Salt and health

An article about New York's new salt reduction guidelines triggered a question I've long had: What is the health-related argument for lowering salt intake if you have healthy blood pressure? I've never read anything that says that salt builds up over time and can cause elevated blood pressure if you ingest too much. So what are the mainstrean health related arguments saying that too much salt is unhealthy?

Jonah

Here's a piece that addresses this in part, with links to various other articles. For context, this is from Reason magazine's weblog, so they are obviously coming at it from the libertarian/less-regulation-is-preferred standpoint.

So will athletes need a prescription for Gator-Ade? (High in sodium, as sodium is what you lose when you sweat.)

Everyone has to suffer because 10 percent of the population would be better off with less salt -- and in actuality, it would only help that sub-portion of that 10 percent that hasn't already reduced their salt intake.

Not that I needed another reason to be glad I don't live in New York -- but it definitely reinforces my being glad I don't live in New York.

We just need to find a way to make sure it doesn't happen here.

Okay -- did a little research, and according to reports in Science and The American Journal of Epidemiology, the real culprit in hypertension is being deficient in other minerals, rather than having too much salt. Mineral supplements lower both blood pressure and reduce risk of death.

Politicians in England, where they are even crazier than New Yorkers about regulating stuff and already have salt limits in place, are accusing American scientists of being irresponsible for sharing this information. Apparently, making them look bad is not polite.

So apparently the verdict is, take a mineral supplement and don't worry about the salt. (And stay away from New York.)

My understanding (from fairly extensive reading on the subject) has always been that salt exacerbates hypertension but doesn't cause it. This new movement seems like a classic instance of over-reactionism by those who are genuinely concerned but misinformed.

=R=

ronnie_suburban wrote: This new movement seems like a classic instance of over-reactionism by those who are genuinely concerned but misinformed.

Misinformed about a few things -- such as the role of government, as well as the effects of salt.

As for what causes hypertension, for me, the government telling me what I can and can't eat does it.

My strong belief is that internet food discussion forums are not good places to look for (or give) medical advice, and I encourage the OP or anyone else reading this to take it all with a big grain of salt (or other mineral).

Kennyz wrote:My strong belief is that internet food discussion forums are not good places to look for (or give) medical advice, and I encourage the OP or anyone else reading this to take it all with a big grain of salt (or other mineral).

Totally agreed. Ask a doctor or a professional, not LTHForum.

While some have complained about New York telling folks what to eat, I must say, I have the same reaction with posters telling me rather paternalistically that I shouldn't post this question but should instead go to doctors for advice. Of course I ask doctors pertinent medical questions (and have a son who is a medical student).

Having just snidely rejected advice I've been given, however, I will now offer this advice in return. I'm in my mid-fifties, where you begin to get more concerned about health, and have to see more and more doctors for various reasons. If there is one big lesson I've learned from dealing with the health care system, it's that you need to be self-educated and should not rely solely on doctors. You need to ask know how to ask good questions. In areas such a what is a healthy life style, and what preventive measures can be taken for various afflications, doctors are particularly weak and frequently give contradictory advice. I could give specific examples of where my reading and research has led to a question to a doctor that produced a revised recommendation that the doctor agreed was an improvement.

Finally, back to the original point of the post, it seems that, as I've concluded, there does not appear to be any basis for heart healthy individuals to attempt to reduce salt as part of a healthy life style.

Jonah

Jonah wrote:While some have complained about New York telling folks what to eat, I must say, I have the same reaction with posters telling me rather paternalistically that I shouldn't post this question

Not telling you not to post, only that I don't think you (or anyone) should take the "answers" posted here all that seriously. It doesn't sound like you would do that, but - unfortunately - there are lots of cases where people take what sounds like convincing advice off of internet discussion forums, and live (if they're lucky) to regret it. Already there is plenty of misleading, potentially damaging "information" in this thread.

The Supreme Court, in First Amendment cases, has referred to the "marketplace of ideas," which can be either dangerous or wonderful, depending upon how its used.

Jonah

I'd say the one piece of advice above that you can take without any fear or ill effect is Jonah's comment about doing your own research and knowing about health, nutrition, conditions, etc. -- because I have a LOT of friends who have regretted not doing that research before going to the doctor (some of them now deceased). As the health care professionals taking care of my mom after her surgery told me again and again, doctors don't study nutrition, doctors can't keep up with all the new research, and doctor's don't know you all that well -- you need to do the research.

So go ahead and ignore the comments above about the research that shows that additional mineral supplementation is a life saver -- but at least research it yourself. Just as with food and restaurants -- you get recommendations here, but you don't really know until you check it out yourself.

But don't leave your health solely in the hands of the doctors -- and definitely don't leave it in the hands of politicians.

Doctors, maybe. Nutritionists, definitely.

The earlier LTH discussion of salt and health contains links to studies showing that too low a salt intake is linked to increased mortality.

I am an abuser of salt. My food has a grittiness from too much salt. I have below normal blood pressure. My husband restricts salt and has high blood pressure. The only thing I can say about reduced salt intake - pre high blood pressure diagnosis- is getting used to the food sans or reduced salt before someone makes you do it later in life when changing habits can be harder.

Study Counts Benefits of Cutting Salt. From today's Wall Street Journal - http://online.wsj.com/article/SB1000142 ... 12776.html

That Wall Street Journal article (thanks for the link) is exactly why I raised the question in this thread. It talks about the overall societal benefit if we cut salt. I think many would be of the view that someone with hypertension will benefit from reducing salt intake. The assumption seems to be that certain people can benefit from cutting salt, but that there is no way to induce that kind of behaviour only from those it will benefit. Thus, the article reflects the benefits from society as a whole cutting salt. The article does not in any way explain what kinds of individuals will benefit and why. I'm not for or against trying to cut salt intake in our culture as a whole; I'm just interested in what it might do for me.

Jonah

When food and politics intersect, I like to check out what Marion Nestle has to say. In this case, here you have it:
http://www.foodpolitics.com/2010/01/eat ... bout-salt/

One part I like:

Some food makers are already gradually cutting down on salt, but quietly so nobody notices. If every food company were required to do that, everyone would get used to a less salty taste and we all might be able to better appreciate the subtle tastes of food.

This is an important point: the salt issue is not about "telling" you not to put salt on your steak to bring out its flavor, nor aimed at restricting how the staff at Per Se prepare their meals. It's aimed more at processed foods and certain restaurant products. As she points out, nothing stops you from adding to salt to any dish but you can't easily reduce the salt in a pre-packaged food.

The whole post is interesting. Here's one line that I like:

I love nanny-state accusations. Whenever I hear them, I know either that food industry self-interest is involved or that the accuser really doesn’t understand that our food system already is [as] government-regulated as can be. These kinds of actions are just tweaking of existing policy, in this case to promote better health.

I happen to be a quite a libertarian, and I haven't yet decided how I feel about the NY regulation, but I find that "nanny state accusations" are a generally used to replace thinking about an issue with ideology and narrow-mindedness.

Jonah, to answer your question: a good friend of mine had to reduce his salt intake. He did it, and also lost about 50 pounds. The reason for this is that people who consume a lot of salt tend to get it through processed foods. These foods also tend to be loaded with calories. So when he stopped eating this stuff, he also -- inadvertently -- ate a much healthier diet. Naturally, if you already eat a healthy diet, reducing your salt is not likely to have this side benefit.

Bottom line - we're all responsible for what we consume. You can't blame anyone but yourself. Just my two cents.

Dave, could you be a little more clear (I'd like your 8 cents-worth, not just 2)? I presume you aren't saying that anything and everything should be legal and let buyer beware, that we'd be better off with the absence of all food, health, and safety regulations.

Some food makers are already gradually cutting down on salt, but quietly so nobody notices.

There was a long article on this a week or two ago in the Wall Street Journal. The gist of it was that having failed to sell consumers on low sodium varieties of base line products, manufacturers about 5 years ago began slowly reducing salt in their base products without telling consumers. Soups and cereals were mentioned, with a number of varieties having 30-40% lower sodium today than back then. Also sticks in my mind that Kellogg All Bran cereal has had something like an 80% sodium reduction.

Yup, that was interesting article. I just found it online too. Here you go.
http://online.wsj.com/article/SB1000142 ... 95666.html

I thought I read somewhere a few months ago that salt in the American diet had been selected (in a New Year's resolution sort of way), as the next target of some scienceinthepublicinterestish sort of group. 'Course it could have been some far more respectable group like the AMA; I can't remember. Anyway, having read that some group had chosen it as its latest cause, the recent appearance of news articles on the topic strike me as no coincidence.

My google-fu is weak today; somewhere on this forum, I recall seeing a link to a study that suggested the human tongue can't taste particulates of a certain fine-ness (that's the scientific term, I'm sure )

At any rate, what I extrapolated from this is that many of the substances added to flavor heavily processed foods - e.g. salt or sugar - might disperse to the point that we can't taste them any more. This might explaine why processed foods contain so much more of these substances. I've noticed this when home canning: I finally decided not to salt my canned tomatoes at all; I add salt as needed when I'm cooking with them, it seems to do a better job of flavoring the dish.

I have no opinion on whether or not salt is good or bad for any individual (I try to watch my own sodium intake, but I do it primarily by cooking from scratch; I love salty foods and I hope it doesn't catch up to me - thus far, it hasn't.) However, does it make any sense to eat salt that doesn't offer you any flavor benefit? (Gatorade and its cousins aside - yes, sometimes you need salt.) I do appreciate that many canned foods are now available without added salt.

Mhays wrote:particulates of a certain fine-ness (that's the scientific term, I'm sure )

It is indeed.

Darren72 wrote:Dave, could you be a little more clear (I'd like your 8 cents-worth, not just 2)? I presume you aren't saying that anything and everything should be legal and let buyer beware, that we'd be better off with the absence of all food, health, and safety regulations.

My point is that today just about every packaged food item has the contents and nutritional value clearly printed. Whether an item contains 5% sodium or 25% sodium, it's the buyer's responsibility to decide whether or not that item is suitable for them. Same for the fat content. Do most people read the label when they pick up a bag of Cheetos or the fruit juice that contain high fructose corn syrup? Probably not.

Last week I had some time to kill between appointments. I decided to walk through a Food 4 Less grocery store in Chicago. I had never been in one before. It was laid out like a typical grocery store where you must walk past the deli and bakery and produce sections before you hit the grocery aisles. The produce section, while somewhat extensive, didn't have much foot traffic. I was amazed as to what people were putting in their carts. The store has quite a bit of space delegated to snack-type foods. There was (I think) about two full aisles of potato chips, pretzels, and related items. Why? Because it's inexpensive and people buy them.

Yes, I believe that there needs to be some government involvement when it comes to the safety of the food that we consume. Many years ago, I used to drive a delivery truck for a (now defunct) wholesale food distributor. Every day I was in about 20 different restaurant kitchens in Chicago and the suburbs. Some were spotless. Others were not. If there were no regular inspections done of restaurant kitchens, would it be different? You bet.

All I'm saying is that we choose our own destiny when it comes to our health. Some things, such as family health history (genetics) we can't control. As a society we are becoming more sedentary and we are getting larger. That's why places like Jenny Craig, Weight Watchers and TV shows like The Biggest Loser are thriving.

Just my 7.5 cents worth.

Dave148 wrote:My point is that today just about every packaged food item has the contents and nutritional value clearly printed. Whether an item contains 5% sodium or 25% sodium, it's the buyer's responsibility to decide whether or not that item is suitable for them. Same for the fat content. Do most people read the label when they pick up a bag of Cheetos or the fruit juice that contain high fructose corn syrup? Probably not.

I agree and find it astonishing. Core nutritional attributes -- sodium, fat, calories, protein and carbohydrates -- do not change. And their measures are required on all retail food product labels and many foodservice products, as well. Subcategories -- cholesterol, fiber, sugars, etc. -- are often listed, too. In very straightforward terms, the information is out there for anyone and everyone to see.

Yet, it seems many people are oblivious to them and their meaning. How long do we have to go before everyone knows how to pick up a package, read its label and understand what they are buying? You only need to learn this once. It's not like these categories are continually changing. Ignorance is no longer an excuse nor should it be the manufacturers' charge to cure it.

There are a variety of reasons why people eat poorly and/or unsafely and many of them are real issues that definitely do need to be addressed further by goverment and the private sector. But lack of information isn't one of them. It's way too late in the game to blame any food-related information gap -- personal or societal -- on anyone but ourselves.

=R=

ronnie_suburban wrote:Core nutritional attributes -- sodium, fat, calories, protein and carbohydrates -- do not change. And their measures are required on all retail food product labels and many foodservice products, as well. Subcategories -- cholesterol, fiber, sugars, etc. -- are often listed, too. In very straightforward terms, the information is out there for anyone and everyone to see.

Yet, it seems many people are oblivious to them and their meaning. How long do we have to go before everyone knows how to pick up a package, read its label and understand what they are buying? You only need to learn this once. It's not like these categories are continually changing.

No, but their implications are. In this thread, we see the controversy over salt.

When I was growing up, it was accepted fact that eating chocolate would give you pimples and too much spicy food caused ulcers. Now we know that neither of those things is true. The four food groups have given way to the food pyramid, and its carbohydrate-laden diet remains controversial.

For many consumers, keeping up with all the latest food/health theories is difficult -- the experts don't agree with each other, and the media are full of poorly written, single-source stories based on whatever special-interest group has most recently issued an alarmist press release.

The problem isn't lack of information today, but information overload.

LAZ wrote:

ronnie_suburban wrote:Core nutritional attributes -- sodium, fat, calories, protein and carbohydrates -- do not change. And their measures are required on all retail food product labels and many foodservice products, as well. Subcategories -- cholesterol, fiber, sugars, etc. -- are often listed, too. In very straightforward terms, the information is out there for anyone and everyone to see.

Yet, it seems many people are oblivious to them and their meaning. How long do we have to go before everyone knows how to pick up a package, read its label and understand what they are buying? You only need to learn this once. It's not like these categories are continually changing.

No, but their implications are. In this thread, we see the controversy over salt.

When I was growing up, it was accepted fact that eating chocolate would give you pimples and too much spicy food caused ulcers. Now we know that neither of those things is true. The four food groups have given way to the food pyramid, and its carbohydrate-laden diet remains controversial.

For many consumers, keeping up with all the latest food/health theories is difficult -- the experts don't agree with each other, and the media are full of poorly written, single-source stories based on whatever special-interest group has most recently issued an alarmist press release.

The problem isn't lack of information today, but information overload.

I don't think there's overload at all. The attributes are out there for all to see. Regardless of how the plethora of information is interpreted, it surely can't (and shouldn't) be the responsibility of the food industry to do the interpreting. If the industry accurately provides the cold nutritional data, there are more suitable parties out there to engage in the ever-evolving discussion about what are really the best ways (and best foods) to eat. The essence of what I'm saying is that I don't think the industry can or should do more than it already is. Even in the instances you provide here about chocolate and spicy foods, it wouldn't have been the industry's place to make the determinations about the effects of these foods. There's no way they could effectively take on that role without it being compromised by self-interest.

=R=

ronnie_suburban wrote:Regardless of how the plethora of information is interpreted, it surely can't (and shouldn't) be the responsibility of the food industry to do the interpreting. If the industry accurately provides the cold nutritional data, there are more suitable parties out there to engage in the ever-evolving discussion about what are really the best ways (and best foods) to eat. The essence of what I'm saying is that I don't think the industry can or should do more than it already is.

Oh, I agree completely. I'm just saying that one reason many people don't bother to read labels is that they're too overwhelmed by the plethora of conflicting dietary information available.

Another reason is that they don't really care. Despite all the supposedly bad for us food that we eat, and despite our supposedly increasing avoirdupois, Americans are living longer than ever.