April 26, 2018

Salt and High Blood Pressure, part 1

Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.


Is salt really bad for your blood pressure? There is a new book by Dr. James DiNicolantonio called, “The Salt Fix: Why the Experts got it All Wrong – And How Eating More Might Save Your Life.”

He found that patients who were on a low salt diet were having many new symptoms like muscle fatigue, cramps, spasms and heart palpitations. They were ordered not to add salt to food because they have high blood pressure, yet were having all these new symptoms…those of salt deficiency.

Historically, salt has been widely used the world over. It was the primary way to preserve food prior to refrigeration. The rampant increase in high blood pressure didn’t start until the early 1900’s. The rise in hypertension, obesity and diabetes parallels a reduction in salt intake. Salt intake has significantly decreased since the 1930’s, yet all these chronic diseases have gone up.


Does salt intake really correlate with blood pressure? The short answer is no. So why do doctors consistently advise reduction of salt in hypertensive patients? The answer goes back to a flawed study done in 1953 by a guy named Lewis Dahl. This guy, much like Ancel Keys did for the cholesterol hoax, cherry picked a few civilizations to study, those that correlated with his hypothesis that salt caused high blood pressure.

That leaves us with the probability that low salt recommendations does more harm than good when looking at heart health, not just blood pressure. Lowered salt intake changes the total cholesterol to HDL ratio, a better predictor of heart disease, along with triglycerides and insulin. All are worsened and the risk of heart disease goes up.

As your salt levels directly control magnesium and calcium, both are disrupted with a low salt diet. Without enough salt, the body pulls calcium and magnesium from the bone, butting it into the blood to help maintain a normal sodium level. This increase helps keep sodium in the blood by decreasing what is lost during sweating, excreting magnesium and calcium instead of sodium.

This means a low sodium diet is bad for your health, especially your bones and heart, because it causes the body to be depleted of magnesium, an essential mineral for all body functions.

The American Heart Association recommends eating 1 teaspoon (2300mg) of sodium per day and sometimes less than 2/3 tsp (1500mg) a day. This is far too low for normal people.

Dr DiNicolantonia says a normal person with healthy kidneys can consume at least 86 grams of salt per day, that’s 80,000 plus milligrams! He says, “…all the studies show the highest risk of cardiovascular events and early mortality are at a low salt intake, even versus really high amounts of salt. I’m talking 70,000 to 80,000mg of sodium per day. The rise in cardiovascular events may be only around 20 percent [at that rate]versus 3,000 to 4,000mg. If you go low salt [1500mg per day] the heart disease mortality can be increased almost two fold.” That means a super high salt diet may increase your risk of a cardiac event by 20%, but a low salt diet can increase your risk by 200%!

Your body regulates its salt levels on its own, by giving you a craving for salt. If you sweat and exercise a lot, use a sauna, or drink caffeinated beverages, you automatically need more salt than usual. There is little concern for getting too much salt, all excess salt is expelled through the kidneys.

If you drink four cups of coffee, or its equivalent in other caffeinated drinks, you can easily lose 1 tsp of salt in your urine daily. On a low salt diet, this quickly puts you in a deficit in just days.

The next article will follow up on this discussion with other ways to reduce blood pressure and maintain a healthy cardiovascular system.