If you’ve been diagnosed with high blood pressure, most likely your doctor has told you to lower your salt intake. New science is showing that this recommendation may be backfiring for patients.
Salt has long been vilified for causing high blood pressure. James DiNicolantonio, a doctor of pharmacy and cardiovascular research scientist, and author of The Salt Fix, argues that our fixation on lowering salt intake as a means to manage blood pressure is based on faulty science. He contends that there is a huge variety in people’s sensitivity to salt, and that needs to be taken into account. He also shows that there is serious health dangers associated with limiting salt intake to the degree that we have been.
The first danger DiNicolantonio describes is one of internal starvation. When salt intake is restricted, the body compensates by creating hormonal changes designed to hold on to the salt it has; essentially it goes into panic mode. Since salt is a nutrient required by the body, it will go to great lengths to maintain internal levels. These include “insulin resistance, an increase in sugar cravings, an out-of-control appetite, and what’s been dubbed ‘internal starvation’.” Essentially, you may be gaining weight, while inside your cells are not functioning properly, sending cues that you are not getting enough nutrients, causing you to be hungry all the time.
The second danger of a low salt diet is that it could set you up for sugar addiction. The body requires salt. It has an “internal fluid-salt-electrolyte balance” that is monitored and adjusted for automatically by the brilliance of our body. If that balance is thrown off, we crave salt. Caffeine causes you to release salt from the body, as does vigorous exercise.
Interestingly, if our system gets too low on salt, salt starts to taste better; we become sensitized to it. The reward systems in our brain actually shift so that we get more pleasure from salt. DiNicolantonio describes a shocking find, “These modifications resemble the changes that occur in people who have become addicted to drugs of abuse, and this sensitization can be hijacked by other substances of abuse.” In other words, when salt intake gets too low, we become more susceptible to addictions.
He describes that our fixation on lowering salt intake could be what has set us up to become so addicted to sugar. Sugar is not required by the body to survive. Sugar cravings, as DiNicolantonio shows, are based purely on “psychological desire” and “physiological cravings”, both of which stem from an addiction framework rather than a physiological need.
While he recognizes that there are certain conditions that require medical management of salt intake, (Cushing disease, Hyperaldosteronism, and Liddle syndrome being the main ones), for most of us, we can handle more salt than we are most likely getting.
The solution for this deficit in salt caused by many factors is a visit to your doctor and “test for internal starvation”. The next step, according to DiNicolantonio, is to fully succumb to your salt cravings, (without going “overboard”), and to dramatically limit your sugar intake; he recommends no more than 20 grams of sugar per day. To satisfy both these recommendations, he insists on keeping food sources as close to the source as possible; no, he does not recommend as many potato chips as you can possibly manage. Whole foods, seasoned with a variety of well-sourced salts is his suggestion for a path out of obesity and the crisis of being overweight, yet undernourished.