Salt—The Spice of Life?

The explosive rise in salt consumption is among the most dramatic changes in our diet. For most of our existence, we took in only the pinch of salt that naturally occurs in a whole-food diet. Today, industrial foods expose us to ten times the amount our bodies can handle, and that has catastrophic effects on our health.

I have already mentioned four of the five deadliest dietary traps captured in the Global Burden of Disease Study: too few whole grains, fruit, nuts and seeds, and vegetables, but the fatal weak point in the human diet is not what we eat too little of, but what we eat too much of. Excess sodium consumption is the number one dietary risk factor for death.

To learn more about this topic, please read the chapter “How Not to Die from High Blood Pressure” in How Not to Die. That sodium raises blood pressure has been clearly demonstrated—even in randomized double-blind trials going back decades. A single meal is enough. When participants with normal blood pressure ate a bowl of soup with the amount of salt equivalent to that of a typical American meal, their blood pressure rose more over the subsequent three hours than in the participants in the group that ate the same soup without added salt. “Normal” salt intake leads to “normal” blood pressure, and that can ensure that we die of “normal” causes such as heart attacks and strokes.

In the United States, most adults have hypertension by 45; by age 74, it is nine tenths. You do not, however, find higher blood pressure with age among peoples such as the Yanomami in the Amazon, who eat a salt-free diet—meaning they take in only as much salt as is normal for the human species. Not a single case of hypertension was known. On average, they are born with the same values as all human infants, namely approximately 100/60, and those do not change over an entire lifetime.

With a few simple strategies, you can leave your saltshaker alone more often. Cook without salt, and don’t salt any dish at the table, either. At first the food may taste a bit bland, but after just two to four weeks your salt receptors in the mouth will become noticeably more sensitive, and it will start to taste better. After two weeks, you may even find that you prefer the less salty version. Experiment with pepper, limes, onions, basil, garlic, tomatoes, thyme, paprika, parsley, celery, chili powder, lemon, rosemary, smoked paprika, curry, and coriander to find new, more intense flavors. According to an article in the prestigious New England Journal of Medicine, such an “individual approach is likely not goal-directed,” since about 75 percent of salt comes from industrial foods, but that wrongly assumes that processed foods are somehow fate. But we decide which foods we buy, even if it is repeatedly surprising where a lot of salt turns up.

For example, in the 20-to-50 age group, chicken is responsible for most sodium intake. The poultry industry routinely injects the dead chickens with saltwater to artificially increase their weight, and still gets to label them “100 percent natural.” The consumer organization Consumer Reports found chickens in stores that were pumped so full of salt that they contained a whopping 840 milligrams per serving. That is more than the entire daily salt requirement in a single chicken breast.

The now-defunct Salt Institute used to campaign vehemently against public health recommendations to reduce salt intake. Before a US Congress committee on dietary guidelines, they voiced doubts about the assumption that healthier diets reduce health-care spending. “In fact,” declared one defender of industrial foods, “health-care expenditures increase with generally longer life spans.” If people live longer because they eat healthier, that could become more expensive, the argument went, and in this context they said: “If tobacco were banned, the rising life expectancy would increase the costs of caring for the elderly …”

Bring on the tongue scraper!

As we get older, our sense of taste can diminish. That is why older adults often oversalt their meals. This loss of sensitivity can be counteracted in an innovative way by scraping the whitish-gray coating off the tongue, which may be blocking the taste buds. Check out my video see.nf/tonguecleaning to learn how you can regain the ability to taste salt by brushing or scraping. This works in younger and older adults and noticeably reduces the desire to die.

Potassium-Based Salt Substitutes

Hypertension, that is, high blood pressure, is referred to as a “silent, invisible killer” because it rarely causes symptoms, while at the same time being one of the most telling independent indicators of some of our most common causes of death. The American Heart Association recommends consuming no more than 1500 milligrams of sodium per day. Care to guess how many Americans come in higher than that? An incredible 99.4 percent. The overwhelming majority of adults in the United States consume too much sodium and at the same time too little potassium, a mineral that lowers blood pressure. (Fewer than 2 percent of adult Americans take in the recommended daily minimum amount of potassium.) This is all the more striking when we compare our current values with those of our ancestors, who ate potassium in enormous quantities. During evolution, it was probably more than 10 000 milligrams daily. The recommended daily amount is only half as high, and yet most people don’t even come close.

If you look at these two recommendations together, fewer than 0.015 percent of Americans currently meet the sodium and potassium goals. Nearly 99.99 percent do not; only every 7000th American even reaches the recommended minimum amount. Could a potassium-based salt substitute help? Instead of seasoning our food with sodium chloride (salt), we could use potassium chloride. This naturally occurring mineral salt can be obtained in the same way as ordinary sodium salt. Randomized controlled trials have shown that replacing regular salt with potassium chloride not only contributes to a significant lowering of blood pressure, but above all it prevents hypertension, and most important, it saves lives. Even if you replace only half the salt with potassium chloride, that makes people more than ten years younger in terms of mortality risk. I discuss these studies in my video see.nf/ksalt.

All of that sounds a bit too good to be true, though. Why aren’t more people using this salt substitute already if it works so well and tastes just as good? Potassium chloride is “generally recognized as safe” by the Food and Drug Administration (FDA), the US agency for food and drugs. If you are healthy, you don’t need to worry about getting too much potassium, because our kidneys just pee out the excess. If, however, kidney disease is known, or diabetes (which can lead to kidney damage), severe heart failure or adrenal insufficiency, or if you take medications that impair potassium excretion, then: caution. Older adults should consult their doctor and have their kidney function tested before replacing salt. You can find further details at see.nf/ksaltsafety.