Salt — is it good or bad for us?

There has long been a debate about the potential benefits or detriments of using salt. There is no doubt that human beings have acquired a significant taste for salt and in fact, that it is one of the key ingredients in most of our foods to make it palatable.

But, there has been increasing scientific work, especially over the past two decades to suggest that modern society is using far too much salt and there is a clear link with all forms of cardiovascular disease, in particular hypertension.

The World Health Organisation has published a statement suggesting we should have no more than 5 g of salt per day which is the equivalent of 1 teaspoon. The American Heart Association says approximately the same thing but also states that ideal salt intake is no more than 2 ½ g per day or in other words, half a teaspoon.

But, there are some researchers around the world who have disputed this and in fact have stated that salt is good for us and helps prevent heart attack. A recent study published in the Lancet may have found the answer to this dilemma.

This study followed 94,000 people, aged between 35 to 70 for eight years from 18 different countries. It found that the vast majority of people ingested up to 5 g of sodium which is just over 12 g of salt per day and those with the highest salt intake up to this point had the lowest rate of cardiovascular disease including stroke, in the entire cohort. But, in China where typically they have a salt intake above this level that is when the risk for cardiovascular disease and in particular stroke starts to kick in.

So, it does appear that there is a J-shaped curve for salt intake as there is for alcohol i.e. moderate amounts are probably good for you but too much then starts to cause problems.

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Photo by Emmy Smith on Unsplash

Probably the most important message from the study was that those people who benefit from a moderate salt intake are also those who had a diet high in potassium and low in processed foods. Natural foods such as fruit and vegetables are high in potassium whereas processed foods have little potassium and thus high unopposed salt without an adequate potassium intake may have adverse effects on blood pressure as well as all other forms of cardiovascular disease.

Fruits and vegetables which are particularly high in potassium include bananas, oranges, tomato and spinach, kidney beans and avocado. Almonds are also very high in potassium as well.

One word of caution is that some blood pressure drugs lead to higher potassium levels in the bloodstream and when combined with foods very high in potassium, may lead to a dangerous rise in your blood potassium levels. If you have long-standing high blood pressure and in particular are an elderly diabetic, it is important to have your potassium checked on a relatively regular basis and not to go overboard with the foods containing potassium.

As with most aspects of life, this is more evidence where moderation in all things is good for your health. Unfortunately, 80% of the salt we ingest comes from processed, packaged foods and not from the salt shaker on the table. Because of this, it is still unnecessary to add salt to anything. Also, don’t be deluded into thinking that rock salt, sea salt or Himalayan salt is any different. It’s still all salt.

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Dr Walker is an expert in the field of preventative cardiology and has published seven books. He gives lectures nationally and internationally.

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