Too little salt or too much salt?

Is everything I’ve written about salt wrong? As well as that of Stephen Havas, Professor of Epidemiology at the University of Maryland?

He claims that “the number of deaths from excess salt is equivalent to a commuter jet crashing every day in the U.S. And that people should be outraged”. Now, a report from the Institute of Medicine (IOM) suggests instead that low sodium intake can be harmful for some people!

IOM analyzed nearly 40 studies and found that high amounts of sodium are associated with increased risk. This has always been the theory of the American Heart Association. But the report proposed that low sodium intake could be risky for those suffering from heart failure. Moreover, the report showed no evidence that a low sodium intake of less than 2,300 milligrams (mgs) benefited those suffering from diabetes or chronic kidney disease.

Media headlines following this announcement conveyed the impression that consumers did not have to worry about salt. Or that they should consume more salt. In fact, why not sprinkle more of it over your fries? Several blogs said, “Salt isn’t so bad after all”.

So how much salt do we really need? Dietary guidelines suggest no more than 1,500 mgs daily. But the majority of North Americans consume a whopping 4,000 mgs. daily. Studies routinely show that the greater the amount ingested, the higher the risk of hypertension.

High blood pressure is like too much air in a tire. The heart has to work harder and arteries in the brain may rupture, causing a stroke. Increased blood pressure in the kidneys may also result in kidney failure.

A high sodium diet increases the amount of calcium excretion in the urine. This calcium is removed from bone and increases the possibility of bone fractures. But one problem often leads to another. For instance, the more calcium excreted in the urine the greater the risk of kidney stones.

High dietary sodium has also been linked to the risk of stomach cancer. Salty foods may affect the stomach lining making it easier for the bacterium H pylori, a cause of stomach ulcers and cancer, to infect tissue.

Studies also show that one in two North Americans over the age of 65 suffers from hypertension. Moreover, the Framingham Heart study in the U.S. reported that at age 75 nine out of ten people have high blood pressure. Contrast this to the non-industrialized countries that consume little salt. The blood pressure of their citizens does not increase with age.

Today, pharmaceutical companies make billions warning us on TV about the hazards of high blood cholesterol. But don’t hold your breath for ads alerting you to the dangers of excessive salt. There’s no pill to correct this problem. Rather, you have to learn to use your wits. Be a smart shopper.

The best start is to read labels. I recently had three thin slices of salami for lunch. I was surprised to read that I’d just consumed 810 mg of salt. Grocery shopping is not high on my list of priorities. But next time I’ll purchase a low salt brand such as President’s Choice Blue Menu uncured turkey breast that has only 60 mg in three slices.

If you choose the wrong salad dressing, two tablespoons could contain 500 mg of salt. Compare this to President’s Choice Blue Mango Vinaigrette with a mere 10 mg.
And consider that most hamburgers have 1,100 mg, chicken pot pie 1,420 mg and a Rueben sandwich 3,270 mg. And remember that most packaged foods are loaded with salt.

To avoid excess salt, buy foods with a single ingredient such as fruits, vegetables, meat, poultry, grains, nuts and fish. Food chains also have fruit salads that contain a mere 70 mg of salt.

How much does smart shopping pay off? Norman Kaplan, an expert on hypertension at the University of Texas, says lowering salt intake to 2,400 mg has about the same effect as blood pressure medications.

The real message is that most people don’t have to worry about low salt intake. Rather, it’s high salt that kills the majority.

Dr. W. Gifford-Jones (Dr. Ken Walker) has published a weekly medical column in Canada for the past 30 years. Visit his website docgiff.com and send comments to [email protected].