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Doctor’s Tip: Cutting back on salt would save millions of lives

Dr. Greg Feinsinger
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This is the second-to-last in a series of columns about foods we should avoid if we want optimal health.

Salt is sodium chloride, which is an essential nutrient in humans and animals. It is thought that early humans consumed about 500 to 750 mg. of sodium a day, which they got from the plant-based diet they ate.

Then, centuries ago humans discovered that salt could be used to preserve food, and in most “developed” societies people now eat many times more salt than humans were genetically programed to eat. This is unfortunate, because too much salt results in the following health problems:



• Hypertension (high blood pressure), which is the main risk factor for strokes and an important one for heart attacks. According to Dr. Michael Greger (“How Not to Die,” nutritionfacts.org), reducing sodium consumption by just 15 percent worldwide would save millions of lives per year.

• Excess salt directly damages and stiffens arteries, independent of its hypertensive effect.



• Kidney damage.

• Water retention, leading to swelling and contributing to heart failure.

• Stomach cancer, particularly prevalent in people who eat pickled (salted) vegetables.

How much salt is recommended? The American Heart Association recommends less than 1,500 mg. of sodium a day, although Dr. Joel Fuhrman in “The End of Heart Disease” states that “for maximal disease prevention, sodium levels should probably be less than 1,000 mg./day.”

The average American, however, consumes 3,500 mg. a day, and 90 percent of Americans eventually suffer from hypertension, which contributes to the main cause of death and disability: heart attacks and strokes respectively. Ideal blood pressure is less than 115/75, and in the few remaining societies in the world untouched by the Western diet blood pressures remain at that level irrespective of age.

Where do we get excess salt? Surprisingly, the salt shaker isn’t the primary culprit:

• In kids the main source of sodium is pizza (cheese in particular is laden with salt).

• For adults between the ages of 20 and 50, the main source is chicken, which when raised commercially is usually injected with salt water to increase the weight/price.

• For adults older than 50 it’s bread.

As mentioned in previous columns, Big Food has people hooked on salt, sugar and fat. The industry tends to add salt to many products, and it’s virtually impossible to find a processed food product with no added salt. The Salt Institute and the food companies use the usual tactic of trying sow seeds of doubt on established science, but as Dr. Tom Frieden, director of the Centers for Disease Control and Prevention said in the August issue of the Journal of the American Medical Association, “There is incontrovertible evidence of a direct, dose-response relationship between sodium and blood pressure.”

Are you concerned that your food will taste bland without salt?

• You will miss it for about 10 to 14 days, and then you will lose your taste for it as the taste receptors in your mouth become more sensitive.

• Add other flavorings such as pepper, onions, garlic, tomatoes, sweet peppers, basil, parsley, thyme, celery, lime, chili powder, rosemary, smoked paprika, curry, coriander and lemon (per Dr. Greger).

• Try potassium chloride instead of salt, which looks like salt but has a slightly different aftertaste until you get used to it. It’s available in the salt section of the grocery store, one brand being No-Salt (I put this plus nutritional yeast on my popcorn).

Read food labels at the grocery store and try to buy things with little or no added salt (no problem if you’re in the produce or fruit section). A good rule of thumb is to buy foods with fewer milligrams of sodium on the label than there are grams in the serving size. So, as Dr. Greger says, “If it’s a 100 g. serving size the product should have less than 100 mg. of sodium.” Avoiding salt when eating at restaurants can be difficult, because they too take advantage of people’s addictions (there’s a reason why bars serve salty snacks, which make you thirsty). Request a low-salt meal, and avoid the salt shaker.

Remember to reserve your space at Dr. Greger’s talk in Carbondale on Feb. 9, sponsored by the VVH Connie Delaney Memorial Medical Library. This is a wonderful opportunity to hear a nationally and internationally respected expert in nutrition (plus he’s funny and gives a great talk, geared to the general public, but health care providers would learn from it as well). Go to onebook@vvh.org.

Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at gfeinsinger@comcast.net.


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