Salt in diet is a sneaky thing

[Capsid]

VoM, it's still argument from concensus.

I want to read the results of the study on which it is based. How much will a low salt diet cut somebody's BP?

I mentioned the work by MacGregor in my post above.

See this meta-analysis

Additionally, our analysis demonstrates a significant association between the reduction in 24-h urinary sodium and the fall in systolic BP, indicating the greater the reduction in salt intake, the greater the fall in systolic BP. The current recommendations to reduce salt intake from 9-12 to 5-6 g/d will have a major effect on BP, but are not ideal. A further reduction to 3 g/d will have a greater effect and should become the long term target for population salt intake.

 

[Pixel42]

No, it isn't an "argument" from consensus What I have presented is a fact! Go talk to your medical doctor! Do you have a medical doctor? I think not! Because everyone I know personally has a yearly physical exam with their primary physician who will do a through lab work on his/her patient. Lab work will determine many factors, including sodium intake. If it is high then the doctor will definitely advise the patient to reduce his/her sodium intake.

The current discussion is about whether the accepted wisdom on safe levels of salt consumption is correct. Simply quoting that accepted wisdom does not advance that discussion. Other posters are attempting to dig deeper into the studies which are the basis for that accepted wisdom, in order to assess whether the evidence is sufficiently robust.

 

[Ron Swanson]

There is no evidence that reducing dietary sodium improves the risk for heart attacks or strokes for the general population.

"In 1999, the Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Health Canada Laboratory Centre for Disease Control and the Heart and Stroke Foundation of Canada issued a joint statement opposing general recommendations for sodium reduction."

This is one of the very few times ALL there four agencies organized to issue a joint statement.

there are many more more studies world wide that support this ... why is salt being demonized? who knows

 

[Capsid]

There is no evidence that reducing dietary sodium improves the risk for heart attacks or strokes for the general population.

"In 1999, the Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Health Canada Laboratory Centre for Disease Control and the Heart and Stroke Foundation of Canada issued a joint statement opposing general recommendations for sodium reduction."

This is one of the very few times ALL there four agencies organized to issue a joint statement.

there are many more more studies world wide that support this ... why is salt being demonized? who knows

Let's see the studies then so we can discuss.

 

[Ziggurat]

Ziggurat, I most definitely don't think you know much about the American medical community.

I know enough, and obviously more than you.

Furthermore, your statement to me is outrages!

Your emotional state is not relevant.

A doctor has to pass a bar examine.

Case in point: lawyers have to pass a bar examine, not doctors.

There is no argument thus no fallacies!

We're arguing, so obviously there is an argument. And you keep using the same fallacies.

I support the medical community.

And I support the truth.

In an emergency room or hospital or in a office of a primary care doctor, it will be the doctor who decides what is best for the patient!

Is the emergency room where people consume most of their diet?

It occurs to me that you don't take a yearly exam by a professional doctor.

Irrelevant non-sequitor.

Let's carry on..."The National Kidney Foundation (NKF) is the largest, most comprehensive and longstanding organization dedicated to the awareness, prevention and treatment of kidney disease". . .

More argument from authority. If my claim is that the conventional wisdom is wrong, then pointing to more examples of conventional wisdom saying the same thing doesn't challenge my claim. You need actual evidence. This isn't evidence.

Top 10 Tips for Reducing Salt in Your Diet

If you don't need to reduce salt, then ways to reduce salt don't matter.

When it comes to dietary sodium, less is certainly best

That's not what the evidence says.

Speaking of which, do you even understand what the word "evidence" means? Because you have yet to produce any.

yet Americans today consume 50% more than the recommended daily quantities of sodium.

Government dietary recommendations are crap.

Diets high in sodium increase blood pressure levels.

I already provided a link demonstrating that this isn't actually true in the general population. Here it is again.

"A new study published in the American Journal of Hypertension analyzed data from 8,670 French adults and found that salt consumption wasn’t associated with systolic blood pressure in either men or women after controlling for factors like age."

See that? That is evidence.

 

[Ziggurat]

I mentioned the work by MacGregor in my post above.

See this meta-analysis

So we've got conflicting results: some studies say reducing salt will reduce BP, some say it won't.

But not everyone needs to reduce their BP. If you don't have hypertension, why would further reducing your BP lead to better health outcomes? Is there any actual evidence that healthy people should reduce their salt intake to 3 g/day, as the authors of your source recommend? And how does salt intake affect all-cause mortality rates? If reducing salt lowers BP but doesn't improve all-cause mortality, it's not a benefit.

 

[Capsid]

So we've got conflicting results: some studies say reducing salt will reduce BP, some say it won't.

But not everyone needs to reduce their BP. If you don't have hypertension, why would further reducing your BP lead to better health outcomes? Is there any actual evidence that healthy people should reduce their salt intake to 3 g/day, as the authors of your source recommend? And how does salt intake affect all-cause mortality rates? If reducing salt lowers BP but doesn't improve all-cause mortality, it's not a benefit.

One of the biggest causes of death is hypertension, makes sense to address it in those that have it. Is it detrimental to have a lower salt intake? The issue lies with the food industry who put too much salt than is needed in processed food.

Do most people consider themselves healthy until they have a heart attack or stroke?

The article by Lelong does have some caveats. Those on hypertensive drugs were excluded from the study and these may have been on a high salt diet. They also state that "hypertensive participants consumed salt at a significantly higher rate than did those who were nonhypertensive". As usual more research needed.

 

[casebro]

I mentioned the work by MacGregor in my post above.

See this meta-analysis

My abstraction form that study: Cut 4 grams/day, drop 4 1/2 points. Cut 6 grams/day, cut 6 points. Criminy! How much salt do you folks eat?

I home cook exclusively. I made 18 lbs of Italian sausage last week. It has 3T of salt added. And I'll throw a t into the spaghetti water. I guess I am low salt already? No wonder I don't feel the need for the water pills. What do you folks eat, nothing but Pretzels?

Seriously, 6 grams is a modest reduction per that study? ? The Soviet Astronauts were studied at up to 12 grams/day?

But other side of the coin, if I were to go hog wild on the salt, adding 6 extra grams, my BP would go up by 6? When it's 100 too high, 6 is petty. Very petty.

Perspective: That whole HUGE one pound bag of potato chips has 2 grams salt, or one day RDA.

I just googled, 3.4gram'day of sodium is avg comsumption. 2300 is RDA. So on the one hand they want us to cut one gram/day, or enough to drop our avg BP by two points. Or, per the study above, drop it by 200% to lose 6 points?

 

[The Don]

What do you folks eat, nothing but Pretzels?

Salt is pretty ubiquitous in pre-packaged food of all kinds. Whilst it may be quite obvious that there is salt in salted crisps (though those in the UK seem much saltier, 0.35g in a 25g bag of crisps - about 6.5g in a 1lb bag) and other salted snacks, the level of salt in bread, breakfast cereal, biscuits (cookies) and so on may be less clear.

https://www.theguardian.com/lifeandstyle/2017/mar/20/salt-reduction-food-guidelines

Convenience foods have also been very high in salt in the past - it's a cheap way to add flavour - but in the UK at least, salt levels have been dropping steadily.

I'm very lucky, I work from home Mrs Don is an excellent and enthusiastic chef and baker. We're in total control of pretty much everything we eat - apart from if we eat out, maybe a couple of times a month. One or two harassed parents without much time and/or cooking skill and relying on convenience or take-away food for a lot of meals or someone like I used to be - working away all the time relying on restaurants and sandwiches may end up with a lot of salt in their diet without realising it.

 

[casebro]

Here's a better study, because they comapre normotensives and hypertensives:

https://www.ncbi.nlm.nih.gov/pubmed/28391629

Sodium reduction from an average high usual sodium intake level (201 mmol/day) to an average level of 66 mmol/day, which is below the recommended upper level of 100 mmol/day (5.8 g salt), resulted in a decrease in SBP/DBP of 1/0 mmHg in white participants with normotension and a decrease in SBP/DBP of 5.5/2.9 mmHg in white participants with hypertension. A few studies showed that these effects in black and Asian populations were greater. The effects on hormones and lipids were similar in people with normotension and hypertension. Renin increased 1.60 ng/mL/hour (55%); aldosterone increased 97.81 pg/mL (127%); adrenalin increased 7.55 pg/mL (14%); noradrenalin increased 63.56 pg/mL: (27%); cholesterol increased 5.59 mg/dL (2.9%); triglyceride increased 7.04 mg/dL (6.3%).

Drop your BP by 1mm/hg, screw up your hormones and cholesterol.

But again, they are comparing 12 grams/day to 6.

 

[Myriad]

I home cook exclusively. I made 18 lbs of Italian sausage last week. It has 3T of salt added. And I'll throw a t into the spaghetti water. I guess I am low salt already? No wonder I don't feel the need for the water pills. What do you folks eat, nothing but Pretzels?

You might be low salt, but let's take a more careful look first.

That sausage salt comes to about 290 mg sodium per 4 oz serving. Not excessive, but a major bookkeeping entry if you're trying to stay within a typical "low sodium" limit of 1500 mg per day. (And might the actual serving size per person be closer to 6 oz. or more?)

A slice of Italian bread on the side will likely add another 175 mg. (Might some diners be choosing two slices instead?) Double that, more or less, if it's garlic bread. More still, if there's cheese on the bread, or anyone is shaking a little Parmesan or Romano on their spaghetti...

Does the garden side salad come with Italian dressing, by any chance?

ETA: Oh yeah, I forgot sauce. It's possible, if you're making your own sausage, that you're also making your own sauce from fresh tomatoes, without adding any salt. If so, well done! But using canned tomatoes (unless you go out of your way to find the "no salt added" variety) adds about another 75 mg per serving, about triple that if using a can or a jar labeled as "sauce."

A low-sodium goal for a typical dinner is about 500 mg, to allow for the day's other meals and snacks. (Lunches, because they usually involve prepared foods and/or mayonnaise-based sandwich salads, bread, condiments, etc., tend to have more; breakfasts less; and snacks are a sodium minefield.) So, how do you do it? Let's assume no sodium in the sauce, and no cheese anywhere, and a sausage serving less than one typical Italian link which run between 5 and 6 ounces. That leaves you a choice between bread OR salad dressing.

 

[Ziggurat]

One of the biggest causes of death is hypertension, makes sense to address it in those that have it.

Sure. But the recommendations are being applied to everyone, including people who don't have hypertension, and there isn't actually much evidence to back up those general recommendations.

 

[Dr. Keith]

Sure. But the recommendations are being applied to everyone, including people who don't have hypertension, and there isn't actually much evidence to back up those general recommendations.

Exactly. I have gout and find that some foods trigger my gout. I don't think it would be wise for everyone to reduce those foods in their diet, but it is very effective for me to do so.

 

[Capsid]

Sure. But the recommendations are being applied to everyone, including people who don't have hypertension, and there isn't actually much evidence to back up those general recommendations.

I understood this to be a prophylaxis measure. Reduce salt to prevent you getting hypertension as you get older. In the podcast I linked to, MacGregor says that blood pressure should not normally increase with age.

 

[casebro]

You might be low salt, but let's take a more careful look first.

That sausage salt comes to about 290 mg sodium per 4 oz serving. Not excessive, but a major bookkeeping entry if you're trying to stay within a typical "low sodium" limit of 1500 mg per day. (And might the actual serving size per person be closer to 6 oz. or more?)

A slice of Italian bread on the side will likely add another 175 mg. (Might some diners be choosing two slices instead?) Double that, more or less, if it's garlic bread. More still, if there's cheese on the bread, or anyone is shaking a little Parmesan or Romano on their spaghetti...

Does the garden side salad come with Italian dressing, by any chance?

ETA: Oh yeah, I forgot sauce. It's possible, if you're making your own sausage, that you're also making your own sauce from fresh tomatoes, without adding any salt. If so, well done! But using canned tomatoes (unless you go out of your way to find the "no salt added" variety) adds about another 75 mg per serving, about triple that if using a can or a jar labeled as "sauce."

A low-sodium goal for a typical dinner is about 500 mg, to allow for the day's other meals and snacks. (Lunches, because they usually involve prepared foods and/or mayonnaise-based sandwich salads, bread, condiments, etc., tend to have more; breakfasts less; and snacks are a sodium minefield.) So, how do you do it? Let's assume no sodium in the sauce, and no cheese anywhere, and a sausage serving less than one typical Italian link which run between 5 and 6 ounces. That leaves you a choice between bread OR salad dressing.

Except no sauce, no bread. Pasta is enough cabs for a meal. And I prefer butter and sour cream.

But I don't usually eat it as Ital meal. I might break one apart, fry it in coconut oil, and crack a couple eggs on it. That is my breakfast, complete.

And yes a link is about 5 oz. But so lean it won't grease the pan if I fry it alone. And if you want to discuss sat fat and health, we can start another thread.

Point is, preconceived notions don't count.

 

[Ziggurat]

I understood this to be a prophylaxis measure. Reduce salt to prevent you getting hypertension as you get older.

But there's not much evidence for that either.

In the podcast I linked to, MacGregor says that blood pressure should not normally increase with age.

Lots of things should not happen when you age but frequently do. For example, you shouldn't get sarcopenia, but it's quite common. And it leads to a whole host of problems, including high blood pressure, diabetes, osteoporosis, and frailty. What are we doing about that? Stupid **** which doesn't work.

Reducing salt intake isn't that high a priority for most people.

 

[aleCcowaN]

.

Maybe I can run the math in a hours on my lunch break. I'm not averse to getting corrected if I'm wrong.

Mined salt is about 40% Na, sea salt is about 35% Na, and if you like -and you taste them that way- some bitter and tangy overtones, it may lead you to consume less sodium. Monosodium glutamate (known here as aji-no-moto) is just 16 or 18% Na (I'm not doing the math), but it won't taste salty. Baking soda is dangerous because it tastes a little salty but it adds a lot of sodium without being "salty enough". Some products like ricotta cheese manufactured in certain ways are known to contain a lot of sodium but they don't taste salty, so reading the labels is important, even with sweets.

Some low sodium salts might be dangerous. The typical mix one third sodium chloride and two thirds potassium chloride works well for certain people, but there are those who hardly perceive any taste when they ingest potassium chloride, so any person trying this substitute should have one gram of sodium chloride and three grams of low sodium salt precisely weighed and use it with equal parts of liquid to really confirm by tasting that they get the saltiness in the substitute. Additionally that extra potassium works well together with thiazide diuretics, but it's a no-no when spironolactone is used alone because your physician found a secondary aldosteronism.

 

[Roboramma]

But there's not much evidence for that either.



Lots of things should not happen when you age but frequently do.

I listened to the same podcast a week or so ago. The guy's claim was that an individual's chances of having high blood pressure increase with age, but that this is only true because we are all eating copious amounts of salt, and in societies where salt consumption is very minimal (3g/day?) there is no association between age and high blood pressure. The example he gave was the yanomamo.

Of course correlation is not causation. I'm just trying to clear up the exact nature of the claim.

 

[Capsid]

There has been a reasonable study done in chimpanzees too.

Addition of up to 15.0 g/d salt to the diet of chimpanzees caused large rises in blood pressure, which reversed when the added salt was removed.

This was using a vegetarian diet supplemented with biscuits in which the sodium level was changed.

 

[Ziggurat]

I listened to the same podcast a week or so ago. The guy's claim was that an individual's chances of having high blood pressure increase with age, but that this is only true because we are all eating copious amounts of salt, and in societies where salt consumption is very minimal (3g/day?) there is no association between age and high blood pressure. The example he gave was the yanomamo.

Of course correlation is not causation. I'm just trying to clear up the exact nature of the claim.

Let's assume it is causative. Is there harm in eating lots of salt when you're young? Or is it enough to cut back when you're old and you start to develop higher blood pressure?