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Thanks for that article. I've had high BP for years but... »
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I looooove salt. Five years ago I stopped eating salty ... »

Salt: Friend or Foe?


By: Alison Mitchell, Naturopath

Salt (sodium chloride) is a staple of every household, having been used by many cultures to flavor food for thousands of years. We have always valued salt highly, so much so it was a form of wage for Roman soldiers, known as salarium, from the Latin word for salt, sal(and hence our term for salary).

Sea salt is the result of evaporated sea water. Salt can also be mined from the earth, from salt lakes and dried ocean beds. The quality of salt varies greatly depending on where the salt is mined from (e.g. Himalayan salt is of high quality due to the pristine environment from which it is mined), and the level of refining that occurs (the less refined the salt, the better for you).

Unrefined sea salt is usually quite grey in colour and is derived directly from an ocean or sea. It is harvested through channeling ocean water into large clay trays and allowing the sun and wind to evaporate it naturally. Manufacturers of sea salt generally do not refine it much, so the salt still contains traces of other minerals. All salt, regardless of its type is generally 98% sodium chloride, with the remainder being a variety of other beneficial minerals (the less refined varieties containing up to 84 types). The more salt is processed and refined the less of these beneficial minerals remain in the salt.

Sodium is an essential electrolyte mineral, it is important for conveying energy and enabling nerve impulses and muscle contractions. In the past, salt tablets were recommended in the summer for people to replace sodium lost by exercise or heavy sweating. This is rarely recommended nowadays as we now know that it is more important to replace a combination of electrolytes, in particular potassium which is important as it helps to keep the correct balance of sodium in the body.

In our body salt has an affinity for water, so when we consume salt this causes a large percentage of sodium to settle in our vascular fluids. The sodium then attracts more and more fluid, causing an increase in pressure in the vascular system, which is one of the reasons excess salt can contribute to high blood pressure.

To prevent many of the conditions caused by excess salt consumption it is important to have adequate levels of potassium. Potassium is a mineral that resides on the inside of cells, whereas sodium dwells in the fluid outside and between our cells. When the potassium/sodium ratio is out of balance our body's water and acid/alkaline balance become unstable and our nerves and muscles aren't able to function properly. The majority of people in our society have a potassium to sodium ratio of less than 1:2. However the recommendation is to have a ratio greater than 5:1, which is ten times higher than average intake. A natural diet rich in fruits and vegetables can easily produce a much greater ratio, because most fruits and vegetables have a ratio of at least 50:1. Some examples include: Apples 90:1, Bananas 440: 1, Carrots 75: 1, Oranges 260:1, Potatoes 110:1. [2]

Main food sources of sodium include: Anchovies, bacon, processed meats, celery, cheeses, pickled olives, peas, pickles, table salt, tuna, salted butter, sardines, sauerkraut, pasteurised cheeses, potato chips, softened water and clams. [3]

RDA:0.75-3.5gm
Maximum recommendation: 2.4-3.0g/day (equivalent to 6-7.5g of salt per day)
Deficiency limits: <0.5gm

Salt is widely known to have an effect on blood pressure. There are some people who are very sensitive to sodium, and consuming even a small amount can cause their blood pressure to increase dramatically or to develop excess fluid retention. These people need to not only increase their potassium intake but abstain from all major sources of salt.

Between 40-60% of people with high blood pressure are sensitive to salt. People with diabetes and chronic kidney disease and greater age also tend to be more sensitive to the blood pressure raising effects of salt. Being overweight also appears to increase susceptibility to being sensitive to sodium, and increases risk of stroke and heart attack. If people who are overweight have a diet that is high in potassium then that risk is greatly reduced. [5] There are some other conditions which will increase your sensitivity to salt, such as Menierre's disease.

A meta-analysis looking at the effects of long term sodium reduction of blood pressure found that on average, people with elevated blood pressure who reduced their salt intake by 4.6g/day had an average reduction of systolic blood pressure by -4.97 mmHg, and an average reduction of diastolic blood pressure by -2.74 mmHg. For people with normal blood pressure an average reduction of salt intake by 4.4g/day reduced systolic by -2.03 mmHg and diastolic by -0.99 mmHg. [6] So while we need to respect the effect that excess salt intake can have on our blood pressure we also need to realise that just reducing salt in our diet in isolation will not have a large effect.

To support healthy blood pressure, focus on both increasing potassium intake through fruit and vegetables and avoiding excessive sodium intake from added salt or processed foods (and also working on all the other necessities for a healthy cardiovascular system) rather than just reducing or avoiding salt altogether. People with salt sensitivity and cardiovascular risk factors should reduce their salt intake to less than 2g/day and only choose unprocessed salt.

Food Standards Australia-New Zealand (FSANZ) estimates that:

"Australians aged two years and older eat an average of 2,150 mg of sodium per day from an average of 5,500 mg of salt (5.5 g). About 80 per cent of this would be from processed foods and 20 per cent from salt used at the table or in home cooking. This estimate does not include the smaller amounts of sodium coming from naturally occurring sodium or sodium-containing food additives… Foods that contribute the most to Australians' salt consumption are bread and bread rolls, meat, poultry and game products, including processed meat, and cereal products and cereal-based dishes such as biscuits and pizza." [7]


Here are some tips to avoid excessive salt intake:

  • Take the salt shaker off the table
  • Gradually reduce added salt to foods so that you can learn to enjoy the flavours of unsalted foods.
  • Try flavouring foods with herbs, spices, and lemon juice.
  • Choose low-salt products when available.
  • Read food labels carefully to determine the amounts of sodium and learn to recognise ingredients that contain sodium a food with salt, soy sauce, salt brine, or any ingredient with sodium, such as monosodium glutamate, or baking soda (sodium bicarbonate) as part of its name contains sodium.
  • In reading labels and menus, look for words that signal a high sodium content, such as barbecued, broth, marinated, Parmesan, pickled, smoke and tomato base.
  • Prepared sauces and condiments are often high in sodium; these include barbecue sauce, cocktail sauce, mustard sauce, soy sauce, teriyaki sauce as well as many salad dressings.
  • Don't eat canned foods as these are often high in sodium.
  • Serve lemon wedges at the table instead of salt which can be a good flavor enhancer because of its acidity.
  • Use a salt free dukkah to sprinkle onto veggies or coat meats with. This imparts good flavor and crunch.


    Works Cited

    [1] P. Pitchford, Healing with Whole Foods, 3rd Edition ed., Berkeley, California: North Atlantic Books, 2002.
    [2] M. Murray, J. Pizzorno and L. Pizzorno, The Encylopedia of Healing Foods, New York: Atria Books, 2005.
    [3] H. Osiecki, The Nutrient Bible, 7th ed., Eagle Farm: Bio Concepts Publishing.
    [4] J. M. Mercola, "Mercola.com," 25 August 2010. [Online]. Available: http://articles.mercola.com/sites/articles/archive/2010/08/25/why-has-this-lifesustaining-essential-nutrient-been-vilified-by-doctors.aspx. [Accessed 2013].
    [5] J. He, L. G. Ogden, S. Vupputuri, L. A. Bazzano, C. Loria and P. K. Whelton, "Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults.," The Journal of the American Medical Association, vol. 282, no. 21, pp. 2027-34, 1999.
    [6] F. J. He and G. A. MacGregor, "Effect of longer-term modest salt reduction on blood pressure," The Cochrane Database of Systemic Reviews, vol. 3, no. CD004937, 2004.
    [7] FSANZ, "Sodium and salt," August 2011. [Online]. Available: http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets/sodiumandsalt.cfm. [Accessed 12 February 2013].

    Alison Mitchell is a naturopath who practices at Health Dimensions, a multi-disciplinary clinic located in Windsor and Bella Vista. Alison enjoys working with womens health, chronic pain and digestive health. For more on Alison and to visit her blog visit www.naturopathnsw.com.au
    She consults at Bella Vista: 02 8824 6792 & Windsor: 02 45776215 Health Dimensions & Path to Health Northmead - (02) 9683 7995

    Comments

    Jenny
    Aug 8 2013 12:22PM
    I looooove salt. Five years ago I stopped eating salty foods and adding it to my food. After some time, I started to taste salt in foods that I didn't know had salt, like the chocolate sprinkled on top of a cappuccino. On the rare times when I did eat something with salt, like hot chips, they tasted way too salty. But nice. I want to be there again, as now I need more and more salt to get that salt hit, it's like an addiction!Thanks for the article, it inspires me to try again.
    Comment by: Jenny
    Tracey
    Aug 8 2013 9:24PM
    Thanks for that article. I've had high BP for years but it's much better now (losing weight, exercise, herbal remedies, etc). I was warned about the danger of high sodium intake. I don't like over-salty foods and rarely use salt in cooking, preferring to only use a few grains of salt post-cooking and only on certain foods (some veg, noodles and egg). I've never given it up completely because in years to come they're just as likely to say we're missing something important! My father always said, "Eat anything in moderation." People should take all advice with a grain of common sense.
    Comment by: Tracey
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