
Low-Salt Diets May Pose Health Risks, Study Finds - wfjackson
http://online.wsj.com/articles/recommended-salt-levels-could-do-more-harm-than-good-study-suggests-1407964274?mod=WSJ_article_EditorsPicks
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jandrewrogers
Anecdotally, I have been a massive consumer of salt for my entire life. I
consume almost no sugar; I have no attraction to eating food that is sweet and
therefore do not eat it. Insulin resistance, and its myriad side effects, are
not a major risk factor for me.

I would argue that my risk factors are probably driven by factors associated
with salty food that have nothing to do with sodium consumption per se. My
blood pressure (and blood sugar) is essentially perfect after decades of
absurd sodium consumption. However, as an example, a lot of salty food is deep
fried and so there are other relevant consumption biases. Salt and sugar are
not uniformly distributed throughout our food. My current (Pacific Northwest)
diet of lean protein and fatty fish plus fresh vegetables has not exactly been
detrimental as far as I can tell, even though it is loaded with salt.

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userbinator
_The new study, which tracked more than 100,000 people from 17 countries over
an average of more than three years, found that those who consumed fewer than
3,000 milligrams of sodium a day had a 27% higher risk of death or a serious
event such as a heart attack or stroke in that period than those whose intake
was estimated at 3,000 to 6,000 milligrams. Risk of death or other major
events increased with intake above 6,000 milligrams._

What are the chances that there are many other confounding factors? The first
one that comes to mind is that people with extremely low sodium intakes may
also be the same ones who are malnourished because they can barely afford
food.

It might also be interesting to see if there's a strong correlation between
sodium intake and life expectancy; comparing [http://cdn.chr-
hansen.com/fileadmin/user_upload/Salt_Consump...](http://cdn.chr-
hansen.com/fileadmin/user_upload/Salt_Consumption_Map.png) and
[http://en.wikipedia.org/wiki/File:Life_Expectancy_2005-2010_...](http://en.wikipedia.org/wiki/File:Life_Expectancy_2005-2010_UN_WPP_2006.PNG)
roughly, it doesn't seem like there is much of one... and in fact the other
sources I could find indicate a slight _positive_ correlation.

~~~
dap
Isn't it also plausible that many people on low-sodium diets were at risk of
heart attack or stroke already (and that's why they were on the low-sodium
diet)? Interesting result, for sure, and it'll be interesting to see the
follow-up studies.

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higherpurpose
We're finding out that fat [1] isn't actually bad for you, now salt, too. I
wonder if we'll find out sugar is good for us, too, before long.

[1]
[http://online.wsj.com/news/articles/SB1000142405270230367840...](http://online.wsj.com/news/articles/SB10001424052702303678404579533760760481486)

~~~
learc83
There's been some evidence that sugar is actually worse for you that we used
to think.

It makes a bit of sense really. Fat and salt has always been part of the human
diet, but large quantities of refined sugar are very recent.

~~~
ekianjo
> It makes a bit of sense really. Fat and salt has always been part of the
> human diet, but large quantities of refined sugar are very recent.

That kind of reasoning is very much flawed. Why would the diet of x years ago
be relevant versus having a better diet nowadays ? For all we know, our
ancestors were eating berries and much less meat than we do, yet we seem to
live longer those days and yet we ingest substances (such as medicines) that
were not part of the human diet before.

Actually, that line of reasoning does not make sense at all. That's why we run
clinical studies. To find out answers.

~~~
quattrofan
Possibly but two things to consider:

\- big factor in longer life spans are the advances in medicine last 150 years
\- our increase in meat consumption and cooked meat goes ways back and likely
tied to our (threefold) increase in brain size

~~~
ekianjo
We have been eating meat for a long time, but the quantity of meat eaten since
the second half of the 20th century is unprecedented. We are eating way more
meat than before, that's for sure.

~~~
learc83
>he quantity of meat eaten since the second half of the 20th century is
unprecedented.

That's not true at all. We're eating more meat than we did 100 years ago sure.
But looking back significantly further than that, it's estimated that hunter
gatherers got about 65% of their calories from animals, compared to much less
than 20% we get today.

See my reply above for references.

~~~
ekianjo
I'll check you references later, but I'm wondering where the hunter gatherers
got so much meat before they had industrial meat factories that we have - it
cost much more energy before to either hunt or breed animals than it does now,
it was not a viable proposition to eat as much meat as it is now. It just does
not make sense to me at all. Besides, percentages is one thing, absolute
intakes are another, too.

EDIT: Besides, I can tell you from what I know on how people were living 50-70
years ago (grandfathers for example) that meat was expensive during their
youth and that they only ate it once or twice a month, certainly not every
single day like we do now. So I'm not sure where you got the impression people
ate so much meat in the early 1900s while it defies all conversations I had
with people who lived in that era.

~~~
learc83
> So I'm not sure where you got the impression people ate so much meat in the
> early 1900s

I said this in the comment you're replying too "We're eating more meat than we
did 100 years ago sure". I'm agreeing with your assertion that we eat more
meat than we did 100 years ago. 100 years ago we ate significantly less meat
than our hunter gatherer ancestors did.

>I'll check you references later, but I'm wondering where the hunter gatherers
got so much meat before they had industrial meat factories that we have

They didn't need industrial farms because there were far fewer people. They
hunted animals, which were relatively abundant. Meat is much more calorie
dense than most plants.

Hunter gatherers didn't have agriculture, so many of the plants we eat today
weren't yet domesticated. They lacked entire categories of food that we have
today.

The largest percentage of daily caloric intake today comes from grains--hunter
gathers didn't farm grains, so they had to get the largest share of their
calories from something else--meat.

>Besides, percentages is one thing, absolute intakes are another, too.

An average adult male can't live long term with fewer than around 2000
calories per day (A very active hunter gatherer would require a far amount
more than 2000 per day). The average American male eats about 2700 calories
per day.

Let's take the lower end estimate for 2000 calories per day for a hunter
gatherer. At 65%, meat accounts for 1300 calories per day.

At 20% of 2700 calories, an average American male gets 540 calories per day
from meat.

So 1300 for the hunter gatherer vs 540 for the average American male. Almost 3
times as much. Even in absolute numbers, the hunter gatherer at much more
meat.

------
MealSquares
The cochrane review
([https://www.ncbi.nlm.nih.gov/pubmed/21735439](https://www.ncbi.nlm.nih.gov/pubmed/21735439))
already pointed in this direction, namely that although a reduced salt diet
reduced blood pressure, that reduction was not correlated with decreased
mortality in this case. Looking at sodium consumption without taking into
account potassium consumption also appears to be a major issue with lots of
previous salt studies. We had people recommend putting 1500mg (DASH diet
level) in MealSquares, but we feel confident not going below the 2400mg level
for health.

Soylent ran into issues by including around a gram of salt in their 1.0
version with people getting dizzy from too little sodium in the diet. They're
now suggesting adding some extra.

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k-mcgrady
So once again the advice seems to be, "eat a balanced diet, everything in
moderation".

~~~
Evgeny
This one appears to be useful because it has some concrete numbers. Because
otherwise how would you define moderation? What is moderation to one is excess
to another. Here we at least have "less than X and more than Y appears to be
harmful", which is some actionable information.

Edit: actually, my opinion on "everything in moderation" is even stronger: I
consider it a useless advice. Because, where do you even begin? Should you use
_some_ salt in your cooking? But how much? Or should you use _none_ , because
there is already some present in foods you buy? Or should you _actively avoid_
foods that have already some salt added?

And it ends up like this: everyone thinks that he eats X in moderation, while
anyone who eats less X is just unnecessary resticting himself, and anyone who
eats more X is a glutton.

Or consider, would you say "smoking in moderation is okay and healthful"? And
if not, how do we know that there are no substances consumed as foods that act
in a similar way - hurt us even taken in moderation?

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andreash
Why isn't there a soap opera about nutritional research?

~~~
beagle3
Nutritional research is more ridiculous and less scientific than any soap
opera could ever hope to portray.

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egypturnash
IMHO it is damn near impossible to cut salt out of your diet in America unless
you prepare everything you eat from scratch. Salt is _everywhere_.

This sort of study makes me feel better about my intuition of what to do when
my doctor told me to cut back on the salt, though: stop letting myself use it
as a seasoning, think a few times before grabbing a snack whose entire purpose
is to shovel salt into my mouth, but still eat things that had salt involved
in their preparation. My blood pressure has gone from "why are you not keeling
over right now" to "slightly elevated" thanks to this.

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nilsimsa
Next thing they will me telling me there is no evidence than salt raises blood
pressure.

~~~
johansch
Yeah?

[http://www.scientificamerican.com/article/its-time-to-end-
th...](http://www.scientificamerican.com/article/its-time-to-end-the-war-on-
salt/)

[http://www.economist.com/blogs/economist-
explains/2014/04/ec...](http://www.economist.com/blogs/economist-
explains/2014/04/economist-explains-12)

------
tsmash
lol no shit, old news

do people still believe salt raises blood pressure too?

keto recommends between 3 and 5 grams of salt per day

your blood is salty, only way to replenish salt is through the diet,
especially important if you're sweating

~~~
Semaphor
> keto recommends between 3 and 5 grams of salt per day

While I'm on keto myself and I love it, that sentence isn't exactly a proof
for anything.

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panarky
_The research was funded through a variety of public, private and corporate
sources, according to PHRI._

Until I know who funded the research, I'm taking the results with a grain of
salt.

Do populations with high sodium intake also have other lifestyle factors that
influence mortality and morbidity? Is it really the sodium that's causing the
differences found in the study or are there other factors?

How many times have we seen corporations fund research designed to support
their interests and then selectively publish the results that are favorable to
them?

Would you view the research in a different light if you knew it was funded by
PepsiCo, McDonalds, Sara Lee and Campbell Soup Company?

Why aren't the funders disclosed along with the results?

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trhway
considering the role sodium and potassium ions play
([http://en.wikipedia.org/wiki/Sodium_in_biology#Animals](http://en.wikipedia.org/wiki/Sodium_in_biology#Animals)),
it isn't surprising that too low of them is bad. Of course it is already well
known that too much of them bad also.

"Sodium is an essential nutrient that regulates blood volume, blood pressure,
osmotic equilibrium and pH;..."

doesn't it sound like it better be not too low and not too much ? :)

~~~
jimmaswell
>doesn't it sound like it better be not too low and not too much ? :)

That statement is pretty much impossible to logically disagree with so yes

~~~
trhway
>That statement is pretty much impossible to logically disagree with so yes

not impossible. At least for proponents of low sodium it is possible.

~~~
jimmaswell
If you're a proponent of low sodium then you don't believe the amount of
sodium you advocate is "too low", you believe it's correct, and that the
standard amount is "too high".

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joyjoy
Tomorrow high-salt diets may expose severe health risks, haha theese studies
need to be drowned.

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Mikeb85
Come on, some common sense is needed. Salt is required by our bodies, too
little and we die, too much and the same thing. Same goes for fat, sugar,
vitamins, minerals, etc...

This isn't even new knowledge... Our bodies need various proteins, sugars and
minerals in certain quantities - call the fucking press...

~~~
nitrogen
As I've commented on similar articles in the past, it's not enough to "just
know" things; science has to _prove_ them, repeatedly, in multiple ways. Sure
it's tedious and repetitive, but it's absolutely essential to lay a solid
foundation for the next generation of research.

~~~
Mikeb85
One only has to look into history - where there have been epidemics and people
have died from lacking salt in their diet in various salt-deficient places.

As an aside, there's also a reason that iodine is required to be added to salt
and various stable products in some countries.

Animals seek salt because they need it, as did ancient humans to the present
day, saying humans need salt is like saying humans need water, or protein, or
vitamin B.

It's not like salt is some new chemical we know nothing about - we've known
about it for at least 10,000 years (probably longer). It's nice and all that
now we know you should have between 3000 and 6000 mg per day (which is higher
than what agencies recommend, but apparently around the average consumption in
many places anyway), but come on...

[http://en.wikipedia.org/wiki/Hyponatremia](http://en.wikipedia.org/wiki/Hyponatremia)

Also, there's a reason athletes drink liquids with electrolytes in them (salt
is one) - because the effects of a deficiency of salt and other electrolytes
is known...

------
refurb
You know what would be super helpful? If scientists came up with a rating
system that described how confident they were in the results from a study.
That way the public would know how much weight they should give the results.

Independent body who runs a well-controlled double blinded study? A+

Biased organization who runs an analysis of questionable observational data
with barely passible statistical significance? F

They already do this for cancer therapies. NCCN gives rating that describe how
much evidence exists for a given therapy.

~~~
Swizec
Scientists do in fact report how confident they are in their findings. Read
original sources, most of them say things like "in X% of observed cases there
was a Y% of Z over the course of T with confidence level of P".

But that sells a lot less clicks than "SCIENCE SAYS LOW SALT IS BAD FOR YOU
OMG"

~~~
colechristensen
The truth of the matter is that the general public shouldn't be reading
scientific publications, because without the context of the intended audience,
reasoning about what you read is incredibly difficult or impossible. This is
doubly true for 'science journalists' who so very rarely are educated to be
able to correctly translate and very often distill a paper into an incorrect
and baiting article with only the tiniest shreds of truth.

The confidence rating you mention has little value to the general public, and
even among scientists, the value of 'p-value' is questionable and the matter
of occasional debate.

[http://annals.org/article.aspx?articleid=712762#ThePValueFal...](http://annals.org/article.aspx?articleid=712762#ThePValueFallacy)

