Doctor's Note

This is my second video in my new in-depth series on the sodium “controversy.” See the first one at High Blood Pressure May Be a Choice.

More on hypertension in How to Prevent High Blood Pressure with Diet and How to Treat High Blood Pressure with Diet. What if you already eat healthy and still can’t get your pressures down? Try adding hibiscus tea (Hibiscus Tea vs. Plant-Based Diets for Hypertension) and ground flax seeds (Flax Seeds for Hypertension) to your diet. And make sure you’re exercising regularly (Longer Life Within Walking Distance).

But if you cut down on salt won’t everything taste like cardboard? Your taste buds shift remarkably quick: Changing Our Taste Buds.

If you’re surprised about industry tactics to distort the balance of evidence, here’s a few other poignant examples:

Lots more salt videos to come!

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  • Wade Patton

    So I kinda get it. That all the negatives of NaCl are with regard to hypertension, and the SAD level of consumption. I was under some impression that there was other mechanisms to the negative health issues of excess salt. Apparently those do not exist. Industrial food not a significant factor in my diet. My consumption (of salt) is far far below the SAD levels, and even when I ate SAD (and was nearly overweight) I never had hypertension issues. So I shan’t fret over it again and will continue with my personal seasoning salt fortified with B12 and amla…

    • largelytrue

      Apparently those [other mechanisms] do not exist.

      How are you getting to that conclusion? Admittedly Greger is focused on the hypertension connection in these recent but that isn’t the only concern that proponents of salt restriction cite.

      • Wade Patton

        Because I have been unable to unearth any other mechanism of salt in the literature I’ve seen. And I’ve asked here over and over again.

        I’ll be happy to hear what other negative aspects NaCl may pose at a given dosage. But the “hypertension model” has nothing to do with me. Just doesn’t apply to my set of facts.

        • Endothelial dysfunction secondary to free radicals caused by sodium crippling our antioxidant enzymes–video coming. Stay tuned!

          • Wade Patton

            Like I don’t check in every morning 8^)

          • Noe Marcial

            https://youtu.be/x6DNns4oFao?t=2h22m18s what the “responsable” people says about sodium…

          • rumicat

            I’ve been doing a plant based diet for five years, but it doesn’t keep my blood pressure in a good range. Even adding regular exercise and cutting out caffeine doesn’t do the trick. Now going low salt and adding 25mg a day of HCTZ and finally seeing good numbers consistently.
            I think some people just can’t handle even small amounts of excess salt as they get older.
            I know Dr. McDougall says don’t worry about your BP unless it’s above 160/100 but I known too many people who’ve had aneurysms and hemorrhagic strokes and would rather not be in that boat.
            Looking forward to seeing more videos on this topic.

          • Brux

            What is HCTZ?

          • rumicat

            It’s a first line diuretic for treating high bp. Been used for decades and has fewer side effects than many other meds (always individual of course). Works to prevent sodium re-adsoprtion in the kidneys initially but is also reported to have and mysterious dilatory effect on the endothelium. It’s not supposed to be very effective, but seems to work better on me that other people (20 pts systolic/10 pts diastolic lowering effect). The fact that it works so well for me makes me think I have a sodium sensitivity issue. My dad had high bp in his twenties, so I think it’s familial.
            I keep my sodium intake below 2grams, but less than that requires more meal planning than I am willing or able right now to do.

          • Brux

            Thanks, that’s really interesting.

            > less than that requires more meal planning than I am willing or able right now to do.

            This is interesting. What kind of planning? Do you actually add some salt to meals or do you plan at a level of salt within the ingredients themselves. That sounds like a lot of effort if so. I am not sure I could do that either.

          • rumicat

            I think 1.5 g is the dash diet recommendation. This is hard to do if you eat out at all, even sticking with vegan fare. Most commercial bread products have salt and restaurant food is highly salted to make it palatable. Basically you will eat at home, cooking everything from scratch, and forget using commercial hot sauce, soy sauce, veggie broth, or miso.

          • Brux

            I mostly do that already ( eat from scratch at home) … it pretty much ensures that I eat whole foods, because I don’t know how to cook really! ;-)

            Lucky for me I like bland food, always have. But I do have a taste for wasabi and ginger on occasion.

            I have not had luck as you say with vegan fare in restaurants and usually just stick with salads, dry.

            There was one doctor. I think it might have been Barnard who talks about how some bodies are just evolved to hold onto salt.

          • Brux

            What is HCTZ?

          • lilyroza

            A prescription diuretic

          • Wannabemd

            Could you do a video about the pink salt and the white salt?

      • newjumpswing

        Aloha,
        Please see my link above to Pubmed.

  • Noe Marcial

    whats about people with low blood presure. i have a friend that gets really dizzy when she stand up .. and there for the advice of the doctors it is to take salt, salty food. and Coke… and in short term works both.. but would you recommend salt to a person with very low blood pressure? or there is other healthy option for this situations or in general? which is the best advice for this situation?

    • My husband’s doctor also recommended that he increase his salt intake or his low blood pressure and dizziness so I also interested in the answer to this question.

    • Joseph Gonzales R.D.

      Hard to say. Dr. Greger mentions if low-salt diets can be bad for the heart in this segment. The question may be what’s causing the low blood pressure? I am not sure it’s lack of salt.

      • Noe Marcial

        that’s my concern it is a common belief that as high blood pressure people have to avoid salt so people with low blood pressure have take salt.. i dont think it is the cause.. maybe it is a sedentary life make a weak heart .. but i don’t know..
        and seems that most of doctors don’t border to discover what is causing the low or the high blood pressure..they just treat the symptom.

    • Leslie Stanick

      coke? why is that?

      • Angela Himm Wolfenberger

        Coke is high in sodium, and is associated with elevated blood pressure

      • Noe Marcial

        caffeine, sugar and additives that i think that rise you blood pressure

    • Wade Patton

      I’ve been give saline solution in order to raise my BP so I could walk out of ER after “letting” a whole lot of blood (MVA), but never have I correlated postural hypotension with higher/lower salt with my food intake. I’ve always been borderline hypotensive, and it was back when I took pharmaceuticals regularly (to control sinus issues-later determined to be casein related (milk)) that I would have bad cases of orthostatic hypotension (new name, same thing with quantitative specs). So those were OTC drug created situations. OTC drugs, not much safer than Rx.

      • Kim Churchman

        Wasn’t it isotonic saline solution they gave you? Isotonic, meaning same salinity as blood?

        • Wade Patton

          exactly. It was more about bringing up my blood volume to increase my blood pressures.

    • Rebecca Cody

      My understanding is that becoming dizzy or faint on quickly standing up is a symptom of adrenal fatigue, which needs to be addressed. Perhaps adrenal fatigue or exhaustion causes low blood pressure. I used to have that symptom, along with low blood pressure, and was told to eat salt. I do eat unrefined sea salt now, after years of not salting food, but it hasn’t increased my blood pressure. I don’t have the dizziness or faint feelings any more, and haven’t for a long time. My blood pressure has been as low as 80/60, even less one time, but that was due to dehydration caused by cancer treatments.

    • Isabel

      That sounds like me when I drink a lot of water my blood pressure gets really low and I get light headed and really sleepy. I read articles by Dr Klaper about no salt & tried it. It’s NOT for me. I have a plant base lifestyle for 3 years and mostly fix my own food and bring my own lunch and snacks with me which are whole food based. Many times I forget to add salt. And since I drink between 8 to 12 glasses of water a day I add just a little sprinkle of Himalayan salt and iodized sea salt to the bottles of water that I refill from home. Now for the past few months i rarely have problems with lightheadedness or a feeling extremely sleepy. My blood pressure is usually 95/65. Of course it’s higher if i eat a processed store bought meal. However my blood pressure has been as low as 79/55. And 81/49. But lately it has not been lower than 90/60 and is sometimes as high as 110 / 68. It has been a few months since I have had those symptoms of lightheadedness and sleepiness and extreme fatigue.

      • Bruce Cropley

        Perhaps it is iodine that you are low on, and getting from fortified salt? Just an idea.

  • Noe Marcial

    i really curios to about potassium chloride based salts.. (alternative to traditional salt) do they have any side effect?.. because taste super good and seems a very good option to lower the intake of sodium.

    • Wilma Laura Wiggins

      I’ve been led to believe they are dangerous by a couple of doctors. Maybe only because I have just one kidney, not sure.

      • Noe Marcial

        what they have told you?

        • Wilma Laura Wiggins

          No details. When I said maybe I should take potassium the doctor said “If you want to die.” I didn’t ask her why. I mentioned it to another doctor and she just nodded like she agreed. Guess I should ask but I just don’t really think they know what they are talking about so do my own research. Haven’t done it yet.

    • Moneybags

      I’d go for a potassium/sodium, instead of just switching to potassium only. I use this: http://www.amazon.com/Morton-Lite-Salt-Mixture-Canister/dp/B007GADZHC

      • Noe Marcial

        well i believe that in bread and all proced food i take more that enough sodium to even add more salt to my food.
        and when my grand mother that have high blood pressure stop adding sodium and meat and fish her blood pressure gets stable with no need of pills..but if she it 50 50 salt.. her blood presure go up again…

    • Darryl

      My favorite study on potassium salt substitutes. 5 kitchens serving retired Taiwanese veterans’ homes were randomized to either use ordinary salt, or 50/50 KCl/NaCl (comparable to Morton Lite Salt) in both their kitchens and at the table. After 31 months, the potassium enriched salt group had 41% lower CVD mortality and lower healthcare costs.

      • Noe Marcial

        yeap but at least here in spain we have 0 % sodiums salts and taste ok with natural ingredients (they say).. and seems that the benefits should be even better . because one still eating a lot of salt when one eat outside or buy food ready.

  • Noe Marcial

    I still not understand witch is the long term effect of salt. why the pressure goes high and high.. do salt make arteries more stiff? i understand the short term effect of salt on blood pressure but i don’t understand in long term and if have an accumulative effect during time

    • Veganrunner

      Salt causes people to retain water. That causes the heart to have to push against more resistance. The heart has to work harder. A diaretic causes a decrease in fluids and a decrease in blood pressure.

      • Noe Marcial

        Thats the part that i understand. but its not any other long term effects? does salt affect artery stiffness?

        • Veganrunner

          i just came across this article and it says yes about stiffness. I don’t have the time right now to read the research articles they are referring to but you should be able to find the answer there.
          http://www.udel.edu/udaily/2015/mar/sodium-health-031015.html

          • Noe Marcial

            super interesting thank you!

          • Joseph Gonzales R.D.

            Nice article! I have also seen the 500 mg minimum. I mention more about this here for anyone interested.

          • Wilma Laura Wiggins

            How much Himalayan pink salt is that is teaspoons, please?

          • Joseph Gonzales R.D.

            I don’t have a bottle in front of me I assume each brand will vary. Check the nutrition label or send me a link and we can look together!

          • Atlantisarch

            That’s no study, that’s a review. In other word, just some Int€r€$$€$t€d opinion. And even their mentionned (own) “study” about endotelium is a 7 day study on a poor sample … => not worth publishing unless calling for sponsors …

          • Veganrunner

            Atlantisarch that is an article. And for people wanting to understand the effects of dietary salt it is a good one. I never said it was research.

          • I know. Nothing personnal. But the fact is they dont have reliable information or they wouldn’t quote premium a poor study of their own group on a side field.They may explain things well, if the things they point out are crap then the article is crap. As a scientist I’m tired of the spamm/biaised/founds requesting “articles”.

          • Brux

            >> spamm/biaised/founds requesting “articles”.

            What does that mean … kind of hard to parse language for a scientist?

          • Noe Marcial

            but i don’t believe that is not a single study out there about the impact of sodium to the arteries . most be hundreds of them, No? its kind of basic thing to know i think..

      • S Slavin

        I’ve heard this a bunch of times but I also heard that water dilates the vessels (when taking a blood test the nurse said to drink first so the vein is easier to find).

        Is it not “dilated” by water but rather just bloated (hence easier to find, but harder to pump blood through?).

        • Wilma Laura Wiggins

          I am confused by the exact same thing. I am usually dehydrated yet have high blood pressure. I also hardly eat any processed food, no animal products, no added fat, few canned foods and only add salt on my food after it is cooked, and almost never eat out. Some people seem to think sugar is a bigger culprit than salt. I just wish I knew. I have copd and suspect the medicines I take but I just don’t know. I take lisinopril and still it just keeps going up.

          • S Slavin

            Hm, well based on something I read on here ( http://nutritionfacts.org/questions/hibiscus-and-coughing/ ), Hibiscus has the same function as lisinopril, so might be worth looking into.

            Sorry about the copd, I’m no pharmacist or doctor but I’m sure some of the medications have “higher bp” as a side effect, but if you need the meds, not sure what you can do.

            The only thing I can think to add is that often people think about what NOT to eat vs what TO eat. Perhaps instead of focusing on cutting things out you can also focus on taking the right things in (there are tons of interesting videos on here of the all the various foods that can lower BP).

            I have also read about sugar causing artery related issues even though that’s not the first association people make.

          • Wilma Laura Wiggins

            Yes I read that about the hibiscus tea and that’s why I tried it. Maybe I didn’t try it long enough. I don’t love the taste but it isn’t bad. Maybe I’ll start drinking it again anyway – maybe in a while it would help.

          • Johanna Martin

            Hm… Maybe you could hide the taste by cooling it in your fridge and adding it to a smoothie to hide the taste with something else whose taste you prefer?

          • S Slavin

            Hmm, the studies Dr. Gregor cited in the various Hibiscus videos seemed to have a measurable effect after a pretty short time.

            Did you use “red zinger” as your Hibiscus source? If you buy something like this: http://amzn.com/B0089VPTXK (no affiliation) it lists the actual amount of hibiscus in each bag, so you have a better idea of how much you’re getting.

            I tried the one in the link above, more for the antioxidants than the BP effects (would be nice though), and I can tell you after one bag I can really feel the diuretic effects, so whether it’s lowering my BP or not I don’t know, but the diuretic effect definitely kicks in. If I have a generic “red zinger” the effect is not the same.

            In terms of taste, as Johanna below mentioned, I found I was able to drink tea with NO sweeteners at all after I switched to iced, and after doing that for a while, your taste buds get used to it.

          • Wilma Laura Wiggins

            The kind I bought is Stash wild raspberry hibiscus herbal tea.

          • S Slavin

            Ah, looks good. I don’t see a listing of the actual hibiscus amount though, so I wonder what it is.

            The one I linked to (and I’m sure others) lists an exact amount so you can at least compare.

            If you read the amazon reviews of the tea you bought, it seems that a few people mention “licorice” as a BP RAISING ingredient (which I never heard of), so maybe that’s what happened.

            There doesn’t seem to be much on this website about licorice and BP, but you can do some research and see what you find. At the very least, it’s worth trying JUST hibiscus to see if you can get the effects that Dr. Gregor constantly cites.

            Interesting side note, I just realized I’ve been spelling Dr. GregEr’s name wrong all this time!

          • Wilma Laura Wiggins

            O.M.G. I didn’t realize it had licorice in it. Of course, I do not want that. My sister is a Traditional Chinese Medicine practitioner and she warned me against it a long time ago but I don’t remember the reason she gave. Thank you for pointing it out to me, I’ll be giving it away. And I will try the just hibiscus tea.

          • S Slavin

            Just looked at the Red Zinger I have (which I believe Dr Gregor mentions in his video which shows the antioxidant content of hibiscus) and it TOO has licorice. I think this is something people should be aware of.

            I don’t know what the amounts are, but if someone is drinking tea for the purpose of relaxing arteries and whatnot, they may as well avoid licorice.

          • Wilma Laura Wiggins

            Your post made me wonder. You don’t suppose that hibiscus contains licorice, do you?

          • S Slavin

            Nah, they just add a bunch of ingredients. The hibiscus tea I have is just hibiscus and green tea, nothing else. Not sure why other companies add licorice.

          • S Slavin

            Thought I replied to this:

            No, hibiscus itself does not contain licorice – tea companies just seem to add it as an added ingredient to alot of teas, but there are definitely hibiscus tea’s out there with nothing else as an ingredient. The one I’ve been trying is hibiscus and green tea ONLY.

          • Darryl

            If you have local markets catering to Hispanics or West indians, you’ll likely find whole dried hibiscus petals there, sold as flor de Jamaica, for a small fraction of the cost of bagged tea. The one I frequent sells these in bulk bins, by the pound. Traditionally its brewed with a lot of sugar, but I make a teapot full at bedtime from a palmful of petals, with much less of an alternative sweetener.

          • Wilma Laura Wiggins

            Thank you, Darryl. I doubt I could find such a market where I live but I might find it online.

          • rumicat

            If you like raspberry iced tea you could always make some raspberry zinger iced tea (all the celestial seasonaings zinger teas have hibiscus). I make it using half decaf regular tea and then add truvia (stevia + erythritol) and a little sugar. My daughter likes the tangerine zinger.
            I’ve been trying to improve my bp with hibiscus tea also, but I have a hard time getting in three to four cups a day. I figure if I drink any at all I’m going to get some extra antioxidants so why not?

          • Brux

            I think the good doctor talks about in other videos why he switched his tea drinking around because of the acidity of the hibiscus tea and what it does to your teeth over time. I wonder if there is a better way to get this hibiscus value … can people get capsules that bypass the mouth and teeth?

          • rumicat

            That’s true! Maybe best to rinse with water after drinking hibiscus tea.

          • Noe Marcial

            also flax seeds :)

          • S Slavin

            One other very long shot thing is since you mentioned you don’t eat animal foods, it might be worthwhile to check your B12 levels, which apparently is related to cardio health, see here: http://nutritionfacts.org/video/vitamin-b12-necessary-for-arterial-health/

            Lots of other videos on this site about B12, and my two cents is that the standard lab tests I believe measure B12 in a range of 200-1000, so if you have “250” it’s “normal”, but that’s a long way from “average” so you need to look at the number and not just the computer generated “normal”/”abnormal” output.

          • Wilma Laura Wiggins

            I take B12 (methylcobalamin) under the tongue a couple times a week. They didn’t test it but I am low on chloride (do I need that?). My sodium was 141 mmol/L on a scale of 135-145 (so high normal, I guess).

          • S Slavin

            The under tongue one probably has a decent dosage, so I imagine your levels are ok.

            Never heard of chloride being tested but I am no dr/nutritionist, just a recent NutritionFacts,org reader,

            I didn’t realize the sodium scale is 135-145, if it is, then 141 sounds totally fine…there are health food stores which will look over your blood work from a nutritional perspective, but you need take the advice with “with a grain of salt”, since they do have a financial interest in selling supplements.

          • Matthew Smith

            Prevention of exacerbations in patients with COPD and vitamin D deficiency through vitamin D supplementation (PRECOVID): a study protocol.

            http://www.ncbi.nlm.nih.gov/pubmed/26399451

            Serum magnesium and not vitamin D is associated with better QoL in COPD: A cross-sectional study.

            http://www.ncbi.nlm.nih.gov/pubmed/25892292

            Magnesium and D3 have been helpful to people with COPD.

            Perhaps this book would of interest.
            How Asthma is Finally Being Cured-Quickly, Simply, & Safely With Human Lung Remodeling Hormone by Jeff T. Bowles.

          • Wilma Laura Wiggins

            Mathew Smith, thank you for your links to try to help me. However, I have never had an exacerbation bad enough to be hospitalized or even go to the doctor. I follow the advice of Dr. McDougall who says taking vitamin D (which is actually a hormone, not a vitamin) can be harmful to your health. Over the course of 30+ years, I have always found Dr. McD to be correct and proven so by science in time. Although he advises against supplements in general except B12, I personally though the years have tried tons of supplements and the only one I keep taking and do not give up is NAC. It is a lifesaver for me and I recommend it to anyone who has a phlem issue. As to vitamin D, I read recently that the vast amount of it is stored in our fat and so testing our blood may be testing the wrong thing. If you think about how they say even people in Southern California and Hawaii have low vitamin D, I think it should raise a red flag. I do know also that you need cholesterol on your skin in order to be able to make it. It is possible that our propensity for daily showering with soap may contribute to the low vitamin D “problem” if such really exists. Our bodies continue to make vitamin D after exposure for 48 hours. I rely on the sun and in the winter I may not need it but I do go to tanning salons. This may sound extremely biased, but anytime mainstream doctors start promoting anything (vitamins), I get suspicious. Thanks again for your help.

          • Noe Marcial

            try with 0 sodium.. i sow it working.. i think one end up eating enough sodium anyway in a single piece of bread

          • Get hydrated

            Dehydration: Chronic dehydration also can be a cause of high blood pressure by making the body to hold onto sodium. This increases blood volume and thus blood pressure.

      • Noe Marcial

        that’s the part that i understand with salt .but does salt cause artery stiffness? or any other accumulative effect?

      • Wilma Laura Wiggins

        And yet they say to not drink coffee because it is a diarhectic and raises blood pressure?

  • Noe Marcial

    it is true that 1,5 olive a day give you all the sodium an average person need ?

    • Joseph Gonzales R.D.

      I don’t think so. It depends on the olives and how much they indeed contain. That’s the problem with pickled and fermented foods like kimchi.

      • Charzie

        Which is why it is so much more beneficial to make fermented foods yourself… it is not only extremely easy but you can control the sodium used and it isn’t always even necessary. (Maybe not technically, but, it does taste a lot better with some anyway!) Along with my switch to a WFPB diet, adding ferments has really done wonders for me, even my mental health…and apparently many others too. I have never felt so alive and joyful!

    • Brux

      I can’t stand olives for just that reason. I don’t know how people can eat them. And now they are a big gourmet item and Whole Foods has a whole “olive bar” like they are some kind of health food. People somehow have got it into their heads that anything with the word olive in it is health food.

  • Julie

    “Nearly all government appointed bodies and nutrition experts who have considered the evidence have recommended a reduction in salt intake from around an average consumption of 10-12 grams to 5-6 grams per day.” (1:12) YIKES, 6 grams of salt is over a TABLESPOON–isn’t that a “tad” too much?!?

    • Noe Marcial

      in the video appear that we as a human where use to eat 0.25 grams per day.. for me too 5 grams seems too much!

    • Joseph Gonzales R.D.

      I saw that too, but think it was just one commentary and not a decisive piece of evidence that recommends 5-6 grams. American Heart Association still recommending very low salt intakes. The American Heart Association still has national goals for health promotion and disease prevention, including its recommendation to reduce dietary sodium intake to <1500 mg/d. Dr. Greger's videos on salt in his awesome Doctor's Note explains this.

      • Brux

        I just got this from Googling “how much salt is a gram”

        Apparently from AuthorityNutrition. Com ….

        >> 1500 mg of sodium equals about 0.75 teaspoons or 3.75 grams of salt per day,
        >> while 2300 mg equals about one teaspoon and 6 grams of salt per day.
        >> Most people today are eating much more than that.
        >> The average intake of sodium is about 3400 mg, most of it coming from processed foods.
        >> The Salt Myth – How Much Sodium Should You Eat Per Day?
        >> authoritynutrition.com/how-much-sodium-per-day/

        WHAT???? Does this make any sense to anyone …
        that 1500mg is equal to 3.75 grams ????

        If 1500 mg of salt equals 0.75 or 3/4 of a teaspoon,
        then 500 mg salt would be 1/4 or 0.25 teaspoon.
        A full teaspoon of salt, according to this would be 2000 mg or 2 grams.

        This was at the top of what Google returned on searching “how much salt is a gram”

        I am flabberghasted … did somebody change math while I wasn’t look or did I miss something here? I realize they are roughly multiplying by 3 for 3 meals a day, but that is not even right.

        • largelytrue

          Well, first off, I don’t know everything about how “Authority” Nutrition has evolved in terms of staffing, but I don’t consider it to be a reputable, clear-eyed, or particularly knowledgeable authority on nutrition.

          Salt, NaCl, is about 40% Na by mass. So 1500mg of sodium would come from 1.5/.4=3.75 grams of salt. A full teaspoon of salt has about 2000-2300mg sodium in it depending on how the grains pack and moisture content, but its total dry mass is (2 to 2.3)/.4= 5 to 5.75 grams.

          You are just getting confused about the distinction between salt and sodium in your computations, I think.

          • Brux

            Thanks, good point. I was expecting a clear distinction when I asked how much SALT by weight is in a teaspoon. I was going to worry about sodium, yes 39.2% of salt by atomic weight, later. The recommendations I have heard about sodium intake are a teaspoon and a half max per day. I never get close to that, at least by adding salt to food. I don’t eat that much prepared food.

            These companies seem to want to hide everything they do and lie about it, just like Volkswagon, who knows what is in our food anymore.

        • Joseph Gonzales R.D.

          1500mg should equal 1.5 grams. I am not following those calculations either.

        • Johanna Martin

          I don’t know how much difference there is, but finely ground salt would be different than coarsely ground, as well….

          • Brux

            Yeah, that is probably true, but I just wanted to get an estimate.

            From what people are saying here the average person really has no idea if they have enough salt, too much salt or just enough.

            And one thing that bothers me is that for those with high-blood-pressure, can they be low in salt, but not able to really eat it because it would raise their BP, a kind of damned if you do and damned if you don’t position?

      • Julie

        Thanks, I thought 5-6 grams of salt sounded like too much. By eating 100% unprocessed whole foods it’s quite easy to get <1500 mg/d of sodium.

  • Leslie

    Does salt kill good gut bacteria? Maybe it alters proper gut bacteria? Does it weaken the macrobiome in our mouth? Salt is a preservative, right? This has me thinking that daily consumption of salt might be killing some good stuff in us. Maybe making our body’s innate abilities weaker?

    • Joseph Gonzales R.D.

      Salt (3% NaOCl) has been found to help kill oral bacteria, but I’m not sure about gut health. Perhaps it’s best to use salt as a vegetable washing agent or orally for gargling when we have a sore throat.

      • Leslie

        Yeah, but it seems that the salt would also be killing the beneficial bacteria as well, does it not?

      • Kal

        3% NaOCl is household bleach, not salt. Your referenced paper is about using bleach in root canals.

        • Joseph Gonzales R.D.

          Forgive me for leaving out important details I was editing the comment as you replied it should read more accurate now. Thanks for that HUGE catch!

    • Wilma Laura Wiggins

      How about chlorine in your water? Do you think that might kill some good stuff in us?

  • Joel Santos

    Are Dr. John Mcdougall’s recommendations with respect to salt wrong?

    • Joseph Gonzales R.D.

      What are his recommendations? He works with a strict population set so I am not sure exactly his thoughts.

  • mbglife

    People who reduce their salt intake dramatically should also know the symptoms of low sodium and always watch for symptoms. I get a lot of pushback whenever I mention this here, but I think it’s important for new people and those who develop symptoms to hear.

    I don’t usually add salt. Several times over the past few years I have gotten sick, can’t focus, weak and have developed campus and constant pain across my shoulder blades. My blood tests always show slightly low in sodium. So I add salt and within a day I start to feel better and in about 3-4 weeks my symptoms are all gone.

    This is where some commenters get upset and tell me to never take salt and get it all from food (celery, etc). Sorry, but everyone’s body is a little different and I have to intake some salt every day, either from one of the very few prepared foods I eat (like bottled pasta sauce or bakery bought whole wheat bread) or I have to add a very small amount. I mention this because I don’t want anyone to go through the months and repeated times of feeling horrible because they fear adding a small amount of salt to their diet. It was the lack of salt that was hurting me. I wonder how some people managed before salt was cultivated.

    Having said this, I don’t think people know visually or in measure how much salt is “small” and “too much”, just like most of my finds that think 60 grams of sugar in a drink isn’t much, they think 100 is too much. But really 5 grams with a meal should be the cutoff.

    Mark

    • Joseph Gonzales R.D.

      Keep in mind blood sodium levels are not indicative of dietary salt intake. Dr. Greger says “drinking too much water without replacing electrolytes on hot days in people unaccustomed to the heat can lead to dangerously low sodium levels, but that doesn’t mean we shouldn’t in general lower our sodium intake”

      • mbglife

        Thanks Joseph, but your reply makes me feel like you didn’t fully read my comment.

        • Joseph Gonzales R.D.

          Forgive me if you feel that way I did read your comment I was just pointing out that the blood tests that measure Na+ (sodium) are not indicative of dietary salt intake. I agree that everyone’s body is a bit different and total diet matters most so in general if you eat healthy and add a bit of salt it’s likely not going to put someone at risk, but like Dr. Greger mentions the science clearly states folks are consuming way too much and could benefit by reducing intake.

          • mbglife

            Well, I think my comments are in line with Dr Greger’s statement, as I indicate that in my comment that I still only intake a little salt. My point is that because of the “no added salt” admonition, some people, like me, cut out too much salt and I was unknowingly hurting myself and I suffered for months each time. And this happened a several times. So I believe we do need some salt and I think it’s reasonable for people cutting down on salt to also know the symptoms of low serum sodium so they don’t hurt themselves while trying to eat right. And to keep their salt at the right level.

            I don’t mean to be argumentative, but neither your comment that a little but if salt won’t put someone at risk; nor Dr Greger’s comment about “people consuming way to much salt” speaks to my point of going too low.

          • Wilma Laura Wiggins

            I might add something here that has sort of become a new mantra of mine. I think, when it comes to food, our bodies know better than our brains. Not to say we shouldn’t use our brains, but trying to regulate all the different nutrients available and the order of taking them, etc. (as in food combining) is just way beyond us. We could drive ourselves crazy trying to regulate it ourselves when the body just knows and handles everything with ease IF we use common sense and feed it mainly only healthy food. Not sure how this relates to salt but there it is.

          • Joseph Gonzales R.D.

            No worries you don’t sound argumentative I think we’re both just trying to understand this better. I guess I am curious to know how eating less salt hurt you? Again, forgive me as the last thing I try to do here is be argumentative or give false advice. I am only trying to help. The reason I replied was because serum sodium levels are not indicative of dietary salt intake. I know that sounds strange but apparently the body needs to tightly regulate serum sodium. The best available evidence we have suggests a limit at 1500 mg. So I guess I am missing the point of why it’s harmful to go too low? Please forgive my confusion.

          • mbglife

            Well I don’t know anything about how serum levels relate. And I dint think I drink too much water. But here’s what’s happened to me 4 times.
            – I don’t add salt to my diet,
            – In a few months I develop non-stop pain in my shoulders, and recurring muscle cramps around my body,
            – I feel lousy, like when my vit D got low,
            – I can’t think right, get confused, can’t focus,
            – Go to my doctor, blood tests show my serum sodium low,
            – I add salt slowly throughout the day, and a little each day,
            – By the end of the first day I feel slightly better, and better each day after. Shoulder pain goes on 2nd 3rd day.
            – Over time I slack if on adding salt because it’s not my hadn’t to do it. If I eat foods that have some salt I don’t add any. In time the problem repeats.
            – And as I mentioned, I only add a little. I’m not suggesting typical levels in the SAD. And again, I only posted this for over achievers like me. I feel part if why I kept having this problem was because if the admonition to not add salt. For me, what works is don’t add a lot of salt.

            And I’ve created a test for me: when everything tastes too salty to me I taste one of my tears. If it taste like there’s no salt, I’m too low.

          • Brux

            That’s very interesting … but why are you crying so much? ;-)
            I would never have though in todays world people would not be getting enough salt … sodium … whatever.

          • mbglife

            Tears of joy for having someone like Dr Greger provide such a great service. :D

            My doctor says he’s got about 1300 patients and he only has four of us that he has to tell to add salt. But in general he supports my vegan WFPB diet. He told me that if he could get even a tenth of his patients to have numbers close to mine he’d be a happy doctor. I thought that was a sad commentary on SAD.

  • Nick Presidente

    I’ve been tracking myself on cronometer, and I’m in the 9% but under 1500 mg? Some days sure but wow I’m finding it tough. Though cronometer is really really bad for adding in massive amounts to sodium on most of their foods, finding canned beans without salt isn’t easy on it, so you’re recipes are often stastically over salted but maybe not in reality.

    It along with Vitamin E and little potassium are the only things that aren’t perfect right now.
    I’d imagine real world sodium defiiciency is pretty damn rare.

    • S Slavin

      Can’t you just use “cooked beans” instead of canned beans? If it’s a good no salt canned bean then the nutrition should be basically the same as if you cooked it yourself, no?

      • Nick Presidente

        I’ll need to look again, I remember when I was looking there wasn’t a good set of choices for a few of the things. It isn’t limited to beans though, take Hummus. I’ve made it at home, salt is minimal, some restaurant/store bought stuff is a bit salty. You use their homemade or store bought and its insane amounts of sodium. Some of their breads are packed with transfat, some don’t.. there seems to be no reason to why.

        • S Slavin

          Well homemade hummus is just chickpeas, maybe some oil, and some negligible ingredients (like lemon juice and spices), so If you use a cup of chick peas,for example, why not just enter that as your ingredient?

          I never tried cronometer, but I have tried nutritiondata: http://nutritiondata.self.com/mynd/myrecipes/welcome?returnto=/mynd/myrecipes

          I’ve entered some smoothie recipes in there and they output a VERY detailed nutrition label, with minerals and vitamins broken down into fine detail. Might be worth a short depending on what your goals are.

    • Joseph Gonzales R.D.

      Rinsing your beans can help reduce the sodium from canned sources. It sounds like you’re part of the 0.6% that follow the recommend guidelines so a bit of salt in your canned beans shouldn’t be a problem. I would agree sodium deficiency is extremely rare.

    • mike

      For vitamin E check out sunflower seeds. They have way more Vitamin E per grams of fat than almonds. Something like 4 tablespoons of sunflower seed kernels should get you your vitamin E without sending your fat intake overboard like almonds.

      • Nick Presidente

        Ya, I was looking that up today. I’m still balancing out my omega 3/6 ratios, they seem to range anywhere from 3 to 5 : 1 on a day, I’d like better. Sunflower seeds are all 6 unfortunately, but I think I can make a small adjustment

    • Johanna Martin

      Nick Presidente, there are also “no salt” canned beans.

      • Nick Presidente

        ya, I get that. But chronometer doesn’t pop those up very often, its difficult to track foods, especially if you ever buy anything because it assumes a boat load of salt in it, even if you make sure it doesn’t.

        I know the video says salt is bad for us, and I get why. But isn’t this speaking to the SAD people the most? If the studies were done on someone who gets more than 100% of their potassium intake a day, would sodium have such harsh effects?
        Halving your potassium and tripling your salt is nasty, but a little less severe maybe wouldn’t be an issue.

  • Lily Romagnoli

    Not all salt is equal! I agree that consuming Morton iodized salt is one of the worst things someone could do for their health, however there are more and more holistic physicians who promote sea salt, especially Celtic and Himalayan non refined salt, as an excellent support for health and longevity. Dr. Brownstein is one of the pioneers in the studies of the sea salt benefits and published some excellent resources to back up the theory that the right type of salt can be an ally in the fight for wellbeing. http://www.amazon.com/Salt-Your-Way-Health-Edition/dp/B000R8ZTGK

    • David Johnson

      What is the objective (published in reputable journals) medical evidence for your statement:
      “consuming Morton iodized salt is one of the worst things someone could do for their health”?

      • Brux

        There’s a lot of that going around, apparently on all sides of every issue.

    • Joseph Gonzales R.D.

      I am not sure the evidence on these alternative salts. I do have more on himalayan salt. I do not think it’s all cracked-up to be what many folks claim. I mean sure it may have more minerals than other salts but here is how much Himalayan salt you’d need to meet mineral needs.

    • Tobias Brown

      Doubtful. This non-fancy salt can be one of your few sources of required sodium.

      • LR

        I take iodoral daily along with the celtic sea salt. The iodine is needed and the severely processed, bleached, readily available table salt does more harm than good for your thyroid and generally for the immune system

        • Tobias Brown

          I’m going from Dr Greger’s advice in a different video where he dissed those fancy salts and recommends using regular iodized table salt.

    • Brux

      When after years I finally ran out of salt in my regular small single salt shaker ( try saying that 10 times fast ) I thought I would try the fancy schmancy sea salt stuff. On the rare occasion when I might use salt I noticed it really does have a better taste, but I seriously doubt there is much difference between it and Morton salt. I just don’t buy Morton salt because I don’t see a small enough container of it for sale.

      The sea salt container is small, and a little more expensive, but I rarely use salt so it will last for years.

  • Bob

    It’s scandalous that such a gratuitously dangerous substance is allowed in the food supply. Even liberal ultra liberal European countries have not been able to ban it. I wonder what are the politics behind it?

    • Brux

      How come the vote down button doesn’t work ? ;-)

    • Johanna Martin

      You might say the same thing about some other things in the diet…. (I’m thinking animal proteins here….)

  • Will

    Interesting video, I did a 23nme genetic scan and it said that I was 7.4x times higher predisposed to hypertension and I have been on meds for it previously..but I’ve also noticed that cutting salt does indeed lower my BP …I’ve toyed with keeping avg. salt intakes and upping my potassium levels but the best results happen when I cut back on salt altogether…I wonder if this salt reduction explains the success that Kempner had with the ride diet.

    • S Slavin

      Wow didn’t know you can know something like that, 7.4x higher sounds so specific…I feel like knowing that would increase bp just because you’d be nervous about it!

      I believe it’s been mentioned that while genetics play a role, it doesn’t mean you are doomed to have high bp. What kind of readings do/did you have and what have you found to help? What about things like hibiscus tea and beets which (based on videos here) lower BP within hours by quite a few points – do those things work “7.4x” less since you’re predisposed, or do they have the same benefits?

      • Wilma Laura Wiggins

        Those things did not work for me. Eating greens did work but only for a short time each time I ate them. I guess that’s why Dr. Esselstyne (sp?) suggests you eat them 6 times a day.

        • S Slavin

          I assume this belongs in the other thread, but either way, I do remember hearing that it could be better to do small spurts of exercise (i.e. 10min 3x a day vs 30m 1x a day) to increase the time your body stays in the “beneficial” zone of these things.

          I can see that applying to food as well, in fact in Dr. Gregor’s antioxidant videos he always points out how you need to constantly be taking them in, and you can’t just take a bunch at once and walk away.

      • Will

        yes, genetics only play a small role but I try to to maintain a decent diet and exercise to help myself out…I use a lot of flaxseed and some hibiscus too. I can’t do the beet juice, doesn’t agree with me.

        • S Slavin

          I don’t like beet juice either but lately I use raw beets as a snack and they’re actually really good – healthy or not. If you chop them up into sticks, one medium beet makes enough sticks to keep you munching for a while. Beats the heck out of popcorn!

          Just don’t wear a white shirt..

    • thorn324

      Will, from what I’ve read of Kempner’s diet, it was indeed the paucity of sodium that made it so successful. In addition to the (unsalted) rice that his patients consumed every day, the only other components of the regimen were sweet fruits (i.e., no olives, avocados, peppers, etc.) and sugar. Vegetables were disallowed because even unsalted some of them contain sodium. From what I’ve read of the post-Kempner Rice Diet that was (but is no longer) run at Duke University, vegetables were allowed sooner in the diet. Btw, the all-potato diet (under various names) operates on the same principle as the rice diet; it seems to me that it would be even more effective given the generous amount of potassium found in potatoes.

  • Tobias Brown

    While on a 100% plant diet and in quite good physical shape, I had a high blood pressure scare earlier this year but I concluded it was not a problem. I use “added” salt only, added by me, and in moderate amounts only. Anyway. My doctor noticed elevated blood pressure on a couple of visits. One visit I noticed it was “normal.” As someone who prefers to stay away from doctors and has some disdain for the industry, it seems that I get a bit anxious at visits and my blood pressure reflects this. But I was concerned so I pulled out my blood testing machine and began monitoring it closely. I confirmed the problem, consistently above 120, pushing 140 oftentimes. Then, totally by accident, I learned that you are supposed to keep your arm elevated above your heart when taking readings. As well, you are supposed to wait a few minutes, calmly, before taking the reading. This resulted in consistent sub-120 reading, some approaching the levels Dr Greger cites as ideal, I believe below 115(?). So, do you think that both in doctors’ offices and at home that maybe we misread, over-read, our pressure levels?

    It’s interesting to look at Pam Popper’s contrasting reports (on her YouTube channel) concerning this issue.

    • S Slavin

      I looked into this recently and it seems that getting an ACCURATE reading is the exception, not the case.

      First off, lots of people get nervous in offices or even just by taking the BP, anywhere, which raises BP. Secondly, from the way I understand BP measuring to work, is that the cuff inflates to a certain pressure, then deflates slowly until it feels a beat, when it does, that’s the systolic (the 140 you’re talking about). So the 140 is the pressure of the CUFF, not your arteries, so if you put it on too loose, or too tight, that alone can affect the measurement.

      Then on top of all that, there’s the ACTUAL fluctuation in pressure caused by, as you mentioned, position of arm, whether you rested or not, whether your legs are crossed, etc. I believe it needs to be heart level, not above heart, the idea being that if the arm is below the heart, gravity pulls the blood and increases pressure, and if it’s above the heart, there is less blood going through the arm although I’d imagine pressure would be higher (although not measurable in the arm) since your heart probably needs to pump harder to get blood to the elevated arm.

      To get an accurate idea you’d need to be relaxed, not have done any exercise for half an hour before, make sure you didn’t recently eat anything known to increase BP like caffeine, and make sure the cuff is properly positioned.

      • Thea

        S Slavin: Thanks for this post. I saw it after I posted my comment. Your comment is very helpful.

      • Joseph Gonzales R.D.

        Great points! Also the fact is it takes 3 readings and if you are nervous all 3 times then how accurate is that?

        • S Slavin

          Recently I was anxious about BP so I spent a stupid amount of time (maybe half hour) taking a few readings (like 7 -8) and between changing positions, thoughts, and cuff position, I had every reading from good (12x/8x), to borderline (13x/8x), to stage 1 hypertension (14x,9x). And not in that order!

          It’s at that point I realized how ridiculous it was to take your BP when you’re nervous and aren’t sure if you’re positioning things correctly.

    • Thea

      Tobias: I can’t answer your question about whether your doctor’s readings were valid or not. I can say that I had an experience recently where the doctor’s office said I had high blood pressure. I hadn’t heard that before and decided not to worry about it. Then soon after two things happened: 1) someone here mentioned that the position our body is in can make a big difference in the pressure reading and 2) I had an unexpected need to go into doctor’s again for an unrelated reason and they took my pressure.

      So, the second time I went in, I made a point of making sure my body was in the position mentioned by someone else on this site. (I don’t remember all the details, but I think it was something like: Make sure your back is resting against something, both feet on the ground, and arm resting on a surface.) This time, just 2 months after the previous reading, they said my blood pressure was *really* good.

      So, I believe I can testify to the differences one can get just by changes in body position (though it is certainly possible that other factors affected the two different readings also), and that it is easy for even a doctor’s office to get wrong. And *if* that’s true, it really makes me wonder how accurate our measures of high blood pressure problems really are.

      • S Slavin

        What were the two readings? Readings can fluctuate by the minute so if they just take one random reading they wouldn’t be able to call it “high” bp. On your second visit something as simple as having waited longer (more relaxing time) or maybe waited less (less anxiety over waiting) could have made all the difference.

        The position of the cuff makes a massive difference as well, and I feel that there’s an astonishing inconsistency between how various people take the readings.

        • Thea

          S Slavin: Sorry I don’t remember the numbers. I’ve never been concerned about blood pressure before, so the numbers go in one ear and out the other.

      • Tobias Brown

        I will add one fact that is very concerning and which suggests that high blood pressure readings at the doctors office might be the norm… for everyone. The second sentence out of my doctors lips when she mentioned the “high blood pressure”, and I quote exactly, was “We have some very good medications today for high blood pressure.” Yeah, take a few deep breaths here! Relax. Breath deep. :) Pam Popper discusses what happens with those blood pressure medications. Not pretty. (I get so frustrated with our professional classes in so many domains today. Medicine. Banking. Etc. Etc.)

      • Tom Goff

        Yes, I think there is some real doubt about whether measurements are accurate. I’m not convinced that all busy doctors routinely take the time to use proper measurement techniques. There is an interesting article on this broad topic here:
        http://iv.iiarjournals.org/content/19/1/179.long

        In addition,Tobias may find it helpful to read the AHA 2004-05 scientific statement on blood pressure measurement:
        http://hyper.ahajournals.org/content/45/1/142.full

      • Darryl

        I never thought I’d lust after a medical device, but my new doctor just let me try out his little battery powered, wrist-cuff BP monitor. Now I can measure myself again and again and again…

        • Tobias Brown

          Would you dare mention the model?

        • Thea

          :-) You just made me laugh.

    • thorn324

      Miso *is* high in salt as are pickled foods, soy sauce, and some seaweeds used in Japanese cooking. As Walter Willett points out when discussing the search for an ideal diet (in his book _Eat, Drink, and Be Healthy,_), although the Japanese traditionally had low levels of things such as heart disease and cancer, they were particularly prone to strokes. Excess sodium!

  • Tikiri

    BMW industry? Dr Gregor’s tone is priceless. Just priceless! Thanks for the (informative) laugh.

  • Brux

    The food industry gets in this escalating war of … what they call flavor … which is using cheap salt and sugar to make us think our food is better than it really is. For years and years they keep raising the amounts of sugar and salt in the processed food, it’s no wonder people finally get sick … and for what reason?

    I never add salt to my food. I have had the same small salt shaker in my kitchen for years, and the same with sugar. Can I really be getting an overdose of these things from a regular diet that very rarely even includes any processed foods?

    The thing is I guess I don’t know how much salt is in my food. When I do go out and eat, mostly to have Chinese food – vegetarian, brown rice and vegetable, I ask for reduced salt or low salt. I don’t really know what I am getting or know if they are doing anything differently? Or I sometime have a veggie sandwich at Subway. Can that have excessive salt in it? It’s all produce and some bread?

    I try to keep away from places where I cannot tell exactly how much salt there is, or cannot see the ingredients, usually I keep as simple and unprocessed as possible. This whole situation with processed food and what is in it has be trying to avoid it as much as possible. I guess I am paying for eating the standard American diet for much of my younger life, but I thought we were supposed to be able to reverse this.

    I pretty much agree with the WFPB diet, but maybe the WFPB’ers need to come out with some real specific dietary suggestions that do not change from day to day, what to eat and how much of it instead of focusing on every single food and rating it and endlessly discussing these minor tweaks.

    • Joseph Gonzales R.D.

      I don’t think the guidelines change from day to day it’s just that Big Business loves to build controversy around the guidelines. The good doctor mentions how <1500 mg per day is still best to shoot for. You bring up a great point about dining out, as if we do it often there's no way to know how much sodium is added. And even more important perhaps the totality of the diet is most important? We all run into situations where we're hungry and not cooking ourselves so I try to be practical and not overly worry about a subway sandwich from time to time. I think you hit the nail on the head that processed foods are the worse. I actually think adding your own salt is better, and to the top of foods rather than "in" a dish because you'll taste more of and still use less.

      • Brux

        1500 grams … We talking salt or sodium, because when you mention sodium? What amount of “salt” by weight do you recommend. I don’t know anyone who sprinkles sodium in their eggs? ;-) The image I had was anything less than a teaspoon I don’t have to worry about. So since I never use salt from a shaker, I usually feel OK, but as we agree … you just never know.

  • Leanne

    What about BioSalt? Dr. Henry Gilbert, found that if ordinary table salt “had all the other salts of the body combined with it in correct physiological proportion, it would be a food; but when only one element is present [sodium chloride], the mineral balance of the body is completely upset, and so the body is poisoned.”

    • Joseph Gonzales R.D.

      Sounds neat! Is there any research on it that we could all learn from? Thanks for mentioning.

    • Brux

      What is he selling?

      • Moneybags

        BioSalt

    • Noe Marcial

      WOW how humanity has lived for millions of years without Biosalt?
      Health and healing Equal BIG business

  • David Colin

    What do you make of Dr. John McDougall’s questioning of the validity of dietary sodium reduction? See https://www.drmcdougall.com/misc/2008nl/aug/salt.htm

    • mbglife

      David, thanks for this. I respect Dr McDougall as much as I do Dr Greger. And this is in line with how horrible my over reduction of salt made me feel.

      • David Colin

        I’d like to know the truth, though. Diametrically opposing views.

        • Tom Goff

          You might want to look at the US National Evidence Library’s summary of the evidence then ……………….
          http://www.nel.gov/evidence.cfm?evidence_summary_id=250164
          Also the 2010 and 2015 US Dietary Guidelines Committee reports identified high sodium consumption as a health challenge.

          I don’t think Greger’s and McDougall’s positions are diametrically opposed. If I remember correctly, McDougall’s view is that diet (saturated fat, cholesterol, low fibre) and lifestyle (smoking and no exercise) are bigger problems than salt and should be the main focus. I think he accepts that lower sodium consumption would be helpful. The differences between Greger and McDougall, such as they are, seem to be more about emphasis than anything else.

  • Kal

    Will the body eventually learn to excrete potassium in sweat in place of sodium?
    I dont eat junk food or meat so my sodium intake is around 600 mg per diem unless I use the salt shaker, which I have to do when the weather is at least warm enough to sweat on runs.

  • S Slavin

    This is unrelated (hate doing this) but I see people are very active on the salt debate, is it possible Dr. Gregor or the staff can look at this semi related question I had on another video about coffee and BP?

    http://nutritionfacts.org/video/coffee-and-artery-function/#comment-2284217271

    • Joseph Gonzales R.D.

      Thanks for reminding me! Please click this link as Dr. Greger explains a lot about caffeine and artery function.

      It looks like from the study you referenced that caffeine seems to increase blood pressure, especially in those who already had a higher blood pressure. However, I am not sure that study accounts for all, as this one found the opposite effect showing systolic blood pressure was inversely associated with urinary excretions of caffeine and other caffeine metabolites. Hope that helps a bit.

      • S Slavin

        Thanks for the reply! While it sounds like the link (caffeine and artery function) is contradictory to the study, it isn’t necessarily since one measures FMD and one measures BP.

        The second link shows a lowering of BP but if I’m understanding the abstract correctly, it’s a very very small amount, and the subjects all seem to have normal BP. It’s possible any lowering effect was due to the inevitable increased urination that comes along with the caffeine intake.

        The study I posted (which was really just one of the first few Google results) tested the BP within 45 minutes, so before any diuretic effect would have come into play.

        So, so far, still confused :).

        • Johanna Martin

          I had occasion to have my blood pressure taken at a work health fair and it was normal. Then I had a cup of coffee and got to wondering if it affected my blood pressure so I asked the nurse if she would take it again. Wow! It was quite elevated–as I recall, about 20 points on the upper number…. I have confirmed this experience a few times since with the result that I think coffee is probably not so good for me.

          • S Slavin

            I’m afraid to do that! The anxiety of seeing an elevated number would probably further elevate it, so thanks for sharing!

            I think this is the difference between the study that worried me (which checked BP 45 minutes after caffeine), vs the ones that show benefits via either non BP tests, or long term BP tests.

            I believe that coffee and caffeine are not synonymous though, as Dr. Gregor mentions many times, there are things at play in coffee so any BP effects should be solely blamed on caffeine.

          • Johanna Martin

            Yes, I agree about caffeine. I seem to tolerate green tea just fine, but then it *does* have less caffeine….

          • Wilma Laura Wiggins

            Well I did the same thing (by myself at home) and found the opposite. My bp went down after the coffee.

          • S Slavin

            Wait I missed this comment, how long after having coffee did you check your BP? And what kind of coffee was it? (i.e. brewed, instant, decaf, cappuccino, etc?)

          • Wilma Laura Wiggins

            I drink regular medium roast coffee, brewed with filter. I took my pressure about 5 minutes into my first cup. And I have given up all coffee for a few days and it did not help my bp.

  • newjumpswing

    Aloha,

    Along with hypertension, why is no one talking about salt and stomach cancer? Here’s a ling=k to Pubmed that gives a great overview of the many health conditions affected by salt. Very important for people who think that since they don’t have hypertension they can eat salt with impunity.

    Much thanks Dr Greger for your work.

    http://www.ncbi.nlm.nih.gov/pubmed/20649083

    • Joseph Gonzales R.D.

      Thanks for posting that study! Dr. Greger has said “kimchi is likely why Korea has the highest stomach cancer rate in the world!” This meta-analysis mentions how salt and kimchi are associated with increase stomach cancer risk in Koreans. More videos on stomach cancer and stomach health are available.

      • newjumpswing

        Aloha,
        Your welcome. There are many people who have a false sense of indulgence in salt because they figure they don’t have HBP-WRONG!

  • Russell

    I add salt in order to get sufficient daily iodine, because I don’t like to get iodine from seaweeds given their high metal contents (cadmium, lead, arsenic, etc.). Does anyone know how much added salt (Morton, or otherwise) is needed to get the required minimums?

    • Joseph Gonzales R.D.

      Good point and perhaps that is one small advantage for using iodized salt, as I explain in this post: Should we take iodine supplements? Furthermore I don’t think all seaweeds are contaminated. Some have amazing benefits! I think each brand varies for iodine content I looked at a bottle and one serving (1/4 tsp) give 590mg of sodium but supplies 45% of daily iodine needs.

      • Russell

        Actually, there is some data suggesting that seaweeds are accumulating metals, but looking at the web today I found this article which also points towards high levels of radiation from Fukushima. Perhaps seaweeds from countries outside Japan would be better…

        http://www.enviroreporter.com/2012/04/japanese-seaweed-radiation-doubles/all/1/

        • Johanna Martin

          Doesn’t looking at the flow of water in the ocean make all seaweed suspect?

        • Joseph Gonzales R.D.

          This is great and many folks are asking about contaminated seaweed I am going to make a post about this soon but first please check out this video on radioactivity in certain foods.

        • Joseph Gonzales R.D.

          Also, help me out but sending more research or articles about this! Thanks Russell

          • Russell

            These guys appear to have done some pretty good metals testing in seaweeds recently.
            http://labs.naturalnews.com/heavy-metals-chart-Superfoods-Sea-Vegetables.html

            To get the full results, they require that you enter your email address. There are significant levels of lead, arsenic, cadmium, mercury, and aluminum in many samples. And all of their samples from a variety of different brands, including Nori, have lead. As you know, there is no safe level of lead exposure so speaking personally, I’m going to avoid all seaweeds for myself and my 9-year old.

            Here’s a good connection at Berkeley for radiation in seaweed. Their testing shows zero radiation (in 2013) in California seaweeds, but they don’t offer data on Japanese seaweeds. But I’ll bet they can refer you to someone with that information.
            http://www.naturespiritherbs.com/Seaweed%20and%20Radiation%20Testing.html

          • Joseph Gonzales R.D.

            THANKS!

  • Atlantisarch

    1/ then what about hyponatremia for endurance athletes ?
    2/ is salt guilty by itself or is it just an amplifier of toxic food effet on the body ?

    • Is sodium the guilty one or chlore ? : what about sodium bicarbonate effect on various accusation associated with salt ?

  • Matthew Smith

    Okay, here goes. I started taking vitamins to treat mental illness in March. I suddenly thought, hey, I haven’t had any Iodine in a while. I took a teaspoon of salt and swallowed it. Within 20 minutes I could no longer feel my heartbeat. I went for a long winter walk as I struggled with what I thought was a heart attack. I was still up and walking around after an hour. I still could not feel my heart beat even when I pressed on my throat or on my wrist. I called 911 and told them I thought I was having a heart attack. The ambulance came and took me to my local hospital. They showed me that I had a very normal heartbeat. I had an EKG that showed the same. I was in shock. I finally looked down at my shirt and realized I could see my heart beat in my belly. I started taking a multi vitamin with Iodine in it and have not felt my heartbeat since March, except when I lay down. This goes to show how little salt I have eaten. You recommend at this very site one half teaspoon of Idoized salt a day. This is more salt than I have ever eaten and I have never had low blood pressure. Most Americans, hearing that salt causes high blood pressure, have avoided iodized salt like the plague. I do not work for the salt industry. I do not think that salt is the cause of high blood pressure. Take Sodium bicarbonate for instance, baking soda. It is known to lower blood pressure. Sodium bicarbonate and sodium chloride: effects on blood pressure and electrolyte homeostasis in normal and hypertensive man. http://www.ncbi.nlm.nih.gov/pubmed/2168457 How could one form of Sodium lower blood pressure and another raise it? This study found that salt does not raise blood pressure. Maybe Chlorine is the main cause of high blood pressure. From Wikipedia about Ancel Keys: “Once in Copenhagen (1931), he would continue to study fish physiology and developed techniques for gill perfusion that provided evidence that fish regulated their sodium by controlling chloride excretion through their gills.” Everyday of my life since I had that Iodine has been a profound near death experience similar to what was as described in the movie Flatliners. When Dr. Condet discovered Iodine as the treatment for Goiter, he invented modern medicine, and Iodized salt was one of the cheapest and most effective health interventions ever created. When people heard Iodine treated goiter, they went crazy for it, and started using it until they were blue in the gills. Perhaps this is part of the French Paradox. I would like to know if those people could feel their heartbeat. Feeling or hearing your heartbeat is a problem of your thyroid. Ideally, doctors know you should not feel your heartbeat. Iodine might be the causal factor. Could you imagine your heart beat getting slowly louder everyday until you have a problem from an Iodine deficiency? I read on the internet about a woman who also after taking Iodine could not feel her heartbeat. There is a company, Infowars, that sells Nascent Iodine. The reviews of that product mimic my joy at Iodine. I personally think given what happened when I ate some MSM and the fact that Magnesium Sulfate is the front line drug of choice for high blood pressure, that a sulfur deficiency is more likely the cause of high blood pressure. Reducing salt intake has not been effective at treating the blood pressure crisis and has created a renewed problem with Iodine deficiency.

    • Fred

      Some people have the “ability” to mentally affect their own heart rate…I’ve had this issue at times when learning to meditate….or when taking my own blood pressure. I’d recommend that you don’t fixate on it…probably best to let physiological processes be controlled naturally. Might try a magnesium supplement?

  • Frank

    Interesting, but what about athletes? In the summer time, it’s not at all uncommon for me to go out running and come back looking like I’ve just gone swimming…

  • SHANE EKENAIKE

    is it the salt, or what you put the salt on? I love a salt but eat a plaint base diet.

  • Darryl

    Michael Alderman has disclosed work as an unpaid consultant for the Salt Institute, but the other 78 authors of the prospective studies (1, 2, 3, 4, 5, 6, 7) and reviews (8, 9) commonly cited by salt “skeptics” appear to lack affiliations or funding by food industries. Pharmaceutical industry support is fairly ubitquitous, at least among the American researchers. I don’t see food industry machinations, just an emerging story that salt effects more than just hypertension, and not always negatively, such that the the net effect is a J-shaped risk-curve. And per Thomas Kuhn, shifts in scientific consensus, particularly when some have invested much of their careers on some side of a debate, are always contentious.

    When I first encountered Dr. John McDougall’s Salt: The Scapegoat for the Western Diet, I thought McDougall was wisely “choosing his battles”, but now I think salt moderation is wise for all, salt elimination is wise for those with hypertension and unwise for many others, and we should pay more attention to the potassium story, where the evidence is unequivocal in favor of more.

  • 2abner

    Dr. Peter Landless, the director of the health department for a world-leading faith-based institution known for its wellness knowledge vouches for potassium salt as an alternate.
    Another physiology researcher known around the world for his lecturing activities, Dr. Walter Veith, mentions the benefits of mineral salt due to its complete micronutrient content & which has also been shown to even positively affect blood pressure in as little as 30 days.

  • Sidney

    Any opinion on the popular theory being floated around in the “bro” community these days that a little bit of salt water immediately upon waking up is good because it will cut back on stress the adrenals face for increasing bp upon waking?

  • 5ko

    How about if someone has very low blood pressure? they are safe to consume salt?

  • I’m still one of those sodium skeptics. I just want to see ONE case report about a vegan who was eating a whole food plant based diet, worked out regularly and had a normal BMI, suffering a cardiac/stroke event because of high blood pressure caused by adding salt to their food. Does anyone know of such a case report?

  • Joe

    But – Salt is more than just NaCl. There are substantial differences between unrefined sea salt and pure NaCl, which I don’t believe the bulk of the research individuates.

    I do agree with Dr Greger that this issue has been highly skewed by protectionist industries – but I also believe that if you are doing all cooking at home – using unrefined sea salt – that it would be difficult to consume too much sodium – especially if your diet contains no cured meats and cheeses, and plenty of potassium rich vegetables. The real villain is processed foods and their hidden quantities – because in home cooking, 4 or 5 grams of salt goes a very long way.

  • Carrie Deane

    I have been a fairly heavy salt user but but stay away from all processed and fried foods. I am not a vegan but I try to avoid or keep consumption of animal foods to minimum. I also eat lots of fruits and vegetables and so eat a mostly plant based diet. High blood pressure runs heavily in my family but I have yet to be plagued with any issues and my blood pressure last checked was 91 over 64. I don’t know if it makes any difference, but I never use table salt, only buying & using brands such as “Real Salt”. Oh, and I am 65 years old and very healthy! I also am not on any medications. Could it be that it is not the salt as much as what people are eating that has salt in it that is the real problem? It is interesting that most members of my family on both sides has high blood pressure, and they all eat the typical American diet. The only exceptions are me and my husband, whose diet is influenced by what I feed him (and don’t feed him!).

  • Tom Goff

    Another great video by Dr Greger. The 2010 and 2015 US Dietary Guidelines Advisory Committees also concluded that high sodium is a genuine health concern.
    However, and this is only nitpicking, I wish he would avoid phrases like “we were designed to eat” …. perhaps “we are adapted to eat”?

  • Daniel

    It is a wicked lie that salt is bad for us. First of all, there is a difference between processed table salt and unrefined salt. Also, all the foods that are salted are bad for you to begin with. Buy unrefined salt like celtic sea salt or himalayan pink salt. I urge everyone here to read the book “Salt Yout way to health” by David Brownstein below is a description of the book ( http://www.drbrownstein.com/Salt-Your-Way-to-Health-p/salt.htm)

    “This book will show you why salt is the most mistunderstood nutrient. See how adding the right kind of salt to your diet can help:

    Fatigue
    Adrenal Disorders
    Immune System Function
    Thyroid Disorders
    Headaches
    Cholesterol Levels
    Blood Pressure
    For years, we have heard the following: A low-salt diet is healthy. There is no difference between table salt and sea salt. Low-salt products are better for you. These are the myths of salt. Dr. Brownstein will present the research on salt that will change the way you look at this vital substance.
    All of these comments are believed to be true, both by physicians and lay people. Dr. Brownstein will show you what are the myths of salt and why adding the correct form of salt to your diet can markedly improve your health. Salt Your Way to Health, 2nd Edition will challenge each of the above statements and give you a healthier alternative to regular table salt.
    This book will show you:
    The Difference Between Unrefined and Refined Salt
    The Toxicity of Refined Salt
    The Mineral Content in Unrefined Salt
    The Relationship Between Salt Deficiency and Hormonal Imbalances
    Balance and Replenish Minerals” http://www.drbrownstein.com/Salt-Your-Way-to-Health-p/salt.htm

    • o99o

      Coincidentally, this Dr. Brownstein sells celtic sea salt on his website and a book about “salting your way to health”

      Some people are just born to be suckers.

  • Daniel

    Here is some more revealing information on the lie that salt is bad for us.

    https://www.youtube.com/watch?v=MHcehQBrzZw

  • Daniel

    Please read the book “Salt your way to health” by Dr. David Brownstein

    http://www.drbrownstein.com/Salt-Your-Way-to-Health-p/salt.htm

    • Brux

      Just tell us, who signs your paycheck, just so we know?

  • Surfer2u2015

    Dr. Greger, do these studies use white, refined salt (>98 percent purity), or grey, unrefined salt from the ocean (87 percent NaCl with 17 percent other minerals)? My understanding is that it’s the refined salt that causes the detrimental osmotic imbalances due to its high concentration, whereas the same is not the case when using unrefined salt from the ocean, which closely matches blood mineral composition. Can you please help illuminate on the topic of the type(s) of salt used in the studies? Thanks.

    • Brux

      People getting their “understandings” from videos by diet doctors or other selling products are problematic. If you have “white” refined table salt on one side of a membrane, osmosis says that a substance will move from an area of high concentration to an area of lower concentration. So, adding in some other things that will also move from an area of high concentration to an area of lower concentration will still occur. Is that correct Dr. G.?

  • Dee Davis

    About six months ago, I decided to hide the salt shaker. Soon thereafter, my blood pressure went down and I was able to eliminate medication I’d been taking for years. What a wonderful decision that was!

  • Heather Kennedy

    The studies cited in this video do not distinguish between toxic table salt (manufactured, highly processed) and Celtic Salt from reputable companies. Humans need the right combinations of mineral intake daily, including sodium. Would you please cite studies that indicate a lowering of blood pressure in those who switched from table salt to celtic salt? I have plenty of evidence-based cases in my midst. Frankly, when “anecdotal” health improvements occur in an individual, the “research” is quite stunning!

  • William Dwyer

    Question: Is it the sodium per se or the sodium chloride, which is what you get in ordinary table salt? I read (I don’t remember where) that Japanese scientists discovered that it’s really the chloride that’s the culprit in sodium chloride, not the sodium. If true, that would implicate so-called “lite” salt as well, which substitutes potassium chloride for sodium chloride.

  • Daniel

    To everyone here, i urge you not to restrict your salt intake, unless maybe you have heart or kidney failure. Do eliminate or reduce all the white flour, sugar, added oils, processed meats, fried foods, and other junk (They are still bad for you when they’re unsalted). Do reduce or eliminate regular table salt if you can. But do not eliminate salt from your diet. Salt is an essential nutrient, and you can have too little salt. Redmond’s salt, celtic sea salt, and himalayan pink salt are some good brands (No Brux, I don’t work for them or any sources that I recommend) For most people, it is simply idiotic advice to advise reducing or eliminatig salt. However, for some people, it is actually dangerous advice to recommend eliminating salt, especially for athletes and people who exercise heavily. What you should do is salt to taste. If you feel like you desire salt, you should have more, and if not, then you don’t need it for the moment.

  • Brux

    I am very curious about GMOs.

    I am just about the finish the new book by Steven Druker entitled “Altered Genes, Twisted Truth” about the genetic engineering industry and its lies, incompetence, lack or regulation, political interference with the FDA and USDA.

    One would think that this is a very important industry for vegetarians and vegans to know about, yet I see nothing about it. The book is very well documented, backed up with all kinds of facts and footnotes. It is written clearly and concisely and starts at the very beginning and follows through to the present day.

    These industries are working to pass legislation right now in Washington at the federal level to make it illegal to label GMO foods, meaning that we will not be able to know what foods have been genetically engineered and what foods haven’t. Just about everything is wrong about this industry and the lack regulation and corruption and intimidation of regulatory bodies.

    I would urge anyone, but especially vegetarians to read this book and inform yourself. And please, can the doctors comment or produce some videos on this important subject ?

  • S Slavin

    Just a note to everyone, whether you think salt is good or bad, there is NO question that there is an INSANE amount of sodium in our current food supply. There is no reason for somebody who wants to eat some canned beans in a wrap that they need to subject themselves to 80% DV sodium from the beans and another 15% DV from the wrap.

    By just removing those unnecessary salts from your diet you’re already down to normal salt levels that I’m sure everyone can agree on.

    • Joe Caner

      I always purchase the no added/low sodium options now. After weening myself off conventionally salted foods, they now tastes incredibly unpleasant and makes me feel terrible afterwards. It’s amazing how quickly one’s tastes auto-range to a more natural sodium intake, and you really don’t miss it providing you get adequate sodium which now a day’s is difficult to avoid. Gone are the days where salt would fetch its weight in gold. Now it’s a cheapest and most ubiquitous flavor enhancer.

  • Johan Wallström

    Do we seriously wanna claim that doctors intentionally want people sick in order to keep their jobs? I think that claim would require some pretty hard evidence…

  • Surfer2u2015

    Again, any distinction in the studies of refined versus unrefined salt? I am referring to salt from evaporated sea water that is UNREFINED; not “sea salt,” which is always refined (i.e., white, flowing, with minerals removed and the NaCl concentrated to >98 percent).

  • Sebastian Tristan

    My girlfriend and I started not using salt at all some 2 years ago. We mainly eat food & snacks we prepare ourselves at home. However, after a while, I realized that my libido decreased substantially and my physical shape also suffered (I train a lot and I am very active). I then tried to tweak things in my diet to see if something I ate (we eat very healthy, we follow most of Dr. Greger’s advice) or didn’t eat caused this. I tried really a lot of different options and spent a lot of time on this. Finally, by accident, I realized that following the days I ate food with salt (whether when we were on vacation and had to eat food cooked in restaurants or when we went to eat out more often than usually) my libido came back to normal. So, I started to add some salt in my food and things came back to normal. Additionally, it has also helped a lot with my training (before, there were days when I inexplicably couldn’t lift as hard, do as many pull-ups, run as fast. I simply “run out of fuel”). Therefore, I guess that, maybe like Iodine, Sodium is necessary but only in certain amounts. Too little or too much can be both bad. Just my 2 cents. =)

    P.S. Before adding salt to my diet again, I had checked and my blood pressure was low.

  • Surfer2u2015

    Again, did the studies control for refined versus unrefined salt??? I would really like to see a reply please…

    • Brux

      What I seem to hear you saying in this comment is, were the people in the study
      lacking in another nutrients or minerals? If you have a problem with sodium I
      don’t see why it would be necessary to get unknown unmeasured stuff in some
      concoction of sea salt, as opposed to just making sure that the subjects were not
      mineral deficient in general. Does that make sense?

      • Surfer2u2015

        How can you possibly interpret my question any other way? Your reply is irrelevant and does not answer my question. I did not ask about people lacking other nutrients. If I did, please show me, but I did not. I am asking, again, is the salt used in the cited studies refined or unrefined?

  • Surfer2u2015

    I’ll ask for a third and maybe final time: Are the studies cited using refined or unrefined salt?

  • Bravo, Dr. Greger!

  • Leonid Kalichkin

    http://www.webmd.com/heart-disease/heart-failure/news/20151228/reducing-salt-intake-might-harm-heart-failure-patients-study-claims

    That’s not a RCT, of course. But still it brings a doubt that sodium restriction should be advised for everyone without consideration for their health condition. We find salty foods tasty for a reason. It’s an evolutionary advantage, it is beneficial for our survival. The questions are: how much do we need and what influences our individual needs? I bet there is a J-shaped curve for salt consumption. You need to be in a sweet spot, no less, no more.

  • Carina Ekström

    I had the impression that most people get high blood pressure because of too much cholesterol in the diet. And that salt will then compound the problem. But if blood pressure is normal and I eat only plants, then why should salt intake be reduced? I thought salt, like for instance Himalayan salt, is a good source of much needed minerals? Salts and minerals that are otherwise hard to get becuse of depleted soils nowadays. Maybe ancient peoples had access to plants with better salt and other mineral content?

    • Thea

      Carina: Himalayan salt can be described slightly contaminated salt–it has trace amounts of various substances, some of which are good for you and some of which are not. Himalayan salt probably doesn’t hurt you more than any other kind of salt, but there’s no reason I’m aware of to believe that Himalayan salt is healthy or supplies needed nutrients. As for healthy people and salt, this NutritionFacts video addresses that question:
      http://nutritionfacts.org/video/salt-ok-if-blood-pressure-is-ok/

      • Carina Ekström

        Thanks for the response, Thea. But the video does not explain exactly what happens to the arteries with a salt intake that does not raise blood pressure too high. Bad things happen, apparently, but how and what would be interesting to know. Is there a link somewhere to the study that explains this?

  • Scott

    What about stocks in cooking or Himalayan pink salt?