Should You Take Your MD’s Advice With a Grain of Salt?

[Ed. note: From today to Feb. 6, I’m running a special series for Tomorrow in Review readers I’m calling “The Truth About MD Warnings.” I’ll break down the new research on:]

  • Blood pressure
  • Statins
  • Salt
  • Artificial sweeteners
  • Red meat.

[And I’ll tell you exactly what these guidelines mean and what my inside sources are telling me about how to follow them. You won’t want to miss a single day.]

It’s time to take science with a grain of salt.

I keep a close eye on medical studies. I want to stay healthy, so I try to follow recommendations — but good science is shredding old ideas.

Take the case of good-old table salt.

Should You Still Put Down That Shaker?

In ancient times, salt was a precious resource, and our ancestors did what they could to get enough.

It was even once used as money, which is where we get the word “salary,” from the Latin word for salt.

To this day, hunters still put out blocks of salt to attract game.

But too much of a good thing is almost always bad for you.

The Dangers of Salt (So We’ve Been Told)

The American Heart Association, the Centers for Disease Control and the U.S. Department of Agriculture are nearly unanimous on the subject of sodium. They recommend consuming no more than 2,300 milligrams per day, and getting consumption below 1,500 milligrams a day is ideal — especially if you are older than 51 or have a condition like diabetes or high blood pressure.


Although salt isn’t the only source of sodium in our diets, it’s the major source, and the official recommendation works out to not getting more than one teaspoon of salt per day. But good luck to you following those guidelines.

I’m looking at a can of olives right now, and three olives have 110 milligrams of sodium. A tablespoon of A.1. sauce? That’s 280 milligrams. A single egg, no salt added, comes out of the shell with 70 milligrams of sodium. One cookie is going to come in at 200-300 milligrams. A small cube of feta cheese clocks in at more than 300 milligrams. And forget hot dogs — many exceed 1,000 milligrams. Put some mustard (60 milligrams per teaspoon) on a hot dog in a bun (140 milligrams sodium) and you’re over the limit.

I watch my salt intake carefully because I sample my blood pressure at home, and I find that a very small increase in salt not only adds a pound to my daily weight but can increase my blood pressure by 20 points.

To really meet the daily suggestions of no more than 1,500 milligrams means you have to live on most fresh foods.

Packaged goods are full of sodium. That’s what gives them flavor. So none of my favorite ranch dressing on tonight’s salad! That’s 300 milligrams of sodium in a single tablespoon.

But as I suggested earlier, the recommendations behind my herculean efforts to reduce my sodium intake are coming into doubt.

One study published in The Journal of the American Medical Association this month found that the amount of salt people between the ages of 71-80 ate didn’t affect their death risk or rate of heart disease and failure. Well, I’m not that old. What does it mean to me?

Other evidence published in The New England Journal of Medicine last year also goes against the received wisdom. The study analyzed 100,000 individuals in 66 countries. If you didn’t already have a condition like high blood pressure, eating more salt didn’t increase your risk of dying or getting high blood pressure. But I do have high blood pressure.

And yet another study, published in the American Journal of Hypertension, is further muddying the waters. It examined more than 250,000 people and found that those who ate very little salt or a lot of salt had the worst health outcomes. Those who ate the average daily amount for Americans (2,645-4,945 milligrams) were the healthiest.

Despite these studies, health organizations are sticking to their guns. The real question is what should you do? There’s almost certainly a strong genetic component to how we age and respond to sodium in our diets, but until we suss that out with even more research, we won’t know what the optimum is.

For now, pay attention to conventional wisdom and eat far less salt. The research has not been accepted yet by medical colleges (the professional organizations, not schools) as reason to change.

In the very near future, we could all have our genomes sequenced cheaply. When that happens, you’ll know exactly how much sodium your body can handle.

Until then, it’s olive oil and lemon juice on my salads.

And no cookies.

To a bright future,

Stephen Petranek
for The Daily Reckoning

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Stephen Petranek

Stephen Petranek’s career of over 40 years in the publishing world is marked by numerous prizes and awards for excellent writing on science, nature, technology, politics, economics and more. He has been editor-in-chief of the Miami Herald’s prestigious Sunday magazine, Tropic, and has covered a wide range of topics for Time Inc.’s Life magazine. His...

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