It’s Time To End The War On Salt
The zealous drive by politicians to limit our salt intake has little basis in science
For decades, policy makers have tried and failed to get Americans to eat less salt. In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.
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 urinean excellent measure of prior consumptionthe 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.
Myth : If You Had High Blood Pressure Caused By Too Much Salt Youd Be Able To Tell
More than 30% of Australian adults have high blood pressure, and according to the Heart Foundation, half of them dont even know it.
Most people with high blood pressure dont display any symptoms, so its important to get your blood pressure checked regularly. If you do have high blood pressure, reducing salt, along with getting regular physical activity, moderating alcohol intake, quitting smoking and reducing stress, might help manage it, reducing the risk of damage to your body.
You can find out more about blood pressure here.
How Does Salt Raise Your Blood Pressure
Salt makes your body hold onto water. If you eat too much, the extra water in your blood means there is extra pressure on your blood vessel walls, .
If you already have high blood pressure, too much salt will raise it further, and may mean that any youre taking don’t work as well as they should.
Cutting down on salt is one of the simplest ways to lower your blood pressure, and will start to make a difference very quickly, even within weeks.
Eating too much salt can lead to all the health problems high blood pressure causes, including , , and some types of .
Salt and your kidneys
Your kidneys play an important role in removing fluid and waste products from your body and in controlling your blood pressure. Eating too much salt makes them less able to do their job, raising your blood pressure and leading to .
Your kidneys filter out excess fluid from your blood, which then collects in your bladder to be removed as urine. They draw water out of your blood through osmosis where the water travels from the blood which is relatively low in sodium into channels which are higher in sodium sodium is the part of salt that raises your blood pressure.
Eating too much salt raises the amount of sodium in your blood, throwing off this fine balance of sodium and water, and damaging the tiny blood vessels in the kidneys.
Eating less salt can help your blood pressure medications to work
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Reducing Sodium Is A Challenge What Can We Do
When you look at the menus of fast food, fast casual and even high-end restaurants, you will see that its very easy to exceed the recommended daily intake of 1500 mg of sodium. Unfortunately, the American palate has become so used to high sodium foods, anything with a normal amount of salt tastes downright boring. Further, some dishes, including soups, that you would think are very healthy, may contain upwards of 2000, 3000 or even 4000 mg of sodium. The bottom line its hard to get away from sodium.
However, we often recommend that patients reduce their sodium intake significantly by cutting out fast food, checking labels on the goods they buy in the store and prioritizing fresh fruits and vegetables. Doing so has immediate health benefits in the form of reducing blood pressure and strain on the kidneys and other organs of the body. Over the long term, fresh food begins to taste better, and we realize very quickly that we do not need so much sodium in our daily lives.
Just as with any lifestyle change, reducing sodium is difficult and requires an understanding and appreciation of how it affects our bodies. While sodium is a necessary nutrient to stay healthy, excess sodium has become a hallmark of the American diet. Reducing sodium can go a long way to eliminating many of the diseases associated with high blood pressure and obesity while also enjoying what we eat.
The Roles Of Aldosterone And Epithelial Na+ Channels In The Brain
The effects of prolonged icv infusion of Na-rich CSF, which include the secretion of EO in the brain, the increase of SNA, and the elevation of BP, are all inhibited by local application of a steroid synthesis inhibitor or by mineralocorticoid receptor blockade . Conversely, icv infusion of aldosterone raises the EO content in the hypothalamus, increases SNA, and induces hypertension . Indeed, a systemic administration of aldosterone also appears to act largely via the brain MRs because systemic aldosterone plus salt-induced hypertension is antagonized by icv administration of MR blockers and MR silencer RNA . This mineralocorticoid hypertension also has a distinct salt-dependent component, however, because thiazide diuretics prevent or attenuate the BP elevation even though the brain MRs may be flooded with aldosterone . The specific role of the salt in this situation is, however, unresolved.
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How Would I Know If I Have Low Blood Pressure
The only way to tell would be to get your blood pressure checked, he confirms. Any reading under 90/60 millimeters of mercury is considered low.
However, there may be signs including:
- Lightheadedness
- Dizziness
- Fainting
These symptoms tend to occur more when someone goes from lying down or sitting to then standing, he adds.
How Blood Pressure Changes
Your body controls the pressure in your arteries using a complex system of regulators including your heart, kidneys, enzymes, hormones, and nervous system.
Your blood pressure is always adjusting, based on your activity level, stress level, time of day, and even the position of your body. Lifestyle factors such as alcohol, caffeine, food, tobacco , and stress can all change your blood pressure.
There are several categories of high blood pressure:
- Normal
- High blood pressure stage 1
- Hypertension stage 2
- Hypertensive crisis
If either of the numbers in your blood pressure measurement is higher than normal, you should work on reducing your blood pressure through lifestyle changes and should seek the care of a physician.
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High Sodium Intake And Other Health Conditions
Excessive sodium intake has also been linked to other conditions, such as:
- Heart failure
- Osteoporosis.
A high level of salt intake increases the amount of calcium excreted in the urine, which may also contribute to osteoporosis and increased risk of fracture.The balance of sodium and water in the body can also be disrupted if there is not enough water. This may be caused by a damaged thirst mechanism or by limited access to water. Hypernatremia is a very serious condition that occurs when your sodium levels rise above 145 milliequivalents per litre . It can lead to death. A major symptom is thirst and treatment usually involve controlled water replacement.
How Sodium Impacts Blood Pressure
Even though sodium is an essential mineral, too much of it can increase your blood pressure. Sodium pulls water into your bloodstream, but if there is too much sodium, it pulls in too much water. The increase in water increases the volume of blood in your blood vessels more blood equals more pressure.
High blood pressure can damage your blood vessels over time by causing them to overstretch. Additionally, higher blood pressure can impact your heart by forcing it to work harder to pump all of that blood throughout your body. Despite all of these changes going on inside your blood vessels, most people dont notice any outward symptoms of high blood pressure. Thats why routine blood pressure screenings are so important.
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If I Have Low Blood Pressure What Should I Do
Dr. Patel recommends establishing a close, trustworthy relationship with your health care team. Everyone has a support circlewhether that includes family, friends and/or colleagues, he says. Your doctor should also be a part of that inner circle for regular support and expertise.
Dr. Patel is located in Hoboken and is a physician at Hackensack Meridian Health Medical Group, a network of more than 1,000 physicians and advanced providers at over 300 practices throughout New Jersey. Our care network can help you better manage your health. Visit HMHMedicalGroup.org to find a practice near you.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
How Does Salt Increase Blood Pressure
When you eat too much salt or sodium, extra water is retained in the bloodstream to flush out the salt from the body. This makes your kidneys work overtime to release chemicals such as renin and angiotensin, which cause the blood vessels to narrow and blood pressure to increase temporarily.
Additionally, the renin-angiotensin spike causes the release of another hormone called aldosterone, which increases blood pressure through water retention. Consistent high intake of salt thus results in a constant increase in blood pressure, eventually leading to hypertension.
Additionally, excess salt consumption causes hardening of the blood vessels, leading to increased resistance in the small arteries. This causes the heart to have to work harder to pump blood, resulting in hypertrophy of the heart muscle. Over time, the heart is unable to pump the blood with increased force, causing gradual weakening of the muscle.
- Potassium
- Magnesium
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What Is Salt And How Does It Affect Our Blood Pressure
Salt has been used to flavour and preserve foods for thousands of years. We all need some salt for good health but eating too much can increase our blood pressure, increasing our risk of heart disease. Here we discuss how too much salt can increase blood pressure, the relationship between salt and high blood pressure across Europe and what we can do to reduce our salt intake.
About Salt Sodium And Potassium
- Sodium is an essential nutrient necessary for maintenance of plasma volume, acid-base balance, transmission of nerve impulses and normal cell function.
- Excess sodium is linked to adverse health outcomes, including increased blood pressure.
- The primary contributors to dietary sodium consumption depend on the cultural context and dietary habits of a population.
- Sodium is found naturally in a variety of foods, such as milk, meat and shellfish. It is often found in high amounts in processed foods such as breads, processed meat and snack foods, as well as in condiments .
- Sodium is also contained in sodium glutamate, used as a food additive in many parts of the world.
- Potassium is an essential nutrient needed for maintenance of total body fluid volume, acid and electrolyte balance, and normal cell function.
- Potassium is commonly found in a variety of unrefined foods, especially fruits and vegetables.
- Increased potassium intake reduced systolic and diastolic blood pressure in adults.
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Are There Other Ways To Reduce Blood Pressure
- Cutting down on the amount of salt we eat helps reduce blood pressure. But our whole diet is also important, as is being a healthy body weight, and if drinking alcohol doing so in moderation.
- An example of a dietary pattern shown to improve blood pressure is the DASH diet. It emphasises a good intake of fruit and vegetables, low fat milk and milk products , choosing wholegrain foods, poultry, fish and nuts and eating less fats, red meat, sweets and sugary drinks. The DASH diet has a higher intake of potassium, calcium, magnesium and fibre. Saturated fat intake is lower than the typical Western diet, and protein intake is higher.
Our ‘Salt and the heart’ evidence paper recommends we continue to reduce dietary salt intakes, you can read more about our recommendations around salt and the heart in our Sodium Position Statement .
Peripheral Sympathetic Innervation And The Consequences Of Increased Sympathetic Drive
Tonic sympathetic drive is the predominant mechanism for maintaining vascular tone, and a block of 1-adrenoceptors in vivo rapidly lowers arterial myocyte , dilates arteries , and reduces BP . Thus augmented SNA should elevate BP directly. This sympathetic nerve-mediated vasoconstriction and elevation of BP must surely come into operation when the central sympathetic drive increases, as in the case of a sudden, short-term rise in CSF . Compensatory mechanisms, including the baroreflex response and endothelium-mediated vasodilation, should, however, counter the tendency for a sustained, large elevation of BP unless they are downregulated , a subject we address below.
The topic of increased SNA usually focuses on augmented norepinephrine release and rapid activation of vasoconstriction the roles of the cotransmitters, ATP and neuropeptide Y , are often ignored. Release of the cotransmitters is greatly influenced by the pattern of SNA and increases with bursts of activity moreover, ATP and NPY both modulate the effects of norepinephrine on smooth muscle . Of particular interest in the present context is the fact that NPY, especially, is a mitogenic agent and growth regulator that may make an important contribution to vascular remodeling .
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How To Reduce Salt In Diets
Government policies and strategies should create environments that enable populations to consume adequate quantities of safe and nutritious foods that make up a healthy diet including low salt. Improving dietary habits is a societal as well as an individual responsibility. It demands a population-based, multisectoral, and culturally relevant approach.
Key broad strategies for salt reduction include:
- government policies – including appropriate fiscal policies and regulation to ensure food manufacturers and retailers produce healthier foods or make healthy products available and affordable
- working with the private sector to improve the availability and accessibility of low-salt products
- consumer awareness and empowerment of populations through social marketing and mobilization to raise awareness of the need to reduce salt intake consumption
- creating an enabling environment for salt reduction through local policy interventions and the promotion of healthy food settings such as schools, workplaces, communities, and cities
- monitoring of population salt intake, sources of salt in the diet and consumer knowledge, attitudes and behaviours relating to salt to inform policy decisions.
Salt reduction programmes and programmes that promote fortification with micronutrients of salt, condiments or seasonings high in salt can complement each other.
Salt consumption at home can be reduced by:
Other local practical actions to reduce salt intake include:
How Common Is High Blood Pressure In Europe
In 2015, an estimated 1.13 billion people were living with high blood pressure globally, of which 150 million were living in Europe .4 Although the prevalence of high blood pressure in many European countries has decreased slightly in recent years, current levels are still of great concern. Reducing salt intake remains an important public health strategy to decrease levels further.
As with salt intake, the prevalence of high blood pressure tends to be higher for men than for women . The exact reason for this difference is not fully understood, but higher intakes of salt may be partly to blame.
Figure 2. Prevalence of high blood pressure 140 mmHg OR diastolic blood pressure > 90 mmHg) in men and women across European countries.4
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How Much Salt Is Too Much
Though it depends on each individuals health, Dr. Patel generally recommends the following daily salt consumptions depending on your blood pressure reading:
- At least 6 grams for individuals with low blood pressure
- Around 4 grams for individuals with normal blood pressure
- Less than 2 grams for individuals with high blood pressure
How Nacl Raises Blood Pressure: A New Paradigm For The Pathogenesis Of Salt
Departments of Physiology and
Medicine, and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Address for reprint requests and other correspondence: M. P. Blaustein, Dept. of Physiology, Univ. of Maryland School of Medicine, 655 W. Baltimore St., Baltimore, MD, 21201 .
the Hypertension Unit, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
Medicine, and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Departments of Physiology and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Departments of Physiology and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Medicine, and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Departments of Physiology and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
Departments of Physiology and
the Center for Heart, Hypertension and Kidney Disease, University of Maryland School of Medicine, Baltimore, Maryland and
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