Is eating too much salt really dangerous? Mainstream medical advice and routine doctor visits may have convinced you that this is a clear “yes,” but the science is not uniform. So why is that not reflected in normal clinical practice?
The salt controversy doesn’t just raise questions about how much salt is too much; it points to the heart of an issue that is little discussed: that much of the medical information we receive is not based on scientific consensus, despite the definitive tone and certainty in statements made by leading voices, including our doctors.
We’ve all gotten the message that we tend to eat “too much” salt—and too much salt is a bad thing. Doctors, dietitians and health associations have long warned that excessive sodium intake can inhibit kidney function, raise blood pressure, increase the risk of cardiovascular disease, and even harm sleep quality.
Recognizing that, for most people, processed foods are the main source of sodium, the US Food and Drug Administration (FDA) announced in October 2021 a new plan to encourage packaged food manufacturers to reduce added salt in their products. The FDA set a new goal for average salt intake of 3,000 milligrams a day, a 12 percent decrease from the American average of about 3,400 milligrams a day.
However, the Dietary Guidelines for Americans, issued by the US Department of Health and Human Services and the US Department of Agriculture, recommend that adults limit sodium intake even further, to less than 2,300 milligrams per day, or about 1 teaspoon of salt. table.
More recent research in animals reveals that excess salt can affect the mind as well as the body. Too much salt can increase stress levels, thereby affecting behavior (at least in rats), according to some studies.
A recent study, conducted at the University of Edinburgh in Scotland and published this month in the journal Cardiovascular Research, found that, in mice, a diet with too much salt increased stress hormones in the body.
The researchers found that a high-salt diet increased levels of the stress hormone glucocorticoid by 75 percent. In addition, not only were resting stress hormone levels elevated in the mice, but their hormonal response to environmental stress was also doubled compared to mice on a normal diet.
“We know that eating too much salt damages our heart, blood vessels and kidneys. This study now tells us that high salt in our diet also changes the way our brain handles stress,” study co-author Matthew A. Bailey, professor of renal physiology at the University of Edinburgh’s Center for Cardiovascular Sciences, said in a statement.
A paper published this year in the journal Neuroscience & Biobehavioral Reviews reviewed several studies to measure what is known about the effects of salt on behavior in animals.
The authors of the review, from Kent State University in Kent, Ohio, wrote that although excessive salt intake is a well-known risk factor for cardiovascular disease, until now “little has been explored about how it affects behavior, despite its ubiquitous salt in the modern diet.”
The research tested behavioral changes such as anxiety and aggression in mice with a high-salt diet. It has been found that excessive salt intake in adult animals affects their spatial memory and “fear expression”. High salt intake early in life has been shown to increase their mobility and inhibit social and spatial behavior.
The study authors wrote that these findings suggest that “expanded studies of the effects of salt may reveal broader behavioral implications.”
Is Salt So Bad?
James DiNicolantonio, a doctor of pharmacy, objects to what he calls the “low-salt dogma” and believes that salt has been unfairly maligned.
He claims that our body prompts us to consume about 3,000 milligrams to 4,000 milligrams of sodium per day to stay in homeostasis, “the optimal state where you put the least amount of stress on the body.”
DiNicolantonio told The Epoch Times that among the salt intake studies done on humans, everyone “has an inherent weakness.”
“Almost every study does not provide the same diet with the only difference being the level of salt intake,” he said. “Usually, what [researchers] do they give more fruits and vegetables, [a diet] which happens to be lower in salt, and then they extrapolate the benefits … and you can’t necessarily extrapolate that.”
In his book “The Salt Fix: Why Experts Got It All Wrong and How Eating More Might Save Your Life,” DiNicolantonio, who is a cardiovascular research scientist at St. Luke’s Mid America Heart Institute in Kansas City, Missouri, thinks that most of us don’t need to monitor our salt intake. He believes that salt restriction is dangerous and that too little salt can cause us to crave sugar, leading to weight gain and Type 2 diabetes.
In fact, low-salt diets may have created America’s high blood pressure epidemic, DiNicolantonio writes. In South Korea and other parts of the world, people routinely consume more than 4,000 milligrams of salt per day yet have very low rates of heart disease and hypertension.
For many people, DiNicolantonio claims, eating more salt can improve energy, sleep, vitality, and even fertility and sexual function. He argues that “until the low-salt dogma is successfully challenged, we will be stuck in the same perpetual loop that keeps our bodies salt-deprived, sugar-addicted, and ultimately deficient in many critical nutrients.”
For animals, he points out, “there are no dietary guidelines, of course—no medical directives to establish a conscious effort to restrict salt intake.” Except for those with certain medical conditions, DiNicolantonio notes that we don’t need to worry about “hitting a salt binge,” because our bodies take care of any excess. A low-salt diet “represents a crisis for the body, not a recipe for optimal health,” he writes.
An Ongoing Controversy
Researchers at Columbia University and Boston University in 2016 conducted a “metaknowledge analysis” of what they called the “salt controversy.” The analysis, published in the International Journal of Epidemiology, looked at 269 reports published between 1978 and 2014 that examined the effect of sodium intake on cerebro-cardiovascular disease or death.
The researchers found that 54 percent of the reports supported the hypothesis that reducing dietary salt led to population health benefits. A third (33 percent) do not support this hypothesis, and 13 percent are not convinced.
So, while scientists have long disagreed about the benefits of reducing salt intake, public health messages about salt don’t seem to reflect this uncertainty, the researchers said.
“The disparity between the uncertainty in the scientific literature about the potential benefits of salt reduction in the population and the certainty expressed by decision makers involved in developing public health policy in this arena is staggering,” they wrote.
“Assuming that all parties involved have the best interests of science and public health in mind, this controversy raises questions about knowledge production in population health science and how that production affects public health practice.”
The researchers found that report authors were 50 percent more likely to cite papers that reflected their views, whether they believed that salt reduction was beneficial or not. Moreover, only a few prolific researchers produce most of the work in the field and seem unaffected by the work of researchers who come to different conclusions.
“We found that the published literature has little impact on ongoing controversy but contains two almost distinct and different lines of scholarship, one supporting and one contradicting the hypothesis that salt reduction in the population will improve clinical outcomes,” the authors wrote.
Public health officials, it seems, may have chosen to reinforce the findings of only one body of research produced on this topic, rather than admit that there are two “sides” to the salt controversy.
DiNicolantonio offers practical advice for those concerned about salt intake.
“If you’re someone who eats a whole foods diet consisting primarily of whole, nutritious foods—meats, vegetables, fruits—you’re going to get very low amounts of salt and you may need to add some back to bring you back to normal intake,” he said.
“Whereas if you’re someone who eats mostly processed foods … you’re probably getting enough salt already,” he said.
“Salt is an important mineral. There will be insufficient amounts, as with any mineral. There will be too much, just like with any mineral, and there is an optimal intake. The optimal intake appears to be normal salt intake. So not high, not low, but allowing your body to take in the salt it’s really looking for, which is basically how we treat thirst.”