
Anti-Salt Narrative Needs a Shakeup - petethomas
https://www.bloomberg.com/view/articles/2018-06-15/salt-intake-is-not-even-clearly-a-cause-of-hypertension
======
ralusek
As someone who loves salt, I will gladly add this to my collection in the game
of Cherry Pick Evidence For Your Preferred Nutrition.

You'd think that science would make things here a little more conclusive by
now...

~~~
rgrieselhuber
One of the little talked-about but very prevalent problems in research is the
endless number of lobbyists behind “scientific” findings and the products they
promote.

~~~
matte_black
Why isn’t research more decentralized?

~~~
marcosdumay
Who would do that decentralized research? Why would they do that?

The real question is why do governments watch private interests take over
public research institutions and not only do nothing to preserve the lack of
bias, but even go out of their way to help the process? (And yes, the answer
is not secret.)

~~~
skookumchuck
Do you really think government research absent private bias is free from bias?

How government money gets spent is a very political process, and naturally
that puts a lot of pressure on research organizations to produce the
politically correct result.

------
joshgel
There is just such a lack of good, well-done dietary research that it's almost
impossible to know what advice is true, what advice is probably true and what
advice is just made up. Obviously these studies are extremely difficult to do
well, and hence why they haven't been done. But the cost to society is much,
much greater than the cost of these studies.

~~~
narag
There is a way to know: self-experimentation. I do realize you mean knowledge
as a society. But I'm happy there's at least a way to resist the generalized
brainwashing. And maybe if more people tried by themselves, it would be more
difficult to get away with the current bs.

A few advantages are that you find out what's good for you in particular, not
every body works the same, that you don't get confused with partial results
that get canceled and, my fav, that you learn what works in practice: it's
useless to know that you can lose fat with a diet you are unable to follow.

You've probably realized that my experience is about losing weight and general
wellness, but that's just _the_ problem with nutrition for most people.

~~~
skookum
Given the number of variables that can be adjusted, the extent to which they
can be adjusted, and the time it takes to see results, self-experimentation is
barely viable for even trivial short-term goals. How many chances does one
have to try a different set of inputs for 3 months apiece?

Even for short-term goals anything non-measurable is highly prone to
confirmation bias - e.g.: "I feel more energetic on this keto diet!" because I
expected to feel more energetic on this keto diet and these Instagram accounts
I follow keep reinforcing that this is what I should expect. Additionally
there is the issue that the human body is a complex system where things that
seem good in the short term can be quite bad in the long term - e.g.: "These 6
cigarettes a day are really helping with the over-eating I'd been struggling
with!".

For many of us who care to research nutrition more than superficially the
goals tend to be more long-term ones like not developing Alzheimer's, cancers,
atherosclerosis, organ failures, etc., all in support of staying healthy &
active for as long as possible. Those goals don't lend themselves to a hill-
climbing optimization via self-experimentation.

~~~
narag
_How many chances does one have to try a different set of inputs for 3 months
apiece?_

No need to spend three months. The body raise all kind of signals in reaction
to food, almost instantly.

 _Even for short-term goals anything non-measurable is highly prone to
confirmation bias_

Are bathroom scales also affected? Are keto test sticks too?

 _For many of us who care to research nutrition more than superficially the
goals tend to be more long-term ones like not developing Alzheimer 's,
cancers, atherosclerosis, organ failures, etc._

Don't worry. Considering the level of aggressiveness industry has shown
against low carbs diets, if any of those scares had any minimum basis, we
would know by now.

Look, this post is no longer in front page, so it's doubtful anyone except us
is reading it. I take for granted that you genuinely think what you say and
hope you give me the same benefit of doubt. I haven't done keto in like twenty
years? (not sure) but I can't tell you this: it works. Last time I did it, I
spent two years in low carb with no adverse effects whatsoever. I ran every
other day, was in a very good shape.

I can't help chuckling when I read hit pieces like what Wikipedia has to say:

[https://en.wikipedia.org/wiki/Atkins_diet](https://en.wikipedia.org/wiki/Atkins_diet)

If you read carefully you'll see that they suggest that it doesn't work at all
and that it's just placebo, "nutritional nonsense", water losing or simply
caloric reduction due to unpalatable plan. That's idiotic, as you can see if
you go to other more technical article:

[https://en.wikipedia.org/wiki/Ketosis](https://en.wikipedia.org/wiki/Ketosis)

Surprise! It seems that there is actually a non-contentious, perfectly known
mechanism to burn fatty acids induced by fasting or _reducing carbs intake_.

Try to reconcile that with: _The Atkins diet is promoted with questionable
claims that carbohydrate restriction is the "key" to weight loss._
Questionable my ass. That's what the diet is and it works. If you don't like
the kind or food you need to eat to follow the diet, it's OK and it's really
the reason most people quit.

If you're worried about _unknown_ long term risks, choose your poison: do you
think it's safer to be fat? can you achieve the same results as easily with
other diets? Power to you. But don't believe the army of liars that's been
spreading FUD consistently over the years.

~~~
skookum
You seem quite defensive about keto and missed most of the point of my post. I
wasn't writing about keto specifically, I just needed a few examples and that
was one that came to mind at the time. You can sub in "eating nothing but
sauerkraut and grapefruit" or anything else that springs to kind. My post was
about self-experimentation in general. The "scares" you refer to, I did not
claim were a result of a low carb diet - they were examples of the types of
long-term issues that some of us would like to avoid. Unfortunately the impact
of diet & lifestyle on those can be decades in the making - not to mention
that some, like Alzheimer's, don't allow for do-overs - which makes it rather
hard for an individual to employ self-experimentation to avoid them. The fact
is that an individual won't be able to determine if consuming more or less of
vitamin X or mineral Y will increase or decrease their probability of
developing condition Z via self-experimentation for most of the scary
conditions, let alone if vitamin X needs to be present in combination with
compound Z, etc.

> choose your poison: do you think it's safer to be fat?

This is a false dichotomy. The choice is not keto or obesity. And
losing/maintaining weight is one of the short-term & measurable goals I was
alluding to. It's trivially achievable in a fairly short time with various
approaches and keto is certainly one of them. Many of the others require less
self-discipline than keto however, and a number of those have orders of
magnitude more man-years of aggregated long-duration testing behind them.

> But don't believe the army of liars that's been spreading FUD consistently
> over the years.

That's good advice, but how do I identify which one is the army of liars and
which one is the army of truth? :)

~~~
narag
How body work is a complex subject indeed. But if you remember, this all began
as a response to joshgel complaining that it's impossible to tell good advice
from bad one.

I'm not proposing that every person invents own diet, just to use common sense
if a diet works for you and another doesn't.

As to how to identify who's lying, how about people telling lies? When Atkins
wrote the book in the seventies, his critics told that his diet didn't work
and provoked a series of terrible side effects, none of what was true.

The fact was that thousands of people were trying the diet and it worked and
it didn't make them sick. So where did the criticism come from? You can tell
me that there are _unknown_ risks and ask for caution. But if someone is
saying in no uncertain terms what they said in the face of evidence, that's a
strong indication that they have no interest in truth.

Of course, diet is not the only matter in what some powerful entities try to
manipulate the public, it happens in a variety of matters where science,
politics and private interests meet. The first principle here is follow the
money.

~~~
skookum
You first make the claim that your chosen diet must be safe because if it
weren't safe there would be evidence to the contrary. Then you dismiss those
people who try to bring forward evidence to the contrary as liars. You can't
have it both ways.

It's funny that you should bring up Atkins and then suggest "following the
money"... Atkins Nutritionals sued some of the people that you are labelling
as liars, and lost all of their lawsuits. If there's one thing I've learned
from my two decades living in America it's that when a corporation loses a
lawsuit to individuals here, the individuals are probably barking up the right
tree.

Have you considered the possibility that what you are terming "liars" is just
"people that disagree with my strongly-held belief"?

------
nxc18
Very interesting. I'm affected by high blood pressure so I monitor it pretty
closely.

If I need to get my blood pressure down, there are three levers that
consistently work:

° reducing sodium - note: I really like salty things, so it's very easy for me
to push 6-7k mg or more, especially when I was in college eating cafeteria and
frozen food constantly. Also, drowning things in hot sauce, to which I am
mildly addicted.

° exercising.

° cutting out alcohol and certain other vices.

Everyone's different, so if you're worried about it, talk to your doctor and
consider starting a monitoring program. I like home monitoring; IME knowing
exactly the impact of my choices on my blood pressure helps me make good
choices.

It's good to hear the guidance might become a little more sane - it is
extremely difficult to eat a normal (by any American standard at least) diet
and be less than a few thousand mg.

~~~
Swizec
> 6-7k mg

Why not say grams? A thousand miligrams is a gram.

I've always "suffered" from low blood pressure. Never quite to the point of
fainting when I stand up too quick, but it's been close a few times. Exercise
for me means I have to go out of my way to supplement sodium or I start
getting muscle cramps.

So I wonder, what does high pressure feel like? How do you know when it's too
high? Or is it just something you notice on a device and know to fix because
doctors say so?

~~~
dharness
Most food packaging measures sodium in mg, so I feel using those units is
easier to reason about for most people.

~~~
namibj
There is a reason the SI system uses decades. It's exactly that it makes this
trivial, but I guess if one is not that accustomed to thinking in
decimals/metric, it might not be as obvious.

mg is also just composed of the SI prefix m = milli, and the SI unit g = gram,
where the latter is a little weird due to naming problems early on leading to
it being the only SI unit where the base unit, the kg = kilogram already has a
prefix.

The milli means thousands, so you are just saying 6 thousand thousands gram.
If you internalize SI units, and decompose them automatically, this seems at
least confusing, possibly worse, depending on how picky the reader is about
unnecessarily contorted grammar in general.

I myself advocate the use of prefixed gram for the cases where people use
tons, but I accept that people in general don't like them being called
megagrams = Mg from now on. This is by the way the reason why mb != MB when
denoting storage space, but 8e9 mb = 1 MB, due to the former denoting
millibits, and the latter megabytes. There is also MiB, mibibytes, denoting
2^30 B. Microsoft denotes MiB as MB, which is wrong, and lead to great
confusion. Be careful, embrace SI units, they make your life easier.

~~~
commandar
Using SI doesn't mean you shouldn't maintain consistency between units you're
actively comparing to avoid inadvertent conversion error. If your working
units are mg, using mg across the board is completely sensible. It lowers the
mental load involved and reduces the chance of the human factor introducing
errors.

It has nothing to do with being uncomfortable with working with SI units and
everything to do with having a consistent working environment for me.

For example, If I were drawing something up in CAD and needed a particular
face to be 120mm, I'm completely aware that could be represented as 12cm, but
I _want_ the software to label that as 120mm so that it's consistent with
e.g., a 23mm face next to it.

Your working units for sodium in food consumption are milligrams. Labeling the
final sum the same way is a good thing.

~~~
DanBC
Sure, but say 6000 mg, don't say 6k mg.

~~~
commandar
That'd be ideal, yes, but I'll take 6k mg over 6g when mg are the working
units every time. The k makes it much more explicit that there was a shift in
magnitude than just silently converting between units.

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

Scientific America (2011)

 _”This week a meta-analysis of seven studies involving a total of 6,250
subjects in the American Journal of Hypertension found no strong evidence that
cutting salt intake reduces the risk for heart attacks, strokes or death in
people with normal or high blood pressure. In May European researchers
publishing in the Journal of the American Medical Association reported that
the less sodium that study subjects excreted in their urine—an excellent
measure of prior consumption—the greater their risk was of dying from heart
disease. These findings call into question the common wisdom that excess salt
is bad for you, but the evidence linking salt to heart disease has always been
tenuous.”_

------
Barrin92
>I found an advocate for rationality in Richard Sloan, a professor of
behavioural medicine at Columbia University. He said that when it comes to
hypertension and other health problems, Americans put too much faith in the
power of personal agency.

Isn't that the truth. Another example came to mind immediately which is the
treatment of alcoholism. AA is really big in the United States but has abysmal
recovery rates, whereas preliminary studies with muscle relaxants have shown
great promise.

Yet in public discourse diseases are treated like one's 'personal demons', a
'challenge that has to be overcome' and so on. It almost seems like a personal
growth lifestyle change rather than an objective medical assessment with
programs like AA suggesting opening oneself up to 'higher powers' in their
official guidelines.

There really needs to be a big culture shift that moves health debate from a
sort of Puritanism to objective medical evaluation that keeps the personal
angle out. Especially when it comes to drug abuse and dietary related
illnesses. Obesity is a big issue as well.

~~~
eanzenberg
What are you talking about? There's plenty of stories out there of obese
people who lost weight on their own and got their life back into shape (myself
included). This ivory tower elitism is nonsense. They are worried that if
enough people took actions into their own hands they'd be out of business.

~~~
asveikau
I think a lot of people could "will" to fix some of these problems in an ideal
world, but other factors beyond their control prevent them.

I "beat" obesity in the last year. My BMI was low 30s and it's now low 20s.
Knock on wood, after some time I don't seem to be regaining it like a lot of
people do (as suggested by my sibling post). Without getting into too many
personal details, the biggest thing to cause that was a radical re-shift of my
work habits. A vast majority of people do not have the luxury of chosing when
and how they work. I do not fault them for not replicating what I did. I
struggled with it myself for a long time, before my recent success, until I
was able to make these latest changes.

In general I think things which lead to judging other people for their
circumstances is a bad idea. There are probably people who could will it away.
Is it their fault that they don't? Honestly, probably not usually.

~~~
yosito
Out of curiosity, what did you change about your work habits?

~~~
asveikau
Quit a job, replaced it with zero commute, making room for daytime exercise
and better meals.

------
jgrowl
I'm on a ketogenic diet and I measure out a full tablespoon of salt for my
daily consumption. I usually get somewhere between 7-8 grams of sodium a day.
My mind was blown when I saw the McMaster study on sodium that found that for
normal diets, 5 grams daily showed no increased mortality of all causes. I
think it was too much below 3g or much above 7g is where things start to get
dangerous. I had to do some trial and error to find the right amount of salt
for me and I'm still tweaking it here and there.

~~~
DanBC
But they're talking about all source sodium, not just added sodium. How much
sodium is in the rest of your food?

EDIT: one tablespoon is 18 gm of salt. That's over 6 gm of sodium.

EDIT2: Also, the study you're talking about says this:

> We noted that most of the world’s population (about 95%) studied consumes
> more than 3 g/day of sodium, regardless of hypertension status and only 22%
> consume 6 g/day or more of sodium—the threshold above which we note an
> increase in mortality and cardiovascular disease risk.

~~~
jgrowl
I don't really eat any prepackaged foods besides macadamia/coconut milk.
Mainly broccoli, spinach, celery, eggs, chicken, turkey, tuna and a ton of
coconut/olive oil. A tablespoon of salt is 7080 mg of sodium. There haven't
been any studies looking at ideal sodium intake for people on keto as far as I
know, though it is generally accepted that there is a higher need since the
liver gets efficient at excreting sodium.

I wouldn't necessarily recommend others take as much sodium as I do, only that
personally I seem to feel better around that level. I have heard from some
people that take as much as 11g a day on keto. I would definitely not exceed
5g much if I was on doing a standard diet though.

------
kdtop
I was taught that salt (sodium) unmasks hypertension, but doesn't cause
hypertension. In other words, sodium is the tool that the body's regulatory
systems use when trying to raise blood pressure. So a healthy younger person
can probably not worry about sodium intake. But for an older person with
congestive heart failure, a bag of potato chips might end them up in the
hospital.

------
pfarnsworth
High salt diets == Hypertension and High fat == heart disease are two
"scientific truths" that have been propagated for decades and have turned up
as bad science.

I've heard the argument of "all the scientists believe this, so you must be
wrong" so many times with these and it turned out I was right. I believe the
same will go for other incidents of bad science that most people believe these
days.

~~~
graeme
Did anyone familir with the literature say "all the scientists believe this"?

~~~
reitanqild
We've all heard it in school and through major newspaper and TV shows since we
entered school.

It doesn't matter what the best experts says as long as those picked up by
mainstream media and textbook authors consistently agree on the wrong thing.

~~~
graeme
Makes sense. Just wanted to clarify in order to distinguish from a case like
global warming, where there really is expert agreement.

~~~
pfarnsworth
There was expert agreement on both high salt and high fat diets for decades.

------
noetic_techy
Recommend people read the book The Salt Fix, by Dr. James DiNicolantonio. Just
like cholesterol and Ancel Keyes, opinions of just a handful of people, in
particular Dr. Walter Kempner, changed public health policy against salt with
very little evidence to back it all up. Now you are starting to see all this
terrible advice unravel.

------
BadassFractal
Stan Efferding, who not only holds world records in power lifting but who also
trains Hafþór of Game of Thrones fame, is big into recommending at least 6g of
sodium a day for people who are pretty active and exercise regularly:
[https://youtu.be/BeOc7TRo9Os?t=16m49s](https://youtu.be/BeOc7TRo9Os?t=16m49s)

Admittedly, some of the practices that work for genetic outliers of the
caliber of Stan Efferding and Dan Green (or people who train as hard) don't
apply to the rest of us regular mortals.

~~~
3131s
Dan Green and Stan Efferding both take steroids though (or at least Stan did
at one time), and they weigh a ton. Not sure anything that applies to them
would apply to most anyone else. It's probably best not to glean health tips
from powerlifters in general...

~~~
BadassFractal
It'd be pretty shocking to find someone performing at that level who doesn't
increase their testosterone levels (and much, much more) artificially. I'm
pretty sure Stan is still on HRT these days. It's sort of a loophole in the
system these days for how to obtain it legally. It's not nearly as powerful as
cycling it, but it's better than nothing.

I always find the whole "but they take steroids" argument strange.

It's actually funny you should mention taking health advice from powerlifters,
bodybuilders and strongmen. Stan Efferding has an entire video on the subject,
where he makes it clear that if you want to look or perform like him or some
of his peers, you will most likely not be healthy:
[https://www.youtube.com/watch?v=yxHZrF4AFRg](https://www.youtube.com/watch?v=yxHZrF4AFRg)
. The part that struck me the most was that some of these guys need CPAP to
sleep once they get into the 300-400lbs weight category, just because a human
body isn't supposed to weigh that much.

------
carapace
Eat freshly picked organic vegetables, a lot. Some fruit. No dairy. No grains.
Meat once a week or so. Within a month or so you will positively glow with
health.

~~~
FuckOffNeemo
Organic, huh?

The other parts of your argument I doubt many would disapprove of. More
vegetables, eat less meat. But any argument that start's with 'freshly picked
organic vegetables' screams prejudice and ignorance.

[https://www.health.harvard.edu/staying-healthy/should-you-
go...](https://www.health.harvard.edu/staying-healthy/should-you-go-organic)

"While organic foods have fewer synthetic pesticides and fertilizers and are
free of hormones and antibiotics, they don't appear to have a nutritional
advantage over their conventional counterparts. "There've been a number of
studies examining the macro- and micronutrient content, but whether
organically or conventionally grown, the foods are really similar for
vitamins, minerals, and carbohydrates," says McManus."

~~~
carapace
"PREJUDICE! IGNORANCE!"

Trolling with science is still trolling FuckOffNeemo

~~~
FuckOffNeemo
No trolling here. I'm pointing out scientific facts that are contrary to your
opinion.

And my mention of 'screaming' was used metaphorically. That is to say, your
bias was evident from your posturing. Not that you or I were _literally_
screaming about one opinion or the other.

~~~
carapace
> No trolling here.

Ok, cheers.

> I'm pointing out scientific facts that are contrary to your opinion.

I'm gonna have to go ahead and disagree with you there. What you're pointing
out is one article that contradicts my own lived experience (on which my
opinion is founded.)

I love Science. I've got a copy of Linus Pauling's "Chemistry" on my desk
that's I'm reading for fun. But a scientific study that shows that "Organic"
food is no better than (let's call it) "Conventional" food in terms of
nutrition and health? Friend, I just laugh.

To even get my attention such a study would have to have at least three
groups: one eating only organically grown food, one eating conventionally
grown food (same diet), and a control group that eats what everybody else
eats. Then you'd have to keep it up for several generations!

Which brings me to my main _scientific_ objection to conventional agriculture:
it's new. We know, thanks to science, that the living system we are a part of
is approximately 3.5 to 4 _billion_ years old. The primary constituents of the
system (microbes and viruses) have a life-cycle measured in hours. This system
evolves. Along comes the naked ape sprinkling fixed nitrogen on his crops and
patting himself on the back. One of the apes puts on a lab coat and gives the
rest a thumbs up, "It's just as good!", while another sprays nerve toxin on
the crops to kill the "pests". Meanwhile Gary in the back is starting to ask,
"Hey, where are the bees?"

The word I'm looking for is "Hubris".

Now then, the _pragmatic_ argument against modern conventional agriculture is
that it's unnecessary. We now know, again thanks to science, that soil is not
a passive receptacle or matrix for chemical nutrients. It's a living dynamic
system comprised of tens of thousands of species on all scales from the virus
to the mole, and that has more in common with a vast city than a pile of
minerals. We know that micro-rhizome interconnects plants in huge networks
that shuttle water, nutrients, and chemical signals (often involving the
_same_ molecules that occur in humans as neurotransmitters and hormones)
between them. We've also learned that we ourselves host a "microbiome" and
it's obvious that, in a healthy relationship with your local gardens, your
microbiome is effectively _an extension_ of the soil into your system. (And
back out again. Feces are ~80% microbes.)

(As an aside, given the above it should not be surprising that it's possible
to _taste_ the difference between home-grown organic food and store-bought
conventional food.)

The way to grow healthy food is to _garden the soil_ , the plants grow
themselves. You can't really control plant growth too well. It's easy,
however, to improve the soil, which then affects the growth of the plants.

One amazing example of this is a project that was done in Jordan. Agriculture
had been practiced on the site until salt had gotten so bad that nothing would
grow there. It was a patch of barren salty desert. Using applied ecology
("Permaculture") they were able to establish a nascent ecosystem. Within two
years it was producing figs. The soil regenerated, mushrooms appeared.

There's a short video about it, "Greening the Desert" with Geoff Lawton. "You
can solve all your problems in a garden." as he says.

Direct link:
[https://www.youtube.com/watch?v=xgF9BU4uYMU](https://www.youtube.com/watch?v=xgF9BU4uYMU)

Main page: [https://permaculturenews.org/2007/03/01/greening-the-
desert-...](https://permaculturenews.org/2007/03/01/greening-the-desert-now-
on-youtube/)

The bottom line is, if you practice applied ecology you can grow all the food
you need in a garden without any artificial inputs at all. It's cost effective
and it will make you and the world around you healthy. It's also soundly
scientific.

~~~
FuckOffNeemo
I wish I could engage you further here, I'd love to dive more into your
argument but time is not forgiving.

Thank you for your response however, it was very informative.

I only have one comment to make from the above:

I'm gonna have to go ahead and disagree with you there. What you're pointing
out is one article that contradicts my own lived experience (on which my
opinion is founded.)

For some one who's embedded and has a solid understanding of the scientific
process, you're contradicting the scientific community here by saying your
opinion and anecdotal evidence proves otherwise?

~~~
carapace
Well met!

Let me say that, while I have huge respect for science and the Scientific
Method, my _faith_ in science is weakened as one departs from physics.

To be specific, before I could credit (believe in) a scientific paper
purporting to show no appreciable difference between "organic" and
"conventional" produce there are a lot of boxes I'd have to check off. For
example, how long after they were picked were the vegetables tested?

