Americans receive health information that is extremely confusing. Some sources are based in science and have your best interests at heart. Others are not based in science and have a different agenda. You need health information that you can depend on. One confusing topic is salt or more precisely sodium. Some say that salt is harmful. Others say it is not. It is a very important topic because our fast and processed food is loaded with salt. In fact, it is very hard to buy products that are low in sodium and that is the main consideration. It’s not just salt. Baking soda and monosodium glutamate have lot of sodium too.
Now there is a study that has hit the news on the topic. It is critical to know the facts about sodium. Does it really matter? The truth is a little complicated because salt intake is critical for some people and does not seem to matter for others. That is the reason for the controversy.
Here is what the study found. Compared with a high-sodium diet (over 2000mg), the low-sodium diet reduced in blood pressure in 73.4% of individuals. A 5 point drop in blood pressure between a high-sodium and a low-sodium diet classified 46% of individuals as “salt sensitive.” At the end of one week, the top number blood pressure number, (systolic) difference between individuals on a high-sodium vs a low-sodium diet was 8 point lower. Here is an analysis of the study in layman’s language. Bottom line: some of us can reduce our blood pressure by salt restriction as much as a single medication for high blood pressure does.
So here is the obvious question. How can we easily identify people who are likely to be salt sensitive? How can we identify people who will benefit by limiting salt in their diet. Too much abdominal fat is a major clue. Obesity may be the main cause of high blood pressure in up to 75% of individuals with that condition. The good news is that we know a lot about how that works and we can do something about it.
When we have extra abdominal fat, that favors an increase in two hormones (angiotensin II and aldosterone) that cause us to hang onto salt, increase oxidant production, and produce inflammation. Those changes increase our blood pressure. Once the genes that make those hormones are switched on, they continue to be more active, but weight loss produces some benefit. Losartan precisely blocks the effects of angiotensin II and eplerenone precisely blocks the effects of aldosterone. They are precision medicines.
The best way to lose weight permanently is to eat real whole food. Fast and highly processed foods are loaded with salt, and they also contain sugar, processed carbs, and fat in combinations that are addictive. You will eat them when you are not hungry and the more you eat the more you want. That means you are taking in lots of salt. Here are some examples of how hard this is in our country. The patients who dropped their blood pressure had a sodium intake of 500 mg a day. Here is the big picture from Harvard Health Publishing: “Current recommendations urge us to consume less than 2,300 milligrams (mg) of sodium a day, equivalent to about a teaspoon of table salt. The bar is set lower—1,500 mg a day—for those with cardiovascular disease or high blood pressure. Yet the average American takes in about 3,400 mg a day.”
I have a can of Campbells’ chicken noodle soup here beside me. The label says there are two and a half servings in one can. Each serving has 890 mg. of sodium. The entire 11 ounce can has 2225 mg. of sodium, which is almost the entire daily allowance. A McDonald’s meal of a double cheeseburger (1360 mg), large fries (400 mg) and a large coke (80 mg) has 1840 mg of sodium. The foods Americans eat most commonly are loaded with salt.
Sure, salt makes food taste much better, but the more you eat the more you want. I used to eat lots of salt. I can’t do that anymore. Since I have cut down on salt, I am just as happy with food that has much less salt. If I eat more salt than I should, I retain lots of fluid. If you retain fluid and have swollen legs, you are eating too much salt. I was recently traveling by car for two weeks and eating processed, restaurant, and fast food. When I got home, I went back to my salt restriction and lost 11 pounds in a week. The twin eating goals for many people with high blood pressure are losing weight and restricting salt. Eating real, whole food without added salt—lean meat, seafood, eggs, fruits, vegetables, beans, peas, and nuts is the only path that I know of to permanent weight loss and lower blood pressure for people who have been too heavy like me. If you struggle to get that done, that makes medicines like lisinopril, losartan, spironolactone, or eplerenone especially important.
Lowering insulin levels naturally will also help.
Yes, correct. If belly fat, especially the liver fat are the root cause of the chronic diseases, including but not limited to Hypertension, let’s focus on getting rid of them. It can be done!