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Salt Your Way To Health
Dr. Brownstein is a family physician and the Medical Director of the
Center for Holistic Medicine in West Bloomfield, Michigan. He has authored six
books including Salt Your Way to Health.
by Dr. David Brownstein, MD
Dietary Villain or Foundation of Health?
Low-salt diets have been recommended for many years. It is not too hard to find
an article in a magazine or medical journal recommending that the readers lower
their salt intake. Like dietary fats, salt has become a convenient boogeyman,
responsible for all manner of health ills. Government agencies, the American
Medical Association, and many dietary groups all recommend a low-salt diet.
Conventional wisdom holds that consuming less salt will lower your blood
pressure and reduce your chances of heart disease or a stroke. By now, everyone
knows that a low-salt diet is healthy, right? Wrong. But unfortunately, this is
another one of those cases where conventional medical wisdom simply does not add
up.
To develop an accurate understanding of the importance of salt in a healthy
diet, we must look beyond what passes for "conventional wisdom." A
review of the research literature, as well as my own clinical experiences have
convinced me that unrefined salt is vital to good health.
Hypertension and Salt
Early in my medical career, I accepted the "low salt = lowered blood
pressure" hypothesis unquestionably. My medical training was clear: A
low-salt diet was good and a high-salt diet was bad. In all hypertensive cases,
I was taught to promote a low-salt diet. In fact, I was taught that in order to
prevent people from becoming hypertensive, it was better to encourage them to
adopt a life-long dietary plan of low-salt. However, my experience with
promoting a low-salt diet to treat hypertension was not successful. Not only did
I find a low-salt diet relatively ineffective at lowering blood pressure, but I
also found a low-salt diet made my patients miserable due to the poor taste of
their low-salt food.
It wasn't until I began to look at my patients in a more holistic manner that I
began to research the medical literature about salt. What I found was
astounding; there is little data to support low-salt diets being effective at
treating hypertension for the vast majority of people. Also, none of the studies
looked at the use of unrefined sea salt, which contains many valuable vitamins
and minerals such as magnesium and potassium, which are vital to maintaining
normal blood pressure.
The conclusion that salt causes high blood pressure is based primarily on a
couple of studies; neither have conclusively established a causal link between
salt consumption and hypertension.
Although considered a part of medical orthodoxy, the idea that salt consumption
causes high blood pressure is relatively recent, and is, in fact, based on
questionable conclusions drawn from a handful of studies.
The first report of a relationship between salt and high blood pressure appeared
in 1904. Two researchers, Armbard and Beujard, asserted that salt deprivation
was associated with lowered blood pressure in hypertensive patients. Over the
next 50 years, this theory was tested in various studies, which usually involved
giving test animals huge amounts (10-20 times greater than normal) of refined
salt, to induce hypertension. As would be expected, when the animals were no
longer overdosed, the blood pressure levels returned to normal.
Given the high amounts of salt being given to the animals, the correlation to a
human population should have been suspect, but that did not stop medical
researchers from erroneously extrapolating the results to human salt
consumption.
The most popular study cited to prove the "increased salt = elevated blood
pressure" link was the INTERSALT Trial. This study looked at over 10,000
subjects aged 20-59 from 52 centers in 39 countries. The authors of the study
looked at the relationship between electrolyte excretion (i.e. sodium in the
urine) and blood pressure. A higher salt intake will result in a larger amount
of sodium excreted in the urine. Although there was a slight relationship
between blood pressure and sodium excretion, a "smoking gun" could not
be found. This study showed only a mild decrease in blood pressure, even when
there was a dramatic decrease in salt excretion.
The results of this study did show that various indigenous groups in South
America and Africa did consume relatively little salt and had low blood
pressure. But these tribes were relatively untouched by modern life as whole -
they generally did not drink or smoke, they were physically active and their
diets consisted primarily of whole, unprocessed foods. In all likelihood, these
factors were more significant in determining blood pressure levels than relative
salt intake.
Study after study has failed to establish a significant causal relationship
between salt intake and hypertension. In fact, there is some research that would
seem to point to a different conclusion.
Every 10 years, the government conducts the National Health and Nutrition
Examination Survey (NHANES). This comprehensive analysis of thousands of
citizens looks at various markers of health, including the relationship between
inadequate mineral intake and hypertension. After reviewing the data gathered
from several surveys, researchers concluded "Our analysis confirms once
again that inadequate mineral intake (calcium, potassium and magnesium) is the
dietary pattern that is the best predictor of elevated blood pressure in persons
at increased risk of cardiovascular disease."
The Center for Disease Control's own data over the last 30 years clearly shows
little relationship between low-salt diets and hypertension. This data
unequivocally shows that ensuring adequate mineral intake is much more important
to maintaining low blood pressure.
Salt & Heart Disease
Another purported benefit of a low-salt diet is a reduced risk of cardiovascular
incidents, such as heart attacks or strokes. But again, the evidence is less
than overwhelming. In fact, there is some compelling research which seems to
indicate that low-salt diets may actually increase the likelihood of a
cardiovascular event.
Eleven trials, which included follow-up from six months to seven years, were
reviewed. Researchers found that there was no difference in deaths and
cardiovascular events between the low-salt groups and the high-salt groups.
Systolic and diastolic blood pressure declined in the low-salt group by very
small amounts. The authors of this review comment that the miniscule lowering of
blood pressure with a low-salt diet did not result in any significant health
benefit. They also comment, "It is also very hard to keep on a low salt
diet."
In another study, researchers examined the relationship between a low-sodium
diet and cardiovascular mortality. Nearly 3,000 hypertensive subjects were
studied. The result of this study was that there was a 430% increase in
myocardial infarction (heart attack) in the group with the lowest salt intake
versus the group with the highest salt intake.
Why would a low-sodium diet predispose one to having a heart attack? Low-sodium
diets have been shown to cause multiple nutrient deficiencies, including
depletion of minerals such as calcium, magnesium and potassium, as well as
exhausting B-vitamin stores. There are numerous studies touting the benefits of
magnesium in treating cardiovascular disorders. Adequate amounts of potassium
and B-vitamins are also crucial for healthy heart. Many studies have shown that
a deficiency of minerals, particularly calcium, potassium and magnesium is
directly related to the development of heart disease as well as hypertension.
Unrefined Salt & Health?
We have established that a low-salt diet is not very effective at significantly
lowering blood pressure in most people. In fact, as salt levels have declined in
this country over the last 50 years, there has been no trend toward lowered
blood pressures in the population. Could mineral salt usage result in a
significantly lowered blood pressure? Many minerals, including magnesium and
potassium have a direct anti-hypertensive effect. As previously mentioned, the
NHANES study revealed that a pattern of low mineral intake, specifically
magnesium, potassium and calcium were directly associated with hypertension.
Repeated measurements over 20 years have confirmed the relationship between low
mineral intake and elevated blood pressure.
Unrefined salt has a wide range of minerals including potassium and magnesium,
providing the body with a complex of nutrients that it needs to function
optimally. The use of unrefined salt will not cause elevated blood pressure; in
fact, due to its abundance of minerals, it can actually help lower the blood
pressure in hypertensive patients.
Salt & Special Health Concerns
Researchers have looked at numerous studies to arrive at their recommendations
for sodium intake. Hypertensive patients can improve blood pressure moderately
by limiting their sodium intake to 3-7 grams (app. 1.5-7 teaspoons) per day. Too
much of anything can be a problem for the body. Salt, like any other substance,
should not be taken in excess. Since refined salt is a toxic substance, there
should not be any refined salt in anyone's diet.
However, there is a great difference between refined and unrefined salt. I
recommend only the use of unrefined salt in one's diet. This will supply the
body with over 80 minerals that are useful for maintaining the normal
functioning of the body. My experience has shown that the use of unrefined sea
salt has not resulted in elevated blood pressure in my patients. The addition of
small amounts of unrefined salt to food or cooking will not adversely affect
blood pressure or other health parameters in someone with normal kidney
function.
While there is considerable research indicating that unrefined salt can be an
important part of a healthy diet, there are some situations that do require
special consideration.
For example, there are some hypertensive patients who are salt sensitive. Salt
sensitivity is defined as an increase in blood pressure due to a high sodium
intake. Not all hypertensive patients exhibit salt sensitivity. The only way to
tell if an individual with hypertension will respond (via lowered blood
pressure) to a low-salt diet is to institute a low-salt diet. The research shows
that older individuals with hypertension will have a modest response. A review
of 56 trials showed that a low-salt diet had minimal effect on blood pressure in
the vast majority of people studied.
Another special concern related to those with kidney problems. Salt is excreted
in the kidneys and individuals with renal failure will have a decreased ability
to clear salt from their diets. These individuals must watch their salt intake
carefully. If you have renal failure, I suggest you speak with your doctor
before instituting any dietary change, including a change in salt intake.
Final Thoughts
Although promoted by conventional medicine as part of a healthy diet, my
experience has clearly shown the fallacy of low-salt diets. They are not
associated with a reduction in blood pressure for the vast majority of the
population and also have adverse effects on numerous metabolic markers including
elevated insulin levels and insulin resistance. Low sodium diets have been
associated with elevating total cholesterol and LDL cholesterol levels, which,
in turn, has been associated with cardiovascular events.
Furthermore, it has demonstrated that mineral deficiencies are present in most
chronic illnesses and it is impossible to overcome these disorders unless
mineral deficits are corrected. What conventional doctors and most mainstream
organizations have failed to grasp is the difference between refined and
unrefined salt. Unrefined salt contains over 80 minerals in a perfect proportion
for our bodies. Our bodies were meant to function optimally with adequate
mineral levels and adequate salt intake. Only the use of unrefined salt can
provide both of these factors.
For the great majority of people a low-salt diet does not work. Patients do not
feel well when sodium levels are lowered. Their energy level drops and they
develop hormonal and immune system imbalances. It is refined salt that needs to
be avoided - it is a toxic, dangerous substance that fails to provide the body
with any benefit. Unrefined salt should be the salt of choice.
Visit Dr Brownstein on his website: http://www.drbrownstein.com/index.shtml
Note:
The FDA has not evaluated these statements. This product is not intended to
diagnose, treat, cure or prevent any disease.
If under medical supervision or pregnant, it is recommended you consult your
health professional before use.
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