Home The "Study" Guide Recent Studies Challenge Anti-Salt Thinking

Recent Studies Challenge Anti-Salt Thinking

by Erika Nicole Kendall

So, this happened, and it’s had a lot of different organizations up in a tizzy about it:

Got an uncontrollable love for the salt?[…] the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day. The group examined new evidence that had emerged since the last such report was issued, in 2005.

“As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms,” said Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania. He explained that the possible harms included increased rates of heart attacks and an increased risk of death.

The committee was not asked to specify an optimal amount of sodium and did not make any recommendations about how much people should consume. Dr. Strom said people should not eat too much salt, but he also said that the data on the health effects of sodium were too inconsistent for the committee to say what the upper limit of sodium consumption should be.

Until about 2006, almost all studies on salt and health outcomes relied on the well-known fact that blood pressure can drop slightly when people eat less salt. From that, and from other studies linking blood pressure to risks of heart attacks and strokes, researchers created models showing how many lives could be saved if people ate less salt.

The United States dietary guidelines, based on the 2005 Institute of Medicine report, recommend that the general population aim for sodium levels of 1,500 to 2,300 milligrams a day because those levels will not raise blood pressure. The average sodium consumption in the United States, and around the world, is about 3,400 milligrams a day, according to the Institute of Medicine — an amount that has not changed in decades.

But more recently, researchers began looking at the actual consequences of various levels of salt consumption, as found in rates of heart attacks, strokes and death, not just blood pressure readings. Some of what they found was troubling.

One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths — 15 as compared with 6 in the higher-salt group.

Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day.

There are physiological consequences of consuming little sodium, said Dr. Michael H. Alderman, a dietary sodium expert at Albert Einstein College of Medicine who was not a member of the committee. As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. Each of these factors can increase the risk of heart disease.

“Those are all bad things,” Dr. Alderman said. “A health effect can’t be predicted by looking at one physiological consequence. There has to be a net effect.” [source]

The articles goes on – and, if you haven’t read it by now, you really should – but there are a few points I want to make clear, here:

1) The last set of dietary guidelines included a upper-limit of 2,300 milligrams of sodium for generally healthy individuals, 1,500 milligrams for those with heart conditions. Those guidelines were published in 2010; one of these studies was published in 2008. If it was more advantageous to the food industry to push this study in favor of them being able to keep their sodium levels up without having to reformulate their recipes, then I’m pretty sure that food lobbyists saw to it that this study got in front of the right people. Right?

So, assuming that it did, why don’t the guidelines reflect as much? Either the study is flawed, or the organizations and governmental departments who backed these figures (and, apparently, doubled down on them in this article) would prefer to save face. (It’s not like there’s no precedence for that.)

2) Food research frustrates me because most research has considered all food as equal, regardless of source – processed food, fast food, produce, whatever. It doesn’t matter because a calorie is just a calorie. When I look at an article on a food study, and I see this:

“Until about 2006, almost all studies on salt and health outcomes relied on the well-known fact that blood pressure can drop slightly when people eat less salt.”

My assumption is automatically that they swapped out whatever processed food a person was eating – and that assumption comes squarely from the fact that most people are eating processed food – and are trading in something far fresher… and, if you’re demanding that people actually cook fresh food, instead? Whew, listen. Their insides might start doing the tootsie roll, they’re so happy.

What I’m getting at is that, in food, it’s difficult to ascertain exactly what is causing the problem and what, exactly, is creating the solution. There are so many variables – is it vitamins? is it minerals? is it the source of the food? is it the kind of vegetable? is it the color? is it something that happens when this vegetable is paired with this fruit? is it a certain macro-nutrient? is it an overabundance of a macro-nutrient? is it a macro-nutrient in the absence of exercise that’s doing it? – that I’d be curious as to how salt appeared on everyone’s radar as the constant in the first place, let alone how you’d test for all those other variables outside of salt, thereby eliminating salt as a contributing factor. And, I would’ve looked at that myself, if I wouldn’t have to spend my entire life’s savings to be able to subscribe to the health journals where this research hides.

3) Remember those dietary guidelines I mentioned earlier? You know, the ones that tell us what to eat, created by a sublet of the governmental agency whose intention is to protect and support the people who grow what we eat? Those guidelines are only up for review every five years. What happens in the interim, when new research comes out that challenges what the government pushes? Those guidelines also affect school nutrition, generic health advice given to people in inner-city environments who use government agencies for support, and practically any nutrition-related policy. Do we just… wait? The people most unlikely to be able to keep up with the Times – probably because they can’t afford it, hell, I can barely afford it! – are also the people most likely to need the information, and if they’re getting it from sources with outdated info because they use what the government hands down, then…

4) Speaking of the information that the government hands down, let’s acknowledge that this research was convened by a government agency against the agency’s earlier decisions. This is what makes funding science research so important – because government enacts policies that affect our everyday lives, and it needs to consistently check itself to ensure that it remains current. Without federal investment into research, the only people doing the work… are the people seeking to profit off of it; any research proving something disadvantageous to a corporation would never see the light of day, no matter how much it might need to be shared. We research, because knowledge equates to improvement, when you know better, you do better.

That being said, whenever you see news about government officials seeking to cut research funding, it should give you pause. Give ’em an inch, and they take your entire 40 acres.

5) Lastly, my column for EBONY this week discusses what I think people should do with this information. Go check that out. (And check it out every week!) If you think this may be a green light to go back to those old processed foods, well… you might have another thing coming.

What do you think?

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Renee' May 21, 2013 - 2:48 PM

I wonder if its also primarily depending on the individual. My entire life, my dad went super heavy on salt. I have tasted something he had and it was way to salty to eat. He could use up a standard size salt in a month. It lasts me for years. My dad rarely ate processed foods though and loved his meat boiled in water. He also loved vegetables. My father never had blood pressure. If he wasn’t a smoker, he would be alive today. Even when he was going through his chemo and radiation, he didn’t have any issues that usually pledge African Americans or cancer patients for that matter. That’s not an excuse to consume loads of salt. My mother is overweight but suffers from hypertension. I think that tells you that not one size fits all. You have to do your own research and figure out what is your “healthy.” I love your site!!!!


Meg July 11, 2013 - 8:38 PM

Sidenote: You may be able to save money on journal subscriptions through seeing what your local library subscribes to and even requesting a few particular ones if they’ll allow it. Also, a lot of universities subscribe via Jstor or Ebscohost and if you know a university professor or student they may give you access via their logins.

Erika Nicole Kendall July 11, 2013 - 11:01 PM

VERY good ideas. I wonder how hard it’ll be to swing that.

Pam August 12, 2013 - 6:43 AM

“created by a sublet of the governmental agency whose intention is to protect and support the people who grow what we eat?”

Excerpted from Recent Studies Challenge Anti-Salt Thinking | A Black Girl’s Guide To Weight Loss

You hit the nail on the head. It’s all about the money in processed foods. That being said, I know that I am salt sensitive. I always have been, even before I was hypertensive, and I eat little to no processed food.

carmie February 21, 2015 - 10:22 AM

It is most definitely about the money in processed foods. I’ve read in a few places that high BP may not even be caused by the sodium intake alone so much as the sodium-potassium ratio. Not a lot of research yet, but here’s a (free-access) lit review from last year that looks promising. And yes, like most nutrition research, some of its funding came from industry sources.


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