Salt—the spice we love to hate. But fess up, you know popcorn wouldn’t taste the same without it. Despite salt’s delicious zing, it’s been widely vilified ever since studies in the 1970s linked diets high in sodium to high blood pressure and increased risk for cardiovascular disease. Doctors and nutritionists have long recommended low-sodium diets to treat and prevent high blood pressure. Now, new research suggests we can take some of these cautions with, well, a grain of salt.
In a study published in the American Journal of Medicine in March, researchers from the Albert Einstein College of Medicine in New York City found that people who ate low-sodium diets were 37 percent more likely to die from cardiovascular disease. The researchers examined nutritional information surveys that tracked the dietary habits of 7,154 Americans for 13 years. The data showed that those who restricted their salt intake to less than 2.3 grams a day were much more likely to die from stroke, heart attack, and other cardiovascular problems than people who ate more salt.
The researchers haven’t figured out why a low-salt diet would raise someone’s mortality risk, but doctors and researchers have debated the pros and cons of salt for years. “The alleged relationship between sodium and heart disease—that salt equals high blood pressure and heart disease—is a total myth,” says David Brownstein, MD, author of Salt Your Way to Health (Medical Alternatives Press, 2006). According to Brownstein, research never has proven that salt raises blood pressure in everyone.
In a pinch
So why have we heard for that salt raises blood pressure? Well, because for those people who are overweight, hypertensive, or genetically “salt-sensitive,” it’s true—salt does tend to increase blood pressure. But for people of normal weight with normal blood pressure levels, research shows that salt intake has no significant effect, says Brownstein.
In short, sodium spikes blood pressure in some people, while others can eat as much as they want without an effect. “It is increasingly evident that one size doesn’t fit all when it comes to diet,” writes Hillel W. Cohen, MPH, PhD, lead author of the March study. “This was an observational study, and not a clinical trial, so we can’t really conclude from our findings that low-sodium intakes are harmful. But our study certainly doesn’t support the idea of a universal prescription for lower salt intake.”
In fact, not only is salt not evil—it’s downright good for us. We need it to live. Sodium transports nutrients into cells, regulates fluid volume in the veins and arteries, and helps relay electrical signals between nerves. Cutting your salt intake way down may harm your health, as substantial research shows. A study in the American Journal of Hypertension, for example, found that reducing sodium intake increased insulin resistance, a risk factor for diabetes. Dramatically cutting back on salt also can raise the body’s levels of renin, an enzyme that affects blood pressure, says Michael Alderman, PhD, one of the authors of the March study and president of the International Society of Hypertension. High levels of renin are associated with increased risk of heart attack. “It is the sum of these effects that determines the overall health impact of salt,” Alderman says. In other words, over time a low-salt diet may do more harm than good for some people and may increase the risk of cardiovascular disease.
The mineral balance
Our overall diet plays a big role in salt’s effect on us as well. “Consuming sodium isn’t the issue; the real issue is consuming refined salt and virtually no potassium or other minerals,” says Shari Lieberman, author of The Real Vitamin and Mineral Book (Avery, 2003). “It’s the ratio of sodium to potassium that influences fluid balance and blood pressure.” You can get potassium and other essential minerals in fruits, vegetables, whole grains, and legumes; potassium is abundant in leafy green vegetables, cruciferous vegetables, winter squash, cantaloupe, blackstrap molasses, tomatoes, and bananas.
The bottom line? If you have normal blood pressure and weight and eat a healthy, whole-foods diet, you may not need to worry about your salt intake. If, however, you are overweight, hypertensive, or salt-sensitive, a lower-sodium diet may benefit you. The FDA sets the daily value for sodium at 2.4 grams—a little more than a teaspoon of salt. But according to Alderman, the optimal level of sodium intake “depends on individual behavior, environment, genetics, and preference”—which means for many people, salt represents one love-hate relationship with a happy ending.
Salts of the Earth
Why stick to plain old refined table salt? Exotic salts—with their richer, more complex flavors, essential minerals, and appealing colors—can make any meal more tantalizing. “Natural, unrefined salts have a unique but subtle flavor that is best experienced when added at the end of your cooking process,” says Steve Petusevsky, author of The Whole Foods Market Cookbook (Clarkson Potter, 2002). “Because of the variation in origin, each one has a different balance of minerals, producing its own delicate but distinctive flavor and texture.” For costs, suppliers, and more, see our Web Exclusives at alternativemedicine.com.
Smoked Sea Salt
Origin: Coastal Maine
What it’s about: Sea salt crystals roasted over wood fires—usually alder or applewood—to add a smoky flavor
What it looks like: Light tan, with a smoky flavor and aroma and a coarse texture
Best used in: Roasts, salmon dishes, hearty soups and chowders, chicken, turkey, and coleslaw
Gray Sea Salt
Origin: Coastal France
What it’s about: Contains mineral-rich clay deposits from surrounding salt flats; also called Celtic sea salt and Sel Gris de Guérande
What it looks like: Pale gray, almost light purple, with a mildly tangy flavor and a “moist” texture
Best used in: Salads, pastas, tomato-based dishes, braised greens, roasted corn, casseroles
Hawaiian Red Alaea
Origin: Kauai, Hawaii
What it’s about: Contains volcanic red clay, rich in iron oxide
What it looks like: Reddish-pink to deep red, with a soft, mellow flavor
Best used in: Traditional Hawaiian dishes like kalua pork and Hawaiian jerky, stir-fried vegetables, prime rib, and pork loin
Black Sea Salt Flakes
Origin: Larnaca, Cyprus
What it’s about: Pyramid-shaped flakes found in fresh water; hand-harvested
What it looks like: Distinctive dark-gray to black flakes, with a rich, intense flavor
Best used in: White fish and chicken, green salads, roasted potatoes, basmati rice, and curries
Himalayan Pink Salt
Origin: Himalayan Mountains, south-central Asia
What it’s about: Salt deposits formed 200 million years ago in an ancient ocean and are collected from altitudes higher than 10,000 feet
What it looks like: Pale pink, with a mineral-rich flavor and crunchy texture
Best used in: Sliced ripe tomatoes, salads, roasted vegetables, and white fish