Dr Michael Daignault
For years, we have continued to debate whether salt is really “bad” for our health. And when discussing healthy diet and lifestyle choices with both my ER patients and friends, the common thread is the inability to distinguish between salt and sodium. They are often incorrectly used interchangeably.
Sodium is a mineral and metallic element symbolized by “Na” in the periodic table. It is an essential nutrient and an ion necessary to maintain the balance of fluids in our body, contract and relax muscles and conduct nerve impulses. But we only need a minimal amount of daily sodium to achieve these goals.
Salt is a chemical compound that is only 40% sodium and predominantly 60% chloride or “NaCl”.
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Salt has been an epic part of human existence for thousands of years, transcending generations, religion, and culture. For centuries, salt was used as currency given its value in preserving meat and fish. Today, when people think of salt, they think of “table salt” to flavor foods. And we have salt in many popular forms, including sea salt and Himalayan salt.
But it is not necessarily the salt that is dangerous to health. A landmark meta-analysis published in the Journal of the American Medical Association in 2011 involving a combined 6,250 participants showed no convincing evidence that lowering salt intake reduces the risk of heart attack, stroke, or death in people with normal blood pressure or elevated.
However, excess sodium has been linked to high blood pressure, heart disease, and stroke. The strongest evidence links elevated sodium intake to high blood pressure and the opposite: reduce sodium intake lowers blood pressure. The mechanism for this is complex. For the average healthy individual, your kidneys can handle excess sodium in your blood. However, excessive accumulation of sodium over time causes the body to retain water longer to dilute the sodium and manage the fluid balance I mentioned earlier. This leads to an increase in blood volume and subsequently more work for the heart and additional stress on the blood vessels, which can raise blood pressure.
The CDC estimates that the average American consumes about 3,400 mg of sodium per day, which far exceeds the recommended limit of less than 2,300 mg per day. Americans love their sodium. However, they get about 70% of their daily sodium not from table salt, but from processed and restaurant foods. The biggest culprits are pizza, tacos, deli sandwiches, soups, burritos, tacos, salty snacks, and even chicken, cheese, and eggs.
More Americans than ever are being diagnosed with high blood pressure. High blood pressure is a major risk factor for heart disease, which, along with stroke, kills more Americans annually than any other cause. Much of that high blood pressure is due to our excessive consumption of sodium due to our love of processed foods.
Are you next? More Americans than ever before are being diagnosed with high blood pressure.
The bottom line is that we can make healthy food and lifestyle choices to significantly reduce our sodium intake. This can be done primarily by avoiding processed foods. Further reduction can be achieved by switching to Himalayan salt, which has less sodium than table or sea salt, and includes trace amounts of other key elements. Also consider boosting your potassium level with fresh fruits and vegetables: a high dietary potassium intake can relax blood vessels and help excrete sodium while lowering blood pressure.
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Michael Daignault, MD, is a board-certified emergency room physician in Los Angeles. He studied Global Health at Georgetown University and has a Bachelor of Medicine from Ben-Gurion University. He completed his emergency medicine residency training at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps volunteer. Find it on Instagram @dr.daignault
