The salt shaker has been a major topic of discussion and controversy for quite some time now, holding a nefarious reputation in the nutritional realm. Sodium, with its most common source being table salt, is linked to high blood pressure, cardiovascular disease (CVD) and stroke. This link’s main origin is a study conducted in the 1960s by Lewis Dahl. He fed rats massive doses of sodium (more than 150 times the regular human equivalent dose of consumption), which resulted in elevated blood pressure and changes in overall blood volume. This result spurred on the notion that a high-salt diet induces hypertension. Despite the fact that Americans consume high-salt diets through takeout meals, snacks, and processed foods, we’re not even close to eating the doses Dahl was giving those rats. The Food and Drug Association (FDA) guidelines are consistent with the Dietary Guidelines for Americans, which recommend limiting sodium to less than 2,300 milligrams (mg) per day (about one teaspoon) to decrease risk of hypertension, CVD and stroke. Government recommendations have been clinging to the coattails of Dahl ever since, despite the fact that subsequent research doesn’t even show a clear link between the two anymore.
Americans do love their salt though. The standard American diet consists of sugary, salty and ultra-processed foods, the latter accounting for about 77% of our sodium intake. It’s possible that the ingredients these products are made of could be contributing to their possible effects on our health (i.e. high blood pressure). Also, they may not be taking into account our comorbidities (diseases or medical conditions) that could be contributing to high blood pressure, CVD and/or stroke risk. Salt is not the sole culprit of hypertension; it’s just a snapshot of an overall unhealthy trend that we Americans are exhibiting. An observational study also done by Mente et al. measured potassium in addition to sodium and saw that the higher the potassium levels in our body, the lower the rate of strokes, heart disease and even death. This implies many more factors are at play that contribute to our health; we cannot pinpoint it to one (dare I say outdated) notion.
There are those that are salt-sensitive and feel symptoms after they ingest too much salt, like bloating and elevated blood pressure. They may need to be more careful with their intake. For the majority of the population, as long as we consume moderate amounts of sodium, it shouldn’t cause harm. In fact, a review done by Mente et al. (2021) showed that about 3-5 grams of dietary sodium per day may actually confer benefits to our cardiovascular health since amounts too low or too high may cause more harm than good. When salt intake is cut too drastically, the body responds by releasing renin and aldosterone, hormones that may actually increase our blood pressure.
Contrary to popular belief, we need sodium/salt for optimal health. Salt, aka sodium chloride, is 40% sodium and 60% chloride. The body carefully regulates sodium, which is involved in nerve function, blood pressure maintenance, and overall blood volume. It also helps protect against dehydration, hence this is why sports drinks contain electrolytes, which include sodium, potassium and chloride. Bottom line, it seems that there’s a happy medium when it comes to sodium/salt ingestion: as long as we don’t overdo it, there is no clear-cut evidence that salt is the enemy. Enjoy that salt shaker in moderation; the supporting research is worth its salt!
Melissa Papir Kolb is a registered dietitian working in long term care nutrition in Washington Heights, New York. She works with middle-aged-elderly residents to provide nutrition that can help boost their quality of life. She loves to write about nutrition in her spare time. She can be reached at [email protected]