Forget Salt

From May:

A new JAMA study finds a strong correlation: the third of folks who eat the least salt die over three times as often as the third of folks who eat the most salt. (more)


[A] new analysis … conducted …. for the Cochrane Collaboration … analyzed 167 studies conducted between 1950 and 2011 that compared people who consumed low-sodium versus high-sodium diets. Low-sodium diets did cut blood pressure levels in people with high and normal blood pressure. … But it also significantly increased other risk factors for heart disease, such as cholesterol levels, triglycerides, adrenaline and renin, the researchers reported in the American Journal of Hypertension. “These results do not support that sodium reduction may have net beneficial effects in a population of Caucasians.” (more; study)

The official response is no change in official advice:

U.S. health officials recommend that adults get no more than 2,300 mg of sodium daily. … “We eat a lot of sodium — way too much — and I don’t think it’s going to hurt anybody to lower sodium in the current American diet,” Penny Kris-Etherton, a spokesperson for the American Heart Association [said]. (more)

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  • Michael

    Yet another in a litany of studies that establishes that at best, salt reduction may help some small proportion of the population with high blood pressure (i.e have both high blood pressure AND sensitivity to salt), yet may also increase coronary problems for others. All the way back in 2000, based on the enormous Intersalt study:

    “Therefore, on the basis of the existing evidence, it seems highly unlikely that any single dietary sodium intake will be appropriate or desirable for each member of an entire population.” Michael H. Alderman. “Salt, Blood Pressure, and Human Health” Hypertension. Vol. 36 (2000), pp. 890-893.

    The lag time between current science and public policy suggestions is often quite large. In any event, it is extremely rare that blanket nutritional guidance is useful for everyone unless it is very vague (e.g. “eat lots of veggies”).

    • Todd

      Well, I just happen to be one of those people who is sensitive to salt. So what are we supposed to do? Eat gruel while everything else is filled with salt?

      I understand the impulse, but there needs to be a reasonable way for people like me to eat while keeping my dealings with salt to a minimum. After all, we don’t hide other allergens in the environment. We notify so that people can deal with them accordingly. Why not the same respect to salt?

  • Wonks Anonymous

    One plausible idea I’ve heard is that when you take away one tasty ingredient, people try to substitute with something else.

  • hyp

    I see some correlation that people who show off caring about healthy food have already experienced some health problems. Instead of finding new correlations on what would fix their health they moralize what everybody should eat from now on by associating with current good looking health ideas.

  • Jeff

    It’s carbs.

  • ezra abrams

    is your lead sentance accurate ?
    I don’t think they looked at how much salt people eat, but how much they excrete in a 24 hour period.
    There is a difference.
    there is also a huge logical hole here: you don’t really know, from the presented data, if the people with low sodium excretion are the same as the people with high Na excretion; on superficial characteristcs (age, sex) they are at baseline, but I don’t think the data excludes hypotheses like the following: people with high sodium excretion are healthy people who exercise a lot , and therefore have more sodium excretion….
    That may or may not be true, but it doesn’t seem to be excluded by the data.

    • Evan

      by a simple mass balance, the amount of Na secreted must equal the amount of Na taken in.

      • Yes, though they only looked at “urinary sodium excretion” – not sweat, fecal or other routes.

  • ezra abrams

    There is another logical hole in your blog post: It is not clear what the official response is relative to the study cohort.
    In the study, low med and high were 120, 190 and 290 (mmol/day) for men.
    If the high value here (290 mmol/day) is less then the avg of the US population, the JAMA study and the official response could both be correct

    In any event, if you look at WESCOPS or S4I, you can infer that you need a lot more people followed longer and more closely; the real question here is why the biomedical research establishment can’t get off its **s and enroll 10 or 20 thousand people in a salt study

    • kebko

      So you’re both right….You should always take Robin with a grain of salt….

      ooh, sorry.

    • I believe those numbers are mmol of sodium, which means to get mg we multiply by the atomic weight of sodium (23). So these are low=2760mg, medium=4370mg, high=6670mg. Average american salt consumption is about 3400mg/day. So the high value here is not less than the average of the usa population.

      A full pdf of the study is here

  • What a comedy. It’s like a fiction you’d fabricate to flourish the folly of foolish thinking.

    Doofus McDoctor: People eat too much salt.
    Studious Scientist: Hold on, I’ve found evidence that people who eat the most salt have very few health risks compared to people who eat very little salt.
    Doofus McDoctor: People eat too much salt.

    The alliteration opportunity in the first sentence was too good to pass up. I sincerely apologize for that.

  • John Terry

    The right question to ask from a chef’s perspective is, “Does it taste good?”

    • I think that should be the right question from everyone’s perspective.

  • Dave

    The cause of premature death is determined by epidemiological studies buttressed by ” scientific/ political theory” .

    A combination of risk factors is often behind premature death. Eating salt,eating simple carbohydrates such a white rice, lack of vigorous workouts, and social inequality are factors thought to cause premature death.

    That explains why Japanese women have such short lives?

  • Lord

    What I would want to see is those consciously modifying their diets vs those not doing so. Conscious low sodium diets may be the result problems, not their cause.

  • Terrance Firma

    This salt hoax has become so large with so many public health institutions ascribing to it, the government has no idea how to get out of it – so they carry on with the myth that reducing salt is beneficial. By far the preponderance of medical evidence cautions against population-wide salt reduction – do the anti-salt people believe they can hide these publications of deny their significance forever?

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