Normal salt intake is good for your heart

– but focus on sodium if you have high blood pressure

Salt is a flavor enhancer, and the good news is that salt is not as harmful as previously thought. In fact, salt is essential when consumed in the right quantities, and for most people, it poses no health risk to consume up to five grams – or two and half teaspoons – of salt daily, according to a study that is published in the Lancet. Many people on anti-hypertensive drugs are advised to cut back on their salt intake, but it takes more than that. In fact, it is potassium that controls how much salt the kidneys excrete.

Less than five percent of people in industrialized countries consume over five grams of salt each day. But even for this group of people there is good news. The potential health risk associated with a large salt intake is practically eliminated if you make sure to include potatoes, vegetables, fruit, almonds, nuts, other good potassium sources in your diet. This was seen in a new study carried out by scientists at the Population Health Research Institute (PHRI), McMaster University, and Hamilton Health Sciences in Canada in collaboration with research colleagues in 21 different countries.
For an average of eight years, the scientists followed 94,000 people aged 35-70 years from 18 countries and from different backgrounds. They found that it was only those with an average salt consumption in excess of five grams daily had an increased risk of cardiovascular disease and stroke.

Salt intake in different countries and official recommendations

In the study, China was the only country where 80 percent of the population consumed more than five grams of salt daily. In the other countries, the average salt intake was 3-5 grams daily, or the same as 1.5-2.5 teaspoons of salt.
Nevertheless, WHO recommends keeping your daily salt intake within two grams to prevent cardiovascular disease, yet according to the Andrew Mente, who headed the new study, there is little evidence to support the health benefits of following this advice. He also says that the American Heart Association recommends an even lower salt intake and no more than 1.5 grams of for people at risk of cardiovascular disease. As Mente sees it, the recommendations are far too restrictive.

Moderate salt consumption does not increase your risk of cardiovascular disease

The scientists only managed to find a direct link between salt intake and cardiovascular disease in countries like China, where the average salt intake is above five grams per day. In countries with an average daily salt intake below five grams, on the other hand, the opposite was observed. Here, people had a lower risk of cardiovascular disease and stroke. Therefore, people with moderate salt consumption should not be worried about having an increased risk of cardiovascular disease.

More focus on potassium from coarse, green foods

What the researchers also found was that there was a lower risk of cardiovascular disease, stroke, and premature death in countries that had higher consumption of potassium from potatoes, vegetables, fruit, almonds, nuts, beans, and other good sources of potassium. They therefore call for more varied dietary guidelines that focus not only on salt alone but also include potassium.

The relation between sodium and potassium is even more important

Many studies have shown that the relation between salt (sodium chloride, NaCL) and potassium (K) – alto known as the Na/K ratio – is a more important factor than sodium alone. This is because potassium and sodium work as a team in terms of controlling the body’s fluid balance and cellular nutrient uptake and waste excretion.

Sodium binds fluid – potassium increases sodium excretion

Sodium is said to “bind” fluid. If you consume a lot of sodium, and your kidneys are unable to excrete the excess amounts, it may result in edemas and swelling of the legs or water in the lungs. Also, your blood pressure may go up.
Basic research shows that potassium intake directly regulates the amount of sodium that is excreted from the kidneys. For that reason, a high intake of potassium may cause the kidneys to excrete more sodium.

Why it potassium deficiency so common?

Our refined diets that consist mainly of grain, meat, and dairy products with too few vegetables are to blame for our low potassium levels. Too much sugar, coffee, and alcohol plus the use of diuretics may also result in a potassium deficiency. In addition, there is stress, where the adrenal hormone, adolsterone, retains sodium and excretes potassium.

What type of salt to choose

Sea salt and Himalayan salt contain a number of different minerals and salt that are good for you. On the other hand, there is less iodine, which helps prevent goiter. Avoid eating table salt with anti-caking agents such as aluminum.

References

Andrew Mente et al. Urinary sodium excretion, blood pressure, cardiovascular disease, and mortality: a community-level prospective epidemiological cohort study. The Lancet, 2018

Boye L. Jensen. Højt blodtryk? Så er det ikke nok at spare på saltet. Videnskab.dk, October 2017

Houston M.C. The importance of potassium in managing hypertension. Curr. Hypertens. Rep. 2011. PubMed

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