Are low-sodium recommendations really worth their salt?

The medical myth that just won’t go away

For decades, doctors and mainstream medicine have recommended lowering sodium (salt) intake.

The conventional “wisdom” is that most Americans need to consume less salt. 

Indeed, the advice to avoid salt is so common that it almost goes without saying. BUT, as I have pointed out for years, it also goes without science!

This is particularly perplexing because, as you know, some medical myths about diet and nutrition (that were all wrong, all along) have finally been replaced by the science.

Like the mainstream’s bad advice to avoid dietary cholesterol and essential fats…not to mention cutting out healthy foods like whole dairy, eggs, and even certain kinds of seafood.

Plus, as I revealed in April’s newsletter—and on page 2 of this issue—the “anti-red meat” crusade is flat-out flawed.

Yet, the anti-salt myth persists despite studies showing it’s just as misguided as these other medical myths.

So, let’s talk about it. Then, I’ll tell you all about the health benefits of salt… and how you can effectively manage your consumption.

The real science on sodium

The theory behind low-salt recommendations is that consuming too much sodium can raise your blood pressure—and thus increase your risk of heart disease.

But I’ve reported on research showing the exact opposite.

Some studies have found that lowering salt intake can actually increase blood pressure…and even BOOST your risk of diabetes (the leading cause of heart disease).

And the science continues to speak loudly. In fact, brand-new results from the largest clinical trial to date, which looked at low-sodium diets, found that eating less salt doesn’t reduce mortality or hospital trips in older people with heart failure.1

These results were SO CONVINCING…that the study was stopped halfway through the process. The scientists had enough data to publish the results in the prestigious U.K. medical journal The Lancet without going any further.

This study included 806 patients from 26 medical centers in Australia, Canada, Chile, Colombia, Mexico, and New Zealand. The patients were an average age of 67 years, and all had been diagnosed with chronic heart failure.

The study participants were split into two groups. One group ate a low-sodium diet. They also received nutritional and behavioral counseling. The other group received counseling, but ate whatever they wanted.

The first group consumed an average of 2,286 mg of sodium per day at the beginning of the study. After a year, that number dropped to an average of 1,658 mg a day.

The second group consumed an average of 2,119 mg of sodium daily when the study began. After a year, that number decreased slightly to an average of 2,073 mg a day.

(For comparison, the American Heart Association recommends consuming no more than 2,300 mg of sodium a day—and ideally, less than 1,500 mg a day.)2

During the course of the study, 15 percent of the first group and 17 percent of the second group were hospitalized or died due to a cardiac event.

Statistically speaking, that’s basically the same. Meaning there was no difference in cardiovascular-related incidences no matter how much sodium the study participants consumed.

What salt can do for you

This study, and others before it, shows that the truth about salt and sodium is more complicated than simple-minded advice to cut, cut, cut.

And as the science catches up, some of the misconceptions are being unwound.

Sodium is a mineral that’s naturally present in salt and some healthy foods. It’s even considered an essential nutrient because the body needs it for nerve and muscle function, to maintain the proper balance of water and minerals, and to manage blood pressure.

Low-sodium diets have been shown in experimental laboratory studies to increase the rate of atherosclerosis, or hardening of the arteries. This can in turn lead to high blood pressure and heart disease.

But, as I mentioned earlier, for the vast number of people whose blood pressure is in the normal range, some scientific evidence has shown that lowering salt intake is just as likely to increase blood pressure as it is to reduce it (or to have no effect at all).

Not to mention, when you cut back inappropriately on an essential mineral like sodium, it may trigger physiologic processes and hormones that can stress the cardiovascular system.

One of those hormones is insulin, which is why some studies show that low-salt diets can increase your risk of obesity (insulin is stored in fat) and Type II diabetes.

Individual salt needs can vary

The bottom line is that we all need to consume salt. The healthiest ways to do so depend on the sources—and on your individual body and needs. As always, there is no “one-size-fits-all” solution.

Some people can handle plenty of salt with no effect on their blood pressure. Their kidneys simply eliminate extra salt and other excess electrolytes.

Other people may be more salt-sensitive. Their kidneys may kick into overdrive to help regulate fluid and electrolytes—which may result in increased blood pressure.

Unfortunately, there’s no test to determine if you’re salt sensitive. But there is a way to help ensure you don’t consume excess salt—no matter what your body type may be.

How? Get your salt from natural, whole food sources—and NOT from unhealthy, highly processed foods.

It really is that simple. (No, you don’t have to rely on medical myths and broad, unfounded claims from so-called “nutrition experts.”)

Of course, this recommendation is important for all essential nutrients. But here’s why it’s particularly vital for salt and sodium…

How to get sodium naturally—and safely

There are a variety of foods that are good sources of sodium, including:

  • Meat
  • Eggs
  • Dairy
  • Fruits (like apples, avocados, bananas, melons, pineapple, and pears)
  • Vegetables (like beets, celery, carrots, tomatoes, and spinach)

But, sadly, many people get most of their sodium from junk or snack foods—which are processed with added salt.

As you know, I believe there’s no place in a healthy diet for these ultra-processed, fake foods. Not only because of their high sodium content, but also because they’re often loaded with added sugars and chemical ingredients.

And buyer beware: Even regular table salt may be full of toxins.

Refined salt is often chemically treated to improve its appearance and shelf life. Some of the artificial ingredients found in refined table salt include ferro-cyanide, ammonium, and aluminum compounds (doesn’t sound good, does it?).

By contrast, unrefined sea salt contains not only sodium, but other essential minerals like magnesium, calcium, and potassium. And because it doesn’t have to be processed like table salt, it’s usually toxin-free.

So, my advice is to get your essential sodium intake naturally from foods and a moderate use of sea salt.

Better yet? If you avoid processed Frankenfoods, you likely won’t have to worry about excess sodium consumption in the first place.

Now, that’s a dietary recommendation that’s actually worth its salt.

SIDEBAR: The iodine conundrum

One of the unintended consequences of the relentless campaign to reduce salt intake is a growing deficiency in iodine.

This essential mineral is key for thyroid and hormone function. It’s particularly important for fetal and infant development—which is a big reason why, for decades, iodine has been added to refined table salt.

But, as I mentioned above, unhealthy chemicals may also be added to table salt. So, while eating less refined salt lowers your levels of iodine, it also helps keeps you safe from toxins.

The good news is that iodized salt is not the only way to add this essential mineral to your diet. Iodine is naturally found in seaweed and animal proteins, including fish and seafood. Full-fat dairy, eggs, beef, and poultry are also great sources.


1“Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial.” Lancet. 2022 Apr 9;399(10333):1391-1400.