Society has this huge focus on salt.
After all, processed food is absolutely full of sodium and most of us use salt to make food taste better.
Salt is one of those things that we all ‘know’ is unhealthy, but we choose to use it anyway (a bit like fat really).
But, how does salt affect your health? Is it as bad as everyone says?
Current estimates suggest that Americas eat around 3,400 mg of sodium per day (with some estimates putting that number upwards of 4,000 mg per day), a level that most major health organizations think is far too high (1,2).
For example, these are some of the commonly recommended ranges. Note, that these tend to be maximums. In general, most health agencies focus on the idea that people should be eating as little sodium as possible.
- American Heart Association: 1,500 – 2,400 mg (with 1,500 mg being optimal) (3)
- Food and Drug Administration (FDA): 2,300 mg (1,500 mg for at-risk groups) (4)
- Official Dietary Guidelines: 2,300 mg (1,500 mg for at-risk groups (5)
- American Diabetes Association: 2,300 mg (6)
- World Health Organization: 2,000 mg (7)
It’s important to note that recommendations are given for sodium intake, not for salt itself.
Despite a little variation, you can see that the idea is that most health organizations think we should be consuming less than 2,300 mg of salt and ideally less than 1,500 mg of sodium.
How Much Salt is That?
Salt is an ionic compound, made up of sodium and chloride atoms in roughly a 1:1 ratio.
By weight, salt is roughly 40% sodium and 60% chloride, because the two compounds have different weights.
That’s partly why you see sodium levels listed on ingredient labels, rather than the actual amount of salt.
Technically, table salt is a salt, as the term ‘salt’ refers to the specific type of ionic compound (table salt just happens to be the most common of these – probably because we use it so much). That distinction is purely academic however, and isn’t relevant to this discussion.
In general, one teaspoon of salt equals around 2,300 mg of sodium (8).
So, you can see how easy it is to consume ‘too much’ salt.
However, in most cases, people are getting most of their sodium from eating high amounts of processed foods, rather than from salt used in cooking or on food.
How Does Salt Affect Your Health?
In general, health recommendations are tricky.
There is a lot of official advice out there about our food consumption. That includes how much salt we should be eating, as well as fat, red meat and other areas (9).
We tend to believe these health recommendations most of the time.
But often, politics plays a huge role in things like the recommended levels of salt intake.
Sometimes that means that the actual science isn’t nearly as strong as you might imagine.
That’s certainly the case with salt because the evidence for harm really isn’t what you’d expect.
Salt as an Electrolyte
Despite its reputation, salt does actually have positive roles in the body.
In particular, it is an important electrolyte.
This means that it plays a role in the balance of water in your body.
It also plays a role in a number of other biological functions, including nerve functions and muscle contraction.
So, our bodies need sodium to function.
Because of this, people on extremely low sodium diets can sometimes run into health problems because they aren’t getting enough sodium for their body to function properly.
In some cases, this can lead to a condition called hyponatremia.
This is a sodium deficiency and it is particularly significant in athletes and people who work out (as they lose a decent amount of sodium through sweat) (10).
It is also an issue that can be dangerous.
This issue is well-recognized in relation to athletes and athletic events and is one reason why sports drinks are so useful for athletes.
But, many members of the public don’t know about this issue.
With the popularity of being healthy, including doing exercise and following diets, it’s likely that some people have a dangerously low sodium level without even being aware of the risks.
Likewise, low sodium diets have also been associated with increased triglycerides and LDL cholesterol (11) and increased insulin resistance in patients with type 2 diabetes (12).
All of this suggests that restricting sodium can have more negative effects than most people assume.
If you're concerned about your sodium levels, the site Healthline offers detailed information about the symptoms of low blood sodium.
Impacts of Reducing Sodium
So, how does salt affect your health?
With so much emphasis on reducing sodium – you would think that sodium reduction has huge impacts on health.
But, for most people it doesn’t.
For example, one comprehensive meta-analysis found that salt restriction did lower blood pressure, but not by very much.
Additionally, the decrease was around twice as strong for people with high blood pressure (11).
The exact averages were:
- 5.39 mm Hg systolic / 2.82 mm Hg diastolic (for people with high blood pressure)
- 2.42 mm Hg systolic / 1.00 mm Hg diastolic (for people with normal blood pressure)
Because these are averages, there would have been some people who responded more strongly and others who responded less strongly.
Now, high blood pressure is an important health issue and acts as a risk factor for many health problems, including heart disease (13).
Nevertheless, the impact of sodium intake on blood pressure is so low that it probably isn’t even relevant for people with normal blood pressure.
Plus, blood pressure itself is a risk factor.
So, decreasing your blood pressure decreases your chance of conditions like heart disease – in theory anyway.
That’s the thing with risk factors.
At best, improving a risk factor decreases your risk of a disease. Realistically, though, you may still get that disease anyway.
Likewise, people with very high levels of a risk factor will often not end up getting the associated disease.
To improve your health, decreasing your risk factors makes sense.
But, only if the cost isn’t too high.
For example, things like eating whole foods and getting exercise make sense.
Likewise, cutting out a lot of processed foods is a good move for health (which is one reason so many people swear by the Paleo Diet).
In fact, cutting down sodium doesn’t seem to offer any direct benefit.
For example, one meta-analysis looked at outcomes from 7 different randomized controlled studies (14).
The authors found that decreasing sodium intake didn’t have any significant impact on heart disease or on the risk of death.
That was even true for people who had high blood pressure.
Another study found that changing sodium levels did change blood pressure, but didn’t result in an increased risk of hypertension or of heart disease complications.
Additionally, that same study found that lower levels of sodium were associated with higher levels of heart disease mortality (15).
This suggests that decreasing sodium intake doesn’t actually do much at all to your actual chances of disease.
In fact, all of the evidence for decreasing sodium seems to come from the connection between sodium and blood pressure.
Honestly, that’s bad science.
The logic here is that A influences B and B influences C, so A must influence C.
But, reality is often more complicated than that.
The Politics of Salt Intake
All of this might seem confusing.
If decreasing salt intake really doesn’t help health, then why all the recommendations?
A lot of it seems to come back to politics and confirmation.
Once a particular perspective starts being common, it seems to keep getting repeated across different channels – even if the science behind the message was never that strong.
The same thing happened with the cholesterol controversy and we’re only just starting to realize that we can eat things like butter and eggs and still be healthy.
In fact, you’ll often find that health advice tends to repeat the same pieces of evidence, without really looking at any of the newer science.
For example, most discussions on sodium intake focus on the evidence for an impact on blood pressure, ignoring the lack of evidence for things like heart disease.
But, there is a growing interest in debunking some of the myths around salt and looking more into the science.
For example, the Reader’s Digest published an article criticizing the focus on cutting back salt, as did Scientific American.
As the article in the Scientific American points out, most of the evidence behind the current emphasis against salt is based on limited research that has then been extrapolated.
At the same time, people vary in how they respond to salt.
So, for some people, having a lot of salt might be a major issue.
But, for many others, having that much salt might have no impact at all.
That variation makes extrapolating research that much more inaccurate.
Part of the argument in the Scientific American article is that there needs to be a large controlled experimental study to see what impact low salt diets have over time.
The odds of that actually happening are slim.
For one thing, such a study would be expensive.
Additionally, the government is already convinced about their science and seems to have little interest in funding a study to prove what they think they already know.
As more research is conducted, we may learn more about salt and the true effects of low salt diets.
In the meantime, the science that we do have suggests that salt isn’t really a big deal for most of us.
Should You Reduce Your Salt Intake?
At the beginning, I asked the question, how does salt affect your health?
As you can see, there isn’t all that much evidence about salt at all.
Most of the research suggests that the hype around salt is majorly overblown.
So, how do you respond to this information?
Well, that’s going to depend on a few things.
Firstly, there are certainly some groups of people that should be watching their salt intake.
For example, anyone who has problems with water retention may well need to be very careful with their salt intake.
In fact, if you have a serious health condition then you should be focusing on the advice that your doctor gives you about sodium intake and other practices.
But, what about the rest of us?
If you’re physically healthy, then it seems that the scare tactics surrounding salt are majorly overblown. In fact, you might even cause yourself more harm by restricting salt.
Here’s a question.
Is it worth the tradeoff?
If you wanted to dramatically cut down your salt intake, you would have to cut down how much processed food you eat, as well as the amount of salt you use on food and in cooking.
Now, the first of those approaches is a good idea in general. Realistically, many of us eat processed food far too often and we would be better off switching to more natural alternatives.
But, what about the rest of it?
If you’ve ever tried an extremely low salt diet, then you’ll know that food ends up tasting pretty bland without salt.
This can majorly decrease how much you enjoy your food.
If cutting out sodium made a huge difference to your health, then doing that might be worth it.
But clearly, that isn’t the case.
For healthy people, perhaps the idea is to stop focusing so much on salt.
Instead, perhaps we step back and look at the foods we are consuming in general.
If we focus on foods that are healthy and have little processing, then we can improve our health without compromising our enjoyment of food.
It's also possible to vary the ingredients we use. For example, the site Healthy Women talks about ways to season without salt. Learning how to do so can help make your food more interesting overall and give you more flexibility.
In fact, some foods like dark chocolate even low blood pressure, and might be more effective than cutting down sodium.
Likewise, following a low carb diet (rather than a low-fat diet) can also help with blood pressure and other risk factors (16,17).
In fact, low-carb diets are good for weight loss and for health in general (18).
Overall, the science suggests that concentrating too hard on our sodium intake won’t offer many benefits at all for healthy people.
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What are your thoughts about salt? Is it worth cutting out for a small decrease in blood pressure and that's really it?