Salt and sugar, two substances found in most packaged foods, are by far the most widely used additives in food in this country. Their role is to add more flavor and extend shelf life, or in some cases to contribute to the food's structure, such as salt in bread or sugar in cakes.
The majority of salt and sugar intake consumed for most individuals is largely found in processed foods and when dining out. Almost 80 percent of the salt in the American diet comes not from the salt shaker, but from processed or restaurant foods. (source) Many people may not realize how omnipresent sugar and salt are in popular products on grocery shelves, so today we are going to break down the benefits and risk of over consuming both salt and sugar, and when consumed where they should come from.
Both sugar and salt have been linked to obesity and disease, but is it truly both? Or is sugar the bigger problem?
In part 1 we will cover salt and in part 2 we will dive into the effects of sugar.
Disclaimer: this is not a recommendation for any individual and you should consult with your doctor if you are at risk for heart disease, kidney problems or any other health issues.
We are conditioned to fear salt as it has been blamed for health conditions such as heart disease, stroke, hypertension, heart attacks, kidney problems, fluid retention, and osteoporosis. However, is salt really the root cause of some of these health issues? And is low-sodium intake actually healthy?
It is important to understand that salt has been a highly prized substance for thousands of years across all cultures and continents. So, rather than demonize salt altogether we need to understand that, like with all things we ingest, the quality matters.
Sodium is an essential nutrient to the body and our cells cannot function without it. It plays a vital role in the regulation of many bodily functions and is contained in body fluids that transport oxygen and nutrients. It's needed to transmit nerve impulses, contract and relax muscle fibers (including those in the heart and blood vessels), and maintain a proper fluid balance. Salt is both an electrolyte and a mineral and helps keep the balance of our water inside and outside of our cells, and our electrolytes stable.
Sodium is a principal component of a person’s internal environment – the extracellular fluid and is essential for maintaining the volume of the plasma to allow adequate tissue perfusion and normal cellular metabolism. This is, in fact, how nutrients reach your cells and the maintenance of extracellular fluid volume is an important physiologic function of the sodium in the body, particularly in regards to cardiovascular health. (source)
Most of the sodium in the body, about 85%, is found in blood and lymph fluid. Sodium levels in the body are partly controlled by a hormone called aldosterone, which is made by the adrenal glands. Aldosterone levels tell the kidneys when to hold sodium in the body instead of passing it in the urine. Small amounts of sodium are also lost through the skin when you sweat, which is one reason why sodium is especially important for those who sweat frequently. (source)
Sodium and chloride ions also play an important role in the nervous system. Changes in the concentrations of these ions allow neurons to send signals to other neurons and cells, allowing for nerve transmission as well as mechanical movement. Chloride ions provided by salt are secreted in the gastric juice as hydrochloric acid (HCL). And HCL is vital to digestion and our ability to break down, digest and absorb nutrients from food we consume as well as the destruction of food-borne pathogens in the stomach. (source)
So now that you understand just how important salt is for optimal health, what about the argument to reduce sodium intake?
If you dive into the research, the data is inconsistent as it relates to salt intake and cardiovascular disease. No large-scale randomized trials have been conducted to determine the effect of low sodium intake on cardiovascular events. Some prospective cohort studies evaluating the association between sodium intake and cardiovascular outcomes have been inconsistent and a number of recent studies have reported an association between low sodium intake (in the range recommended by current guidelines) and an increased risk of cardiovascular death. (source)
Reducing sodium intake may lower blood pressure in some people, but the research shows this is minimal. Only about 1-to-4 mm in the average person on a scale where 140 mm is hypertension and 139 mm is not. (source) For some individuals, reducing sodium intake may actually increase blood pressure. (source)
The Institute of Medicine concluded that a drastically low salt diet does not seem to improve health outcomes such as lower blood pressure and fewer deaths from heart disease. (source) Additionally, a Cochrane Library review conducted by British researchers found no evidence that small reductions in salt intake lowered the risk of developing heart disease or dying prematurely. Specifically, the new analysis found that reducing sodium intake increases cholesterol levels by 2.5 percent and triglycerides by seven percent. (source)
Further, low sodium intake can have other undesirable effects for your heart, including a higher heart rate and increased cardiac workload and stress. (source)
If a true sodium deficiency occurs, and the concentration of sodium in your blood is abnormally low, you may experience Hyponatremia, which can be dangerous. In hyponatremia, one or more factors ranging from an underlying medical condition to drinking too much water cause the sodium in your body to become diluted. We discussed this more in depth in our blog HERE. When this happens, your body's water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening. (source)
Hyponatremia signs and symptoms may include:
How much salt should you consume?
This will be different for each individual as our sodium needs are bio-individual and influenced by our genetics, dietary habits, lifestyle, how much you sweat, and your metabolic state.
This is a controversial topic and heavily debated amongst various groups, here are the recent recommendations from some of the government guidelines:
The minimum physiological requirement of sodium simply to sustain life has been estimated to be 500 mg of sodium per day. (source)
The American Heart Association (AHA) has the most strict guideline of consuming less than 1,500 mg a day for ‘high risk’ individuals - i.e. those with high blood pressure, over 50 and those with diabetes. (source) However, as mentioned earlier, this group of individuals are exactly who may suffer most from such severe sodium restriction: they may pay with increased rates of heart-related deaths. (source)
According to the CDC, the sodium intake should be less than 2,300 mg of sodium per day. (source)
Further, an Institute of Medicine report concluded there was no compelling evidence to support this minimally more-liberal 2,300mg threshold, particularly for individuals with diabetes, kidney disease or heart disease, for whom the level is still too restrictive and can cause harm. (source) Several studies suggest that for heart health and overall wellness, the optimal intake for most people is somewhere between 3000 to 6000mg per day. (source)
Dr. Chris Kresser states “while salt recommendations vary between individuals based on age, gender, physical activity, and health conditions, I feel that the data supports an intake between 3000 and 7000 milligrams of sodium, or 1.5 to 3.5 teaspoons of salt, per day.” (source)
Fortunately, most people are consuming 3,400mg of sodium; however, it is not high quality salt such as pink himalayan salt or black salt that provides minerals, which is the salt that is beneficial for health. Most sodium in the American diet, about 80%, comes from ultra processed foods, which happen to be rich sources of another white crystal more harmful than salt: sugar. (source)We will talk more about sugar in part 2 next week!
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