Besides rimming your margarita glass, salt is probably the most common seasoning agent out there. However, public health messaging constantly bombards us with guidelines telling us to reduce our salt (i.e. sodium) intake. But, is sodium bad for you?
This article reviews the science on salt health, what sodium does in your body, and why it may not be the villain everyone once thought.
What is Sodium?
Sodium is an essential mineral for the human body. One of its most important jobs is as an electrolyte. Electrolytes, like sodium, potassium, and calcium, are minerals that have an electric charge. They help maintain balance in the body by controlling muscles, nerves, our internal pH, and hydration. If you’ve ever been dehydrated, hungover, or sick from the flu, you’ve probably experienced the not-so-fun side effects of electrolyte imbalances! Extreme imbalances, however, are very serious and can even lead to death.
Does sodium = salt? Not quite. Although the two words are often used interchangeably, they are two different compounds. Sodium is the main mineral and electrolyte (seen on the good ol’ periodic table), while salt is technically two compounds put together to make sodium chloride.
What are the Main Jobs of Sodium in the Body?
Is sodium good for you? Well, we need it to keep the body functioning and in balance!
Our body requires sodium to keep a healthy balance of fluid in our blood and around the cells. When either the sodium level or water volume gets too high, our body sets off a few alarms. This causes our kidneys to filter out more sodium. On the other hand, when sodium or water volume is too low, our adrenal glands (on top of the kidneys) release a hormone that causes the kidneys to keep MORE sodium (1). Your brain also releases a different hormone that tells the kidneys to conserve water. This is why you pee less when you’re dehydrated! Isn’t the body so smart?!
Sodium is also involved in vital body functions such as maintaining muscle contraction and nerve connections.
Sodium deficiency rarely occurs, even in diets very low in salt. However, a true sodium deficiency may occur in certain health conditions such as severe adrenal insufficiency, extensive burns, chronic diarrhea, uncontrolled vomiting, or excessive intake of water pills (diuretics)(2). All these things aside, your body does a pretty great job at maintaining sodium balance in the body thanks to your kidneys.
Research Says…
Sodium is an essential mineral for life. Yet, we’ve been told to avoid it for years! The 2015-2020 Dietary Guidelines for Americans recommends that the average person limits sodium intake to less than 2,300 milligrams (mg) per day. Similarly, the World Health Organization encourages less than 2,000 mg per day. The American Heart Association even suggests that a strict 1,000 mg sodium diet improves blood pressure and heart health (3). The average American intake of sodium adds up to over 3,200 mg per day (4).
Most of these major health organizations recommend limiting sodium, citing connections to high blood pressure, an indicated risk for heart disease.
Does a Stricter Limit of Sodium Help?
A new 2017 research article studying 2,600 men and women for 16 years found that eating less salt did not help to lower blood pressure (5). In fact, the study participants who consumed less than 2,500 mg of sodium per day actually had HIGHER blood pressure than people who consumed larger amounts.
Similarly, another large study looking at over 130,000 people over 49 countries found that people with low sodium intake (categorized as less than 3,000 mg) had a higher risk of heart disease and death than those with moderate intake (around 4,000 mg per day)(6). According to this study, eating moderate amounts of salt did not have the negative consequences reported in government guidelines.
Finally, a study in the American Heart Association’s own academic journal stated that the evidence shows a “J-shaped” association between salt intake and risk of heart attack, stroke, or other chronic heart complications (7). In plain English? The lowest risk of heart disease and death seems to occur in populations eating an average sodium diet (3,000-5,000 mg per day). The researchers go on to write:
“Current evidence would suggest a recommendation for moderate sodium intake in the general population (3–5 g/d), with targeting the lower end of the moderate range among those with hypertension.”
Salt Sensitivity
Research suggests that one in four people fall into a category known as “salt-sensitive.” Basically, these individuals experience a greater change in blood pressure with salt manipulation in the diet (8). These people benefit from more of a salt restriction than the other 75 percent of the general population.
What Gives?!
It turns out that the story behind salt health is much more complex.
Will simply cutting salt in our diet treat and/or cure chronic disease? The research isn’t so convincing. But, we shouldn’t go adding salt to everything either.
Broken down, the research hints that salt eaten as part of a high sugar, processed diet has a much different effect than adding salt as a seasoning to a diet rich in fruits, vegetables, and other wholesome foods. In fact, over 70 percent of sodium eaten in the American diet is from processed foods (9). Much of the other 30 percent is used to prepare baked goods such as bread. So, it makes sense that when people reduce these types of foods, they lower their risk of chronic disease. Perhaps the problem is not the salt itself, but the foods in which added salt is commonly found.
Researchers are now starting to point the finger at another white substance as the main culprit of high blood pressure and chronic disease: sugar.
In one 2014 study, scientists argue that sugar (particularly fructose) may worsen blood pressure (10). Increased inflammation, insulin resistance, and metabolic dysfunction are all key suspects in this scenario.
These researchers concluded:
“It is time for guideline committees to shift focus away from salt and focus greater attention to the likely more-consequential food additive: sugar.”
Don’t Fall Into Traps
By narrowing in on just one aspect of the equation, we sometimes miss the bigger picture. Modern society and diet culture does this all too well. This unfortunate view of food and health is known as “nutritionism,” a term coined by well-known author and activist Michael Pollan. Nutritionism describes the obsession of nutrients rather than the quality of food. The debate, “is sodium bad for you?” is a perfect, and unfortunate, example of this concept.
What if it wasn’t just the salt? Rather than vilify one food aspect or nutrient, look at the entire food. Check where it came from, growing practices, and if/how it was processed.
Addition, Not Restriction
Many lifestyle and nutrition factors benefit blood pressure and chronic disease much more than focusing on salt restriction and finding processed versions of “low salt” foods. Try these…
- For starters, the aforementioned 2017 study on salt intake found that people who had higher intakes of calcium, potassium, and magnesium had lower blood pressure over time than those with just a low sodium diet (5). Foods such as nuts, seeds, fruits, and leafy green vegetables contain these minerals.
- Exercise lowers blood pressure naturally. No need for obsessive cardio either. Studies show that even 30 to 60 minutes of moderate exercise PER WEEK aids in reducing blood pressure (11). Results are even better if you can slowly increase that number to 60 to 90 minutes or more per week!
- Finally, incorporate lifestyle modifications to reduce stress in your life. Activities such as meditation, mindfulness, yoga, or massage benefit blood pressure and your overall health.
Sodium is a necessary mineral of life, and provides many benefits to health and cooking. Severe salt restriction doesn’t affect blood pressure and chronic disease the way the press shows. Instead, focus on limiting added sugar intake, eating a diet rich in plants, and incorporating self-care practices into your life.
References:
- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/overview-of-sodium-s-role-in-the-body
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951800/
- http://www.who.int/news-room/fact-sheets/detail/salt-reduction
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098396/
- https://www.eurekalert.org/pub_releases/2017-04/eb2-ldm041217.php
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30467-6/abstract
- https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.116.303771?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
- https://lpi.oregonstate.edu/mic/minerals/sodium
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098396/
- https://openheart.bmj.com/content/1/1/e000167
- https://academic.oup.com/ajh/article/16/8/629/199247
