The Great Salt Debate: So Bad?

[xchrom]

http://www.theatlantic.com/health/archive/2013/05/the-great-salt-debate-so-bad/275888/



When I first meet Morton Satin, he's seated in an office chair on a Tuesday morning, shaking his head at his computer screen. He glances over, sighing, and motions toward the monitor. Displayed is a press release from Science Daily claiming that salt depletes the body's calcium stores. "Every morning brings a new headline," he says sadly before launching into a diatribe about the supposedly shoddy science used in the article. "Sometimes, you feel like you're spinning your wheels, not moving forward but trying to prevent misinformation."

The misinformation he's worried about concerns one of the most ubiquitous substances in our daily lives: salt. This week, experts convened by the Institute of Medicine concluded that "the evidence on direct health outcomes does not support recommendations to lower sodium intake ... to or even below 1,500 mg per day." The current recommendation is not to exceed 2,300 mg per day, though most Americans do. This slight paradigm shift -- to an idea that less salt is not always better, which is already disputed and will be slow to be accepted -- comes after years of advocacy from people like Satin.

Satin, a molecular biologist, has begrudgingly accepted the nickname "The Salt Guru," after coming out of retirement to be the Vice President of Science and Research at The Salt Institute, a non-profit trade association based in Alexandria, Virginia. Before that, Satin spent sixteen years as the Director of the United Nations Food and Agriculture Organization's Agribusiness Program. It was there he achieved two of his most important successes: a patent for coconut water and one for the creation of gluten-free bread.

His office is more that of a man who writes coffee table books on coffee (which he recently did, to warm reception by The New Yorker) than of a molecular biologist who thinks the public institutes of health are spouting untruths. But, he does think that. He says the 2,300 mg line is too low, and he's not the only one.

[JayhawkSD]

1. Doctors tend to be faddists

My neurologist, treating me for Parkinson's and a series of small strokes, recently left the practice and my case was handed over to another doctor in the same office. She's young, received her board certification from Mayo in 2010, and very impressed with herself.

She freaked out over my cholesterol which has a total of 180, with LDL of 130. She says "we have to get the LDL below 100 because cholesterol causes strokes." On and on, not asking for any input from me. Not asking if I had discussed this with previous neurologist (who was her boss), or with any of my other doctors.

In fact, I have discussed it both with neurologist and with primary care. My blood pressure is nicely low. I have a long history of very low cholesterol, total on to 90's, LDL in the 60's, and it has risen recently only because health has reduced my level of activity. I am not overweight. I have had half a dozen echo studies of heart and other arteries and they show no buildup in my arteries whatever. I had an angiogram five years ago which showed less buildup in my arteries than is normal for a 30-year-old. In view of all of this, both doctors said that the "marginal" degree to which my cholesterol is high is nothing to worry about.

This idiot wants to put me on a statin, which carries a significant risk of side effects. Given that, in addition to the Parkinson's, I have cardiac arrhythmia issues and severe emphysema, such a decision would be utterly absurd.

I am, actually, looking for a new neurologist.

Some are not, however. My wife was at the cardiologist with me and asked him, "Bill uses a lot of salt, should he cut back?" He replied that as long as my blood pressure stayed where it was he saw no reason for me to do that. I wanted to go kiss the top of his bald head.

[bemildred]

2. Two cents:

1.) Salt and Potassium are necessary nutrients. For any particular person, there is an optimal range of intake, which will vary, sometimes quite a lot, from person to person, dependng on activity levels and genetics and (no doubt) other things.

2.) So all simple minded approaches such as minimizing intake are bound to be pernicious for many people.

3.) I think Prof. Satin has it about right.

[xchrom]

3. You really are very smart. Nt

[bemildred]

4. Awww Princess.

Apparently so, though I don't like to talk about it much.
Life has taught me humility too. Humility will never serve you wrong.
Arrogance will make you pay.
Mostly I feel lucky.

[xchrom]

5. Still.. It's nice for someone to notice...

Even an anonymous Internet Princess.

[bemildred]

6. Indeed. Makes my day, and I can use a good day. nt

[Warpy]

7. I think he's probably got it right about the level being too low

but (anecdote warning) I went on a low salt diet with my hypertensive parents when I was ten. I stayed on it, never getting used to salty chips and convenience foods.

I did develop hypertension but a full 20 years later than my parents did.

My only conclusion is that the salt level in a lot of standard diets using convenience foods is too high. Where that level should be is what's up for grabs.

Canned soups, especially, need to have the salt cut.

[bemildred]

8. Yeah, all processed food is crap, and the ones you name, well ...

I eat some, for treats, but not much. Mostly I like to cook for myself and season for myself. You are lucky not to have been accustomed to highly salted food as a child.

There are countries worse than us on salt intake, but with different results, and I wonder about that, but have no explanation, except perhaps less gluttony and more seafood.

I used to work in a sawmill, they had big jars of salt pills, so we would not get cramps, which is what happens, one of the things, headaches too.

It is quite true that too much salt is bad for you too, can be really bad on your kidneys for example.

I try to listen to what my body tells me. I have gout, which I have controlled (so far) with diet, giving up certain things (beer, beans & meat mostly), and by losing 50 lbs. My diet used to be a recipe for getting gout. If I travel or am frustrated, I'm more likely to indulge, but I have learned over time to recognize the signs and back off or fast until it goes away again. You have to watch the yeast and yeast based B vitamins too.

I handle salt the same way, when I work I take more, if I get crampy I have some til it tastes bad again. When I sit, I don't, not necessary. And potassium, in some ways more important really to get that potassium, so I use salt "substitute". Lots of veggies helps with all that too.

I have an older brother that self-manages his diabetes, and very well, and he has to control what he eats too, I think you have to take some responsibility, you can't just go out and buy what you need or follow some rigid rule, and that is what I am trying to suggest.

[Warpy]

9. Canned soup is the worst

I would love to be able to eat some of those chunky soups on my "I don't wanna cook" days, but all I can taste in them is SALT. Even the "low salt" ones taste like that to me.

[bemildred]

10. Yep, Progresso and those ones. I look at the sodium and change my mind.

ALL the processed, packaged, canned stuff they over-season, cook the heck out of it, and add "preservatives".

I use cayenne and ginger and garlic and turmeric and things to tart things up instead. And you can add lots of flavor with vegetables, if they are fresh, not overcooked.

You can make really good soups with a pressure cooker, but don't get arrested. I've only recently discovered pressure cookers.


I used to just not eat on my "don't cook" days, juice and soda water and maybe a little kefir etc.. I'm still trying to figure out what to do now, since I don't want to go much under where I am, at my age the right amount of extra fat is a good thing. I think I'm going to have to start exercising more regularly.

I've completely lost my taste for fast food. I think about that breakfast burrito, yum yum, and then I think about eating it, and it sitting there in my tummy, and unless I plan to go for a long hike or something, I change my mind.

[Warpy]

11. Yeah, your tastes do change as you get older

The last time I had fast food, I could feel the grease oozing out of every pore and said never again. I do not like that feeling.

I've lost 20 pounds over the last year on "don't cook, don't have anything made" days when I just didn't bother to eat, most of it during hot weather. If I lose another 20 this year, I'll be back to my fighting weight and I'll have to watch nutrition a little more closely, adding calories instead of subtracting them.

As for breakfast burritos, try making them at home. You just cook a decent breakfast and roll it up in a flour tortilla. It can be a lot less fatty than the stuff at fast food joints if you cook it yourself. You can make extra to refrigerate and eat for the next couple of days.

[bemildred]

12. That could work. I haven't really applied myself to that one yet.

Last edited Sat May 18, 2013, 08:04 AM - Edit history (1)

Without the bacon. I got two lbs of bacon a month ago and I could feel the inflammation coming back in my feet by the time I finished it. I was taking some nutritional yeast last year and that was a mistake too.

I love fresh potatoes and they are good for potassium, and eggs with fresh garlic, a fresh serrano pepper, and a touch of sea salt, yum.

I do some urban gardening, and it is very cool to go pick a few things to put in your breakfast.

You're on the right track, I spent almost two years taking the weight off, down ten, up five, and I'm glad I did it that way.

Fasting was interesting and kind of pleasant, once you get into it, for a day or two, peaceful but not stupefied, but as I lost the weight it became more of a struggle, which is one way I decided it was time to eat more again.