Salt might be a contributing factor, albeit small, but there's an increasing tsunami of research pinning sugar, especially added sugar in the forms of table sugar and high fructose corn syrup, as the primary cause of hypertension, obesity, heart disease, and a huge host of other diseases.
After listening to that and reading some of the linked studies and articles, it seems obvious to me that sugar is orders of magnitude the highest candidate for heart-related disease and obesity. Just my conjecture though, happy to be proven wrong. In the meantime, I'm cutting down heavily on refined sugar and processed carbohydrates. I've never felt better. Same caloric intake, just different sources.
Very interesting. In the last 2 years I scare-tactic'd myself into seriously restricting my sugar (basically down to what the WHO would recommend for a person like myself) and immediately saw improvements in my skin, and not long after noticed that I don't get sick as often.
As well, I've adopted the practice of avoiding any eating after 7pm.
These two things combined resulted in me going from the 150s down to the 140s, seemingly only losing fat in the process.
All anecdotal but it has been more than enough to convince me that sugar (despite my deep, deep, deep, love for it) is not good for me.
Anecdote of one here, but I've had a lot of success putting all my focus on eating less sugar. After calming the sugar cravings, I moved on to reducing the number of processed carbs. Less hunger / mood swings, more energy; generally fitter and healthier. Again, just my personal experience.
It's true that sugar is responsible for much disease, however "the primary
cause of hypertension"? I really don't think so, unless indirectly, as a
consequence of diabetes and obesity.
In any case, there is no controversy regarding the role of salt in
hypertension. The evidence has been accumulating for a very long time, with
numerous studies and meta-analyses. The physiological mechanism by which
sodium and potassium control blood pressure is also uncontroversial.
And anyway, just because sugar is bad for you doesn't mean salt is good for
you- in the same way that smoking is not good for you just because sugar is
bad.
Taubes has degrees in aerospace engineering and journalism. Not to say that formal education is the marker for expertise, but it's at least a contributing factor.
I'd hardly call him a "health expert" just because he wrote a controversial book about nutrition.
I often feel very “energy depleted” after eating sugar. Yes, you get the initial push, but that is followed by a drag and mood deterioration, which I can only fight by getting something salty or simply waiting it out
Gary is a big proponent of the low carb/insulin hypothesis for weight loss. And so far, with his Nutritional Science Initiative and their testing, it's just not panning out..
Looking at the actual paper the Examine article is based on (https://jamanetwork.com/journals/jama/article-abstract/26731...), you can see that the so-called low-carb diet still included 30% of calories from carbohydrates. That's way more than most low-carb diets, including those promoted by Gary Taubes. The main benefits of low-carb diets come from switching into ketosis.
Weight loss is only one aspect of the nutrition story. That being said, remember that just because Taubes is wrong on a bunch of things, doesn't make sugar any healthier.
I think another direction to look is also seed oils, specifically high polyunsaturated. I am not sure what I believe but I do think it's as valid of a possibility.
Sodium is interesting in that low or high levels in the body are bad for you. But it would appear that sodium promotes weight loss to a certain degree, the undesirable side-effect being the burning of muscle tissue.
That's half a teaspoon a day. I cook every single day, so I'm very well aware of how little that is. Id rather die a bit earlier then limit my added salt to half a teaspoon.
Just don't eat processed food. Also restaurant food uses a ton of salt so tread carefully.
it just takes time for your tastebuds to get used to lower salt, but afterwards food tastes just as good. Some years back after eating probably 8,000-10,000mg of sodium a day for most of my life I had to permanently switch to an extremely low sodium diet (<500mg/day) and taste has not been an issue after the first few weeks of acclimatization, tastebuds are very adaptable and interestingly nowadays some vegetables (potatoes for example) will taste slightly salty to me on their own for example.
The major issue has been of course that eating out or eating pretty much any packaged/premade food is impossible, due to everything having tons of sodium/salt added. For some n=1 blood pressure was not the reason why I had to get on this diet, but my bp went from 145/85 to 105/65 after not that long on it, which really surprised me of course.
To anyone curious about the cooking part: I also cook every single day and my meals have very little salt and nobody had complained so far because we are used to use salt as condiment to make stuff tasty but you need to learn to use real condiments (all those colored powders, you know?) and herbs and build up flavor thru caramelization of the food you prepare (nearly everything edible can caramelize a bit, which enhances flavor and mask out "lack" of salt), then use coarse salt when serving. People will taste the salt, but it will be just a twist and to finish the flavor. If you need a bunch of pinches of salt in your meal you have done something else wrong much earlier. Of course, you eventually need to learn how to live with less salt than you are used to today, but that's another story :-)
If I understand correctly, this is a meta analysis – meaning that they're drawing conclusions based on pooling together existing research.
The very first study they linked was on something called the DASH diet, which in addition to reduced sodium encourages people to stay away from processed carbs and to favor whole grains.
Basically, I'd want to dig in to the linked studies and get a better sense of how other factors besides sodium could be affecting the outcome. For instance, fast food contains a lot of sodium. To get to lower sodium, you'd probably have to cut down significantly on fast food. You'd drop the sodium, but you'd also be changing a lot of other variables.
Salt makes food taste good. If you're cooking at home, you're probably not going to have to worry about salt unless you have a chronic condition of some sort. It just doesn't compare to the amount of sodium crammed into processed food. I'd rather focus on eating less processed foods, and season my home-cooked meals so they're not terribly bland. The high-order bit is to eat less processed foods.
I take 5-7g of salt daily in the form of manual supplementation. I eat a ketogenic diet so it's necessary to combat the diuretic effect of low-carb eating.
I feel like this study doesn't really do a good job isolating the actual changes that might have led to the improvements. How was salt intake determined? Was it controlled? Unless I am getting lost in the technical writing it looks like the results were based purely on urine output tests, not inputs.
Headaches and flu-like symptoms. I take something called "lite salt" which is intended to be a salt substitute for folks with health issues. It's essentially a 50/50 blend of salt and potassium so it's perfect. I put a teaspoon in some water with a zero-sugar flavor aid like mio, shake it up, and boom I got some zero-sugar/low-carb gatorade.
There are other problems with this analysis, but the main problem is this: it does not indicate in any way that reducing salt intake will result in a reduction of morbidity, and reducing morbidity is the only thing that actually matters.
Blood pressure is important as a marker for a whole host of health issues, but lowering blood pressure via reduced salt intake does not mean that you will reduce the incidence of of health issues that are commonly associated with high blood pressure. One simply does not follow from the other.
> it does not indicate in any way that reducing salt intake will result in a reduction of morbidity
It doesn't? I thought it said pretty clearly it will lower the incidence of cardiovascular disease and predicted a reduction in strokes, heart attacks and heart failure.
> Blood pressure is important as a marker for a whole host of health issues
False, blood pressure is far more than a marker. For example: "The incidence of stroke rises progressively with increasing blood pressure levels, particularly systolic blood pressure in individuals >65 years. Treatment of hypertension convincingly decreases the incidence of both ischemic and hemorrhagic strokes."
Salt is responsible for 2 pts of BP benefit. Insignificant for most people. And the depression from being on a low-salt tasteless diet could more than offset for any gain.
My reading is that reduced salt in urine is associated with reduced blood pressure. In a 4 week timespan. As far as I can tell, this is the only thing actually determined by the meta analysis.
The study author then goes on to say that, since high blood pressure over an entire lifetime (not 4 weeks!) is associated with cardio vascular diseases, less salt should reduce the incidence of cardio vascular diseases. But that conclusion is a logical leap on the part of the authors. The studies in their meta-analysis did not show that reducing salt intake also reduces cardiovascular diseases. That may seem like a reasonable logical conclusion, but there are about a billion reasons why it might be wrong.
To go bigger picture, there are a lot of problems with nutrition science, but these are three that stand out to me (this study falls prey to numbers 1 and 2):
1. There are too many short term studies.
The problem with short-term studies is obvious: most health issues that we believe are influenced by diet are a long term and develop over a person's entire life.
2. Too much measuring measuring of risk factors, not enough measuring of health outcomes.
Blood pressure and lipids are mostly risk factors for health problems (read that wikipedia article again; blood pressure is mostly mentioned as a risk factor and the only mention of it being important for treatment is for people who are considered hypertensive, which is not the same thing as having high blood pressure). Most nutrition science research is measuring how diet affects these risk factors, not how diet affects actual health outcomes (morbidity). The reason is that it's cheaper and easier to measure risk factors than to measure actual outcomes. But the problem is that the risk factors are not what you actually care about.
If you never measure actual outcomes, then all of your dietary recommendations are based on connecting a whole bunch of knowledge about individual parts of the system that is the human body, but not based on knowledge about how the system works when taken as a whole. It's basically the same problem as unit testing vs. integration testing. Unit tests are great. But at the end of the day, you need to know if the whole thing you made works the way it's supposed to. Only integration tests get you that.
You may not think this is such a big issue, but American diet recommendations since the 60s have been based on such unit-test style knowledge and the results have been a staggering disaster. The incidence of all the diet related diseases have gone up by a huge amount.
3. Most nutritional research is epidemiological.
Epidemiology is a useful tool, but it can fundamentally only tell you whether two things are correlated. But correlation, at best, can only give you negative knowledge about causality. That is, if two things are not correlated, then you know that they don't have a causal relationship. But correlation can never give you positive knowledge, because both things can be caused by a third, unmeasured, factor. Hence, the famous adage:
Correlation != Causation
For a great dive into why you should basically not draw any positive conclusions from epidemiology, there's a great article by Gary Taubes:
Yep, there are statistical fallacies here which the article does not address.
Even if high blood pressure is correlated with morbidity, and salt intake is correlated with high blood pressure: it does not even follow that morbidity is correlated with salt intake, let alone the adage about correlation and causation.
>The current recommendations to reduce salt intake from 9-12 to 5-6 g/d will have a major effect on BP, but are not ideal. A further reduction to 3 g/d will have a greater effect and should become the long term target for population salt intake.
First, this latter recommendation is not tested by the study; second, lower BP is not always optimal, as anyone who's ever experienced a fall resulting from orthostatic hypotension can attest. It isn't obvious, but accidents are among the top 10 causes of death in older people, and falls comprise more than half:
if you eat cheese you might be surprised by how much sodium it has, and bread can easily be several hundreds of milligrams of sodium too. It's not hard to eat 5,000mg/sodium a day without intentionally adding a lot of salt to your meals just via "hidden" amounts.
I was tempted to answer that I eat very little cheese and not much bread, but OK, this was about average and I have low blood pressure anyway.
What I found extrange is that most people I know are much more concerned with salt intake than I am, often lecturing me that I should be using less salt, and then I read that I am using half of what's considered "current levels".
"Therefore, 3 grams per day should become the long-term target for population salt intake".
But why should this study be regarded as a definitive basis for public recommendation ("should become") given numerous other studies which do not come to this conclusion?
> Ayurveda is showing interesting benefits for hypertension
You’re being downvoted for referencing an article making health claims with zero citations. It should also be noted that Ayurvedic medicine is considered a pseudoscience [1], slightly less useless than homeopathy or crystal healing.
Fair comment about posting an article with zero citations. However Ayurveda is not pseudoscience, rather a complementary health approach. This time more credible source: https://nccih.nih.gov/health/ayurveda
Under “What the Science Says About the Effectiveness of Ayurvedic Medicine Research” section of your own source [1], it says “most clinical trials of Ayurvedic approaches have been small, had problems with research designs, or lacked appropriate control groups, potentially affecting research results.” The page doesn’t define “complementary medicine,” and presents loads of warnings about the heavy metal and toxic contents of many Ayurvedic products. Most notably, the “For Health Professionals” section is blank.
Ayurveda isn’t quite as bunk as homeopathy or crystal healing, where the fundamental mechanisms are flaws. (Aspirin and penicillin came from natural sources.) But any claims about its efficacy are pseudoscientific.
This is a lengthy discussion between a health/fitness expert and Gary Taubes, author of “The Case Against Sugar”: https://bengreenfieldfitness.com/podcast/nutrition-podcasts/...
After listening to that and reading some of the linked studies and articles, it seems obvious to me that sugar is orders of magnitude the highest candidate for heart-related disease and obesity. Just my conjecture though, happy to be proven wrong. In the meantime, I'm cutting down heavily on refined sugar and processed carbohydrates. I've never felt better. Same caloric intake, just different sources.