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SALT: The Truth

President Joe Biden is on Puerto Rico today.  The island has had a history of major hurricane problems, and power from Category 1 Fiona last month is still not fully available.  He next goes to Florida, where parts of the state will just need to be abandoned, while the death toll remains under double digits.  Saturday night 125 people died in Indonesia after a soccer match.

Read this article about how politics can affect recovery attempts from hurricanes.  Florida politicians particularly seem to be caught in this imbroglio.  Biden smartly said all the right things about Hurricane Ian, but notice how he (Ian) only damaged Republican states, skipping around Georgia, which more recently caused problems for Republicans.

On to the topic of the day, salt, or sodium chloride.  

  • Our oceans are 3% salt, and if water is removed and spread evenly over our land surface, would form a layer 500 feet thick, about the height of a 40-story office building.
  • The Dead Sea is 34% salt, yet, algae and other microorganisms can survive.  I have floated here, and tend to sink in other waters.
  • Our body has 0.4% salt, but our blood is at just under 1%.  
    • Too much can cause high blood pressure, heart disease, stroke, kidney diseases and diabetes.
    • Too little can kill us in other ways.  
    • We need salt to control our muscles and to operate our nervous system.  Remember that salt kills most bacteria by sucking the water out of them.  But some bacteria in our body are good.
  • One teaspoon is around 2300 mg (more accurately, 2335 mg) or 2.3 grams of salt.
    • While 2300 mg is about right for most, the American Heart Association says the ideal is closer to 1500 mg.
    • Many of us eat as much as 6000 - 8000 mg/day, which you would think must be way too high.  But is it that true?
  • A normal diet will control salt.  A lot of processed food is not good.  

  • Ranch salad dressing: 405 mg
  • Hot dog: 467 mg
  • Slice of American cheese: 468 mg
  • Plain bagel: 430 mg
  • Frozen lasagna dinner with meat sauce: 730 mg
  • Cream of chicken soup: 750 mg
  • Frozen pizza slice: 780 mg
  • Instant cup of noodles: 1,200 mg
  • ONE PICKLE:  1,300 MG

  • Which is worse, salt or sugar?  Actually, sugar is considered to be worse, and has a greater affect on blood pressure than salt.
  • Is Mrs. Dash a good salt substitute?  Yes.  It does not contain potassium chloride, which is bad for kidney problems.
  • Conversely, Mrs. Taste is a soy sauce with 76% less salt, but the replacement is potassium chloride.
  • SUBSTITUTE:
    • Salad, for example:
      • 3 teaspoons of ranch dressing has 405 mg of salt.
      • 3 teaspoons of olive oil, vinegar and herbs = 0 mg.
    • One hot dog has 467 mg...3 ounces of grilled chicken breast has 183 mg.
HOWEVER, a study from 181 countries indicated A SALT PARADOX, that there was an increase of 2.6 years of healthy life expectancy at birth FOR EACH ADDITIONAL GRAM (1000 MG) OF DAILY SODIUM INTAKE.   To quote one of the researchers:

“If indeed salt is a cardiac nemesis, then there should be [an inverse] correlation between life expectancy and salt intake,” Messerli told TCTMD, but “to my great surprise,” the opposite was seen. He pointed out that various groups recommend daily limits on sodium consumption—1.5 g for the American Heart Association, 2 g for the World Health Organization (WHO), and 2.3 g for the European Society of Cardiology—that were associated with short life expectancy and increased mortality compared with higher levels of intake in this study
.

Messerli acknowledged the myriad limitations in an analysis like this and stressed that dietary recommendations cannot be made on the basis of the results. “Don’t increase your salt intake, but if you’re perfectly normotensive, there’s no reason to follow the recommendation of the American Heart Association to reduce the sodium intake below 1.5 g per day,” he said, adding that “these recommendations have had, I’m not saying no effect at all, but very little effect.”  For hypertensive patients, he continued, “I think it’s reasonable to attempt to reduce your salt intake.”


Mind you, the authors warn those with special kidney and related ailments to go low on salt.  Yet, this paper was rejected by numerous publications until finally being approved for the European Heart Journal, a leading publication in general cardiology.


Oh, be careful what you are comparing, for sodium and salt are different.  Remember that all the above analysis refers to salt, not sodium.


Life expectancy tended to increase along with sodium consumption up to intake of 4 to 5 g per day, which equals a salt intake of 10 to 12.5 g per day. Above that threshold, life expectancy started to level off and eventually declined at higher levels of consumption.


Thus, the 1.5 grams/day recommended by the American Heart Association is 8 times lower than this study saw.  A special mention was made of the high salt content in Japan's nutrition, yet, their citizens regularly led the developed world in longevity.  I further checked, and in 2016 The Japan Times had an article entitled:  How Japan's Saltiest Residents Came To Live the Longest.
  • Men from Nagano Prefecture has had the highest life expectancy since 1990, while their women took over the top spot from Okinawa in 2013.  Okinawa showed women at #3 and men at #30.
  • Nagano men and women now top the country, but the elders seem to stay healthier and active.
  • They consumed the most vegetables/person, 70 grams more/day than the national average.
  • A lot of miso is still used...with their vegetables.  Miso is very salty.
However, a limited 2020 Japan study showed that more salt reduced mortality.  The reason is that the acceptable average in Japan is higher than much of the world, with 6.25 gram / 1000 kcal of daily consumption as the average.  But the world average is 2500 kcal/day.  This equates to 15.6 grams of salt/day, which is ten times the AHA recommendation.  Kind of confusing.


So what is the truth?  My take:
  • The 1500 mg/day American Health Association is a low low.
  • The 2300 mg average salt/day for Americans should be fine if you are healthy with no ailments.
  • The 15,600 mg salt/day for Japan is high.  If they can drop this by a factor of two, they should live longer.
  • As my ethnicity is Japanese, perhaps my body is more genetically able to tolerate a higher salt diet.  While my blood pressure is high, pills are keeping this in check.  I think after researching this subject I will not feel so guilty having shoyu with sashimi, or adding a dash of salt to steak. 
  • Salt in diet will continue to be a controversial subject for a while.
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