Will Salt Kill You?
The newest dire warnings about a common food … table salt … are growing, and about to result in legislation. Busy bodies everywhere are clucking that “something has to be done!”
Adopting a villain is reassuring, as it absolves us of personal responsibility. It explains away some inconvenient facts that might not fit in with our preconceptions. In the seminal story that gave us the term “scapegoat”, the accumulated sins of the people are transferred to the goat, and the goat is sent to the wilderness, presumably to die for the community’s sins. This solves a big problem; the tabernacle that holds the sins transferred by weekly sacrifices is only so big. So you have to get them out of there somehow. It works great, unless you’re the goat. Vaya con Dios, goat.
What is Salt’s Role as a Scapegoat?
The list of errors in public health policy is long and dominated by scapegoats. Dietary cholesterol has no bearing on serum cholesterol levels, despite the scapegoating of eggs. Fat in the diet does not lead to extra fat in the body, yet the scapegoating of red meat and other dietary fat continues. Salt has joined the list because what we are doing isn’t solving our problems. Load up that scapegoat with heart disease, hypertension, and premature death and send it into the wilderness!
Why is Milk White When Cows Eat Green Grass?
Sometimes a childish question is too easily dismissed. Of course everyone knows that eating something green doesn’t make milk, urine or feces green. We know this because the body breaks down the food, and digests it, and we console ourselves that this process is too complex to explain to our children. The truth is, few of us really understand it, and we know that eating green grass does not lead to green milk because … milk is always white.
But often the science, as reported in the media, is something akin to the conclusion a child would come to without noticing that the milk is white. The cow eats green grass. What color is the milk? It must be green. Grass and milk have a close correlation … in one end, out the other. Without grass, there is no milk.
Salt is often associated with hypertension, and hypertension with heart disease and kidney failure. Ergo, salt causes heart disease and kidney failure, leading to early death. The milk is green.
Does Salt Consumption Lead to Early Death?
A meta-analysis of studies on salt consumption and hypertension, covering 6,489 participants with both high and normal blood pressure, with and without heart disease showed no benefit from salt reduction. None.
Despite collating more event data than previous systematic reviews of randomised controlled trials (665 deaths in some 6,250 participants), there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity in normotensive or hypertensive populations.
Are They Trying to Kill Us?
The problem with scapegoats is that they take our attention away from the real problem. And sometimes, the goat is dangerous. The study found that there was a slight, and probably statistically insignificant increase in deaths when salt was reduced in patients with heart failure. Get that? Not only did reducing salt intake NOT increase the life of those with heart failure, but it increased it slightly. In the study’s words:
Further RCT evidence is needed to confirm whether restriction of sodium is harmful for people with heart failure.
Reducing salt can lower blood pressure a bit. That is because salt helps retain water, and the excess water in the bloodstream increases blood pressure. Reducing salt can decrease blood pressure a bit, but usually doctors prescribe a diuretic like hydrochlorothiazide (HCZT) as a first step in blood pressure management. It really reduces the excess water in your bloodstream, as long as you take the drug.
One of the criticisms of low carb diets is that much of the initial weight loss is water, and thought to be temporary. Dieters starting out on a low carb diet are warned about this effect:
If you are currently under a doctor’s care for these disorders or taking medications to control them – especially if you are a diabetic on insulin or oral medications to control blood sugar or on diuretics to control blood pressure – you must consult with your physician before beginning this plan! This nutritional strategy is potent and will rapidly cause changes in blood pressure and blood sugar that will make your current doses of medication far too high.
- Drs. Mary Dan and Michael Eades in Protein Power Lifeplan
The criticism that water loss is temporary isn’t valid; a low carb diet is not a temporary diet to lose weight, but a new way of eating that resolves many health issues. As long as you don’t overdose on carbs, you don’t retain the water, and your HCZT stays in the bottle.
Expect to Hear More
Judging from past media scapegoats, expect the drumbeat of uninformed, erroneous news stories to continue scapegoating salt. As we don’t know the effects of a society-wide reduction in salt consumption as proposed by New York City, it will be decades before a rise in deaths attributable to lower salt consumption. Just remember that cows eat green grass, yet their milk is white. Correlation is not cause, and more study should be done before legislation bans salt shakers from our tables.