27 Responses to “Salt Awareness Week – 10 things to be aware of”

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  1. avatar Martin Dace says:

    You write: “High blood pressure (BP) (even when properly defined as actual high BP and not normal BP i.e. 140/86) is a symptom, not a cause. This makes blood pressure a condition observed at the same time as heart disease and not a risk factor. ”

    This bit I don’t agree with. Some 30 or more years of evidence tells us that reducing blood pressure in essential hypertension reduces mortality and morbidity from cardiovascular causes, irrespective of how that reduction is achieved, and across age groups. I’m a GP not a researcher, so I can’t quote the studies, but there have been a lot of them since the original Veterans Administration study.

    ‘Normal’ is not a relevant concept in this context. Absolute risk reduction is.

  2. avatar Justine says:

    I’m a British expat living in Southern Africa – when I first came here I had my blood pressure checked by a nurse and it was on the low side … she advised that I add more salt to my food :-)

  3. avatar Pauline says:

    Hi Zoe, I have always had generally low blood pressure in the region of 90/60, which means that my circulation is quite poor. When I’m super stressed, I might reach the dizzy heights or 130/100, which is still below average, according to your article. At the same time my sodium levels appear to be absolutely fine, a tad above the middle of the normal range. I dont use much salt in cooking because I don’t like the taste – I’ve sent meals back in restaurants because I thought they were unbearably salty, and had very strange looks from people who clearly don’t taste the extra salt like I do. It looks like I don’t need or want the additional salt. I guess this is anecodotal evidence that salt doesn’t impact blood pressure. So what does? I think I’d probably feel a lot better if my blood pressure was a bit higher. I feel cold a lot of the time, and on my (very occasional) stressed out day, I don’t feel the cold any more, which is a nice offset to the stress. But despite all my sleuthing, I haven’t been able to turn up any good information about what causes low blood pressure. Interested in your thoughts. Pauline

    • avatar Zoë says:

      Hi Pauline – both Andy and I have low BP and the worst problem we experience is light headedness when we bend down to tie shoe laces or stroke the pets. We’ve just got used to getting up slowly and carefully. I hadn’t thought about the feeling cold point. Feeling the cold is more a symptom of poor circulation. I don’t think low blood pressure would equate to poor circulation any more than high blood pressure would equate to great circulation!

      Blood pressure is a measure – not a cause of anything per se. The ’cause’ of low blood pressure is therefore good health! I suspect you are slim, fit and healthy and that you don’t eat much processed food. You can artifically increase your BP by doing unhealthy things – eat processed food – especially refined carbs with white flour and sugar. Drink fizzy drinks at the same time so that the body stores the water to match the stored glycogen from all the carbs you ate, but can’t use up. Smoke. Stop exercising and watch depressing soap operas – that should work!

      Seriously – BP tends to rise with age so enjoy having a great starting base and enjoy having your body’s dashboard telling you that you’re in great shape!
      Best wishes – Zoe

  4. avatar Jonathan Bagley says:

    Great article Zoe. Just found out you studied Maths and Economics at Cambridge. Shame more of our MPs didn’t. We wouldn’t then have to suffer the influence of bizarre cults such as CASH.

  5. avatar Jessica says:

    Quote from BBC news website : – (Professor Randall Thompson) said it is commonly thought that if modern humans could emulate pre-industrial or even pre-agricultural lifestyles, that atherosclerosis would be avoided.

    “Our findings seem to cast doubt on that assumption, and at the very least, we think they suggest that our understanding of the causes of atherosclerosis is incomplete, and that it might be somehow inherent to the process of human ageing.”

    Maureen Talbot, senior cardiac nurse at the British Heart Foundation, said: “This small study takes us back in time to give an insight into the heart health of people in the ancient world.

    “However, we simply don’t know enough about the diet and lifestyle of the people studied to say whether behaviour or genetics lies at the root of the heart problems observed.

    “We can’t change the past, but lifestyle choices can help to affect our future.

    “By eating well, quitting smoking and keeping active, you can help to protect your heart.”

    Is there a case here of one person ignoring the facts to make sure her job is protected over the next few years :-)?

  6. avatar Leila says:

    My favorite saying is from King Lear, “I love you as meat loves salt.” It takes him quite a while to discover the truth and the sentiment behind that statement, but it is true and quite apt nonetheless.

  7. avatar Andrew says:

    I know that. Equating chloride with chlorine (a poison) is incorrect. And sodium (which explodes in water )with Na+ is Incorrect

  8. Andrew,
    Water is a chemically bonded union between two hydrogen atoms and one oxygen atom, hydrogen borrows one electron from oxygen and oxygen borrows one electron from each of the hydrogen atoms. Just to makr the outer electron shells of both hydrogen and oxygen. The water molecule looks like a tiny boomerang and has a slight negative charge at the oxygen end and a slight positive charge at the hydrogen end. So water molecules can weakly attach to each other

    Sodium chloride are dissolved into Na+ (lost an electron) and Cl- (recieved one extra electron) so those ions are dissolved in water and has about 180 water molecules in a cloud around each ion.

  9. avatar Andrew says:

    Do not confuse chlorine with chloride. Or sodium with salt. The body does not break down the compound. That is like talking about hydrogen and oxygen when referring to water!

  10. avatar Steven says:

    I’ve also found that salt restriction has such a small effect on blood pressure (~4/2mmHg for hypertensives) that it’s illogical to blame high salt diets for hypertension. Blood pressure and sodium concentrations are among the most tightly regulated things in the body. If the blood volume is higher than normal the body can regulate blood pressure though vasodilation (a very powerful regulatory mechanism), lowering cardiac output or increasing salt and water loss through the kidneys.

    Salt restriction has some potentially negative effects including massively increasing the renin-angiotensin-aldosterone system, and also increasing adrenaline, noradrenaline, oxidative stress and insulin resistance. It seems salt restriction is a stressor



    By the way, I don’t think there’s good evidence for acid-base theories of osteoporosis are they relate to acidity/alkalinity from the diet (in regards to the comment on chloride)


    That being said there are some people who are salt sensitive. I don’t know much about that, though it may be related to insulin resistance and/or kidney dysfunction

  11. avatar Martin Levac says:

    Zoe, a recent Reuters article with the title “Too much salt may trigger autoimmune diseases – studies” claims salt may trigger autoimmune response, specifically with regards to multiple sclerosis. I, for one, don’t believe a word of it, especially now considering what you just told us about salt. I mean, it doesn’t make sense that we should restrict salt intake to prevent MS or high BP or anything else associated with salt intake, when doing so leads to deficiency and in extreme case death.

  12. avatar Nancy M. says:

    Your blood values were very interesting. Your T3/RT3 looks like mine on low carb. I’m always just a tad under range. I don’t have a functioning thyroid; I had RAI 20 years ago or more. Anyway, I can only tolerate a tiny amount of exogenous T3 and it hasn’t really helped me with the weight loss anyway, but it does make me feel better.

    I was just reading, a few days back, about a certain gene configuration that seems to be the cause of the physiological insulin resistance some of us get from a low carb diet. I looked up the gene–I had my genes done at 23andme.com–and I have one copy of the allele that causes it.

    I wish I could remember the gene and the article. If I track it down I’ll let you know.

  13. avatar Paul says:

    Hmmm, as a 14 year old schoolboy, I was taught that the kidneys maintained the correct level of salt in the body. Too much salt in the blood, and the kidneys removed some of it. Too little salt in the blood, and the kidneys stopped removing it.

    I think that as long as I have working kidneys, I can consume as much, or as little, salt as I care to.

    I hate these one-issue health facists like SALT (I always thought they were a bunch of weirdos ever since they formed their little action group).

  14. Hi Zoë!

    Remember that the glomeruli in the kidneys excrete 1 000-2 000 grams of salt (c 2.2-4.4 lb) per 24 hours. This means that the kidneys excrete 0,7-1,4 grams per minute! So there is no way we can retain salt. The problem is that we have to reabsorb enough salt to maintain 136-145 mmol/L in the blood by three blood pressure increasing hormones, renin, aldosteron and angiotensin II. Normal excretion of salt via urine is 9-18 g per 24 hours. Thus we have to eat the same amount of salt as we excrete, otherwise we will die PDQ due to salt deficiency. If you loose 4 grams of salt in the blood the concentration decreases from 141 mmol/L to 121 mmol/L. Then you need intensive care to survive.
    If you decrease salt intake from 9 grams to 3 grams per day the levels of renin, angiotensin II and aldosteron will increase tenfold. Also, the body tries to keep up the Na concentration by decreasing the blood volume which decreases the blood pressure by 0-6 mm Hg.
    Also, the EFSA found in 2005 no scientific support for an upper limit of salt intake in food.

    All research about salt and blood pressure follows the same scedule. One arm with a low salt intake of 6-9g salt and an exterme low salt arm with 3 g salt/day. Due to decreased volume the blood perssure is lowered a tiny amount. But where is the third arm with 20-30 g salt? Of course it’s not there as it would show no increased blood pressure compared to 9 g. The problem is not getting rid of any excess, the problem is to reabsorb more than 99% from the primary urine unless you eat at least 9 g salt per day.

    So eat good food with enough salt to taste.
    CASH and WASH organisations seem to be unaware of the bodys homeostasis, normal physiology, biochemistry and endocrinology. And there are quite a few professors that are in these salt depleting and death increasing organisations.

    Read more here http://kostkunskap.blogg.se/2012/may/livsmedelsverkets-rad-om-salt-leder-till-dod.html and (Please use Google translate if you don’t understand Swedish)

    And also my comments on salt to the public consultation from Nordic Nutrition Recommendationd 5 (NNR5)
    http://kostkunskap.blogg.se/2013/february/comments-to-the-public-consultation-on-salt-in-nnr5.html and

    • avatar Zoë says:

      Hi Björn – the honour is all mine! Lovely to have your comment and great links. My interest in salt was first sparked by you when you explained to thincs why elderly Parisians were dropping like flies in the scorching summer a couple of years ago!

      Bye for now – Zoe

    • avatar TeeDee says:

      Hi Zoe and Bjorn! Whenever I have a question to get answered, I always consult Zoe’s pages. My blood pressure has been reading ‘high’ for some time now (155-165/78-82) and my doctor has been after me to use BP meds as I did suffer a heart attack when I was much heavier.
      Thanks to Zoe, I’ve dropped 120 lbs so far and have kept it off since losing it in 2011-early 2012. I know I could stand to lose another 40+ and am thinking that is why my BP is higher than normal. Also, I need to exercise more regularly and am starting some stress reduction techniques like mindful breathing.
      Of course one of the first things my doctor told me is to cut out all added salt (something that depressed me as I like to have a little salt on meat, chicken, eggs, etc. but don’t like too much. I find I use a very normal amount of salt, so I’m thrilled with this information.
      I finally gave in this past Monday, and filled a script for Valsartan 80mg/HCTZ 12.5mg. I felt I had no choice and was thinking I didn’t want something happening to me only to hear my family ask why I didn’t ‘do something’ about my higher BP. I’m still not sure whether I should take it just long enough for my renewed efforts to lose more weight kick in or stop it altogether after taking it for a few days.
      I just wanted to thank you both for your very informative comments and your article, Zoe.
      I feel better already. All the best to you both, as well as the other excellent commenters here

      • avatar Zoë Harcombe says:

        Hi TeeDee – well done on your incredible weight loss and maintenance and all the other great health thinking you’re doing. Just walking will help with both movement and stress reduction. We walked the dog for 45 mins at 6am this morning – frost on the ground, sun rising beautifully – that’s a great start to the day.

        Have you seen this article? http://www.zoeharcombe.com/2014/06/diabetes-cholesterol-bp-normal-is-no-longer-normal/
        Normal BP is 140/90. This has been redefined as high and I can see no reason for this other than a financial one. You become a customer for medication if you are declared above normal. The fact that normal was moved is not questioned. I personally wouldn’t worry if my BP were anywhere on the normal scale and I would need a seriously convincing argument to take BP meds. If my BP were genuinely high (way above 140/90) I would want to know why and treat the cause – not shut my body up from telling me that there’s a problem by medicating away the symptom. Plus I know that all meds have side effects – I don’t know of any drug that has one impact and one alone.

        I’ve just checked the patient info for Valsartan (http://www.drugs.com/cdi/valsartan.html) and I can’t believe what I’m reading from what you’ve written above – let alone from what your doc should know about you…
        There’s a caution for those with a history of stroke or recent heart attack!
        There’s a caution if you’re on a low salt diet.

        Check out possible side effects (about two thirds of the page down):

        “All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

        Cough; diarrhea; dizziness; headache; joint or back pain; mild stomach pain; tiredness.

        Seek medical attention right away if any of these SEVERE side effects occur:

        Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue; unusual hoarseness); blurred vision; burning, numbness, or tingling; change in the amount of urine produced; chest pain; difficulty swallowing; fainting; irregular heartbeat; muscle pain, weakness, or cramps; shortness of breath; sudden, unexplained weight gain; swelling of the hands, ankles, or feet; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, severe or persistent stomach pain, yellowing of the eyes or skin); symptoms of low blood pressure (eg, fainting, light-headedness, severe dizziness); unusual bruising or bleeding.”

        I hope the bold on the “unexplained weight gain” shows up.

        The best thing you’ve done for your health is to lose a fantastic amount of weight and keep it off and doc wants to give you something that could jeopardise this – and which you don’t need!

        I won’t tell you what I’m thinking right now!
        Best wishes – zoe

        • avatar TeeDee says:

          Thank you so much, Zoe. I’m speechless right now and have some reading to do! I can’t thank you enough for taking the time to look into this.

          Warmest regards,

          Tee Dee

  15. avatar Liesl says:

    Has everyone else, like me, tried and failed to find the right words to respond to Jessica?

  16. avatar PaleoFastUK says:

    Just to clarify what you refer to as salt is Sodium Chloride (NaCl). The Sodium is the vital part and although we could not live without we do not need added Na to our foods as we can obtain all the Na we need from eating other animal and plants.Like us their cells have electriolyte in similar proportions and contain the right amounts of Na. The Chlorine in the NaCl molecule is what is the most damaging when consumed in excess as we do today can cause the most damage. Apart from being toxic it also acidifies the body causing loss of Ca++ from bones. Moreover domestic watehr supplies are treated with Chlorine bleach in many cases and this enters our system through what we drink/eat and when we shower/bathe through inhalation of Cl rich vapours.
    It is the chlorine that should be labelled and not the Na!

    • avatar Zoë says:

      Hi Paleo! Nice addition on the chlorine. Underground Wellness first alerted me to the dangers of showering!
      Best wishes – Zoe
      p.s. just searched the 134 page Salt & Health document. The word chlorine does not appear once. The word chloride appears 13 times in the context of the full name for table salt – sodium chloride.

  17. avatar Tom Welsh says:

    Thanks, Zoe! Of course, salt is another natural nutrient that is (nowadays) very cheap and easy to obtain, and that requires absolutely no “value-added” processing. Hence it is unprofitable and to be avoided.

    What still puzzles me is that salt is an indispensable part of the processed food industry’s favourite appetite-forming combination: processed carbs, trans fats, salt, and sugar. You find that basic formula elaborated in hundreds of ways, from rice pudding to naan bread.

  18. avatar Jessica says:

    “It has no calories, no macronutrients (no fat, no protein, no carbohydrate) and therefore cannot directly impact obesity.”

    Just one point – the above suggestion would seem to indicate that fat and protein have a direct impact on obesity. I thought it was the case that if it contained carbs and sugar, it would impact obesity but otherwise it’s fine. Unless you’re like me, and pretyy much can’t eat any amount of anything :-)

    • avatar TeeDee says:

      Jessica, I don’t think Zoe was in any way associating fat and protein with obesity. I’m sure she was speaking generally about macronutrients, and the fact that salt has none. She was merely making the point that salt cannot be a direct cause of obesity because there are no calories in it, among other things.

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