What's the deal with Salt?

heart nutrition Jan 31, 2022

Do you believe a low salt diet is a healthy diet?

There are those that consume salt liberally and those that go out of their way to avoid it. It’s such a controversial topic.


(Please note that the information discussed is a general guide and does not take into account your individual circumstances, so if you have been told to be on a salt restrictive diet, please discuss this with your health care provider before making any changes.)


Let’s step back in time for a moment, way back to 1904, back to way before we had the benefit of medical research. Here is where the war on salt began. At this point in time, it was thought 5-10% of the US population suffered from hypertension. And it's when the recommendation to reduce salt to lower blood pressure began. By 1939 we would have hoped to see some positive changes but instead, the American population with hypertension had increased to 13%, and today it's about 1 in 3 people. Hmm, that doesn’t make sense, the recommendations for salt intake have continuously reduced over this time yet the prevalence of hypertension has increased. Maybe we got this wrong? It wouldn’t be the first time this has happened just think about the low-fat movement and how much harm that did. 


When we take a global perspective you would expect to see the countries with naturally high salt intakes to have the highest blood pressure but this doesn’t match either. Countries like Japan, France, and South Korea consume the most salt per capita yet they have the lowest rate of heart disease. Hmm


Luckily these days we do have the benefits of medical research,  The Prospective Urban Rural Epidemiology study, looked at 100,000 from 17 countries and found that people consuming 3-6gm sodium per day had the lowest risk of death from cardiovascular events.

Other data suggest having less than 2.3gm of sodium is associated with the highest risk of death from cardiovascular events.  Unfortunately, our current recommendations are for 1.5-2.3gm the exact amount that is linked with the highest risk of cardiovascular disease! 

Our outdated guidelines, which were started due to expert opinion and not science are linked with the highest risk of the disease it’s actually trying to prevent. These guidelines will be changed but changing them takes time maybe even decades. Can you afford to wait?

Just to recap our current salt recommendations are in the range linked to the highest risk of heart disease, the optimal range for the lowest risk of heart disease is double the current salt recommendations. 

Current sodium recommendation 1.5-2.3gm daily (2/3 to 1 teaspoon salt) Optimal health 3-6gm daily (1.33 - to 2.66 teaspoons)


So let's think about what could be the cause of hypertension if it's not salt. Current research points to sugar being the culprit and not salt when it comes to hypertension. Over the same time frame, sugar consumption increased from 4 pounds to 152 pounds per person per year. Wow, that’s high!  Its common knowledge excess sugar leads to weight gain, obesity, type 2 diabetes. We know that when you gain weight your blood pressure goes up and when you lose weight your blood pressure goes down.  Unfortunately, if you are on a salt-restricted diet and not a sugar restrictive diet the salt deprivation increases your risk of insulin resistance and weight gain, it's a double whammy, especially when it comes to heart health.

You see, insulin helps the body reabsorb salt via the kidneys, so when you are on a low salt diet, your body will try to compensate by increasing your insulin levels.  Elevated insulin levels increase sugar cravings, blood sugar imbalances, increase your risk of metabolic syndrome, weight gain, diabetes, and heart disease.  Salt deprivation leads to sugar addiction.


There are times in your life when you need even more salt and the menopausal transition is one of them.

If during your transition you have been experiencing hot flushes, night sweats, or excessive sweating in general you are losing salt. If you are experiencing heavy menstrual flows in perimenopause you are losing salt. Many women just top up iron in this case and don’t consider that blood is made up of more things than just iron. Sodium is found in high amounts in the blood plasma and is lost when you experience excess blood loss. 

Other reasons why you may need more salt include:

  • eating a high sugar diet
  • drinking caffeine 
  • being a frequent exerciser
  • living in a hot climate
  • regular use of saunas
  • eating a low carb diet or intermittently fasting


Dangers of being salt deficient include

  •  experiencing mental confusion and forgetfulness
  •  being low in energy
  •  experiencing muscle cramps and twitches
  •  feeling nauseous
  • experiencing headaches
  •  enlargement of the heart and increased heart rate (by 4 beats a minute) 
  •  increased arterial stiffness
  •  Increases cholesterol especially the LDL (bad) kind
  •  increasing triglyceride levels
  •  compromising kidney and liver function and may contribute to the development of fatty liver disease
  •  increasing insulin resistance and its associated complications like weight gain
  •  increased risk of dehydration and heatstroke
  •  increased risk of osteoporosis as salt is stored in your bones and contributes to bone strength
  •  increases the risk of developing an addiction


Even if reducing sodium did reduce blood pressure it still won’t be worth it when you weigh it against the dangers of being salt deficient. 


Optimal salt levels may help improve your overall heart health, sleep, energy, focus, exercise performance, waist size, happiness, dietary satisfaction, and more. If you are still living in the times of low salt diets it may be time to move on. (But again please speak to your health care provider first if they have recommended a low salt diet for you.)


What you instead should be focusing on, is ways to reduce your sugar intake and lower your insulin levels. 

While slowly increasing your sodium levels.

Healthy ways to increase sodium include adding natural unprocessed salts such as Celtic seas salt or Himalayan rock salt to your foods. These natural salts include not only sodium but many other trace minerals as well. I recommend avoiding processed table salts as they have had the trace minerals removed and they may have been bleached, deodorised, or otherwise altered.

You may prefer to add a daily electrolyte to your water. If so please look for a clean product without the added artificial colour, or sweeteners.


If you need help getting your diet on track, consider having a consultation or joining the Menopause Makeover group program - Starting 1st of May 2023.


Recommended reading: The Salt Fix



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