Salty Fears

A new analysis of data from the National Health and Nutrition Examination Survey (NHANES) finds that high salt consumption is not associated with an increased risk of cardiovascular disease. In fact, the subjects who consumed the least salt (but who were not on special low-salt diets because of pre-existing conditions) were 80 percent more likely to die from cardiovascular disease than the subjects who consumed the most salt. "Our findings suggest that for the general adult population, higher sodium is very unlikely to be independently associated with higher risk of death from CVD or all other causes of death," says the lead author. These results, which are consistent with earlier analyses of NHANES data, further undermine the recommendation from government health agencies that everyone should strive to reduce salt intake.

By contrast, a 2007 study found that patients who reduced their salt consumption substantially (by 25 to 35 percent) were 25 percent less likely to develop cardiovascular problems than a control group that did not cut back on salt. But these subjects all had "high-normal" blood pressure, which is consistent with the idea that salt reduction is beneficial only for a subset of the population with pre-existing risk factors. Although the weight of the evidence after decades of research supports this understanding of the relationship between salt intake and cardiovascular disease, public health officials and activists (and the doctors and journalists who parrot them) continue to insist that salt is Bad for You, no matter who you are or what your medical condition is.

I noted the Center for Science in the Public Interest's demonization of salt in my 2003 reason story about the group. Gary Taubes reviewed the long-running controversy over salt's health effects in a classic 1998 Science article.

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  • the innominate one||

    to rip off Ron Bailey's phrase (or whoever he was quoting) "carbon is life"

    salt is life

    want to sweat? requires salt
    want to conduct nerve impulses? requires salt
    want to contract muscles, including your heart? requires salt
    want to have your kidneys filter your blood and remove excess water? requires salt

    the salt(s) required are not always or exclusively sodium chloride, but salts are an absolutely necessary part of life

  • ||

    As usual, Mr. Sullum ignores generations of evidence that, the better something tastes, the more deleterious it is for your health. Don't argue everyone's mother.

  • Elemenope||

    Jives with my personal experience; I eat salty foods like they're going out of style, and my blood pressure is an even 110/65, has been for years.

  • ed||

    I'll be celebrating the news with a salty and delicious SW "Red" Smith pickled sausage.
    Good eats. Now with extra pork hearts!

    http://www.swredsmith.com/smith_sausage_combo.html

  • ||

    i'm like you elemenope, bp in the 100/60 range, forever, and put salt on everything.

  • ||

    the innominate one

    salt is life



    My mother is absolutely obsessive about fat (causes cancer) and salt (causes high blood pressure).

    While I realize that obesity is related to a higher risk for cancer I am not sure that mere consumption of fat is harmful. And you sure miss out on a lot of tasty stuff when you avoid it. And most low-fat and no-fat foods are abominations.

    She now suffers from wildly erratic blood pressure and has had to get a pacemaker. She also complains of having no energy.

    Now a lot of this could simply be from being in her eighties, but sometimes I wonder if she has not done herself harm by cutting out so much fat and salt.

    Fat is also essential for proper muscle function and energy levels too, isn't it?

  • ||

    Of great personal concern to me on this topic is that the salt nannies are potentially putting me at risk of my life.
    I have high blood-pressure and am being quite successfully treated for it..
    And hyponatremia (marginally).
    I measure consistently below the minimums for blood sodium and did even before the high blood pressure diagnosis and treatment.
    Yes, I need my blood pressure meds.
    But I also *require* salt in my diet, at levels that would horrify the nannies because I do not conform to their simplistic and simple-minded notions which they want to impose on me as a side-effect of imposing them on all of us.

    no hugs for thugs,
    Shirley Knott

  • ||

    Eat well. Live healthy. Die anyway.

    Have fun instead. It's not the speed that kills you, but the sudden stop.

  • Episiarch||

    As we all know from Supernatural, salt is essential for stopping demons and destroying spirits that have returned to haunt the living. These doctors are just shills for Big Undead.

  • ||

    I've been watching these surprising salt consumption studies for the last year or so. I used to consider salt consumption one of the major factors associated with African American heart disease rates being so high. Not so anymore. It now seems salt intake is, at most, a minor contribuor to the problem.

    Of course that still leaves stress (poverty) and fat consumption on the table.

    Jacob, to your knowledge, has CSPI ever issued an Oops! press release on the subject? I'm not on their mailing list.

  • Neu Mejican||

    Another strawman.

    The recommendations on salt have been evidence-based for quite a time now and conform to "the idea that salt reduction is beneficial only for a subset of the population with pre-existing risk factors."

    Of course, the evidence indicates that there is a correlation between increased salt intake and increased blood pressure...and, of course, this is only a problem if that leads to clinically important hyper-tension.

    And that has been the message coming from "health officials" for years...

    When I look at this,

    http://www.health.gov/dietaryguidelines/dga2005/document/html/chapter8.htm

    I don't see a blanket salt demonization going on. More like information that can be used to tailor an individual's diet.

  • ||

    salt is life

    want to sweat? requires salt
    want to conduct nerve impulses? requires salt
    want to contract muscles, including your heart? requires salt
    want to have your kidneys filter your blood and remove excess water? requires salt


    Yes, but hypernatremia will also kill you. And persistent high blood pressure will cause early organ failure, especially of the kidneys. Homeostasis and health are both about balance. As always, the dose makes the poison.

  • Elemenope||

    Fat is also essential for proper muscle function and energy levels too, isn't it?

    My favorite medical "surprise" of the last few years was that adipose tissue plays a critical role in the human endocrine system, regulating signals for hunger and food consumption et al. People without substantial fat deposits are missing an entire critical portion of that signaling system, which has been associated with all sorts of infirmities later on.

  • ||

    J sub D, as far as I can tell, CSPI has not modified its position on salt, which in the 1970s it was calling "the deadly white powder you already snort" and now calls "The Forgotten Killer." It wants the FDA to stop classifying salt as an ingredient that's "generally recognized as safe."

    See http://www.cspinet.org/salt/ and http://www.cspinet.org/new/200502242.html.

    Neu Mejican, the government dietary guidelines you cite tell people to "consume less than 2,300 mg (approximately 1 tsp of salt) of sodium per day" and "choose and prepare foods with little salt." This is a general recommendation to limit/reduce salt intake, regardless of one's health status.

  • ||

    The government and mainstream medicine are wrong on the salt issue, they're wrong on carbs (a high carb diet, as recommended by the establishment, is behind a host of problems including obesity, diabetes, Alzheimer's, and cardiovascular disease), and they're wrong on fat (the body of research does not demonstrate any benefit to a lowfat diet). Gary Taubes' "Good Calories, Bad Calories" is an excellent summary of how off base the standard advice is. Just remember, whatever the government recommends, it's probably best to do the opposite.

  • Elemenope||

    Just remember, whatever the government recommends, it's probably best to do the opposite.

    Let me know how the arsenic and mercury taste. Oh, and the lead! Can't forget the lead. I've heard that dissolved lead ions taste sweet.

    Then again, phosgene apparently smells good, but I wouldn't recommend inhaling too much of that either. Neither does the government, so...lots of luck!

  • ||

    I have this lovely syndrome. Bullshit. I have to watch everything I eat; too much salt and my nose starts to bleed.

    Although nitrates are much, much worse for me, blood pressure-wise.

  • ||

    dissolved lead ions taste sweet

    They do. Romans sweetened their wine with powdered lead.

  • Naga Sadow||

    Did anyone else think of the theme music to Jaws when they read the title?

  • ed||

    No. I thought of Santorum's kid.

  • Elemenope||

    They do. Romans sweetened their wine with powdered lead.

    *That's* what it was. I couldn't for the life of me remember where or why I had heard that. Thanks.

  • the innominate one||

    Number 6 | May 22, 2008, 12:57pm | #


    Yes, but hypernatremia will also kill you.


    no faeces. so will hyponatremia. both situations usually require extraordinary effort to achieve.

  • Zeb||

    Salty is my favorite taste bud.

  • ||

    A few years ago, I was diagnosed with a quirky heart not-even-a-problem. In a perfect storm of mild dehydration triggering the vaso-vagal reflex at the moment my heart pumps an extra beat (we all do it, some do it more often than others), I could experience ventricular tachycardia. Bad. Two cardiologists agreed that the best thing is to avoid dehydration by ... adding extra salt to my diet. Yes, salt to the point of almost-too-much. Blood pressure? 120/72 or sometimes 115/68. Salt's been keeping me healthy.

  • lunchstealer||

    Salt intake is apparently uncorrelated to high blood pressure, although reduction of salt intake can in normal cases help reduce high blood pressure. However, this is not universal, so if you're getting regular physicals and your BP is normal, salt intake should not be a concern. If your BP is found to be high, you should probably start lowering your salt intake, but you should still be monitored by a doctor. In some cases it doesn't work and you have to go on medication. In other cases, the high blood pressure has nothing to do with sodium levels, and you may need the salt in your diet for other reasons.

  • ||

    There's an optimal level of salt, but if you're in normal health and eat too much salt, you get rid of it by pissing it away. Maybe a little harm from working your liver or whatnot a bit harder, but not on the level of the liver damage caused by, say, chronic alcoholism.

    And if you exercise a lot, or live in a hot climate, you need more salt intake than normal because you sweat more.

  • Neu Mejican||

    JS,

    Neu Mejican, the government dietary guidelines you cite tell people to "consume less than 2,300 mg (approximately 1 tsp of salt) of sodium per day" and "choose and prepare foods with little salt." This is a general recommendation to limit/reduce salt intake, regardless of one's health status.

    I read them...the page provides the information regarding different risk levels for different groups. Talks about "on average" and "more than they need" and "reducing risk." Includes information as to why you might want to limit your salt intake and which groups are at relatively higher risk. It provides essentially accurate information (from 3 years ago).

    Guidelines of this type are regularly updated, and I am sure this one will be too. The "salt nannies" are all in your head.

  • ||

    I have to watch everything I eat

    That's odd. I have to taste everything I eat.

  • Neu Mejican||

    Evidence-based recommendations are fluid as evidence changes. When updating/creating recommendations based on fluid scientific evidence there is a difficult balancing act between being conservative in what you count as evidence and being proactive when preliminary evidence indicates a significant danger.

    In most cases government panels that create recommendations are conservative. This means that new evidence such as the study cited will not lead to instant revision of the guidelines. ..that is, actually, a pretty reasonable way to go about business. If recommendations are based on the best evidence when they are created, then they should remain in place until there is sufficient evidence that they are wrong/useless, over-reaching, or counter-productive. That means the recommendations will not reflect the most recent research, but the most vetted.

  • ||

    "Now a lot of this could simply be from being in her eighties"..Ya think?:) Jeez, in most people EVERYTHING is falling apart in the eighties, if they're lucky enough to get there.

    OTOH, potassium, found in fruits and vegetables, helps balance any excess salt. It could be people who have high blood pressure don't consume enough potassium, rather than consume too much salt.

  • ||

    The "salt nannies" are all in your head.

    They are also here:

    http://www.wndu.com/mmm/headlines/16362456.html

    http://www.cspinet.org/new/200502242.html

    http://health.usnews.com/usnews/health/healthday/071129/fda-mulls-cutting-salt-in-processed-foods.htm

    http://www.cbsnews.com/stories/2006/06/14/earlyshow/contributors/emilysenay/main1710749.shtml

    http://64.233.167.104/search?q=cache:3vRyrYAPgxoJ:www.who.int/dietphysicalactivity/Neal_saltpaper_2006.pdf+average+salt+consumption+U.S.&hl=en&ct=clnk&cd=14&gl=us

    http://www.statcan.ca/Daily/English/070410/d070410a.htm

    http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=443218&in_page_id=1774&in_page_id=1774&expand=true

    Among many other places. Not only do government health agencies commonly advise people (again, regardless of their health status) that they consume about twice as much salt as they should, but salt assaulters at organizations such as CSPI and the WHO want to mandate reductions in salt content. If they don't count as "salt nannies," who would?

  • Thomas Paine\'s Goiter||

    Let me know how the arsenic and mercury taste. Oh, and the lead! Can't forget the lead. I've heard that dissolved lead ions taste sweet.

    Gubament used to say those were safe.

  • SIV||

    Didn't the government used to encourage consumption of hydrogenated and transfats as "more healthy" than animal fats?

  • VM||

    Shirley -

    get a new doctor! mein Gott!

    best of luck to you!!

  • Famous Mortimer||

    "I don't see a blanket salt demonization going on. More like information that can be used to tailor an individual's diet."

    Yes but when the media gets its hands on ever changing nutritional information, it often turns from a cautionary tale to an imminent danger. Of course, the average person is responsible for a lack of skepticism as well.

    It makes the field of nutrition look completely unreliable.

    The living clean cultists love this kind of hyperbole.

  • Thomas Paine\'s Goiter||

    Didn't the government used to encourage consumption of hydrogenated and transfats as "more healthy" than animal fats?

    Yup. I'm still eating raw lard.

  • Neu Mejican||

    salt assaulters at organizations such as CSPI and the WHO want to mandate reductions in salt content

    Given that neither the WHO nor the CSPI have power to mandate anything their advocacy doesn't seem much of a concern.

    And to reiterate, saying you are eating more salt than you need based on the available evidence (i.e., providing information) is only a problem if that is indeed misinformation. I don't see any evidence presented that would indicate it is misinformation.

    Identifying risk factors and spreading that information for public consumption seems like the proper role of health officials. Keeping that information updated based on available research that has been properly vetted is also appropriate. What is your complaint again? Something about the fact that there are private groups that are pushing a different agenda than you?

  • David Brown||

    "Identifying risk factors and spreading that information for public consumption seems like the proper role of health officials. Keeping that information updated based on available research that has been properly vetted is also appropriate."

    Ideally, this is exactly how it should work. Unfortunately, the research on sugar, salt, and saturated fats has never been properly vetted by authors of nutrition textbooks, government agencies, or health promotion organizations. Had scientific authorities done things properly 40 years ago when it was arbitrarily decided that saturated fat was a health hazard and sugar had nothing to do with heart disease, we would not be burdened with fat/salt-phobic dietary advice.

    I suspect the reason reduced salt consumption results in lowered cardiovascular risk in some studies is because research subjects are forced to consume less manufactured food which is notoriously rich in salt, sugar, white wheat, corn, trans-fats and toxic omega-6 polyunsaturated vegetable oils.

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