Is Salt Really Bad for Your Heart?
One of my first patients as a young doctor was a man with an unpleasant bowel condition called diverticulitis. The last time he had been in hospital, he had been told to eat a low-fiber diet, but since then the medical doctrine had changed (low-fiber diets having been discovered to be responsible for everything from bowel cancer and heart attacks to varicose veins), and I told him, with all the zeal of a convert, henceforth to eat a high-fiber diet.
Of course, medical advice must be dispensed according to the best available evidence of the time, but my patient, having been given diametrically opposing advice for the same condition, not surprisingly concluded that doctors did not know what they were talking about and that henceforth he should do what he liked.
For a long time now common salt has been regarded as the deadly enemy of mankind, and the less we take of it the better, the longer we shall live or at least fail to die of heart attack or stroke, or other consequences of raised blood pressure. The late Duchess of Windsor said that you could never be rich or thin enough; she might have added, if she had survived to the present, that you can never take too little salt.
A recent paper in the Journal of the American Medical Association puts this received wisdom in doubt. Comparing the number of “cardiovascular events” (heart attacks, strokes, and heart failure) in people with various levels of salt intake — as measured by urinary output of sodium — they found not a linear relationship but a J-shaped curve. People with high salt intakes had a high rate of cardiovascular events; but so did those with very low intakes.
Thanks, Doctor. Next time you’re in the US, order a salty dog at the bar.
Say, ANYTHING GOES is a great read. Why can’t you advertise that and your other books on the sidebar here? Roger Kimball and Victor Davis Hanson do that with their books on their posts here.
I knew I was right all along. I knew it, I knew it, I knew it. Pass the fries!
Sodium and Potassium are the “electrolytes” whose difference produces the electricity that powers heartbeats and all the electric transactions in the body “The Sodium Potassium Pump” is the term. Thus too little sodium can get you in serious trouble. Having spent the night in the emergency room with a salt drip, I know whereof I speak. Life is an amazing counter-intuitive mechanism and as the ancients knew, the secret is moderation and having a life not worrying about the process.
That’s true. Your nervous system uses electricity to do its work; thus, it needs the correct balance of electrolytes. Too little and the whole thing stops working.
I feel the same way about advice given by MD’s, Big Pharma and their ‘one size fits all’ medical advice. My fathers doctor(in my opinion a complete idiot) advised my Dad to take an 81 mg aspirin a day to ‘prevent a stroke or heart attack’. One day I’m talking with my father and blood starts running, not oozing, running, out of the skin on his right cheek. Without consulting his quack, my mother and I decided to end this idiocy. Did his ‘doctor’ do any bloodwork to see if he needed to take an aspirin a day? I seriously doubt it. Did this advice exacerbate and hasten the progress of his Alzheimer’s? In this layman’s opinion, yes. Aspirin is a known blood thinner and common sense would demand the prescribing physician do minimal bloodwork to ensure that he was doing the right thing. Did he bill Medicare and TriCare for it? That I don’t know, but I wouldn’t doubt it. Ever since that day I have lost a lot of faith in allopathic practitioners. I no longer view them as I used to; to me, they are, for the most part, Big Pharma pushers. As long as they get their cut, you ‘need’ this chemical treatment.
I used to sell Medicare supplemental insurance and have seen firsthand how MD’s will ignore what is best for their patients so that their income from Medicare isn’t diminished. Medicare doesn’t pay much, but some milk it for all they can get. There is no oversight, submit the bill and get paid. The government trusts the pushers not to lie. What naivete!
There is a great read called ‘The Serpent and The Staff’. It exposes the hypocrisy and danger of the AMA. Just because someone is wearing a white lab coat and their name is followed by the letters MD doesn’t mean they have a shred of altruism or decency. Not every allopath is a combination of Albert Schweitzer and Louis Pasteur.
Me, I’m a “bleeder”. It seems to take forever for a razor cut on my chin to stop bleeding. Back in the 80s, I fell for the scam of “aspirin will reduce heart and stroke problem”. I started getting unexpected nose bleeds. I finally put 2 and 2 together and stopped using aspirin. The bleeding stopped.
Not all doctors belong to the AMA. Check it out.
As I retired dietitian, I can tell you that the vast majority of medical students (for at least the last 43 years, since I was in college) receive minimal nutrition information. And we’re supposed to trust their recommendations? Especially when most of the studies being done are paid for by industries that benefit from the results.
I always take these recommendations with – *ahem* – a “grain of salt.”
During the early 70s, if you recollect, the big push was to limit intake of high-cholesterol foods and use lower-cholesterol alternatives. Family physicians were getting entire families to do so. Thanks to my Dad’s cardiac issues, my family was one such. We faithfully followed our physician’s instructions. Hey, it was advice from the Doctor, after all.
Fast forward to today, where we now know that those partially hydrogenated and trans-fats are actually as bad or worse than the natural products they replaced.
Caveat Emptor.
That’s usually the case. The more we mess with it, the less good it is for us.
Not only that, many of our legislators are so idiotic they pass laws based on medical industry recommendations. I wonder if now NYC will rescind the law prohibiting salt in restaurant food. Just as some states and cities across America have passed laws to alleviate AGW, based on environmentalist conjecture.
Thank you Doctor Dalrymple; your essays and books have put a lot of salt in the modern day discussions in order to help spice them up. I agree with you that most of what doctors tell us is about as useful as a witch doctors formulae. I believe you once wrote that all doctors tell people over sixty that they have to take blood pressure medicine even though there is very little evidence that taking blood pressure medicine is helpful; you indicated that it was a form of cya used by all doctors. I like salt and refuse to give it up.
You may be surprised, but Witch Doctor is as good as the Good Doctor in my book. He would be likely to go along with that opinion since in Britain, it is a well-established OTC skin treatment gel.
Well, well! PJ Media is certainly getting up in the world!
It is a lovely thing to open this site and see a new article by the Good Doctor. Just to know that he is still alive and kicking to guide us through life’s vicissitudes brightens my day, somewhat. As always, he offers sound advice, and his writing is a joy to behold.
To all you anti-doctors out there, I offer some advice based on way too much hard-earned experience.
My first wife died (at 42) of cancer over a period of 18 years. I am in the process of having a kidney transplant. I know a thing or two about the medical profession and its pros and cons. It is important to understand that, as in everything, there are good doctors and bad doctors. The trick is to be able to tell the difference before they kill you. This is not a foolproof method, but it has served me pretty well thus far:
Can you contact your doctor easily, or do you call a busy signal many times to get through, or have to leave many messages?
Does your doctor respect appointments, keeping in mind that brain surgeons have emergencies? Still, if he can’t make it, does his office quickly let you know and offer alternatives, so you don’t just waste more time? Is their office, in general, well run?
Do you arrive at decisions together thoughtfully, or does he just breeze in, order you about, and depart unceremoniously?
If you would not be treated disrespectfully at the grocer or the auto repair center, why would you let someone you don’t like tinker with your very person?
After all, every doctor cannot be this Doctor. Hardly!
You may include the fact that some years (40yrs?) ago, the iconic study that first started all this was done in the south on only Black Americans, which revealed that high salt intake was specifically dangerous to them. But of course, the results were thereafter wrongly generalized by the Media for the entire population. Then some 20 years later, another study at Johns Hopkins revealed that for Blacks, the results were accurate, however for White populations, the previous study should not apply, since Whites were thus handicapping themselves with low sodium levels, leading to gross imbalances in their electrolytes. This study was first initiated in the finding at Hopkins that Epstein-Barr’s syndrome was the result of low sodium (salt) levels in the body; and that by simply increasing salt levels, the flu-like symptoms would disappear almost immediately…. since then, most of the public’s Media-fed knowledge about health has proven similarly bogus. Go figure!
Moderation, in itself, should not be practised to excess…
The old British phrase is, “A little of what you fancy does you good.”
Barring something like a dangerous allergy, that’s pretty much all the diet advice you need.
“Such is the state of popular hypochondriasis that this could lead to a run on bananas (high in potassium).”
What fun! Encourage increased consumption of bananas. Then after 6 months remind people that bananas are radioactive.
http://en.wikipedia.org/wiki/Banana_equivalent_dose
What ever the suggestion of the medical community is on any issue, just wait five years, and they will reverse it. That’s why I always take everything they say with a……..er……grain of salt.
To quote my late mother in law:
Everything in moderation, including moderation
In response to the rant of Chris @ #4, may I point out that only 15% of US docs are AMA members, that the AMA would have the sheeple believe it is the voice of American medicine, and that scientific articles in JAMA do not automatically indicate the AMA’s political biases; that his bizarre anti-aspirin tale, which generalizes into a reimbursement-driven, anti-”allopath” rant, are the products of near-paranoid hostility. Not to worry, Chris, because Obamacare will fix all that for you. Stick with homeopathy and naturopathy, which are exempt, and good luck to you.
If the debate about salt is not enuf to confuse you, check out Gary Taubes’ book on “What Makes You Fat.” It will literally make your head spin because of all the history he brings to bear in the low carb debate.
I had always believed that nutritionists had ALWAYS believed that meats, fats, etc would literally kill you, but he shows this view is relatively recent (say, over the last 30 – 40 years or so). A very interesting read and you will come away totally confused, because he presents FACTS (based on many real world tests).
By the way, many years back, while I was in my 20s and exercised a lot, I would eat EVERYDAY two eggs, and my cholesterol levels were very very good.
Then came the “don’t eat eggs” advice from the gods of nutrition.
So, I basically gave up on eggs; my cholesterol levels got WORSE !! Not bad, mind you, but not as good as my two-egg/day days.
Let’s all remember also the “advice” to eat MARGARINE !! because it’s healthy. Yea right.
The fact of the matter is – just like economic “science” – that controlled experiments are really impossible to conduct when determining what’s best to eat. This is why there are so many contrary opinions (and that is exactly what they are OPINIONS !!) about diet and the best foods.
So, just eat all in moderation, drink water (that’s right folks, there is ZERO, NADA, NONE evidence supporting the 8 glasses of water / day advice), and get your exercise, and eat your tuna fish (that’s right folks, the amt of mercury in tuna is insignificant, even for pregnant women!!!; you will be amazed at the amount of “studies” and “advice” coming from the “environmental” / PETA type / vegetarian fanatic folks. )
I never got how ridiculous most studies are until I started reading them a couplle of years ago. The so-called ‘gold standard’ double-blind study is a farce; they don’t control for anything. They don’t put you in a lab and feed you an exact diet where they know ever input and output–they say ‘try these pills’ and then you’re supposed to report back what you felt. That’s right, completely subjective. There’s no way to know what other factors might be involved. So every time I read about some study that some food or other increases or decreases risks etc, I can’t help but think ‘balderdash!’ It would be nice if at some point science became scientific again, but in medicine and nutrition just as in the Global Warming scam, it’s more important that scientists serve their political masters than find the facts and tell the truth once finally discovered.
On several occasions I have had the opportunity to discuss nutrition with various “Registered Dietitians”.
On each occasion, I have found that person to be shockingly ignorant of basic biology.
I put ZERO stock in what they say, individually and as a profession.
I’ve always craved a lot of salt and I have consistently had blood pressure on the very low but still safe spectrum my entire life. One of my favorite salty foods is miso paste and Korean soybean paste which I use as ‘salt’ in my Asian dishes and soups.
Another potassium rich food (besides bananas) is the mighty little date. I just bulk purchased some delicious medjool dates and froze half of them.
I eat one or two brazil nuts a day for my daily selenium.
Coffee is another food that was considered ‘bad’ for you and now more information is coming out about the incredible antioxidant and protective qualities of coffee (even decaffeinated). I’ve always been a coffee and tea drinker and I’ve never felt any ill effects of either.
My motto is to eat what my body craves (within reason).
Besides, who wants to be on their death bed moaning, “I shoulda had that pie!”
Several years ago, I read the results of an interesting study of primarily healthy adults living full lives into their 70s, 80s and beyond. I don’t recall all the particulars, but the group included drinkers, smokers, salt eaters, butter eaters, meat eaters, vegetarians, coffee drinkers, tea drinkers, etc.
What did they have in common? Most of them:
- Got 8-9 hours of sleep almost every night.
- Ate meals at regular times almost every day.
- Got moderate exercise (walking to the store, doing their own yard and/or house work, etc.) a few times a week.
- Avoided doctors and preventive-wellness visits; they sought medical help only for injuries (a bad cut, for example) or persistent disruptive issues
The conclusion, as I recall, was that while moderation helps, the real key was a few core behaviors practiced consistently (rest, eat regularly, exercise some, avoid doctors).
look, its all very simple.
life sucks, so enjoy the little things like food when you can.
A doctor told the story of an elderly lady with a total cholesterol of 300 mg/dl. Other doctors admonished her many times to avoid high cholesterol foods, but her cholesterol level never budged.
Finally, this doctor measured her HDL, the good cholesterol. It was a whopping 100, making her total cholesterol to HDL ratio 3, which is considered ideal.
He told her to eat whatever she wanted, and to keep up her skiing.
As a cardiologist and professor at a medical school, we investigated salt and found that only a small portion of the population has difficulty with it, or those with severe heart failure or kidney failure. The population as a whole has no difficulty.
Also, cholesterol in the diet is not an issue for causing or contributing to vascular diesese.
There is really little link between what you eat and any significant diesease state, unless you eat too much or too little.
The AHA is one of the absolutely worse organizations on the planet.
My grandfather was in his 90s. My uncle was with him a the doctor’s office and asked the doctor if there was any way he could help my grandfather from smoking.
The doctor looked at him straight in the face, smiled and said “Well, it hasn’t killed him yet, he’s in reasonably good health, and he’s 93 years old –why change things now?”
My father tells a similar story, except he’s the doctor, and the busybodies from the state nursing home board have asked the local nursing home to stop serving bacon and eggs to one of his patients. “The man is 87–his wife is dead, his kids are dead, his dog is dead, he can’t walk, can’t hear, can barely see, and they want to take away his breakfast so he can, quote, ‘live longer’?!” The story ends with a prescription for bacon and eggs, qAM, taken orally.
We have too much government.
My brother and I had a conversation a few months back. It was while we were sitting on the deck after having rare 2″ thick ribeyes, potatoes smothered with butter and sour cream, broccoli and onion smothered with butter and garlic powder. We were smoking cigars drinking rum and coke or in my brother’s instance, crown and coke.
The conversation came up about our lack of eating properly and our detrimental habits like smoking and drinking.
What is the purpose of life? Is it to live as long as we possibly can? Was the answer 43? Or was it to just live and enjoy life and be as righteous as one can be?
We also brought into the discussion the choices we would make in doing everything in our power, to just survive no matter what the repercussions. Do we take all those medications to further our lives? Do we take the cocktail of 20 different medications to eek out those extra 3 years?
Death is a part of life. It does not scare those that believe. Life is but just a leaf on the wind. It is a transitive state for you cannot have death without life or life without death.
Salt? Please pass the butter!
Common sense, indeed. I find, at this stage of my life, that I can no longer tolerate the taste of the high-salt foods of my youth (potato chips, ugh), but that doesn’t mean I don’t salt my cooking to my present taste (despite my doctor’s admonitions). My hypertension is a result of my genetics, I believe (the fat, the thin, the smokers and the non-smokers of my family, all developed hypertension in their forties), and I control mine with the miracle of modern medicine.
We are what we were meant to be, and while we can tweak that here and there, to lengthen or shorten our lives, forces beyond our control will make the final determination. This isn’t fatalism, but a recognition of reality. My motto has been for many years, quality over quantity.
As a stockman and big game hunter for my entire life, I have a different perspective on salt and mineral supplementation. In the mountains, I have observed moose and elk eating the mineral rich mud from certain salt licks for several seasons and then quit a lick to eat from another lick for several seasons. They will sometimes eat thirty to forty pounds of the mineral rich mud that is enriched by the artesian spring water traveling through mineral deposits, in one short visit. Although the data is purely anecdotal and based upon observation, it is fairly obvious the animals eat from certain sources until their needs are met and then switch to another source of minerals for their needs.
With cattle and horses, if you deprive them of salt and minerals their condition will deteriorate fairly quickly, with cold and work acting as critical vectors. Unfortunately, people assume that because horses aren’t licking salt blocks and mineral blocks they don’t require supplementation, but if you give them access to granulated minerals they often attack the minerals as if they are starving. It is logical to assume the tongues of some horses can’t cope with the burning sensation resulting from trying to lick their salt and minerals from a solid block.
Behavior, personality, and the general vitality is easily observable in an animal with adequate or insufficient amounts of salt and minerals. It’s true animals and humans are different mammals, but we should remember that the differences are increased with the prejudicial pretenses of the human. We are often willing to compromise our health on the advice of experts who have very limited experience in the real world; rather than being in tune with our personal requirements and needs.
I work as an RN in a small hospital. Over and over we get patients in who have a subnormal level of sodium in their basic chemical profile readings.
The way the doctors choose to fix this is universally to restrict that patient’s fluids. So here we are telling the patient “don’t salt your food”. We don’t salt the food they get from the hospital dietary department. Then we go around cutting their fluids down to a pittance.
Then the patient has hypotension as a result of having their fluids restricted. They can’t participate in therapy because they get dizzy.
I keep wondering why the doctor involved doesn’t just go to the vending machine, buy the patient a bag of potato chips and have them munch out. Then repeat the test.
Maybe we could avoid having the patient suffer from not being able to drink and then not get their therapy from being hypotensive.
Chris, the answer is very simple: Most doctors are idiots.
Thanks G’d for the salt of the earth
For Shame Doctor!!
As you know, there are subsets of people who should eschew sodium or animal fat, etc, and others for whom it makes no difference. The failure of those who preach no salt for everybody are no worse than those who preach it doesn’t matter.
Just a note on your example of the diverticulitis, Doc. During an attack of diverticulitis you eat a low fiber diet as not to aggravate the diverticuli which are inflamed. After the infection is cured with antibiotics, to prevent future attacks, you eat a high fiber diet to keep the digestive system running smoothly.
AMEN !
this is not just with food. the government know-it-alls apply this control to everything.
it used to be people knew what was a dangerous substance …now with the WHIMIS crap everything is poisonous
all the labels read the same …so now we don’t know if it is really bad or just bad. whether touching it will kill us or we would have to consume a ton of it to notice a result.
There have been men in Russia that have lived to be 100+ who claimed that they drank a liter of Vodka a day. They were also farmers too so the physical labor and steady diet helped I’m sure. We’re all different though genetically so that’s why I don’t get salty tears (sorry) over reports telling me something I eat is now bad for me and vice versa. My genetics suck and don’t allow me to eat spicy food for example.
All this talk of food has made me hungry… Think I’ll go get a burger and fries.
HA-HA! Me too!
Salt is a good food made bad. How? By refining out the minerals that are integral to safe consumption. I devoted a whole chapter in my book to this. Don’t know if it will fit here so if you are interested then go to http://www.naturespowerbook.com and get informed.. Please!