So you’ve been told by your healthcare provider to limit salt intake because it causes high blood pressure and leads to cardiovascular disease. Unfortunately, the latest research does not support this narrative and avoiding salt may even be holding you back from achieving your health goals. Low salt intake can cause serious health conditions; responsible for increases in insulin resistance, obesity, diabetes and cognitive impairment.
We’ve been told over the last 40 years that salt is bad for us. Ironically, the only time people now get adequate amounts of salt in their diet is when they are eating processed/packaged foods or take-out. Like other processed foods, processed salt is adulterated in much of the same way, exposed to high heat, bleaching and added chemicals like anticaking agents. Of course, I am not suggesting this is the type of salt to increase in our diet. However, high-quality salt like pink Himalayan is the best way to increase hydration and replenish important minerals. Therefore, broad stroke recommendations like all salt should be limited to 1 tsp per day are dangerous and potentially disease-promoting.
Restricting salt could be holding you back from reaching your health goals. The closer we can get our diets to the way they were 12,000 years ago while humans were hunter-gatherers, the more health-promoting they will be. Studies have shown that people in the 1400s consumed closer to 100g of salt per day by eating foods that were preserved with it. Current recommendations for salt intake in Canada are 1500-2300mg per day or just over 1 teaspoon. This is a dramatic difference, but the occurrences of high blood pressure and heart disease are still climbing regardless of our current low-salt culture. Humans evolved from the sea and our blood chemistry is remarkably similar to the minerals in seawater, especially salt. People with a healthy set of kidneys can filter more than 100x the recommended salt intake per day. The kidneys actually have to work harder to retain more salt when we are low, compared to their ability to simply excrete it when high.
Additionally, the health consequences that come along with sodium depletion are more serious than the mild, temporary effects of too much. Even people with existing hypertension have minimal changes in blood pressure with increased salt consumption. Over the last 40 years, low salt guidelines have been lobbied by the sugar industry to avoid policy change against their highly profitable product, which has led experts to ignore evidence of its involvement in increased rates of hypertension and heart disease. Legislation is sadly often led by money rather than good science. Low salt intake leads to other mineral deficiencies like low potassium, iron, iodine and other electrolytes that can cause fatigue, headaches, increased heart rate, adrenal insufficiency, thyroid dysfunction and bone density loss. Not exactly recommendations we want to be giving to our elderly populations that are already fighting a battle against osteoporosis.
DISCLAIMER: The following information in this article, along with all information on LoLoHealthCo.com is for educational purposes only. It is not meant to replace medical advice. Please use this information to work collaboratively with your healthcare provider to ensure you are getting personalized high-quality medical advice.
THE BENEFITS OF SALT
Salt makes healthy food taste good. Salt improves the flavour of your food, brings out the natural sweetness, decreases bitterness and makes healthy foods more enjoyable. As one of my favourite behavioural change researchers James Clear talks about in his book Atomic Habits, one of the best ways to create a healthy habit is to make it attractive. Making it enjoyable will the likelihood of being repeated and becoming a habit. When we make healthy food taste good, we are more likely to turn healthy eating into a habit. For this, you need both salt and fat – two things the government has been telling us to avoid for the last 30 years – no wonder people have been turning to junk food to satisfy their cravings.
Salt makes nutrients more bioavailable. eating veggies with fat, salt and acid optimizes your body’s ability to absorb their antioxidants, vitamins and minerals. Plant foods already have a lower bioavailability than animal foods therefore, ensuring you take in enough salt can help optimize the beneficial nutrients available in veggies.
Salt improves digestion. One of the best ways to eliminate GI symptoms or gastric reflux is by consuming more salt. Contrary to popular belief, acid reflux is caused by too little acid in the stomach, not too much. This is why taking antacids or acid blockers makes this condition worse. Salt (Na+Cl) is needed to make hydrochloric acid (HCL) to maintain the proper pH of the stomach, which is essential for pH-dependent enzymes to break down protein and ensure the lower esophageal sphincter stays tightly closed. Other things can mess with our body’s ability to keep this pH within its normal range, but low salt is one of them. When pH rises in the stomach (becomes more alkaline), this sphincter loosens causing backflow of acid into the esophagus burning the tissues causing the “heartburn” sensation. Heartburn is annoying, but it’s also dangerous for the lining of your esophagus, which becomes damaged, leaving these cells prone to cancer formation. Na and Cl are also needed by the liver to make bile acids, which are essential for the digestion of fats in the GI tract. If you suffer from indigestion or acid reflux, try incorporating organic grass-fed bone broth into your diet. It is a rich source of salt and minerals, which will help achieve optimal pH balance and heal the gut with its rich protein and collagen content. You can also try supplementing with Betaine HCl to increase the acidity of the stomach.
Salt improves athletic performance and hydration. Hydration is essential for good energy production, immune function and cellular performance. Muscle cells need sodium to create the electrical potentials used to contract muscle fibres. Low sodium means less energy available for movement. Salt is essential for good mitochondrial function, which are the cells that create energy for your tissues. Increased mitochondrial function can help you burn more fat and maintain a healthy weight. Sodium is the primary mineral lost following exercise, you can lose up to 1g of sodium in a sweat session. Restricting salt post-workout is analogous to restricting water post-workout – it’s dehydrating and causes your body to work harder to restore these losses. The kidneys also use salt to help clear nitrogen from the blood which is a byproduct of protein metabolism. If you are active and consume more protein, your salt requirements will be higher.
Salt reduces cravings for sugar and carbohydrates. Salt can help you lose weight by reversing overactive hunger hormones and improving insulin sensitivity. Salt decreases the desire to consume sugar and carbs, which helps regulate blood sugar levels. Low salt causes the pancreas to release more insulin because it promotes the release of aldosterone, which tells the kidneys to retain more salt. Increases in insulin cause weight gain, leading to insulin resistance and type 2 diabetes. Elevated blood sugar levels also promote leptin resistance, which is a key hormone in regulating hunger signals. Resistance to leptin leads to overstimulation of huger by blocking satiation, leading to weight gain. Increasing our salt intake improves insulin sensitivity and allows your body to naturally regulate blood sugar levels and fluid balance. Salt operates on a negative feedback loop in our body, meaning when salt levels are within an optimal range, our body will stop sending craving signals for more energy, making you feel calm and satisfied when you have consumed enough salt. Our body is the expert in our health, listening to these signals will always serve you better than following restrictive advice from health authorities.
Low carb diets: require even more water, salt and mineral replacement. The body naturally makes ketones for energy when you go on a low-carb diet. Ketones cause the loss of water and sodium in the urine because more glucagon (counter-regulatory hormone to insulin) is being released, causing salt wasting in the kidneys. Low insulin also lowers the production of aldosterone from the kidneys, preventing salt retention. Low aldosterone and high glucagon will cause us to lose sodium and other electrolytes, which can quickly deplete our blood levels. Therefore people who consume fewer carbs (or fast) need to be mindful to take in even more salt and minerals than normal.
Salt promotes heart health. Low serum (blood) sodium causes a decrease in blood volume, causing our heart to pump harder to deliver oxygen and nutrients to our organs and tissues. An increase in heart rate means the heart muscle needs to work harder and requires more oxygen to work at this faster pace. Over time, this can lead to stiffening of the heart walls, leading to more serious heart function issues. Salt is needed by the heart’s muscle fibres to create electricity for pumping. Too low salt can cause dangerous arrhythmias, which is why we monitor serum sodium levels closely in the hospital, along with other electrolytes like potassium and magnesium to ensure patient safety.
Salt improves mineral deficiencies. Salt increases your absorption of other important minerals like magnesium, potassium, phosphorus and iodine which are essential for energy production and thyroid health. Sodium pulls vitamin C, biotin and other water-soluble nutrients into the blood where they can be used by your cells. Minerals are used for everything from building strong bones, to cofactors for enzymes and for activating antioxidants as magnesium does for Vitamin D.
Salt is important for brain health. Vitamin C is an essential nutrient in the brain that acts as a potent antioxidant, helping neurons stay healthy and protecting the brain from oxidation. Vitamin C uses salt as a transporter into the brain, so when sodium is low, brain health can suffer and contribute to cognitive dysfunction Vitamin C is also essential for making neurotransmitters, which can be suppressed if this nutrient is limited.
Adequate salt is essential in pregnancy. Mineral deficiencies are common during pregnancy and breastfeeding – our requirements typically double during these periods. Nutrient deficiencies cause our body to crave energy in the form of sugar and carbohydrate in hopes of enticing us to eat something with energy density. This is why women have such strong pregnancy cravings. Iodine is another important nutrient during pregnancy. Avoiding salt can lead to iodine deficiencies that can have a direct impact on the growing baby. If you’ve experienced strong cravings during pregnancy, remember this is your body telling you it’s lacking something – you don’t want your body will start robbing Peter to pay Paul by stealing sodium and other minerals from mom’s bones and teeth, resulting in bone density loss throughout pregnancy. One cavity per baby is the average tooth decay commonly seen for mothers today. P.S. did you know that nausea in your first trimester can commonly be treated or prevented with salt! Nausea can be caused by low salt and electrolytes in the blood, which is why nausea is so common with hangovers. Next time you experience nausea, try drinking some organic grass-fed bone broth or pickle juice, both are high in sodium and will help calm this feeling naturally.
Salt improves bone health. Low serum sodium might not necessarily be detectable on a blood test due to your body’s internal homeostatic mechanisms to maintain healthy sodium levels. If we are salt depleted, the body will start breaking down bone matrix in long bones and teeth, as these are our body’s best stores of sodium. Breaking down bone to maintain proper fluid balance is a great way to achieve early osteoporosis and tooth decay. Ensuring we eat enough salt keeps minerals in our bones where they are needed, especially later in life when our bones start to break down bone matrix quicker than it is replaced. Salt is also needed to make blood in the marrow of the bone. Low salt can lead to low blood turnover in the body which can have a variety of consequences on health.
Salt is important for the immune system. More water and plasma are needed in the blood when the body is trying to fight infection. Low salt depletes this resource and weakens the immune system. The body may compensate for these low levels by pulling water from our skin and other organs, leaving these areas more prone to infections (like UTIs) and slowing wound healing. Salt and water are part of the body’s natural antimicrobial defence system, which is weakened by low salt intake.
Salt is wasted by caffeine, drugs and exercise. Salt is lost when we sweat, drink caffeine or consume some pharmaceuticals (like SSRIs and blood pressure medication). Low salt intake and dehydration cause the body to work harder to break down pharmaceuticals and eliminate them through the kidneys.
HOW SUGAR CAUSES HIGH BLOOD PRESSURE + CVD
Salt improves cardiovascular health. Yes, you read that right, salt is an essential nutrient for good cardiovascular health. Despite the extremely low recommendations of 1500mg of salt/day, which is barely enough to avoid other medical conditions, hypertension has risen over 30% in the last 100 years. Conversely, sugar intake has exploded over the last 100 years rising from an average of 112g/day to now over 300g/day (300% increase). Low sodium levels increase insulin in the blood, which contributes to the development of insulin resistance and obesity. People with insulin resistance or diabetes are at a 3x higher risk of dying from cardiac events like a heart attack or stroke. Furthermore, low sodium in the blood increases its viscosity (thickness) and increases platelet aggregation, meaning that your blood is more likely to form clots that increase the risk for heart attack and stroke – ironic since we put all cardiac patients on a low salt diet in the hospital.🤦♀️
Higher blood sugar levels also increase triglycerides, which is another independent risk factor for developing heart disease. High insulin and triglyceride levels lead to the narrowing of arteries and the development of atherosclerosis. Insulin resistance also inhibits the vasodilatory effects (widening of vessels) of insulin in the body via nitric oxide production, therefore insulin resistance causes vasoconstriction, which leads to endothelial cell wall dysfunction and hypertension. When sugar hangs out in our vessels for too long, a process called glycation occurs resulting in the formation of Advanced-Glycation End Products (AGEs). These are formed through the glycation of protein and fats in the blood as a result of exposure to sugars. These AGEs stiffen vessel walls causing increases in blood pressure and contributing to plaque formation. AGEs have also been implicated in damage to the kidneys and the brain, causing kidney disease and Alzheimer’s disease. As you can see, maintaining healthy blood sugar levels is paramount in achieving good cardiovascular and brain health.
HOW MUCH SALT DO WE NEED?
Rather than making our body scavenge salt from other parts of the body to meet its requirements, adequate salt intake is a simple and delicious solution. As mentioned, salt works on a negative feedback loop; salting our food to taste is an easy way to ensure we are getting enough. Dr. Cate Shanahan, an expert in nutrition suggests that an optimal intake of salt is 5-10g or 1-2.5 teaspoons per day, with higher intakes if you are exercising, consuming caffeine or taking salt-wasting medications. If you have a healthy set of kidneys, there is no need to worry about consuming too much, your kidneys can easily pass excess in our urine as we have seen in the examples above. The consequences of taking in too little salt far outweigh the minimal effects of too much.
Note: if you suffer from a cardiovascular condition known as heart failure, you may need to be more careful with salt intake. Take this information to your cardiologist and ask him how you can optimize your electrolytes in a way that is safe for you. The same goes if you have kidney dysfunction, consult your nephrologist and ask him this same question).
WHAT ARE THE BEST TYPES OF SALT?
Consuming high-quality salt is important. Eating naturally salty foods will ensure adequate levels to optimize your health. Foods like olives, pickles, sauerkraut, kimchi, seaweed/sea vegetables, bone broth, shellfish and nuts are all naturally good quality sources of salt and minerals. They also happen to be good for our gut health. Additionally, salt your food to taste with high-quality salt that is rich in trace minerals. Avoid processed salt, which is bleached and has other harmful chemicals added, along with low mineral content.
There are two types of salt you can buy – mined and evaporated.
Mined salt comes from an ancient salt bed in the earth. One example of this is Himalayan pink salt mined in the Himalayan mountain range. It gets its natural rosy hue from the presence of other beneficial minerals such as iron, potassium, magnesium, and calcium. This is one of my favourite sources of salt due to its mineral content and low risk for contamination with environmental toxins. Redmon’s Real Salt is another, which is sustainably and ethically mined in Utah. This salt comes from an ancient mine protected from pollutants and contains 60 naturally occurring trace minerals.
Evaporated salt comes from a brine, which is evaporated to leave salt crystals. A common example of this is sea salt. Sea salt also contains trace minerals and iodine, but with increased pollution in our seas, sea salt can sometimes contain unsafe levels of microplastics, heavy metals and chemicals depending on the brand.
I hope you enjoyed this content and are able to make a more informed decision about your health with this information in mind. Let us know what you think over on Instagram @lolohealthco
B M Egan, A. B. (1991). Neurohumoral and metabolic effects of short-term dietary NaCl restriction in men. Relationship to salt-sensitivity status. American Journal of Hypertension, DOI: 10.1093/ajh/4.5.416.
Bikman, D. B. (2020). Why We Get Sick. Dallas, Tx: Benbella Books.
DiNicolantonio, D. J. (2017). The Salt Fix. New York: Harmony Books.
DiNicolantonio, J. J., & Lucan, S. (2014). The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart, DOI:10.1136.
Follow, B. a. (1998). Importance of the blood pressure-heart rate relationship. Blood Pressure, 7(3): 133–138.
Freedman, D. A. (2001). Salt and blood pressure. Conventional wisdom reconsidered. Evaluation Review, DOI: 10.1177/0193841X0102500301.
Graudal, N. (2005). Commentary: possible role of salt intake in the development of essential hypertension. International Journal of Epidemiology, 34: 972–974.
J P Midgley, A. G. (1996). Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. JAMA, DOI: 10.1001/jama.1996.03530440070039.
Jaimon Kelly, S. K. (2016). The effect of dietary sodium modification on blood pressure in adults with systolic blood pressure less than 140 mmHg: a systematic review. JBI Database System Rev Implement Rep, DOI: 10.11124/JBISRIR-2016-002410.
Johnson, R. (2012). The Fat Switch. Retrieved from Mercola.com
Kearns, C. E. (2016). Sugar industry and coronary heart disease research: a historical analysis of internal industry documents. JAMA Internal Medicine , 176(11): 1680–1685.
Shanahan, D. C. (2017). Deep Nutrition. New York: Flatiron Books.
Taubes, G. (2007). Good Calories, Bad Calories. New York: Knopf.
Tomoko Gomi, Y. S. (1998). Strict dietary sodium reduction worsens insulin sensitivity by increasing sympathetic nervous activity in patients with primary hypertension. American Journal of Hypertension, 9: 1048–1055.