Salt’s at Fault

October 03, 2007

Salt’s at Fault 

 Competency # 16  Minerals                           ReferenceHe, Ogden et al JAMA, Dec 1999Cook and Cutler:  BMJ April 20, 2007 

 Let’s talk salt.  It’s one of America’s four main food groups: the others being chocolate, sugar, and fat.  And that’s why we are dying like flies from cardiovascular disease.  This is the story.  Salt kills, not just by making high blood pressure, but by also being a direct risk for heart attack.  Drs. Cook and Cutler followed up on three-quarters of the patients from prior large randomized studies that had compared the short-term effects of salt reduction.  Those trials were conducted in 1987-1995.  

Now, 12 years later long-term follow-up of those patients was conducted to see if there were measurable long-term benefits from reducing salt for 18 months.  There was. Yes.  Plain and simple.   This is the nail in the medical coffin for salt intake.  The long-term study showed that you can reduce your risk of heart attack, independently of everything else, by 25% by reducing salt in your diet.  We know that salt causes high blood pressure and is a risk factor for stroke.  

We can now say unequivocally that it’s part of the cause of heart attack too.   It’s effects are long-term, and now conclusive.  Darn it.  I love salt. How does it work?  Your blood is basically saltwater.   .9% saltwater to be medically exact.  If you force-feed yourself salt, your body has to protect the salt concentration in your blood and it does so by making you feel very thirsty and drinking more water.   Your blood volume expands.  Your blood vessels are like a large water balloon and expand too.   And like the balloon, your blood pressure rises along with the expansion.  When you eat that salty meal, your weight can go up 5 pounds in a day, and it then takes three days of eating less salty meals to lose all that “water weight”.  You can wash it out faster by drinking tons of water, but it takes a couple of days. 

 We are eating five to ten times more salt than we need, or used to eat.  We do need salt.  A tiny bit.  If we do sweaty work, we need a tiny bit more.  Our bodies evolved to crave it because sodium, the guilty chemical part of salt, is rare in nature.  Our grandparents had diets with roughly one molecule of sodium for every eight molecules of potassium.  Now we are eating four of sodium for every one of potassium.  That’s a complete reversal of the ratio of those two vital “salts”.  The food industry knows that adding sodium to food makes us crave it more.  We just can’t help but nibble on salty foods: chips, pretzels, fried chicken, burgers…and the salt is part of the puzzle of why we are having so many heart attacks. 

 WWW:  What Will Work for Me?  Now I know.  That’s step one.  I’m trying to get in the habit of not adding salt, ever.  I pick up pepper now at the restaurant and pepper my food.  But Tabasco sauce is salt solution and is soooo good.  And soy sauce makes Japanese food.  Can I do the sushi with just the ginger and not the soy sauce?  I’m trying it out.   And get that bag of pretzels away from me.  Just don’t keep them around.  My heart needs me.  

The column is written by Dr. John E. Whitcomb, MD, Brookfield Longevity, Brookfield, WI (262-784-5300)