Q. About 50 years ago we were told to cut way down on salt. My brother Elmer always ate a lot of salt anyway and was always more healthy than I was. Unfortunately, he was killed in an automobile collision when he was 85.

I am now 86. When I stopped restricting salt, my health improved. If salt causes some people problems, they should avoid it. It doesn’t make sense for the rest of us to deprive ourselves.

A. It has been an article of faith for decades that everyone should reduce salt intake, but the data don’t show that limiting sodium consumption makes a difference for otherwise healthy people.

The latest research in the Journal of the American Medical Association (May 4, 2011) reported that lower salt intake was not associated with lower blood pressure. The people who consumed the least salt had the greatest risk of death from cardiovascular complications.

As paradoxical as this seems, it is consistent with previous research. A national nutrition survey (Journal of General Internal Medicine, Sept., 2008) found that low sodium intake was linked to higher cardiovascular mortality. A recent study of people with type 1 diabetes found that those with the lowest sodium intake were most likely to die during its 10-year duration (Diabetes Care, April, 2011).

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  1. cpmt
    Reply

    Yes, SEA SALT has Iodine and many other minerals depending on the area where it is collected. Besides Rock salt from Utah, CELTIC SALT AND HYMALAYAN
    SALT have lots of minerals including iodine and magnesium.

  2. DR
    Reply

    I’m 68 and deal with asthma, allergies, sinuses and cholesterol. A particularly irritating side effect from meds is a dry mouth and thrush. While cutting out various potential causes, I quit salt. No help for dry mouth, but I lost 10 pounds in less than a month, which was quite startling. My asthma doctor inquired about the weight loss during my next visit, I told him; salt, and he said “no more water retention”.
    Now you say salt is not bad. All I gave up was chips, pretzels and the salt shaker. So I think I’m really getting enough salt right? Your recent column enlightened me to Cetirzine in my Zyrtec, which I had tried to give up several times but had terrible withdrawal symptoms like I had bugs crawling all over me.
    Ultimately, I just cut back gradually by taking 3/4 pill daily for 6 days, then 1/2 pill for 6 days, then 1/4 for 6 days. I finished this regimen several days ago and seems to have worked. I enjoy your column! Keep the information coming.
    PEOPLE’S PHARMACY RESPONSE: THE RESEARCH APPLIES TO A POPULATION, AND NOT TO SALT-SENSITIVE INDIVIDUALS. IT SOUNDS LIKE YOU ARE SALT-SENSITIVE AND YOU’RE DOING WELL TO CUT THE SALT.

  3. Cardiac Kid
    Reply

    How can you possibly say salt is OK for heart patients? Salt is the worst thing a heart patient can take over the daily recommended amount of 1,500mg.
    The AMA does not support taking salt. where are you getting this misleading information?
    Reducing dietary salt intake by as little as half a teaspoon a day could significantly cut cardiovascular disease risks and health care costs, according to a study published Jan. 20 online in the New England Journal of Medicine.
    Researchers used the Coronary Heart Disease Policy Model to quantify the benefits of reducing dietary salt intake by as much as 3 g per day. The population-based model is a computer simulation of heart disease in adults ages 35 and older in the United States.
    The data projected that cutting salt by 3 g each day would lower the annual number of new coronary heart disease cases by approximately 60,000, stroke by 32,000 and myocardial infarction by 54,000. Financially, researchers estimate that the nation would save $10 billion to $24 billion each year in health care costs (content.nejm.org/cgi/content/abstract/NEJMoa0907355v1/).

  4. KrampDPharmD
    Reply

    It seems like for those that do not have hypertension (high blood pressure) reducing salt intake is unnecessary. For those with high blood pressure reducing salt intake seems like a great first step in therapy, in addition to regular exercise, and weight loss if a person is overweight. All medications have side effects, so it certainly would be better to avoid them if possible by restricting salt intake, thus reducing blood pressure without medication.
    Its also important to keep in mind that electrolytes, or minerals, that you eat can have a big effect on your health. Low potassium levels have been linked to increased onset of diabetes. People that do not have enough calcium or magnesium in their diet also are more likely to have heart problems–because the heart contracts by moving around calcium, potassium, sodium & chloride. For people that are recovering from an injury potassium, magnesium and phosphate are necessary for the body to repair its cells–in addition to eating enough calories.
    To answer Steve’s question: Yes sea salt has iodine in it, while rock salt typically does not. However the amount of iodine in sea salt varies.

  5. Cindy B.
    Reply

    I love salt and used to eat it out of my hand regularly. Now I’ve stopped doing that but still sprinkle it copiously on food. I am now 60+ and my BP yesterday was 108/62. Not bad, eh!

  6. STEVE
    Reply

    Does sea salt have iodine in it?

  7. ECC
    Reply

    I’ve had high blood pressure since about 1990, and (like just about everyone else with high BP) was always told to cut way back on salt/sodium intake along with taking a BP med. I had totally given up the regular store-bought iodized salt and was using sea salt in very limited quantities for a while. Then recently I read about Himalayan pink rock salt and found it at a reasonable price at a local natural/health food store.
    Now I only use the Himalayan pink salt. It’s so flavorful that a very, very small amount does the trick. Of course, having such limited salt intake in the past makes most foods taste too salty to me anyway, but I really enjoy a light sprinkle of the pink rock salt — a little certainly goes a long way.
    My BP hasn’t suffered at all either as my BP readings for the last 3 days are 107/68; 116/64 and 107/70. (I’ve been on a no sugar, low-carb diet for about 2 years so that helps as well, but that’s a subject for another forum.) My doc is seriously considering cutting my BP med down.
    I would think that he rock salt from Utah probably has the same type of properties as the pink rock salt. Like others here, I no longer use sea salt due to the impurities/pollution of our ocean waters. I’m female and will be 67 years old in August.

  8. rb
    Reply

    When it was discovered that iodine deficiency was the cause of goiter, which was prevalent in many parts of the country, iodine was added as a trace element in table salt. It worked well until the medical profession determined that salt was poison. Salt consumption went down. Thyroid problems increased.
    Observe how many obese people have the telltale swollen neck indicating a thyroid deficiency. Sodium is an essential trace element as are iodine, calcium, and magnesium. An imbalance of these essential electrolytes can cause a host of symptoms including weight gain, palpitations, irregular heartbeat and muscle twitches and cramps.
    The medical profession seems to have lost sight of the fact that nutrition is an essential element of healthcare and well being.Hippocrates said,”Let food be your medicine”. This seems to be totally overlooked in the new medical philosophy, “Better living through chemistry”.

  9. JRB
    Reply

    I’ve spent fifty years persuading my body not to like salt nor to want much of it. I’m not going to throw all those modified recipes and careful menu selections out of the window.

  10. a.s.
    Reply

    my own doctor (at least 2 of them over the years) have told me that if an individual is sensitive to salt, it might aggravate hypertension.

  11. RL
    Reply

    This article is the opposite of recent studies that healthy folk should all limit salt to 1,500 mg-2,000mg per day. I am being treated by one of the lead research cardiologists at the Cleveland Clinic. Since limiting my salt my blood pressure med was cut in half and the other med dropped. BP is lowest it has been in years. I also no longer get short of breath. (I am no longer retaining fluid in my lungs or legs) The newest studies I have read indicate that salt intake is directly tied to elevated blood pressure… which can lead to many health issues… including heart failure.

  12. MISH
    Reply

    Common table salt is mostly Sodium Chloride with some additives. I suggest trying the Rock Salt from Central Utah. It is an Ancient Sea Salt that is real flavorful and has over 60 naturally trace elements including Iodine. Not all Seal Salts are created equal. Due to pollution issues I am not fond of Sea Salt derived from our present ocean seas.
    This Rock Salt is so flavorful that I find I am using less salt to flavor my food. I suggest one go to a good health food store and try this Rock Salt. Once you do I believe you will never go back to standard table salt.

  13. mkmk
    Reply

    However, in the particular journal article, it states that individual sensitivity to salt can be heterogeneous and that salt sensitivity was not determined for individuals in study. Also, the study focused on Caucasians, not African Americans.

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