If you’ve been following Wheat Belly conversations, you already know that conventional dietary advice has gotten things wrong—desperately wrong.
The obesogenic Dietary Guidelines for Americans; the dusty, antiquated, and completely-out-of-touch dietary advice of the American Heart Association (AHA); the disastrous dietary advice of the American Diabetes Association that makes your blood sugar and HbA1c go UP; the advice of the Academy of Nutrition and Dietetics that favorably serves companies like Coca Cola, Kraft, and Kelloggs . . . you hopefully know by now that nobody here follows such conventional thinking. Time and again, they have gotten dietary advice completely wrong, whether it was over saturated fat, total fat, grains, sugar, calories, etc.
But how about salt? The AHA sticks to its advice for Americans to limit sodium intake to 1500 mg per day (1 teaspoon salt = 2300 mg sodium). The other groups have likewise maintained advice to restrict sodium to 2300 mg or less per day. (Average sodium intake for Americans is 3400 mg per day.)
But the emerging evidence suggests that the problem is not salt and never was salt. It was insulin resistance that causes sodium retention. In other words, you can indeed reduce blood pressure (BP) modestly (typically 5/3 mmHg in hypertensive people, negligible reduction in non-hypertensive people), but the insulin resistance needs to be addressed. Moreover, sodium restriction has now been demonstrated to:
- Increase renin/angiotensin/aldosterone—This is the body’s response to sodium deprivation that has been associated with increased cardiovascular death. Unfortunately, this has led many authorities in hypertension to advocate blocking the renin-angiotensin-aldosterone system using pharmaceutical agents rather than addressing the root cause, insulin resistance.
- Increases resistance to insulin—People with hypertension nearly all have increased insulin resistance to begin with, worsened by sodium restriction.
- Increases sympathetic system activation and heart rate—Increases in hormones such as adrenaline/noradrenaline and increased resting heart rate correlate with increased cardiovascular risk
- Make you miserable—In the real world, a minority of people are able to achieve the low sodium intake advised by the AHA and others due to the poor palatability of foods without salt. Physically active people are especially miserable without salt, sufficient to impair performance.
- Worsen iodine deficiency—A strict sodium limitation such as that advised by the AHA makes it virtually impossible to obtain sufficient iodine through food (unless you eat seafood, seaweed, and thyroid glands frequently).
Cutting salt in the diet is not a benign practice. In people without hypertension, it leads to detrimental changes without benefit. In people with hypertension, sodium restriction can indeed reduce BP modestly but never addresses the real cause and, in fact, makes it worse.
Recall that, in the Undoctored Wild, Naked, Unwashed program, we salt our foods vigorously during the initial 10 or so days due to the increased sodium loss that occurs with wheat/grain elimination and carbohydrate limitation, efforts that help reverse insulin resistance. We also add vitamin D, magnesium, fish oil, iodine, and efforts to cultivate bowel flora, all of which further unwind insulin resistance and reverse sodium retention. As your program progresses, it is important to continue to salt your food with intakes of around 3500-6000 mg per day of sodium that helps suppress insulin resistance and does not lead to activation of the abnormal responses mentioned above.
If you have insulin resistance that causes sodium retention—AKA hypertension—address the insulin resistance. You can indeed restrict sodium temporarily in order to reduce BP but recognize that doing so is not entirely benign. Best strategy: Reverse insulin resistance back to normal and do away with any need to restrict sodium and enjoy the use of the salt shaker on your food.
We discuss these issues in more detail in our Undoctored Inner Circle including what to do in various health situations and what forms of salt are preferable and why.