute to high blood pressure, kidney
and heart disease, heart attacks, and heart failure.
However, compelling evidence suggests that while processed
salt can indeed cause fluid retention and related health
problems, numerous studies have, overall, refuted the
salt-heart disease connection.
For example, a 2011 meta-analysis of seven studies involving
more than 6,000 people found NO strong evidence that cutting
salt intake reduces the risk for heart attacks, strokes or
death.4
In fact, salt restriction actually increased the risk
of death in those with heart failure.
Similarly, research published in the Journal of the
American Medical Association that same year revealed that
the less sodium excreted in your urine (a marker of
salt consumption), the greater the risk of dying from
heart disease.5
This study followed 3,681 middle-aged healthy Europeans for
eight years. The participants were divided into three groups:
low salt, moderate salt, and high salt consumption. Researchers
tracked mortality rates for the three groups, with the following
results:
- Low-salt group: 50 people died
- Moderate salt group: 24 people died
- High-salt group: 10 people died
The risk for heart disease was 56 percent higher for
the low-salt group than for the group who ate the most salt!
Some studies have shown a modest benefit to salt restriction
among some people with high blood pressure, but the
evidence does not extend to the rest of the population. So
what’s really going on? Well, there are at least three factors
that need to be taken into consideration.
- First, an ingredient that contributes to high blood
pressure and heart disease across the board is fructose,
and since so much of salt intake comes from processed foods,
it’s easy to see how the lines of causation may get blurred.
Virtually all processed foods are high not just in sodium,
but also fructose, particularly in processed foods sold in
the US.
- Another factor is that there’s a huge difference between
natural salt and the processed salt added to processed foods
and salt shakers in most homes and restaurants. The former
is essential for good health, whereas the latter is best
avoided altogether.
- A third factor that can have a significant impact on
whether salt will harm or aid your health is the ratio
between the salt and potassium in your diet.
That said, it’s clear that many are consuming far too much
processed table salt and not enough natural salt. This begins
early. According to the featured article, nearly 75 percent of
processed meals and snacks for toddlers contain 210 mg of sodium
per serving or more. Some toddler fare contains as much as 630
mg per serving, which equates to 40 percent of the daily limit
recommended by the American Heart Association for adults. Lead
researcher Dariush Mozaffarian, MD, MPH told MedPageToday:6
"'These findings highlight both the tremendous
disease burdens caused by sodium but also the incredible
opportunities for prevention.' ...He urged global public
health efforts rather than relying on individuals to control
intake of so pervasive an element. 'Our results should
inspire both food industry and policymakers to take rapid
and decisive actions to reduce sodium in the food supply...
If voluntary agreements are not enough, taxation or
restrictions on amounts of sodium should be implemented.'"
The Importance of Maintaining Optimal Sodium-Potassium Ratio
As mentioned earlier, another important factor that needs to
be taken into account is the potassium to sodium ratio of your
diet. Imbalance in this ratio can not only lead to hypertension
(high blood pressure) but also contribute to a number of other
diseases, including those highlighted in the featured research,
along with a few others:
Heart disease and stroke |
Memory decline |
Osteoporosis |
Ulcers and stomach cancer |
Kidney stones |
Cataracts |
Erectile dysfunction |
Rheumatoid arthritis |
The easiest way to achieve this imbalance is by consuming a
diet of processed foods, which are notoriously low in potassium
while high in sodium. (And, to reiterate, processed foods are
also loaded with fructose, which is clearly associated with
increased heart disease risk, as well as virtually all chronic
diseases.)
Why is potassium so important?
Among other things, your body needs potassium to maintain
proper pH levels in your body fluids, and it also plays an
integral role in regulating your blood pressure. It’s possible
that potassium deficiency may be more responsible for
hypertension than excess sodium. Potassium deficiency leads to
electrolyte imbalance, and can result in a condition called
hypokalemia. Symptoms include:
- Water retention
- Raised blood pressure and hypertension
- Heart irregularities/arrhythmias
- Muscular weakness and muscle cramps
- Continual thirst and constipation
According to a 1985 article in The New England Journal of
Medicine, titled "Paleolithic Nutrition,"7
our ancient ancestors got about 11,000 mg of potassium a day,
and about 700 mg of sodium. This equates to nearly 16 times more
potassium than sodium. Compare that to the Standard American
Diet where daily potassium consumption averages about 2,500 mg
(the RDA is 4,700 mg/day), along with 3,600 mg of sodium... As
mentioned earlier, if you eat a diet of processed foods, you can
be virtually guaranteed that your potassium-sodium ratio is
upside-down.
This may also explain why high-sodium diets appear to affect
some people but not others. According to a 2011 federal study
into sodium and potassium intake, those at greatest risk of
cardiovascular disease were those who got a combination of
too much sodium along with too little potassium.
The research, published in the Archives of Internal
Medicine,8
was one of the first and largest US studies to evaluate the
relationship of salt, potassium and heart disease deaths.
According to Dr. Elena Kuklina, one of the lead authors of the
study at the Centers for Disease Control and Prevention (CDC),
potassium may neutralize the heart-damaging effects of salt.
Tellingly, those who ate a lot of salt and very little potassium
were more than twice as likely to die from a heart attack as
those who ate about equal amounts of both nutrients.
How Can You Ensure Proper Sodium-to-Potassium Ratio?
So, how do you ensure you get these two important nutrients
in more appropriate ratios?
- First, ditch all processed foods, which are very high in
processed salt and low in potassium and other essential
nutrients.
- Eat a diet of whole, unprocessed foods, ideally
organically and locally-grown to ensure optimal nutrient
content. This type of diet will naturally provide much
larger amounts of potassium in relation to sodium.
I do not recommend taking potassium supplements to correct a
sodium-potassium imbalance. Instead, it is best to simply alter
your diet and incorporate more potassium-rich whole foods. Green
vegetable juicing is
an excellent way to ensure you’re getting enough nutrients for
optimal health, including about 300-400 mg of potassium per cup.
By removing the fiber you can consume even larger volumes of
important naturally occurring potassium. Some additional rich
sources in potassium are:
- Lima beans (955 mg/cup)
- Winter squash (896 mg/cup)
- Cooked spinach (839 mg/cup)
- Avocado (500 mg per medium)
Other potassium-rich fruits and vegetables include:
- Fruits: papayas, prunes, cantaloupe,
and bananas. (But be careful of bananas as they are high in
sugar and have half the potassium that an equivalent of
amount of green vegetables. It is an old wives tale that you
are getting loads of potassium from bananas, the potassium
is twice as high in green vegetables)
- Vegetables: broccoli, Brussel's
sprouts, avocados, asparagus, and pumpkin
Putting Salt Consumption into Proper Context
More than 80 percent of the salt most people consume is from
processed foods. Indeed, there is far too much sodium in
processed foods. But you shouldn't be eating those foods
anyway—sodium is just one of MANY ingredients in packaged foods
that will adversely affect your health. The salt added to these
convenience foods is bleached out, trace mineral deficient and
mostly sodium—as opposed to natural salt, which is much lower in
sodium and contains a myriad of other critical trace minerals.
Himalayan salt, for example, contains about 86 different
minerals, and in terms of taste, you cannot compare it to
regular table salt. Natural salt has flavor, over and
above just salty taste.
The more you can move toward a diet of whole organic foods in
their natural state, the healthier you'll be—whether it's
veggies, meat, dairy products, or salt. And increasing your
vegetable intake will help insure you’re getting the ideal ratio
of sodium-to-potassium, which may be more crucial for overall
health than we currently imagine.
Given that salt is absolutely essential to good health, I
recommend limiting, or ideally, eliminating processed foods and
processed table salt and switching to a pure, unrefined salt.
Generally speaking, it is perfectly fine to salt your food to
taste, provided the salt you're using is natural and unrefined
and you’re eating plenty of vegetables.
© Copyright 1997-2013 Dr. Joseph Mercola. All Rights Reserved.