Salt: Are you getting Enough? (More Sodium & Health)

Salt. It doesn’t get much attention lately as
the most that is said about it is usually just to eat less of it. But is that always the best advice? A March 1940 paper by Lawson Wilkins in Baltimore
describes the case of a child who, starting from 11-months of age, had a very unusual
craving for salt. In a letter responding to questions regarding
their child’s special appetite, the parents explained how the child would throw up almost
everything except for mother’s milk; at the advice of a doctor, the parents tried
giving the child crackers. He threw those up too… but soon he started
just licking all the salt off the crackers and then would ask for more. Once the boy figured out what was in the salt
shaker, the mother said he refused to eat anything unless the salt shaker was also on
the table. He ate plain salt by dipping his finger into
it and bringing it to his mouth. It was estimated that the child was eating
an extra teaspoon of plain table salt a day in addition to his foods already being saltier
than his parents’. Based on weight, the adult equivalent of that
would be about 20 to 30 extra grams of salt per day. American dietary guidelines by the way, advise
people to limit their daily salt intake to a maximum of only 5.75 grams. Later it was found out that this massive craving
for salt wasn’t just a quirk of the palate, the child’s body was urging him to get what
it needed. He was admitted to the hospital at age 3 and
unfortunately after only 7 days on the hospital’s low salt diet, he suddenly died. The final paragraph of this paper says “A
boy aged 3 1/2 years with deficient adrenal cortical tissue, manifesting various symptoms
of adrenal insufficiency, had a marked craving for salt. …it would seem that this boy, by increasing
his salt intake kept himself alive for at least two and one half years.” As this case illustrates, we can’t live
without enough salt, but of course healthy people can survive on far less than what this
child needed. In 2005, the US federal government’s dietary
guidelines set a maximum limit for sodium at 2,300 milligrams, or about 5.75 grams of
salt per day – this is about as much sodium as is much is in just one and a half large
dill pickles. It was estimated that reducing Americans intake
of salt by half a teaspoon a day (about 2.8 grams) would prevent 92,000 heart attacks
and save the country $20 billion in health care related costs. Their logic behind this is relatively straightforward:
“In large amounts, sodium pulls fluid from the body’s tissues and into the blood which
raises the blood volume and the heart pumps harder. The result: high blood pressure. Chronic high blood pressure stresses the heart
and arteries leading to heart disease. So, less salt should mean less disease. Now, Hypertension is currently at an all time
high – 1 in 3 Americans have it. But is salt to blame? Dietary salt intake used to be far higher
than it is now, mainly out of necessity. Before the industrial era, salt was the most
common and effective food preservative. As Mark Kurlansky points out in “Salt: A
World History,” we know that the salt intake in Europe was very high at least from the
1500’s when it was as much as 40 to 100 grams, thanks to foods like salted fish. This amount would be like consuming the entire
contents of one to two two-ounce salt shakers like you’d see in a diner. If these massive quantities of salt were causing
hypertension induced heart disease, then people at the time must not have cared much about
…sudden death.. considering the first report of heart disease didn’t occur until the
mid 1600s. Then, from the early 1800’s until the end
of World War 2, western societies consumed between 15 and 17 grams of salt per day – Based
on military archives’ data. “After World War II, when refrigeration
began to displace salt as the main means of food preservation, salt consumption in the
U.S. dropped dramatically to about half that rate, or nine grams (1.8 teaspoons) per day
and, based on twenty-four hour urinary sodium data, has remained flat for the last fifty
years.” So, despite this historically low and steady
salt intake, prevalence of hypertension is now three times as high as it was in the first
half of the 1900s. So, salt intake is “still” high according
to health guidelines, but this doesn’t explain how hypertension keeps going up while salt
consumption stays steady. The South Koreans eat a wide variety of salty
foods with the easiest example being kimchi- cabbage and other vegetables preserved in
salt and spices. Kimchi is eaten at literally every meal. The average South Korean consumes around 4000mg
of sodium per day, almost twice as much as the US dietary guidelines recommend. Despite this, South Korea has the lowest rates
of coronary heart disease in the world, according to 2014 data from the World Health Organization. In fact, the data from a September 2015 paper
funded by the Korea Food Research Institute shows that the quartile groups that consumed
the most sodium had the lowest rates of hypertension, coronary heart disease and stroke. This has been dubbed “The Korean Paradox.” And, as Dr. James DiNicolantonio points out:
“you could swap out Korea for any one of thirteen other countries and get a lot more
“paradoxes” regarding high salt intakes.” In his very thorough book “The Salt Fix,”
Dr. DiNicolantonio makes the case that reducing salt intake is not only unnecessary but potentially
harmful to health. Salt has several very important functions:
It’s needed by the heart to pump blood properly, it’s needed by the stomach to facilitate
digestion, and it is necessary for bone formation and bone strength. It’s a key component in cell-to-cell communication
and the optimal transmission of nerve impulses to and from organs like the heart and brain. As is explained in The Washington Manual’s
Endocrinology Subspecialty Consult, at particularly low sodium levels, “patients may present
with neuropsychiatric signs and symptoms, ranging from muscular weakness, headache,
lethargy, ataxia and psychosis to cerebral edema, increased intracranial pressure (ICP),
seizures, and coma.” On the other side of the spectrum, consuming
particularly large quantities of salt can of course have terrible consequences. According to a 1913 article, “in the Chekiang
province, and probably in other provinces of China, the drinking of a saturated solution
of salt [was] a common mode of committing suicide.” People would down an entire pint to pint and
a half of saturated salt solution- they usually drank the brine used for pickling cabbage. But for it to kill someone, all this salt
had to be consumed very quickly in order to overcome the powerful filtration ability of
the kidneys. This is why 16th century Europeans could consume
so much salt- while 100 grams of salt is a massive amount, it can be simply processed
by the kidneys if ingested at a normal pace. So, if humans had to consciously restrict
their salt intake in order to stay healthy, this would suggest that our regulating systems
like the kidneys aren’t very powerful at all, but our history suggests otherwise. In order for our cells to work properly, systems
had to develop that could regulate the concentration of salt and other components of our blood
and extracellular fluid. The kidneys of course are very important in
this respect. Considering cells can’t survive outside
a narrow range of electrolyte levels in the extracellular fluid, the ability to retain
salt and at the same time excrete excess salt is very important. Mammals who get their food from the sea such
as the sea lion, sea otter, walrus, and polar bear, ingest large amounts of salt. But The salt content of their blood is not
very different from that of terrestrial mammals. From our perspective at least, these animals’
“kidneys must be able to excrete massive quantities of salt.” But, the basic physiology of the kidneys is
the same in humans. Through the process of osmoregulation, the
water and sodium levels in our body are constantly balancing each other out. If the blood sodium levels drop too low, water
from the blood will enter our tissues to maintain this balance. When there’s an increase in sodium in the
blood, the kidneys simply excrete the excess into our urine. As is explained in the book the Salt Fix:
“If our blood and fluid levels of sodium get high, we start reabsorbing less salt from
the kidneys and absorb less salt from the foods we eat–the liver can signal the intestine
to reduce sodium absorption. And If sodium begins to accumulate, our bodies
also tend to harmlessly shunt excess sodium to the skin or organs.” In fact, a 1979 paper authored by Friedrich
Luft and colleagues, described an experiment where they gave people with normal blood pressure
various amounts of sodium, going as high as around 87 grams of salt. They found that “The urinary sodium excretion
approached the total sodium intake at each level.” Their bodies were simply excreting these excess
loads of salt, to the point that they were able to excrete ten times a normal sodium
intake, up to 86 grams of salt per day. Dr. DiNicolantonio points out that these kinds
of capabilities “suggest that the human body is well adapted to handle salt overload-but
not salt deficit.” So, If it’s easier for the body to handle
excess salt rather than insufficient salt, we should expect to have data showing higher
rates of mortality from lower salt intake. Well, this data is available. A 2014 article in The New England Journal
of Medicine analyzed the Mortality and Cardiovascular Event rates of 102,000 people assessed for
urinary sodium and then followed them for 3.7 years. The article concluded that “An estimated
sodium intake between 3 grams and 6 grams per day was associated with a lower risk of
death and cardiovascular events…” But, what’s important is that the adverse
effects to health increase much more rapidly when you are under this range rather than
above it. As you go over 6 grams of sodium, about 15
grams of salt, the health risk does start to rise but it rises much more gradually. Based on the data here, eating six times as
much salt as is recommended by the US dietary guidelines would pose less of a risk to your
health than actually following the guidelines. Animals have a very strong innate drive to
acquire salt specifically- just like they would go to great lengths to acquire water
or food when thirsty or hungry. Elephants will uproot entire trees to get
at the salty soil under the roots, gorillas will chew on rotting wood to eat the salty
microbes and some animals will drink urine due to its sodium content. But these efforts pale in comparison to what
humans have done for salt. Mark Kurlansky’s book Salt: A World History
is a 449 page testament to this. As he shows, Salt-seeking drove civilization,
built empires and won wars. Romans established every major city near a
saltworks and for some time roman troops were paid in salt; Britain lost control of its
American and Indian colonies when it lost control of their salt supplies. Kurlansky states, “The history of the Americas
is one of constant warfare over salt. Whoever controlled salt was in power.” When salt is freely accessible, people across
many populations tend to consistently consume between 3000 and 4000 milligrams of sodium
per day. In America, the country infamous for reckless
eating habits, from 2011 to 2012 the average daily sodium intake was only 3600 milligrams. This suggests that the body will push people
to acquire salt, but in accordance with their actual needs for the mineral. In a 1936 paper titled “Experimental sodium
chloride deficiency in man,” through 7 days of sweating and sodium-free diets, subjects
became sodium deficient. “The participants reported that they experienced
extreme, unquenchable thirst. One participant reported that he experienced
a longing for salt and often went to sleep thinking about it. …With regard to mood-related symptoms, subjects
reported a loss of appetite, anhedonia, difficulty concentrating, excessive fatigue, and a general
sense of exhaustion.” A 1995 study at Johns Hopkins University School
of Medicine was done on a group of Chronic Fatigue Syndrome patients. Patients were encouraged not to restrict sodium
intake and were given the drug fludrocortisone, which causes the body to retain sodium. 76% of the patients ”reported a favorable
response to [this] therapy by manifesting reduced CFS symptoms and improved clinical
signs…” Especially noteworthy was the observation
that the patients also improved scores on a test of general well-being that likely reflected
improved mood. at the conclusion of the study, it was learned
that 61% of the Chronic Fatigue Syndrome patients had voluntarily imposed low sodium diets upon
themselves. As the 17th century Chinese scientist and
encyclopedist Song Yingxing said: “[there are] in the world five tastes… A man would not be unwell if he abstained
for an entire year from either the sweet or sour or bitter or hot; but deprive him of
salt for a fortnight, and he will be too weak to tie up a chicken…” Craving for salty foods is surely not indicative
of salt being “addictive”, but just shows that the body has an impressive ability to
drive you to consume what it needs. A 1928 study in the American Journal of Diseases
of Children found that When very young normal children were given free access to a variety
of natural foods to choose by themselves, they selected foods that facilitated normal
growth and development. There was even one child with Rickets caused
by vitamin deficiency that continued to take large amounts of straight cod liver oil over
a period of 101 days. After the deficiency symptoms disappeared,
so did his craving for cod liver oil. The reason humans in general are hovering
around an intake of 3 to 4 grams of sodium per day, despite the world health organization
and US government urging them to cut their salt intake down to lower than 2.3 grams a
day, is probably because their bodies are pushing them to acquire the amount that is
best for them. As mentioned earlier, a sodium intake of 3
to 6 grams (about 7 to 15 grams of salt) seems to be an ideal range for most people. However, if you are losing more salt from
sweating alot or being on a low carbohydrate diet, this range may be shifted upwards to
say 4 to 7 or 5 to 8 grams of sodium or more. Now, there’s still a several points about
specifically why lowering salt intake stresses the body, contrary to conventional health
advice. So stick around, I’ll be covering the science
behind this another time.

100 comments

  1. I keep seeing comments asking "How is 2300mg of Salt = 5.75g????"
    What I'm saying in the video is "2300mg of Sodium ≈ 5.75g of Salt " – if there's a part where I mistakenly said 2300mg of Salt = 5.75g of Salt, someone please comment so I can add an annotation!

  2. funny thing when i was a kid i was doing exactly teh same as this little kid who died with crackers and salt overally i was licking everything what was salty even sea water

  3. Pink Himalayan Salt is HIGHLY TOXIC!!! Beware people, this salt is full of heavy metals that harm all your body! Just use cheap sea salt and eat as much as you want!!!

  4. There’s a lot of difference in Salts. Table salt is garbage that in fact does kill you. We need good salts. (Sea salt, Himalayan, Dead Sea, etc).

    Nice job on your research but you only scratched the surface.

  5. Your videos are totally awesome. With regards to table salt, specifically iodine added, I’ve heard the unhealthy part was the salt per se, but the anti caking agents added. Kosher salt is great. And tastes best in my opinion

  6. 12:54 I guess he mistakenly said 'salt' instead of 'sodium' there.
    It originally should be " – despite the world health organization and US government urging them to cut their 'sodium' intake down to lower than 2.3 grams a day – "

  7. You mention that South Koreans eat twice as much salt as average U.S. citizens and that their incidence of heart disease is lower. We know that correlation is not a direct indicator of causation however, the South Korean incidence of stomach cancer is much higher than in the U.S. While the Korean findings are not definitive, they do support the long-suspected association between salt intake and gastric cancer.

    NEW YORK (Reuters Health) – A salty diet may increase the risk of stomach cancer by 10 percent, South Korean researchers found in a study of more than 2 million people. They found a “weak but positive” association between a preference for salt and an increased risk of stomach cancer.

    Although the mechanisms by which salt may be involved in the development of stomach cancer remain unclear, “restricting salt intake is thought to be beneficial for preventing gastric cancer,” Jeongseon Kim and colleagues from the National Cancer Center Research Institute in Goyang-si, South Korea, note in the American Journal of Clinical Nutrition.

  8. Just because heart disease wasnt diagnosed until the 1600s doesnt mean people didnt have it, people didnt even know about the existence of GERMS until the 1800s but that doesnt mean germs didnt kill people since time began…

  9. In Winter in Austria and i guess in many other european countries they deploy deerlicks with saltstones everywhere over wintertimes for example.

  10. Salt is actually very important since it helps melt internal fat. If you have high BP, it's a sign of diabetes, not too much salt. You need to exercise more to bring down HBP, not eat less salt.

  11. Reducing my salt intake reduced my blood pressure. Some salt is needed but there is far too much salt in all processed foods. If you eat natural foods you will get the right amount of salt.

  12. I find I naturally get repulsed by salt if I eat a lot of it. I'd be surprised if saline balance is not very powerfully regulated by our bodies.

  13. What causes high blood pressure if not salt? My ma has high blood pressure- has had to go to the ER before, takes medicine for it. She always beats herself up about needing to eat less salt. She was a pretty normal weight back when she was first diagnosed.

  14. We can't need salt (it's a very recent invention in our evolutionary history) but we need sodium. And some other forms of sodium like sodium ascorbate don't cause high blood pressure like sodium chloride (a.k.a. salt) does.

  15. 8:00. You failed to mention that there was a positive correlation between salt intake and blood pressure.

  16. Can anyone explain why this video seems to be in contradiction with Dr Michael Greger's videos on salt?

  17. This video to me seemed like the missing puzzle piece for why I feel so tired with my keto diet, I didn't change my salt intake since the start.
    I felt really lethargic because of this mostly perhaps…
    Started eating with more salt recently now I think about it and I do feel less tired all the time, but could've been from other things too though.

  18. This is fascinating, thank you! I use cronometer and used to take exactly 1 tsp of salt per day. I experienced stomach cramps, reduced motility, frequent urination, fatigue, confusion and occasional heart palpitations and muscle spasms. I believe all of these symptoms were due to poor regulation of water in the body due to inadequate salt intake.
    I doubled my salt intake and now feel great! This video was a great help. 🙂

  19. The issue with this video is that salt intake is very important for the body, but salt is a broad term in chemistry. You have SodiumChloride(salt most people know), magnesiumsalts, potasiumsalts and way more. Many people are deficient in for example magnesiumsalts. In that case lowering the sodiumchloride salt(table salt) makes the situation even worse. But its most likely better to lower the sodium chloride(salt) intake and increase the salt intake of other salts.

  20. Haha yeah I realized this several years back when I started sometines feeling sick after drinking water and I've liked salt on level some might consider too much for awhile

  21. I wonder if Celtic salt or Himalayan pink salt would be better than the mineral deficient table salt we have in the US

  22. I personally try to limit salt intake because it causes areas in which your body stores water to bloat due to water storage, most notably in the face.

    This water storage comes immediately after consumption and mitigated but not completely reduced by water intake. It sucks because this is one of the only instances in which doing what is healthy will make you appear worse aesthetically.

  23. Wtv this channel says is so contradictory to what we've been taught im kinda worried if what he says is actlly accurate

  24. You should make the distinction between refined salt and marine/himalayan/kosher/etc salt. Table salt is really toxic and produces much more harm than good if consumed excesively.

  25. What about all the other studies that contradict these? There are many many more studies on the negatives of excess salt consumption.

  26. 12g of salt = 2.11 teaspoons. 4g salt = .70 tsp
    I think it's more helpful to convert…I measure in terms of teaspoons in my kitchen, too, in addition to reading food labels on something already processed which I don't buy really

  27. Much of this content is not so good. You have missed the most simple but important info about salt and our health. Yes, you missed the elephant in the room.

  28. Medical science is not perfect. They think they figured it all out and are still clueless. Doctors always want to put me on a drug for one new issue after another, and I find out I don't need their drugs so long as I Don't follow their ridicules dietary rules.I am doing great since I listen more to my body than a doctor.

  29. can anyone clarify if this still remains true depending on which race you are? For example, African American and Latinos tend to suffer from high blood pressure. Wouldn't reducing the intake of salt be the best thing in that case?

  30. Its high carbs and saturated fats thats causes heart attacks smh. If you eat alot of salt, drink more water

  31. Bah! Salt or sodium is also an electrolyte and if you exercise a lot you need more sodium but milk is very effective in replacing electrolytes.

  32. The like to dislike ration on this thing is so sad. I don't think people are simply gullible, because this video is super well made. But this is just not true. There is so much more evidence than shown here, that support lower sodium intake. Some of the studies shown in this video has already been discredited by the scientific community.

  33. So…. explain to me, what causes high blood pressure. I eat mostly non processed foods with low salt. My daily intake is roughly 1500-2000 mg a day. When I eat foods higher in salt on occasion, not only do I experience bloating but my BP is higher, and it returns to an acceptable level when I resume lower salt consumption for a longer period of time. Not trying to argue with you, but this is how I experience it and I am honestly curious why.

  34. So for the most part of its' history our species was expected to run on infrequent meal consumption with preferable source being meat and fat as evidenced by the power of ketosis and fasting, while constantly intaking water and minerals as evidenced by sweating and powerful salt excretion system.

    Am I understanding it right that we must've been a returned to terrestial life marine carnivirous mamal? That would explain why Orcas in the wild don't harm humans…

  35. Since watching this video I've started adding 1 teaspoon of salt to every 1.5 litres (0.4 gallons) of water I drink and I've never felt better, I feel way more hydrated my only concern is that since I started working out I drink up to 6 litres of water a day, which means I'm taking in about 4 teaspoons of salt a day or 20 grams not even including the food I eat, like I said I feel great but is this something to be concerned about

  36. Does anyone else pee a lot when consuming salt ? Always comes out clear regardless the amount of water i do or do not drink

  37. you're merely scratching the surface with half-baked hypotheses. other animals have other adaptations besides purely using liver.
    USDA is not particularly trustworthy, with powerful lobby groups having a major say on recommendations.
    Salt is a new thing, that used to be very expensive…so insinuations that it was prolific for a long time are not well founded.
    poor kid had some condition, doesnt mean extra salt was healthy.
    so…you're contrasting extremes that have little value in establishing any air of rationality.

    Additionally, excess sodium does a lot more than increase risk of hypertension. 20% of humans are potassium deficient, in part thanks to sodium excess. Influences diabetes and other conditions. Sodium and potassium should be discussed together, as it is their ratios in blood serum that is important. more so than what your liver can or cant handle in excreting sodium.

  38. Can you do a video on acidity? My 94 year old grandma has to put lime juice on all her food or else she won't eat it.

  39. So the little kid was keeping himself alive, and the murderers at the hospital killed him? WTF!? Would like to know more about this.

  40. Wait, people in Japan drank the brine for pickling cabbage to commit suicide?? In Bulgaria we drink that just to get rid of hungover… Must be something wrong with that info…..

  41. One of the key components of metastases of cancer is a break down of cell to cell communication. When cells no longer communicate the tissue will grow out of control. Therefore it could be hypothesized that salt could help signaling, thus prevent the spread of cancer.

  42. I think he’s over simplifying things and mingling two things into one, not sure if he’s doing it on purpose or not. Low sodium for people that already have heart disease, renal insufficiency, etc. saves them, I see it first hand in clinical practice almost daily where they can’t breath from the edema of fluid backup into the lungs. You don’t withhold salt from a patient with adrenocorticol insufficiency; their blood pressure drops so much that the body is literally starved of blood.

  43. Interesting that you mention the low carbohydrate diet. Since around the 1920s they learned that elevated insulin causes the kidneys to retain more sodium. Thus the biggest reason for excess sodium and high blood pressure is constantly elevated insulin, ie a high carbohydrate diet, heading towards metabolic syndrome.

  44. I am very sensitive to salt. I rarely salt my food, and can't stand things too salty. I flick salt off large pretzels.

  45. This video saved my health, thank you. I have "geneticly inherited" hypertension. After watching this I read "the salt fix", stopped reducing salt and increassed potassium with supplements and food.
    I have the lowest, NORMAL blood pressure results in my life since then. It's been a month already.
    THANK YOU!

  46. Oh man I've moved places a few weeks ago and this household really serves a lot of 'healthy' food. I'm grateful there's a ton of veggies on the table but now I know where my craving for crisps came from.

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