Some scientists argue that a low-salt diet is just as dangerous as high salt consumption. What’s the reality?
In 2017, Turkish chef Nusret Gökçe went viral after a video lovingly seasoning a massive steak with a pinch of salt amassed millions of views online and earned him the nickname “salt bae”. But it wasn’t just his attention to detail that captured attention.
We’re obsessed with salt – despite warnings, almost every population around the world consumes almost twice as much as they should be and its harming our health in the process. But a counter-argument is gaining ground, casting doubt on decades of research and shedding light on the questions that still remain unanswered about our favourite seasoning.
Sodium, the key element found in salt, is essential for our bodies to maintain its overall fluid balance, transport oxygen and nutrients. It allows our nerves to pulse with electricity. But most populations have historically eaten more salt than advised and health officials around the world have had their work cut out for them convincing us to cut down.
Guidelines from the NHS in the UK recommend adults have no more than 6g of salt per day, including salt that’s already in the food we buy and salt we add ourselves during or after cooking. In the UK, average salt consumption is closer to 8.4g per day while in the US it is 8.5g. Meanwhile the WHO estimates that average salt intake globally has risen to almost 10.8g per day.
But only a quarter of our daily intake comes from salt we add into food ourselves – the rest is hidden in the food we buy, including bread, sauces, soups and some cereals. Adding to the confusion is that on food labels, manufacturers often refer to sodium content rather than salt, which can make us think we’re consuming less salt than we are. Salt is made up of both sodium and chloride ions. In 2.5g of salt, there is about 1g of sodium. “The general public isn’t aware of this, and just think sodium and salt are the same thing. No one tells you this,” says nutritionist May Simpkin.
According to the US Centers for Disease Control and Prevention (CDC) about 40% of the sodium consumed by people in the US comes from foods including pizza, deli meat, burritos and tacos, savory snacks, poultry and burgers.
Research has found that too much salt causes high blood pressure, which can lead to strokes and heart disease. Experts broadly agree that the evidence against salt is compelling. Our bodies retain water when we eat salt, increasing blood pressure until our kidneys flush it out. Too much salt over a long period of time can put strain on our arteries and lead to prolonged high blood pressure, known as hypertension, which causes 62% of all strokes and 49% of coronary heart disease events, according to the WHO. It estimates that excessive sodium intake is responsible for 1.89 million deaths globally every year.
One meta-analysis of 13 studies published over 35 years found a 17% greater risk of total cardiovascular disease and a 23% greater risk of stroke from consuming an extra 5g of salt per day.
As you might expect, cutting salt intake can have the reverse effect.
In one eight-year data analysis from the Health Survey for England, researchers found that a decline in salt intake by 1.4g per day was likely to have contributed to a fall in blood pressure – which in turn contributed to the 42% decline in fatal strokes and 40% drop in heart disease-related deaths.
A more recent clinical trial published in 2023 found that following a low-sodium diet for one week had a blood pressure-lowering effect comparable to a drug commonly given to patients with high blood pressure.
However, researchers who’ve carried out observational studies often concluded that it’s difficult to entirely separate the effects of eating less salt from other diet and lifestyle behaviours, since those who are more conscious of their salt intake are more likely to eat healthier overall, exercise more, smoke less and drink less.
Long-term, randomised trials comparing people who eat a lot versus a little salt could establish cause and effect. But very few such studies exist because of the funding requirements and ethical implications. “Randomised trials showing salt’s effect on the body are almost impossible to carry out,” says Francesco Cappuccio, professor of cardiovascular medicine and epidemiology at the University of Warwick’s medical school and author of the eight-year review.
“But there are also no randomised trials for obesity, or smoking, which we know kills you.”
BBC
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