Shake That Salt Habit!

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Has your doctor ever told you to decrease your salt intake? Have you ever wondered why? Have you worried about food tasting bland if you do?

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While high salt intake is linked to increased risk of a lot of bad things, including stomach cancer and osteoporosis, its effects on blood pressure are dramatic.

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We know the high rates of salt intake will increase your blood pressure, and decreasing salt intake will lower your blood pressure. 

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A recent study revealed that just 1 week on a low-sodium diet resulted in an average blood pressure reduction of 8 “points”, and that 75% of people achieved lower blood pressure on a low sodium diet. This study enrolled people with normal blood pressure all the way to uncontrolled high blood pressure. So this is an intervention that would work for a whole lot of people.

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And since we know that blood pressure is the main cause of  >60% of strokes and ~50% of heart attacks, then salt MUST play an important role in these horrible events.

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Salt is made up of two elements: Sodium and Chloride. While both are important for human health, sodium definitely has the more dominant physiologic role.

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In ancient times, humans consumed less than 250mg of salt per day. The modern use of salt can be traced to about 5000 years ago when the Chinese discovered that it could be used to preserve food. With the advent of refrigerators and freezers, salt was no longer required for preservation, and intake started to decline. Unfortunately, the large increase in consumption of processed foods in the Western world once again led to a spike in the intake of salt.

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The recommended intake of sodium for most adults is <1500mg each day. That's only about 1/2 of a teaspoon. Unfortunately, the standard American diet averages 3,900mg/day of sodium intake!

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Part of the problem is that people are simply unaware of the importance of limiting sodium in the diet. One research survey showed that 59% of US Adults were “not concerned” about their salt intake, 70% did not know what the guidelines are, and only 38% felt that limiting sodium was important for a healthy diet. The other big problem is that most people don’t realize that the majority of salt in their diet does NOT come from the salt shaker on the dinner table. In fact, that only accounts for ~10-15% of the sodium in a typical diet. The vast majority is ALREADY IN the food we eat, before it arrives on the table.

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The food industry uses so much sodium in the production process, it is really hard to get below the guidelines without being aware of your intake and active effort to reduce it.  Some restaurants can have more than 4000mg of sodium in just one meal!

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Recent studies have taken a different approach to solving this massive healthcare problem. Because consumers and food companies are both reluctant to decrease the amount of salt in the food supply due to concerns about the effect on taste, there is now a movement to increase the use of salt substitutes. These salt substitutes are products that generally are a mix of 75% sodium chloride & 25% potassium chloride. Recent research showed that using these types of substitutes still has a significant health benefit. 

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In one recent study, this type of salt substitute still led to an 8 “point” drop in blood pressure and a significantly lower percentage of people developing high blood pressure over the course of the trial. 

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And in another larger study, use of these substitutes led to a significantly decreased rate of stroke: 14% lower with the 75/25 salt substitute than with regular 100% sodium chloride salt! Additionally, the rates of major cardiovascular events were 13% lower and the rate of death was even 12% lower.

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All of this research really reveals the power and importance of shaking your salt habit.

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At Wisconsin Cardiology Associates, we counsel our patients to aim for a whole foods, plant-based diet, emphasizing fruits, vegetables, beans, lentils, whole grains and nuts. This diet will naturally be low in sodium.

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Gupta, DK et al . JAMA 330(23):2258-66.

Zhang X et al. JACC 2024 83:711-22.

Neal B et al. N Engl J Med 2021; 385:1067-1077

Photo by Faran Raufi on Unsplash

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