Salt: Good or bad?

Health organizations have been warning us about the dangers of salt for a long time.

This is because it has been claimed that high salt intake causes several health problems, such as high blood pressure and heart disease.

However, decades of research have not provided convincing evidence to support this (1).

In addition, many studies show that eating too little salt can be harmful.

This article analyzes in detail salt and its effects on health.

What is salt?

Salt is also called sodium chloride (NaCl). It consists of 40% sodium and 60% chloride, by weight.

Salt is by far the largest dietary source of sodium, and the words "salt" and "sodium" are often used interchangeably.

Some varieties of salt may contain traces of calcium, potassium, iron and zinc. Iodine is often added to table salt (2, 3).

The essential minerals in salt act as important electrolytes in the body. They help with fluid balance, nerve transmission and muscle function.

A certain amount of salt is naturally found in most foods. It is also added frequently to foods to improve flavor.

Historically, salt was used to preserve food. Large amounts can prevent the growth of bacteria that cause food to be damaged.

Salt is collected in two main ways: from salt mines and by evaporating sea water or other mineral-rich water.

Actually, there are many types of salt available. Common varieties include table salt, pink salt from the Himalayas and sea salt.

Different types of salt can vary in taste, texture and color. In the image above, the one on the left is thicker. The one on the right is the finely ground table salt.

In case you wonder which type is the healthiest, the truth is that they are all quite similar.

Bottom line: Salt is composed mainly of two minerals, sodium and chloride, which have various functions in the body. It is found naturally in most foods and is widely used to improve flavor.

How does salt affect heart health?

The health authorities have been asking us to reduce sodium consumption for decades. They say that you should not consume more than 2,300 mg of sodium per day, preferably less (4, 5, 6).

This equals about one teaspoon, or 6 grams of salt (it's 40% sodium, so multiply the grams of sodium by 2.5).

However, about 90% of American adults consume much more than that (7).

It is claimed that eating too much salt increases blood pressure, which increases the risk of heart disease and stroke.

However, there are some serious doubts about the true benefits of sodium restriction.

It is true that reducing salt intake can lower blood pressure, especially in people with a medical condition called salt-sensitive hypertension (8).

But, for healthy individuals, the average reduction is very subtle.

A 2013 study found that for individuals with normal blood pressure, restricting salt intake reduced systolic blood pressure by only 2.42 mmHg and diastolic blood pressure by only 1.00 mmHg (9).

That's like going from 130/75 mmHg to 128/74 mmHg. These are not exactly the impressive results you would expect to get by enduring a tasteless diet.

In addition, some review studies have found no evidence that limiting salt intake reduces the risk of heart attacks, strokes, or death (10, 11).

Bottom line: Limiting salt intake results in a slight reduction in blood pressure. However, there is no solid evidence linking reduced intake with a lower risk of heart attacks, strokes or death.

Low salt intake can be harmful

There is some evidence to suggest that a diet low in salt can be downright harmful.

Negative health effects include:

  • Elevated LDL cholesterol and triglycerides: Salt restriction has been linked to high cholesterol and triglycerides of LDL (the "bad") (12).

  • Heart disease: Several studies report that less than 3,000 mg of sodium per day are associated with an increased risk of dying from heart disease (13, 14, 15, 16).

  • Heart failure One analysis found that restricting salt intake increased the risk of dying for people with heart failure. The effect was amazing, with a 160% higher risk of death in people who reduced their salt intake (17).

  • Insulin resistance: Some studies have reported that a diet low in salt can increase insulin resistance (18, 19, 20, 21).

  • Type 2 diabetes: One study found that in patients with type 2 diabetes, less sodium was associated with an increased risk of death (22).

Bottom line: A low-salt diet has been linked to higher levels of LDL and triglycerides and an increased resistance to insulin. It can increase the risk of death from heart disease, heart failure and type 2 diabetes.

High salt intake is related to stomach cancer

Stomach cancer, also known as gastric cancer, is the fifth most common cancer.

It is the third leading cause of death from cancer worldwide and is responsible for more than 700,000 deaths each year (23).

Several observational studies associate high-salt diets with an increased risk of stomach cancer (24, 25, 26, 27).

A massive review article in 2012 examined data from 7 prospective studies, including a total of 268,718 participants (28).

He found that people with high salt intake have a 68% higher risk of stomach cancer, compared to those with low consumption.

It is not well understood how or why this happens, but there are several theories:

  • Growth of bacteria: High salt intake can increase the growth of Helicobacter pylori, a bacterium that can cause inflammation and gastric ulcers. This can increase the risk of stomach cancer (29, 30, 31).

  • Damage to the lining of the stomach: A diet high in salt can damage and inflame the lining of the stomach, exposing it to carcinogens (25, 31).

However, keep in mind that these are observational studies. They can not prove that high salt intake. Causes Stomach cancer, only that the two are strongly associated.

Bottom line: Several observational studies have linked high salt intake with an increased risk of stomach cancer. This can be caused by several factors.

What foods are high in salt / sodium?

Most of the salt in the modern diet comes from restaurant foods or packaged processed foods.

In fact, it is estimated that around 75% Salt in the United States diet comes from processed foods. Only 25% of the intake occurs naturally in food or is added during cooking or at the table (32).

Salty snacks, canned and instant soups, processed meats, pickled foods, and soy sauce are examples of foods with a high salt content.

There are also some seemingly little salty foods that actually contain surprisingly high amounts of salt, such as bread, cottage cheese and some breakfast cereals.

If you are trying to reduce your intake, food labels almost always indicate the sodium content.

Bottom line: Foods that are high in salt include processed foods, such as salty snacks and instant soups. Less obvious foods, such as bread and cottage cheese, can also contain a lot.

Should you eat less salt?

Some health conditions make it necessary to reduce salt. If your doctor wants you to limit your intake, then definitely continue to do so (8, 33).

However, if you are a healthy person who eats mostly single-ingredient whole foods, you probably do not have to worry about your salt intake.

In this case, you can feel free to add salt during cooking or at the table to improve the taste.

Eating extremely high amounts of salt can be harmful, but eating too little can be bad for your health (16).

As is often the case in nutrition, optimal intake is somewhere between the two extremes.

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