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Tuesday, May 14. 2013
Salt is one of those things that drive dietary cranks, control-freaks, and ignorant do-gooders nuts.
There really is no reason for that. Most of us docs have been saying this for years and I have made this point here in the past. Salt is an absolutely necessary nutrient for all animals, and very low levels of sodium chloride can make you sick or dead.
The average, normal human body contains around 50 quarts of salt water.
The reason people used to advise "low-salt" diet is because excess dietary sodium is a bad idea for people with kidney failure and congestive heart failure, and people with uncontrolled high blood pressure (with its associated higher risks of heart attack and stroke).
However, salt does not cause those things.
Significantly-high blood pressure is easily dealt with these days. Heart failure will likely kill you in time regardless of what you do (barring a heart transplant), but it is treatable with medicines and some salt restriction.
The new study from the CDC: No Benefit in Salt Restriction.
The American Heart Association is not up to date on the topic: Sodium is Your enemy.
If you have high blood pressure, get it under reasonable control with your doctor. If you have organ failure (eg kidney or heart failure), or have some other ailment, do whatever your doc says. If you're healthy, enjoy your salt. It makes food taste better.
One recipe tip: I always season a salad with salt and pepper. It makes rabbit food taste almost good. Don't get me on the topic of whether green salad is "healthy." (It's neither healthy nor unhealthy. It's just filler.)
Tracked: May 23, 01:25
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I wish I had kept count over these 80+ years of how many things how many times have been alternately good/bad for you.
I sprinkle my salad with Tobasco pepper or Habnero sauce depending on the mood. That up my salt in take a bit.
But then what about the salt (sodium and potassium) removal effect of diuretics. Is it good or bad....
Diuretics can be dangerous if abused (as in anorectics) but are useful for those with high BP and heart failure.
Yea, diuretics are keeping me alive along with dronedarone, an ARB, rivaroxaban and a pacemaker.
Over the years, I have discussed with my medical students the theory that the frequency of hypertension in American blacks is related to an advantage that salt retention gave slaves during the middle passage. I've never seen a study of hypertension in Africa.
Careful on this...Increasing salt intake over about 2000mg/day is unnecessary (which we all generally do) to replace loss through excretion and perspiration. It's a simple relationship: To maintain 150 mM NaCl in blood, with increased intake of NaCl solutes, there will have to be a volumetric increase in water. Given fixed cardiac cycles, and vascular lumen flow, something has to give. That would be BP. Over time, with normal renal clearance the Na decreases, as does water, but it takes time. There is a clear linear relationship between dietary NaCl intake and stroke. There is a confound here talking about untreated hypertention vs. treated hypertension in relation to effectiveness of NaCl intake reduction.
Everything in moderation. If someone is moving higher than about 5000mg/day (some countries report upwards of 15K mg/day) they simply are asking for trouble. And, of course, there are cultural/genetic differences that are significantly blurred with averages and ANOVAs.
I have to do low sodium because of Meniere's. And no/low caffeine. But some days, I really miss salt. It just adds that extra something.
Does the restricted sodium intake seem to help with the ringing in the ears?
My salt of choice is primarily sea salt. never table salt if I can help it.
But, I do salt just about EVERYTHING.
The American Heart Association isn't up to date on a lot of things including that stupid call E911 rule they used to have for CPR.
I figured this was true. Too many health scares , when pealed back, are aimed at specifically "at-risk" individuals with certain health issues.
Salt is very dangerous here in Maine, especially this time of year. Moose, it seems, require a high-sodium diet. After the snow melts in Spring, they can frequently be found grazing on the side of roadways throughout the state, where the salt residue remains from a winter of road maintenance. Many an unsuspecting automobile get intimate with moose this time of year.
Always pick up a salt shaker by its top.
This foils pranksters.
Good point with "Get your blood-pressure under reasonable control'.
That does not mean that an 80 year old should have the blood pressure of a 20 year old, and I am sure you know this is true. Why, oh, why do doctors panic at a number! The correlation between CHD/CVA and high blood pressure is a correlation, granted, with a p-value at the 95% level. BUT and this is a BIG but - this correlation IS MOST PREVALENT IN DIABETICS!
I have not seen any studies that show that the significance holds true for the normal population, meaning factoring out the diabetics.
Dang. If we could control diabetes, we would all be so much less sick! I know I'm preaching to the Dr. Joy choir on this ;-> But I can't help myself:
Eliminate those vicious carbs: sugar/starches in purified forms. Limit 'naturally occurring' sugars/starches and keep your blood glucose levels under 100. Steak and Salad - that's what's for dinner. (And only because I LIKE salad. Else it would be steak and bacon)
Diabetes is genetic. You get it from your parents not from sugar. Often most diabetics don't discover they even have diabetes until their late 20's to 30's so it's understandable that anyone might believe they "caught it". They were healthy until they started eating those damned McDonalds French fries don'tcha know. Conversely if you don't have it eating "vicious" carbs sugar/starches in their purified form (or even impure form) doesn't "give it to you".
The refined carbs are heavily present in processed foods.
Soda, packaged foods. and there are significant deficiencies in other vitamins and minerals.
While The ancient Vedic medical system Ayurveda, identifies 10 kinds of conditions that correlate to diabetes. Most of them related to Kapha imbalance. Kapha is imbalanced by sugar, fast carbs, and sweets.
Look up on Kapha balancing diet.
Ayurveda had a different perspective on how things work, would take to long to explain here.
One key principle is Eat what makes you healthy, avoid what makes you ill.
Dear Dr. Joy - thank you - as a long time ob nurse, I'm here to say that salt restriction actually causes/worsens PIH (pregnancy-induced hypertension/Aka toxemia/preeclampsia)....pregnant women NEED salt and protein to maintain increased blood volume.