This post about salt is the penultimate installment in a multipart series about the 2015 Dietary Guidelines for Americans. Since 1977, these guidelines have been the source of endless controversy and mirth to people like me who find controversy and mirth in things most people don’t really care about. But, you should care about them. From the advice you get from your doctor to the products you’re sold in the supermarket, the Dietary Guidelines for Americans are at the center of your overall health and wellness.
Karma Sense Wellness readers know this and requested I analyze and document my impressions of the 2015 version of the guidelines. They knew that setting me loose on this task would result in a no-bullcrap interpretation of this important document. Furthermore, they correctly suspected that engaging in this activity would keep me off the streets long enough to delay my pestering of people to support National Schlumpia Day.
Throughout the year I wrote about various aspects of the guidelines. I’ve poked fun at the absurdity of the process and the confusing nature of its recommendations. However, this time around I’m more direct. This post focuses on salt and sodium. Of all the recommendations in the guidelines, those that are focused on sodium have the most immediate and acute effect on health. Therefore, I’ll be a little less goofy in this post. It’s a fairly simple subject that the guidelines manage to overcomplicate.
Let’s get started.
Salt: Its Abridged History in the Dietary Guidelines for Americans
Salt and the 2010 Dietary Guidelines for Americans
The government updates the Dietary Guidelines for Americans every five years. The 2010 version said the following about salt:
“Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertenison, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.”
If you’re relatively young, healthy and not African American, limit salt consumption to 1 teaspoon or about 6 grams per day. If you’re getting along in years, have certain health conditions or African American, cut that limit by 35%.
Salt and the 2015 Dietary Guidelines for Americans
But in 2015, there was a sudden shift. Here’s what they say:
“Healthy eating patterns limit sodium to less than 2,300 mg per day for adults and children ages 14 years and older and to the age- and sex-appropriate Tolerable Upper Intake Levels (UL) of sodium for children younger than 14 years.”
“further reduction to 1,500 mg per day can [emphasis added] result in even greater blood pressure reduction.”
Forget about that 1,500 mg per day thing unless you already have high blood pressure. One teaspoon is fine for most people. Kids under 14 are the exception. Here are the recommendations for them
Why the Change?
The National Academy of Medicine (formerly the Institute of Medicine) performed a meta-analysis in 2013 on the effects of sodium. What they found is there is no evidence to support singling out specific subgroups of people and treating them any differently than the population at large. Furthermore, there are no obvious benefits to adults when they consume fewer than 2,300 mg.
Clearly, there has been a change of heart. But what should a normal person do with this information? Or in the absence of a normal person…
What Would Davey H Do?
Salt Background Info
The first thing Davey H would do is get science-y on you and make sure a few things are clear.
Salt is Not the Same as Sodium
Plain white salt is comprised of one molecule of Sodium (Na) and one molecule of Chlorine (Cl). Approximately 60% of salt’s weight comes from the chlorine while the rest comes from the sodium.
The Dietary Guidelines for Americans recommendation for daily sodium consumption is 2,300 milligrams or 2.3 grams. But people don’t add sodium to their french fries, they add salt. And 6 grams of salt a day is the equivalent of about 2.3 grams per day.
Nutrition Fact labels tell you the sodium content in milligrams (weight). When you add salt to your own food you eyeball it or do it according to volume (e.g. teaspoon, tablespoon, etc.). To do the conversion, you have to do that math yourself. This is why the Lord invented the swipe-up function on the iPhone. So you could get easier access to the calculator app.
Fancy salts with added flavors or colors are not pure NaCl. For the purposes of our discussion it;’s safe to assume they’re mostly NaCl so you don’t get to shave off points because your Himalayan salt is pink or bacon salt has real artificial bacon flavor. In the latter case, you probably lose points.
The great news is, that when you get to the recommendations below, you see that most of you don’t have to worry about this stuff.
Sodium is an Essential Nutrient
Your body needs sodium and it can’t manufacture it by itself. Salt is the purest source of sodium. People who don’t get enough sodium may see an increase in a number of chronic disease risk factors including elevated LDL (the so-called bad cholesterol), elevated triglycerides and increased insulin resistance. A particularly dangerous condition called hyponatremia occurs when blood sodium levels are especially depressed. Hyponatremia symptoms range from headaches and light-headedness to seizures, coma and death. Athletes and highly active people are most at risk for hyponatremia.
Sodium’s Impact on Blood Pressure is Modest at Best
According to one study, restricting salt lowered the systolic blood pressure of hypertensive patients by 5.39 mm Hg and the diastolic blood pressure by 2.82 mm Hg. For subjects with normal blood pressure, the reduction was 2.42 mm Hg and 1.00 mm Hg respectively.
Potassium in the Diet Has a Balancing Effect on Blood Pressure
Potassium help to lower blood pressure by helping your body get rid of excess urine. The recommended daily allowance for potassium is 4,700 mg. Only 2% of Americans achieve this goal. Meanwhile, the average American consumes 3,600 mg of sodium each day. Research backs this up. So, there is as much opportunity to increase potassium in the diet as there is to decrease sodium. More on that in a bit.
Karma Sense Salt Recommendations
Here are some Karma Sense ways to manage dietary salt for optimal health.
Unless you’re in a specific risk category and you’re under doctor’s orders to reduce sodium, don’t sweat it. Manage your salt intake by eating fewer processed foods. Processed foods and cheap restaurant meals are where most of the added salt in your diet originates. Keep in mind that salt is added to these foods for two reasons:
- Salt hides the fact that food tastes like crap. Your bacon-and-ranch-flavored-chocolate-covered-cheese-puffs would probably taste more like the plastic soda bottles they’re made from if it weren’t for the salt.
- Salt is a natural preservative. The salt in your bacon-and-ranch-flavored-chocolate-covered-cheese-puffs is not only added for flavor. It also ensures they stay fresh even though they were made back when Phydeaux was a pup.
Decrease the impact of salt on your blood pressure by eating more foods with potassium in them. Here is a great list of foods that are high in potassium. If you don’t like any of them, learn a trick from Big Food, reserve your allocation of added salt and sprinkle it sparingly over these foods. It’ll help you choke them down and over time, you’ll learn to love them. I promise.
If you do have high blood pressure, kidney problems or any other condition that influenced your doctor to recommend a low-sodium diet, take the advice but ask questions. Some great questions to ask include:
- How does sodium impact my condition?
- What other lifestyle changes can I make to improve my condition?
- How will we follow up to make sure your recommendations have the desired effect?
- What side effects should I look out for by making the changes?
If your physician doesn’t want to have this conversation with you or gives you answers you’re not comfortable with, change physicians.
Today’s Shameless Plugs
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