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Choosing to Have a Normal Blood Pressure

For the first 90% of our evolution, humans ate diets containing less than a quarter teaspoon of salt a day. Why? Because we ate mostly plants. Since we went millions of years without salt shakers, our bodies evolved into salt-conserving machines, which served us well until we discovered salt could be used to preserve foods. Without refrigeration, this was a big boon to human civilization. Of course, this may have led to a general rise in blood pressure, but does that matter if the alternative is starving to death since all your food rotted away? But where does that leave us now, when we no longer have to live off pickles and jerky? We are genetically programmed to eat ten times less salt than we do now. Even many “low”-salt diets can be considered high-salt diets. That’s why it’s critical to understand what the concept of “normal” is when it comes to salt.

As I discuss in my video High Blood Pressure May Be a Choice, having a “normal” salt intake can lead to a “normal” blood pressure, which can help us to die from all the “normal” causes, like heart attacks and strokes.

Doctors used to be taught that a “normal” systolic blood pressure (the top number) is approximately 100 plus age. Babies start out with a blood pressure around 95 over 60, but then as we age that 95 can go to 120 by our 20s, then 140 in our 40s, and keep climbing as we age. (140 is the official cut-off above which one technically has high blood pressure.) That was considered normal, since everyone’s blood pressure creeps up as we get older. And if that’s normal, then heart attacks and strokes are normal too, since risk starts rising once we start getting above the 100 we had as a baby.

If blood pressures over 100 are associated with disease, maybe they should be considered abnormal. Were these elevated blood pressures caused by our abnormally high salt intake—ten times more than what our bodies were designed to handle? Maybe if we ate a natural amount of salt, our blood pressures would not go up with age and we’d be protected. Of course, to test that theory you’d have to find a population in modern times that doesn’t use salt, eat processed food, or go out to eat. For that, you’d have to go deep into the Amazon rainforest.

Meet the Yanomamo people, a no-salt culture with the lowest salt intake ever reported. That is, they have a totally normal-for-our-species salt intake. So, what happens to their blood pressure on a no- or low-salt diet as they age? They start out with a blood pressure of about 100 over 60 and end up with a blood pressure of about 100 over 60. Though theirs is described as a salt-deficient diet, that’s like saying they have a diet deficient in Twinkies. They’re the ones, it seems, who are eating truly normal salt intakes, which leads to truly normal blood pressures. Those in their 50s have the blood pressure of a 20-year-old. What was the percentage of the population tested with high blood pressure? Zero. However, elsewhere in Brazil, up to 38% of the population may be affected. The Yanomamos probably represent the ultimate human example of the importance of salt on blood pressure.

Of course, there could have been other factors. They didn’t drink alcohol, ate a high-fiber and plant-based diet, got lots of exercise, and had no obesity. There are a number of plant-based populations eating little salt who experience no rise of blood pressure with age, but how do we know what exactly is to blame? Ideally, we’d do an interventional trial. Imagine if we took people literally dying from out-of-control high blood pressure (so called malignant hypertension) where you go blind from bleeding into your eyes, your kidneys shut down, and your heart fails, and then we withhold from these patients blood pressure medications so their fate is certain death. Then, what if we put them on a Yanomamo level of salt intake—that is, a normal-for-the-human-species salt intake—and, if instead of dying, they walked away cured of their hypertension? That would pretty much seal the deal.

Enter Dr. Walter Kempner and his rice and fruit diet. Patients started with blood pressures of 210 over 140, which dropped down to 80 over 60. Amazing stuff, but how could he ethically withhold all modern blood pressure medications and treat with diet alone? This was back in the 1940s, and the drugs hadn’t been invented yet.

His diet wasn’t just extremely low salt, though; it was also strictly plant-based and extremely low in fat, protein, and calories. There is no doubt that Kempner’s rice diet achieved remarkable results, and Kempner is now remembered as the person who demonstrated, beyond any shadow of doubt, that high blood pressure can often be lowered by a low enough salt diet.

Forty years ago, it was acknowledged that the evidence is very good, if not conclusive, that a low enough reduction of salt in the diet would result in the prevention of essential hypertension (the rising of blood pressure as we age) and its disappearance as a major public health problem. It looks like we knew how to stop this four decades ago. During this time, how many people have died? Today, high blood pressure may kill 400,000 Americans every year—causing a thousand unnecessary deaths every day.

I have a whole series of videos on salt, including Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt, The Evidence That Salt Raises Blood PressureShaking the Salt Habit and Sodium & Autoimmune Disease: Rubbing Salt in the Wound

Canned foods are infamous for their sodium content, but there are no-salt varieties. Learn more with my video Canned Beans or Cooked Beans?. Cutting down on sodium is one of the ways we could be Improving on the Mediterranean Diet. Beyond heart health, reducing salt intake could also help our kidneys (How to Treat Kidney Stones with Diet) but if you cut down on salt, won’t everything taste like cardboard? See Changing Our Taste Buds.

For more on hypertension, see How to Prevent High Blood Pressure with DietHow to Treat High Blood Pressure with Diet, and How Not to Die from High Blood Pressure. What if you already eat healthfully and still can’t get your pressures down? Try adding hibiscus tea (Hibiscus Tea vs. Plant-Based Diets for Hypertension) and ground flaxseeds (Flax Seeds for Hypertension) to your diet, and, of course, make sure you’re exercising regularly (Longer Life Within Walking Distance).

Dr. Kempner and his rice diet are so fascinating they warrant an entire video series. Check out Kempner Rice Diet: Whipping Us Into Shape, Drugs and the Demise of the Rice Diet, Can Diabetic Retinopathy Be Reversed?, and Can Morbid Obesity Be Reversed Through Diet?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

131 responses to “Choosing to Have a Normal Blood Pressure

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    1. Himalayan salt is 99.9999% NaCl and 0.0001% iron. It’s literally just rusty salt. That’s why it’s pink. It’s not any healthier than white salt. It just looks fancier.

      1. Correct – Himalayan pink salt is NaCl just like any other sodium chloride (salt) – its false marketing as a “healthier” salt is total bunk. We need our sodium, which is why the Yanomami natives and other no-salt vegans (me, included) thrive on a no-salt diet because we’re getting enough essential sodium, in just about every plant food on earth. I wish Dr. Greger would research and tell us about the difference between Sodium (Na) and Salt (NaCl). Even he may be mixing up the two in error. I bet the Brazilian natives had plenty of sodium to allow them to thrive. Me, too. Be the Change… This recipe book, TO LIVE FOR contains over 450 delicious salt-free raw vegan recipes, more than any other.

    1. Arun, . . .what you have linked to is an article about a study. There is no bona fide link to the research itself. As well, if you read to the end of the article one finds this:
      “The link between mom avoiding meat during pregnancy and her child’s later risk of substance abuse is an intriguing but unproved idea, and in any case the study authors say pregnant women don’t have to be carnivores to modify any such risk from going meatless, since B12 is also found in supplements.”

      Before this subject would have any validity it would need numerous corroborating studies to show a preponderance of like information. A single article about an unlisted study seriously slim information.

  1. This really is incredible ie unbelievable.
    This “clinic” claims to have cured people of all sorts of terminal diseases. There is also a testimonial there from a lady called Michelle but in it she said that she – not her husband – was cured of Parkinsons.
    I suspect spam.

    1. TG: Yes, this is SPAM. We get this type of SPAM all the time. I delete them when I see them. I’m letting you know this because I think when I delete a post or mark it as spam, the downstream posts sadly get deleted too. I didn’t want you to think that anyone at NutritionFacts found your post to be a problem. I just want to get rid of dangerous SPAM like this when I see it.

  2. Sodium and chloride are essential for proper biochemical functions in the body and both are found in small amounts in plant based foods. However, is there a minimum amount of sodium we should be getting in a day just as there is a minimum for potassium, magnesium, and calcium? The RDA says 1,500mg salt/day as the minimum and some studies have reported that low sodium blood levels can be bad for health, however, there has much dispute about potential bias in these studies. I’m curious if we should be aiming for any daily minimum because it doesn’t seem like Dr. Greger has any recommendations on a minimum level?

    1. Regarding minimum salt intake per day:

      Here’s a quote from Harvard Medical School Nutrition department:
      Lower consumption — no more than 1,500 mg per day, about two-thirds of a teaspoon of salt — is recommended for middle-aged and older adults, African Americans, and people with high blood pressure. with no more than 2,300mgs/day for healthy individuals.

      There was no statement that a minimum RDA for salt was 1500 mgs/day. Here is the Harvard link:

      From PubMed research:
      “Thus, a minimum average requirement for adults can be estimated under conditions of maximal adaptation and without active sweating as no more than 5 mEq/day, which corresponds to 115 mg of sodium or approximately 300 mg of sodium chloride per day. In consideration of the wide variation of patterns of physical activity and climatic exposure, a safe minimum intake might be set at 500 mg/day. Such an intake is substantially exceeded by usual diets in the United States ” Here is the link:

      1. Thank you, RDG for the info. However, most of these articles fail to take into account where one live, and activity level.I live in the desert southwest, have to drink a lot to stay hydrated in summer. I feel awful when I run if I don’t get much salt.
        Frankly, I don’t think it’s as simple as very little sodium. Certainly diet and the persons weight matter also?

        1. That makes me think that just sweating a lot and drinking a lot of water is going to flush a lot of salt out of your system. Is that a good cure for those of us who have a really hard time getting the salt intake down where it should be? Of course, I don’t mean just sweating by going into hot room, I mean getting out there and doing a lot of jogging or whatever else helps to work up a good sweat as well is a good aerobic heartbeat for 20 minutes or so.

          1. Hi Chris,

            I am a volunteer for Dr. Greger. Thank you so much for your question.

            Exercise absolutely decreases blood pressure, but it’s not necessarily because of lost sweat. Sweat is primarily water, and very little sodium is lost in sweat to make a big different. While exercise is certainly beneficial for cardiovascular health, cutting down on salt intake is very important as well. Even aside from blood pressure, salt impairs the functioning of our arteries almost immediately after a meal.

            I hope this helps answer the question that you had.

    2. I actually just found this great resource and wanted to share with those of you with similar questions:

      Age AI
      Men 460-920 mg/day (20-40 mmol)
      Women 460-920 mg/day (20-40 mmol)
      Rationale: The AIs for adults were not reviewed in the 2017 update. As there are insufficient data from dose-response trials, an EAR could not be established, and thus a RDI could not be derived. An AI for adults for sodium was set at 460-920 mg/day (20-40 mmol/day) to ensure that basic requirements are met and to allow for adequate intakes of other nutrients. This AI may not apply to highly active individuals, such as endurance athletes or those undertaking highly physical work in hot conditions, who lose large amounts of sweat on a daily basis.”

    1. Foods like canned soup and frozen dinners have an alarming amount of sodium. I looked at one just the other day, and there it was right on the front, one dinner, one serving 1180 mg. sodium! Are they trying to kill us? Do they have a stake in the anti-hypertension pharma industry? And why are lower sodium foods MORE expensive than their higher sodium counter parts? I know this channel is against all animal products, but I looked at canned tuna. The lower sodium version costs 33% more. Just a few absurd observations.

  3. I’m 88, prediabetic and have kept diabetes at bay for the last four years, and one of those who eat a plant based diet, no processed food, no sugar, don’t eat out and for three years – NO salt. I ended up in the hospital due to my sodium level dropping so low as well as a subsequent Emergency room visit for the same reason. In my case, a little common sense meant adding a little salt daily. Haven’t seen any appreciable change in my blood pressure. Use good judgment, listen to your body and do what’s good for you.

    1. Every body is different. In my case the very low sodium intake makes no difference to my blood pressure. But especially in the summer, drinking plenty of water I still got dehydrated. Fortunately I realized what was happening and realized to add more sea salt back into my diet. Otherwise I would have ended in ER.

      Using the Yanomamo people as an example is misleading.
      The Yanomami are an indigenous tribe (also called Yanamamo, Yanomam, and Sanuma) made up of four subdivisions of Indians which live in the tropical rain forest of Southern Venezuela and Northern Brazil. They live in the rain forest which is an environment that lacks salt. Interestingly, they are genetically enabled to not get hypertension even though they have chronically high levels of RAS. However, they have low longevity.

      1. Keep eating your salt if it makes you happy. However, as for me, thanks to dr. Greger, I no longer have malignant hypertension since given up salt–completely.

      2. An drinking lots of water and no salt can result in hyponatremia. Athletes, in particular, need to take care when exercising in hot weather. It’s dangerous. And even mild hyponatremia is to be avoided.

    2. I started a plant-based diet a few years ago and was in excellent health. As the months went by on the plant-based diet I started to have life threatening problems with dehydration, heart irregularities, and neurological issues. After six months on the diet I found myself in the emergency room for the first time (of many visits to come). Eventually, I figured out that a strictly plant-based diet did not provide enough sodium for my body. I increased my sodium intake and a week later all of my health problems were gone. My blood pressure on the no-added-sodium plant-based (~300mg day) diet averaged 138/85, with added sodium (~1200mg day) it now averages 123/76. Not perfect, but considerably better. I now eat a plant based diet with added sodium and feel great. Age 47.

    3. Interestingly my neighbour went in for op but unbeknown to him (and hospital) his salt levels were dangerously low and he nearly died under the op. As you learnt, and I didn’t know, how important salt is in our diet. Everything in moderation!

      1. I posted this because even though I was a perfect example of literally adding NO salt that didn’t necessarily mean that was the best thing for me. My test results for sodium two weeks ago were still low but not below the recommended number. Everybody’s different so use some common sense and do what’s best for you. Worth the effort.

  4. Hi Ilona – Would you please provide a link to your information stating that the minimum rda for salt is 1500mgs/day. All information I’ve seen states that, for those with hypertension, the Maximum allowable NaCl per day goal is 1500mgs. If not heart disease or hypertension then one can go higher to roughly 2300mgs/day.
    The information I have seen is that the National Heart and Lung Institute feels that 500 mgs is the least perday but that people do just fine, also, at 115mgs perday depending on your particular situation (if in heat and perspiring a lot one may require a little bit more).

    One cup of kale contains 47 mgs salt in and of itself. A cup of broccoli, 30mgs. Bread, 90-230/slice.

    While I agree we do require salt for our biological processes, I’m thinking the 1500 mgs minimum/day you are stating is off the mark.

    Anyone else have good scientific links to the supposition that 1500mgs/day minimum is necessary for biological processes?

    1. I think that the 1500 mg/day figure comes from the US Institute of Medicine dietary reference intake tables There, 1500 mg/day is the AI (adequate intake) for adult males. Even then, in the footnotes, it is defined as an average (mean) not a minimum intake. You’d need to chase down the links to find the scientific papers on which this figure is based.

      I understand that the US National Academy is proposing to begin a review of sodium and potassium intakes about now.

      The World Health Organization has observed of sodium
      “Although the minimum intake level necessary for proper bodily function is not well defined, it is estimated to be as little as 200–500 mg/day (18, 27).”

      1. Dear TG,
        You seem really informed; I really appreciate the sources you’ve provided, thank you. Although despite so much information I feel like this debate is still so confusing and I’m starting to wonder if it has to do with the sodium industry lobbying and pull in research efforts. I feel like it’s really easy to find resources saying how dangerous a low sodium diet. Even on this forum there are people, supposedly, claiming that diets with no added sodium landed them in the E.R. So when Dr. Greger recommends a diet with 1,500mg/day of sodium or LESS- I’m inclined to think that this kind of diet has no added sodium (or very little) and a good body of research supports this number. However, how much less than 1,500mg/day is safe? Do you happen to know of any credible sources where they have solid evidence that a diet lower in sodium than 1,500mg is actually bad for health? Because when I looked into some of these studies they often did a poor job in recruitment and the low sodium groups may have had increased mortality because they were sick before the study started and that was why they ate such low sodium levels (and presumably fewer calories, too). I’m really curious what your thoughts are on this debate!

        1. Thank you. You are very kind.
          Unfortunately, I am not trained in any relevant area and my opinions are unlikely to be better than anybody else’s. One of the problems here, as elsewhere in health and nutrition issues, is the base rate versus the case rate conundrum, The science is based on studies of, ideally, large numbers of people and study findings are what happens in most people. For example, in the US most people (about 90% of adults and children) consume too much sodium. We don’t know what too little is.though However, we do kniow that the number of people consuming less than 1,000 mg/day is incredibly small,

          Yet we have a high number of people here saying they had dangerously low levels of sodium in their blood and attributing this to their low salt WFPB diet. There are also some studies that link low sodium consumption levels to increased mortality or rates of adverse events. Most of these studies tend to be conducted by people with a history of producing industry friendly studies.

          My take on this is that many if not most people come to this site and WFPB or vegetarian diets because they have health worries. Many will have pre-existing conditions and be on medications. Many medications and even health practices like consuming large amounts of water daily can cause dangerously low sodium levels, So can conditions like kidney failure, congestive heart failure, adrenal and thyroid problems. Even anorexia.

          1. Oops. That one got away before I had finished.

            My take on this is that it is virtually impossible to be sodium deficient on a no-salt WFPB diet. The WHO has suggested that a minimum of 500 mg/day might be necessary (it says 200-500 mg/day but let’s take the higher figure). If you look at the sodium content of vegetables and consider that most of us will be consuming at least a kilo (dry weight) of vegetables per day, we will easily exceed that 500 mg/day figure. It is not necessary to eat salt to obtain sodium (although the salt industry might prefer it otherwise). And if, like me, people regularly eat whole grain bread and enjoy bottled olives and canned mushrooms, tomato paste and occasionally tinned vegetatble, then the problem will the risk of too much sodium not too little. If you are concerned about your sodium intake levels, you can estimate these using the US National Nutrients Database (there may also be commercial calculators to help you do this but I prefer credible government sources)

            So, in summary, I think that studies showing an association between low salt consumption and mortality/morbidity tend to be from organisations and researchers with industry ties. Independent researchers and crediblle sources like WHO identify overconsumption not underconsumption of salt as a problem. I also suspect that, for individuals here reporting problems with low sodium levels, there are likely to be other factors beside diet in operation. For example, lexcessive sweating, high levels of exercise and water consumption which deplete sodium levels or common health conditions that also result in low blood sodium levels. It’s possible that some people may also have a genetic condition that requires higher levels of sodium intake but considering how rare salt has been in the human diet in our evolutionary history, I’d suspect that this would be unusual. My feeling therefore is that for most of us on a no-salt WFPB diet, without those particular factors I have discussed, excess sodium intake is still going to be the challenge if we eat sufficient calories.

          2. Nice mention of the adrenals. I am very familiar with adrenal gland exhaustion and the dietary recommendations which fit that condition. The science is fascinating. Luckily, it’s no longer a problem for me. I may research the archives on that topic. :)

    2. According to WHO,
      “Although the minimum
      intake level necessary for proper bodily function is not well defined, it is estimated
      to be as little as 200–500 mg/day (18, 27).”

      But the USDA’s RDA puts the upper limit at 2,300mg/day, not 1,500 which is their suggested minimum:
      “The Dietary Guidelines for Americans recommends limiting sodium to less than 2,300 mg a day.”

      The major health organizations recommend that we cut back on sodium:

      United States Department of Agriculture (USDA): 2300 mg.
      American Heart Association (AHA): 1500 mg (2).
      Academy of Nutrition and Dietetics (AND): 1500 to 2300 mg.
      American Diabetes Association (ADA): 1500 to 2300 mg.

      What is confusing is although there are all of these variations on the maximum amount per day there is little support for a minimum amount per day, and as we can see even on this discussion people talk about having sodium blood levels that were too low (ending up in the ER)– which I thought would be much less than common than it is. It seems like these stories end up on almost all of Dr. Greger’s sodium related videos.

      1. I hope I can help clear this up. I am a former dietetic student. It is my understanding that the guidelines were set quite high as to give people a reasonable goal. Unfortunately, because most Americans eat so much salt, asking them to suddenly consume only 500 mg or so would be too drastic of a stretch for most people. Therefore the Dietary Guidelines were set quite high.

        Second point, different conditions require more or less salt. Sweat rates also differ among individuals. Some people lose more salt through their sweat than others.

        Last but not least, I occasionally track my dietary intake over the course of the day to analyze my patterns. When I cook from scratch, I consume around 900 mg of salt per day. (I use a pinch in my cooking… :)

        How could one track it? One could buy a reputable textbook which lists the amount of sodium in all common foods… or use the Super Tracker (Choose my Plate) or perhaps use still another reputable source…. (USDA nutrient database).

        Oh, one last thing… our ancestors lived in hot climates. I am part Cherokee. Somehow, we will too… :) I hope that helps!

    1. Eat seaweed or take a supplement, either kelp or potassium iodide (which is what’s in salt in the US). You have to be careful if eating seaweed though as some kinds have too much iodine, and you have no idea how much iodine you are getting, either too much or too little. Hijiki has too much iodine and can also contain toxic amounts of inorganic arsenic. I usually take 150 mcg of potassium iodide per day.

      1. Ha, that’s kinda funny. Imagine going to a ball game, 80,000+ people. Tell them you can’t have salt, and if you’re low in iodine, “eat seaweed.” Yeah, that’ll go over well.

        1. I’m a vegan, so no dairy. Where did you get the idea there is significant iodine in strawberries or cranberries? I can find no evidence this is true and have seen estimates that roughly 100 grams of fruit provides ~ 4 mcg of iodine. Cf. Figure 52 in

          I’d rather be sure. The last thing I want to contend with is possible hypothyroidism, I eat a lot of goitrogenic foods, and I know that if I have sufficient iodine in my diet, that is not a concern.


        2. Hi GD! No worries, most of us are friendly:) Glad you posted your comment.

          Here’s another reputable link:

          Yes, seaweed and other sea vegetables are great sources of iodine. I double checked on the strawberries and cranberries. Iodine isn’t listed ……

          Of course, Dr. G’s videos and posts are valid sources of information. Very! Thanks for checking in :)

    2. Iodine is very low in a plant based diet unless you eat seaweed. I like kelp because you only need a sprinkle and that would minimize any pollutants from the ocean. I also eat a Brazil nut for selenium which your thyroid needs to process iodine.

  5. Angelica – Dr. Greger has done videos about iodine. Why don’t investigate this site for an answer to your question. I bet you’ll find something interesting.

  6. I am so glad to hear that systolic blood pressure above 100 should be considered abnormal. I’ve shared with friends and family that my blood pressure after adopting a whole-food plant-based diet dropped from 119/79 to high 90’s over low-60’s. The response I have received from some is that my blood pressure is too low and unhealthy. I hope eye-opening articles like this one can serve to educate many.

      1. Jerry Lewis –
        I challenge you to present evidence that high 90s over low 60s has any adverse health consequences. As far as I know, it’s perfectly fine.

        1. [I have to remove the links because it won’t post but you can google search easily]

          I need to clarify further. If you have hypertension to begin with then a high sodium intake will increase the chance of CHD. This is very obvious and well known and there is nothing to debate.

          However, if you have no hypertension to start then a low sodium intake will increase your risk of CHD.

          From thelancet – Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies

          “Compared with moderate sodium intake, high sodium intake is associated with an increased risk of cardiovascular events and death in hypertensive populations (no association in normotensive population), while the association of low sodium intake with increased risk of cardiovascular events and death is observed in those with or without hypertension. These data suggest that lowering sodium intake is best targeted at populations with hypertension who consume high sodium diets.”

          On top of this, you can have an electrolyte imbalance which can lead to other health issues including death. This is particularly important for people who exercise heavily and lose electrolytes through their sweat.

          From draxe electrolyte-imbalance

          “Electrolytes are certain nutrients (or chemicals) present in your body that have many important functions — from regulating your heartbeat to allowing your muscles to contract so you can move.

          The major electrolytes found within the body include calcium, magnesium, potassium, sodium, phosphate and chloride. Because these crucial nutrients help stimulate nerves throughout the body and balance fluid levels, an electrolyte imbalance can cause a variety of serious negative symptoms, including some that are potentially deadly.”

          1. Jerry. I wouldn’t take anything asserted by Axe to be axiomatically true. He is just another internet health entrepeneur. He is not a physician either – perhaps a chiropractor (from memory)so he is not necessarily wedded to evidence-based health practices.

            Yes, we need a certain amount of sodium (it makes up approx 40% of table salt) and this will vary according to age, size, climate, exertion level etc. However, if we want a good overview – and links to relevant scientific papers – then the eg WHO report on sodium is a good placed to start

            You quoted from a paper in the Lancet but didn’t provide a link. After all, it is always important to check if the authors have any links to the industry. Just like the cholesterol -denialist and saturated fat-denialist claims need to be checked but don’t get me started.

            For example, if it is the paper I am thinking of, it was produced by a team at or led from McMaster University that produced the recent PURE article that attempted to exonerate saturated fat. The salt paper in the Lancet, and specifically its methodolgy, was also criticised by a number of credible health authorities. Unfortunately, there seem to be certain groups at McMaster that have a history of publishing pspers that reach conclusions favourable to industry (dairy and salt). I perdsonally therefore tend to be wary of papers from that source that reach conclusions that are contrary to the cuurent evidence base and which can be seen as defending industry interests.

            1. TG, I just did a quick google search of the Lancet article and I I can find it easily as it is at the top.

              thelancet – Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies

              This is business as usual when something does not fit your biased agenda then you would play dumb.

              And in the same breath, you would diss DrAxe as not being a MD because he does not say things that fit your agenda. Of course at other times then you would say that MD are the worse one to give advice about nutrition. Dr Mercola is a MD and you diss him too just because he is a meat eater, although 70% of the times he talked about plant foods, 29% about the environment and 1% about what source of animal foods to eat. And he is nice enough to mention Dr G about hundreds of times and even invited Dr G to his site so that Dr G can promote his book.

              I don’t know about your knowledge because I don’t know you personally but from your postings with limited and biased knowledge, non MD DrAxe knows hundred times more than you do.

              You don’t even critique on the content of what they wrote which is very rich, but only concentrates on labeling and calling name. Sigh!

              You need to watch the following video to open your mind and be less angry.


              1. Jerry Lewis: I’m leaving this particular post you did in place, because TG has said that he wants to reply to your posts and he’s a very nice person with helpful responses the rest of us respect and learn from. However, if you keep calling people “angry” when their posts are calm and rational and in this case, even completely impersonal, then I will delete your/such posts. You have been warned.
                — part time, volunteer, lay moderator

              2. Sorry Jerry but once again, you do not know what you are talking about. There are multiple studies in the Lancet about salt for example.

                The real question is why do you make it difficult to fact check your claims by not providing links to articles which you say support them? And that particular study is the very one that has been roundly criticised for its poor methodology. See for example the Toronto Globe and Mail article I linked to in my previous post. The McMaster University team has a history of publishing industry-friendly studies.

                Also, Mercola is not an MD – this is something else you have just made up. He is a DO.

                Pointing out where you make false claims is not me being angry but this allegation is another example of where, when confronted by the facts which refute your assertions or place them in a fuller context, you try to change the topic by making personal attacks. You seldom seem to debate the evidence but descend to shooting the messenger.

                1. First of all, I already stated that I have problem posting the links, because after I posted, my post disappeared. Ask NF why. Secondly, I am not a paid shill and I have a job to do and therefore I usually already read some facts from some research institutions a long time ago and I didn’t save the link, and so when I come across a misleading statement, I cannot just post those facts without showing some scientific studies or people will accuse me of pulling out of my …, and so I have to google search quickly and it’s not perfect because I cannot find the best research in one minute of search. Thirdly, I called you angry person because one minute you can be courteous and conduct a civilized discussion, and the next minute you will throw insults and all kind of profiling, biases, accusations, etc. And fourth, here again, you judge people based on their title and call them “internet phenomena” whenever it suits you. Do you know that Campbell whom you revere like a demi God is not a doctor either? I don’t care whether Mercola or Axe or whoever is a doctor or a carpenter, not that carpenter cannot be smart but just used as an example, as long as they publish unbiased and rich contents. I bet that those 2 guys did more useful things to people health than some of your heroes, just because they are vegans. And fifth, there are so many people who got sick because of all these biased concept about fat and salt are bad stuff. Of course nobody says to gorge on those foods, but for most people, it is necessary to have some for their wellbeing. Only 30% of people can do well on a low fat, low salt, 100% vegan diet. I read on the MB almost daily, people who post that they feel sick or have no energy, or desire to eat. I know exactly what is the problem with their diet, but I don’t want to post any advice because I know that I will be trashed, and I don’t know those people personally and I can make it worse if they eat other foods the wrong way. But it is so unethical and sickening and cruel when people just throw advices at them like you have to eat WFPB, like they didn’t do and now they feel all guilty.

                  1. There are no problems with you posting links, Jerry. You do it all the time and your posts are still there. You can’t use that as an excuse for failing to back up your claims. If you think you are having technical difficulties, you can go to the help page and work with staff. Since I see so many of your posts, including with links, I’m not seeing a problem from this end.

                  2. Jerry. I don’t think that I have ever mentioned Campbell. However, I would point out that he has a doctorate in nutrition, biochemistry and bacteriology. These are evidence-based scientific disciplines. There is significant doubt about whether osteopathy, chiropractic, homeopathy, acupuncture, naturopathy etc can be regarded as scientific disciplines in the same way sinced they are founded on certain basic principles which are not subject to evidence-based verification.

                    I don’t think you are a shill. I think you are totally sincere and that you do what you do for the best of motives. However, I also think that you habitually make false claims and assertions and that it is necessary to present the facts that refute your claims. “Necessary” because otherwise people’s health could be damaged if they act on your statements in the belief that they are factual and/or represent the views of NF.

                    It is also worth pointing out that while i and others comment on the studies and sites you (occasionally) reference to support your claims, you never seem to address the evidence and arguments set out in the references that I and others offer. Instead, you ignore them and just repeat your claims in another post. You apear to argue by assertion not evidence.

                  3. Campbell has a PhD and is Professor Emeritus of Nutritional Biochemistry at Cornell University. Not only that but Campbell has many relevant publications and other credits of note. Lumping him together with Axe, a DC, and Mercola, a DO, is ridiculous. What original research have they ever done?

              1. If you are talking to me Jerry, I don’t eat fish. This is something else you have just made up.

                However, I have mentioned in other posts that many major nutrition and health reports/guidelines recommend several fish meals a week. This is not inconsistent wiith a WFPB diet and may be advisable for people eating an otherwise vegetarian diet who are unwilling to take B12, DHA/EPA, iodine, vitamin D etc supplements

    1. Keep in mind that blood pressure generally changes substantially in the course of a day. If you are not already, you might take it at various times to get an idea of the variation.

    1. Pickling salt is a salt that is used mainly for canning and manufacturing pickles. It is sodium chloride, as is table salt, but unlike most brands of table salt, it does not contain iodine or any anti caking products added.

  7. Studying biochemistry 25 years ago I learned that adding less than 1,5g of salt to your daily diet would lead to a heart attack. In nursing school 20 years ago it was down to 1g. Five years ago i visited the Gold Museum in Bogota Colombia and learned that the ancient indians would trade gold for salt one to one. Though they had a lot of gold i figured that they ate practically no salt, so I have done the same since plus followed a strict whole food plant based diet.
    I am very much alive. PB 110/70. But then again, I am not exactly a new born.

  8. This anti salt video is a little bit misleading. First of all, salt is needed for your electrolytes and energy, albeit not a lot. Secondly salt is not the main culprit of high blood pressure unless one eats a lot. Poor nutrition which leads to inflammation, is the main source of high blood pressure.

    And some claims by vegans that their BP is below 100 is just insane. At that level, you will be sick and you still have the risk of CHD if you have inflammation regardless of your blood pressure. And low blood pressure is linked to dementia and Alzheimer’s.

    1. Jerry, the article you linked doesn’t make the same claim that you do. If you have temporarily instances of low blood pressure such that you get dizzy or lightheaded, then, yes, that is associated with dementia. It doesn’t say anything about what level of BP is “low”.

    2. Your link does not support your claim that “low blood pressure is linked to dementia and Alzheimer’s.”, especially if you meant to imply low normal BP. The study was about severe drops in BP when people stood up, not about having low normal BP generally.

      ” People with severe drops in blood pressure after lying down were 40% more likely to develop dementia, than those without such severe falls in blood pressure.”

      “‘It’s well known that high blood pressure in mid-life can increase the risk of developing dementia, but now evidence is emerging to suggest that temporary blood pressure drops may also be associated with dementia.”

    3. Jerry, this article doesn’t support your claims. First of all, it wasn’t arguing causality, it was showing an association. It was mentioned that the drops in pressure and dizziness could very well be the result of blood vessel restriction in the first place. Which makes logical sense. Proper blood flow and healthy valves in one’s blood vessels minimizes blood pressure drops and dizziness. It’s a no brainer actually.

  9. Yet another article I get interested, only to find my hopes dashed. I have LOW blood pressure. I am an otherwise healthy 69 year old. My physical was last month, and my blood pressure 109/51. For YEARS she has been telling me to eat MORE salt to raise my blood pressure. She is also concerned because I am a vegetarian. The doctor is convinced something dire is about to happen, so she is sending me to tests, tests, tests. I have been poked with needles many times, had my urine taken, and had x-rays. So far I disappoint all her expectations of complete health. What about low blood pressure? What is causing it? is it something to worry about?

    1. Hypotension is the medical term for low blood pressure (less than 90/60). A diastolic under 60 is considered low, especially in seniors. Do the tests, have an echocardiogram, and maybe a stress test. If everything passes, at the very least, both you and your MD have done their do diligence, and you can put your mind to rest.

    2. Karl, everybody is different and there is no hard number for everyone. The numbers are just for guideline and so you feel that you are healthy then you are probably OK. But you also to understand the cause of your low blood pressure. Is it due to lacking some nutrients or heart valve issue other than just eating no salt?

    3. Karl,

      Let your physician sweat…. if your tests which I am assuming include an echo and other typical non-invasive imaging (US) are ok, along with your chemistries and ….. you’re not experiencing any of the symptoms of low blood pressure….fainting and experiencing any issues with quick movements (think getting up rapidly after sitting) or lack of energy as these tend to be the most common issue. You’re probably fine.

      Blood pressure is typically found in a range and is dependent on many factors. Focusing on the average may not be accurate or healthful for you.

      Dr. Alan Kadish moderator for Dr. Greger

  10. It is important to understand the physics of salt before we can talk about high blood pressure as a disease.

    So blood is a liquid and when you put salt in a liquid, you increase its density and then if you measure the blood pressure then of course it goes up. But high blood pressure is associated with CHD because usually high blood pressure is associated with clogging in the arteries, but when this BP is caused by higher blood density then it is not the same. Of course nobody denies that a blood pressure that is way too high will put pressure of the arteries wall and heart as well as causing stomach ulcer for instance. But certain level of BP is OK and healthy and eating some salt is also OK. For instance fermented vegetables and miso contain salt because you cannot ferment without salt. But miso and fermented vegetable salt are considered OK.

    Now the guys who eat potato chip are in poor health and have a high risk of CHD. Why? It is not really the salt in potato chip (although not good) but it is the inflammation caused by transfat and frying potato. So an association does not mean it is the cause.

    The same thing goes with the false cholesterol theory. Sure you don’t want a too high number but you don’t take statin drug because your cholesterol is above 200, or you eat no fat to keep your cholesterol below 120 or even 100. That is just insane. This fake cholesterol theory has caused so much health issues in the world.

    1. Jerry. Your claims about cholesterol are false. The evidence has been shown to you time and time agian but you still keep repeating this nonsense. Why?

      I can only assume that your opinions about salt are just as loopy since you are unable to post any credible scientific evidence to back them up. You also seem to fail to understand that diseases can have multiple risk factors (“causes”).

  11. Have Dr. Kempner’s findings ever been reproduced? I’ve seen him mentioned many times, but I don’t think I’ve ever seen that his findings have ever been verified. Thanks.

  12. Hi Michael, I adore you and your website. I am a pediatrician and actually a term baby starts out with a bp more in the range of 60-80 over palpable, as we say. Thought you should know. Cheers!

  13. I have bicarb soda everyday, one small teaspoon in a mug of water. Just wondering and thanks in advance, would this be too much sodium intake?

    1. rain,

      there is 629.3 mg of sodium (= 1.57 g of salt) in 2.3 g of bicarb soda (one small teaspoon).

      Hope it helps,

      Moderator Adam P.

  14. I would love to lower my bp.I am taking amolodipine and the side effects are making it difficult and painful to walk.My quality of life is going down,body,mind and spirit. Every time I try to get off the medication the pain goes away and then in a few days my bp goes up. I need help.

    1. If you are overweight, even a little, try to lose it. My husband, a big man, was only about 20 lbs. up. He didn’t look overweight. Had HBP since his 20’s. Lost the weight, BP became normal. Totally off drugs.
      Dr. Mosley, the British physician who wrote “The Fast Diet” relates that same thing happened to him.
      Btw, this means ‘dieting’ only 1-2 days a week, and it works.

    2. You can lower your BP to normal levels in 7 days, according to an English study, with a whole food plant based diet, mostly raw, including sprouts for lots of protein. 100% of subjects in the study went off their meds and normalized BP. We need our sodium (Na), which is why I believe the Yanomami natives and other no-salt vegans (me, included) thrive on a no-salt diet– because we’re getting enough essential sodium, found in just about every plant food on earth. I wish Dr. Greger would research and make more clear the distinction between Sodium (Na) and Salt (NaCl). In this article, I think he may be mixing up the two. I’ve been 99% NaCl free for almost 20 years and my BP is never higher than 110/70 and my skin looks 20 years younger because there is no NaCl to dehydrate the tissues, and I learned to season food with whole plant foods so my taste buds never miss salt. Be the Change… This recipe book, TO LIVE FOR contains over 450 delicious salt-free raw vegan recipes, more than any other.

      By the way, Himalayan pink salt is NaCl just like any other sodium chloride (salt) made pink by its trace iron content – its marketing as a “healthier” salt is totally false, yet they charge 3 times as much as a quality pink salt from say, Normandy. Himalayan salt is promoted like a drug-du-jour culture mentality, where taste rules with only perceived health benefit.

      1. By the way, you’ll lose about 1 lb. per day on a salt-free, oil free, whole food plant based diet, mostly raw, because water retention (edema) caused by the salt intake will melt off you quickly. After about 30 days, the fat will start to dissolve. Exercise will keep your tissues from sagging in the process. You were probably experiencing detox symptoms, but dont give up.

  15. Let me clarify what I am saying one more time. There is no doubt that you need to thrive for a low blood pressure through nutrition. You eat foods such as arugula and beet to clear the arteries, and you eat berries and kale, fish oil or algae oil that decrease inflammation and winter squash that is rich in potassium, etc. etc. But you don’t cut down all salt to just lower BP, albeit not eating too much salt then it’s not good anymore. It’s like drinking coffee is good for your health but too much caffeine is not good. We are not talking about people who eat processed foods or potato chip who are full of salt. We have come a long way from that kind of SAD diet and so there is no point to discuss.

    But what I don’t like about this video is that it portrays salt as the villain and you have to cut down on all salt to achieve low BP like low BP is a goal that you need to achieve at all cost like it is something magic. At no point that the video talked about eating certain foods to lower BP. You get what you get for BP from eating nutritious foods and certain amount of salt. Unless BP is too high then only then you have to cut down salt.

    Same with cholesterol but don’t get me started.

    1. Don’t get me started peeps!

      Let’s just finish it by again confirming to stay off the saturated fats (dairy, eggs & all meat), high cholesterol & salt diet and erm..all bone broths obviously.

      I won’t need to post dubious references from fake to substantiate above as its already common sense (but not too common to the taste buds of many of course).

    2. We need our sodium, which is why I believe the Yanomami natives and other no-salt vegans (me, included) thrive on a no-salt diet– because we’re getting enough essential sodium, found in just about every plant food on earth. I wish Dr. Greger would research and make more clear the distinction between Sodium (Na) and Salt (NaCl). Clearly, research indicates that NaCl is toxic to our bodies, and humans are not designed to use it beneficially. In Dr. G’s article, I think he may be mixing up the two. I’ve been 99% NaCl free for almost 20 years and my BP is never higher than 110/70 and my skin looks 20 years younger because there is no NaCl to dehydrate the tissues, and I learned to season food with whole plant foods so my taste buds never miss NaCl. Be the Change… This recipe book, TO LIVE FOR contains over 450 delicious salt-free raw vegan recipes, more than any other.

      By the way, Himalayan pink salt is NaCl just like any other sodium chloride (salt) made pink by its trace iron content – its marketing as a “healthier” salt is totally false, yet they charge 3 times as much as a quality pink salt from say, Normandy. Himalayan salt is promoted like a drug-du-jour culture mentality, where taste rules with only perceived health benefit. Be clear – salt (NaCl) is a crystalized Na, is a poison in this form. The element Na sodium is beneficial and essential.

  16. Be careful going salt free, I decided one day when I was incredibly fit to amp up my routine. I already ate very, very healthy, never eating out, never using pre packaged food and limiting my salt intake but one this disastrous morning I decided to completely eliminate salt from my diet. Since doctors said this was fine because the American diet was salt laden I went for it, joke was one me, as I did not eat a standard “American diet”. Several months in of a mainly vegetable diet I began havong terrible migraines and then in less then 3 months gained a staggering 25 pounds. This was shocking since I ate very clean and exercised nearly two hours daily. I told my bitch of a doctor and she attributed it to the holidays. I assured her I ate absolutely no sweets, fatty foods etc and she ignored me. My hair started falling out, I felt deathly tired. I was 21. Fast forward 1 year and a half my gynecologist ran my blood and I had developed hypothyroidism. It has ruined my life. I am now 27 and I will say to tailor everything to your own lifestyle. Salt is not your enemy. Unless you eat bad, I doubt you are eating 10 times the amount you should. Also, only use iodozed salt guys, there is not really any point otherwise.

    1. I’m sorry about your condition, it’s not the lack of salt it’s the lack of iopine. After being plant-based for a while a blood test showed that my TSH was up. I ate seaweed but not regularly and I didn’t use iodized salt. I started supplementing iodine and selenium and my TSH doubled. I had read that TSH goes up with supplementation because transporters are being made. I then doubled down on the iodine and at the next blood test TSH was in the normal range. This was over about a two year period. I became nervous about so much iodine and backed off but I haven’t had a blood test in a while. Now a have a sprinkle of Atlantic kelp and a Brazil nut daily.

  17. John. Not to my knowledge. He also refused to use controls. Consequently, his papers are not regarded as strong evidence.

    It was also an in-patient programme sometimes lasting months. It would be difficult and costly to undertake a trial to replicate Kempner’s approach. Who would fund it?
    Note also that fluids were apparently limited on this diet and this would be difficult to control/monitor outside the in-patient setting.

    McDougal is a great admirer of Kempner. You could visit his site to see why he (McD) thinks the approach is valid. Here is a 2014 paper which summarise the Kempner story (you could also look at the Wikipedia article on the rice diet) if you want some details.

  18. I just on TV an ad for a FDA drug that lowers blood pressure. Guess what it contains, nitric oxide.

    You can get nitric oxide just by eating beet and/or arugula. This is what Dr G should talk about, foods that can lower BP and not to avoid all salt. When you have high BP due to inflammation or clogging in the arteries, it will become very dangerous and BP measurement is one indication of such thing. But when BP goes up because you simply eat salt which increases the blood density then it is not dangerous and in fact, it is healthy and advisable to eat some salt for the electrolytes. Of course you should not eat too much salt and that is obvious and well known.

    Now the reverse is equally dangerous. If you have inflammation or arteries clogging all over the place and you simply keep the BP low by eating no salt, then you are just hiding the problem and you will get CHD despite having a low BP. This is no different than taking FDA drug which does not cure anything or fix the root cause but just hide the symptoms by blocking something in the body.

    Despite some people who keep calling DrAxe name, here is one article from him on what to eat to lower BP.

    Google for: draxe high-blood-pressure-diet

      1. Again, you prove yourself that you judge someone based on his/her degree or title, and not based on the merit of what a person said.

        And speaking of believing everything that are posted on the Internet, you may find a lot of “complimentary” articles about Dr G on the Internet by googling “Dr Greger bias cherry pick”.

        And about me not continuing the debate on a particular subject, there are 2 main reasons: 1) I don’t have all the free time in the world to continue to argue about a subject when the other person continues to insist on some wrong and very obsolete concepts, or just cherry pick some articles that fit his agenda or belief to argue his point, and 2) I am limited to the amount of posts that I can make everyday and I already made plenty to counter other people’s postings that are blatantly misleading. In fact this will be my last post for this weekend or I will run into trouble with the cops.

        1. No, Jerry. It is a matter of not wasting time on sites that exist to sell “health” products and services and which make claims contrary to the sceintific evidence. Also, I think it is fair comment to say that chiropracty etc are not appproaches that are fully committed to evidence-based practices. Of course, there are MDs who appear to believe in woo also. However, I would suggest that most MDs practice evidence-based medicine whereas most homeopaths etc appear not to deliver care that is solely based on rigorous scientific evidence.

          That is why I prefer to spend my time reading major scientific reports on nutrition and health, and articles from the professional literature, rather than websites and blogs. NF is the major exception and that is because its approach is firmly grounded in the science and is consistent with the analyses and conclusions found in those major reports.

          Plant Positive’s website was another exception because of its disciplined and uncompromising approach to the evidence. Unfortunately, it hasn’t been active for almost 5 years now. Nevertheless, its analyses remain timely and relevant. For example, he provides some incisive analysis and commentary about the claims of cholesterol “sceptics” like you. I would recommend that everybody watch his videos and follow up the articles and studies that he references eg

          Or just go to his website and type cholesterol in the search box

          If people want something more recent on cholesterol, I would suggest reviewing the April 2017 consensus statement by the European Atherosclerosis Society

  19. I cannot find one single mention or reference anywhere on this site to diabetes insipidus….more importantly, how salt recommendations apply to this condition. I do know that sometimes I feel really awful–like my electrolytes are out of whack—and some gatorade helps. Mostly I don’t pay any attention to my DI and think of it as just a nuisance, but I would like to know if my salt levels should be greater than or less than others.
    Also, my blood pressure has remained steady in the 98/62 ish range most of my adult life (not a typo) but I am concerned about some of Dr. Greger’s other linked articles on how salt relates to auto-immune issues. In other words, I don’t want to aggravate my auto-immune tendencies, but I also don’t want to screw up the sodium balance I need. (Right now I am eat little processed food, but do add salt our homemade food).

    1. Vegrunner66,

      First comment is to recognize that we are all sooooo different. Your attention to your condition is paramount to decreasing salt intake. It’s more important to maintain your electrolytes in as balanced a level as possible. If this included using some salt…so be it. Be safe and do some monitoring to get a handle on when and what levels of salt work for your system.

      Dr. Alan Kadish moderator for Dr. Greger

      1. Dr Kadish, I saw this after I left my post. Otherwise I would have commented here. But I just noted that my experience has been that if I do not add any salt at all, I always end up with painful symptoms and blood tests that show I’m low. So I use a tiny bit of salt a few times a week. Thank you for adding your professional perspective that that we should keep our electrolytes balanced. I don’t want people to go through what I did. All people need to do is be aware of symptoms, which are easy to correct.

        Mark G

  20. Interesting theory but maybe it was another factor that reduced blood pressure, like less processed sugar or more magnesium from the rice or more C from the citrus. In my own case… My blood pressure was always low when I was younger 90/50… when I reached 50s 120’s/70… after an auto accident 140+/80+ consistently the past few years… About six months ago, I started adding sea salt to my water (due to the 82-84 nutrients found in it… as opposed to 2 in processed salt)… I also started taking magnesium chloride, the powdered form in water … Literally within days my blood pressure went back to normal, ranges now from 95-110/55-65. It’s been that way for months. If the sea salt had anything to do with blood pressure, mine would still be skyhigh.

  21. We need our sodium, which is why I believe the Yanomami natives and other no-salt vegans (me, included) thrive on a no-salt diet– because we’re getting enough essential sodium, found in just about every plant food on earth. I wish Dr. Greger would research and make more clear the distinction between Sodium (Na) and Salt (NaCl). In this article, I think he may be mixing up the two. I’ve been 99% NaCl free for almost 20 years and my BP is never higher than 110/70 and my skin looks 20 years younger because there is no NaCl to dehydrate the tissues, and I learned to season food with whole plant foods so my taste buds never miss salt. Be the Change… This recipe book, TO LIVE FOR contains over 450 delicious salt-free raw vegan recipes, more than any other.

    By the way, Himalayan pink salt is NaCl just like any other sodium chloride (salt) made pink by its trace iron content – its marketing as a “healthier” salt is totally false, yet they charge 3 times as much as a quality pink salt from say, Normandy. Himalayan salt is promoted like a drug-du-jour culture mentality, where taste rules with only perceived health benefit.

  22. What about vegans with low sodium intake and exercise yet blood pressure is high. I have heard that auto-immune conditions raise blood pressure. So what to do about that?

    1. Thanks for your great question. Plant based diets have been shown to help high blood pressure and many autoimmune disease. I’m not sure which ones you are referring to specifically. But here are several videos Dr. Greger has made which may have more information for you.


  23. Hello,

    Can anybody help me understand why then Koreans have one of the biggest salt intake on earth but it doesn’t correlate with high cardiovascular diseases ?

    I don’t know what to think about this video pretending to be science-based and highlighting other clues as the deficience in potassium as a potential responsible factor for CAD and hypertension

    Also, what about the figure 1 in this research by O’Donnell et al. showing too low of a salt intake is also associated with increased cardiovascular disease ?

    Any help on that would be greatly appreciated

    Thanks :)

    1. The study, reporting an association between low salt consumption and mortality, is from the PURE project. Some of its authors, mainly from McMaster University in Canada, are noted salt sceptics eg
      Their views are not shared by the majority of the scientific community but a number of publications by this group can be found on the Salt Institute website..

      They also authored a later study also using data from the PURE project which came to similar conclusions. This was published in the Lancet in 2016.
      However, the methodology used by this group has been severely condemned by respected authorities eg

      Personally, I am always wary of studies originating from McMaster. They have a record of publishing papers, based solely on observational studies, which seem to exonerate saturated fat and salt from charges of having adverse health effects, contrary to the findings of most independent research. Dairy products are high in saturated fat and salt. McMaster University is described as a “partner” of the Canadian dairy industry. But perhaps I am too cynical.

      As for the Korean situation, my understanding is
      “It was found that there is a positive correlation between sodium intake and prevalence rates of coronary heart disease, while potassium intake has a negative correlation with prevalence rates of hypertension and stroke”

      i don’t really bother with YouTube videos by opinionated bloggers with no relevant expertise and unknown or dubious agendas. Anyone with an opinion or an axe to grind can upload a video to YouTube. They are not regarded as reliable or trustworthy sources of information. I prefer to rely on scientific reports by credible experts eg

  24. Mother was on a medication and her salt dropped so low she almost died. She couldn’t walk falling asleep in he middle of a conversation. Took months of dr’s visits to find and remedy this.

    I stopped adding salt to my food. I started feeling weak. Couldn’t even feel my pulse. Had my blood work done and salt and chloride were both low.

    But for me I exercise a lot, and drink plenty of beer. So I’m back to adding some salt to my food.

    This advice might work for people in a temporate climate and sedentary life style.

  25. First, I just want to note that I have been a strict vegan and a fan of this site for many years. It’s my number one favorite health site.

    I want to give my experience of eating no salt AND drinking 5 12-oz glasses of water a day. About 8 times over the past 5 years have ended up with low sodium levels and I feel horrible (like I have a flu), have horrible pain in my neck and shoulder blade area, and get muscle cramps. The first several times I went to the doctor and blood tests showed my sodium was low. I added just a few sprinkles of salt to a meal and within minutes my symptoms started to go away. It usually takes a few weeks for all the cramps to stop. I still eat almost no salt. But now, about once a week, I sprinkle just a little salt on one or two meals and that seems to keep this in check.

    To sum up. I’m not advocating adding salt to most meals. I’m just saying that if people start to get symptoms (and they are horrible), you might need to sprinkle a little salt on a meal. And a final note. My doctor says that getting too low on sodium doesn’t do any harm other than the uncomfortable symptoms. And when you get enough, then you’re fine with no damage done.

    Mark G

  26. Does anyone knows about Salicornia europaea?
    It’s an edible plant with 55,6% sodium chloride, but has been shown to have a protective effect on high salt intake-induced vascular dysfunction and hypertension (source:
    I wonder if this could be a safe substitute for salt in a healthy diet?
    Another study shows some health benefits when comparing diets with salicornia versus diets with purified salt (source:
    Maybe a study comparing a diet containing salicornia versus a salt free one, would give us more information and security.
    If anyone knows anything about this I would really appreciate if you shared some information.
    Thanks in advance!

  27. I’m baffled by my high blood pressure & guess it must be genetic? I eat almost no salt, have been vegetarian for 40+ years (vegan for 7), eat only whole foods, organic, rarely eat processed foods, don’t eat out at restaurants, buy salt free, etc…Am 65 & have had high BP for the past 2 years. Does anyone have any input? Thank you!

  28. Sophie,

    High blood pressure can occur from a myriad of causes.

    I’m assuming that you have had an ultrasound evaluation for blood flow and some blood chemistries done ? Since it’s only been 2 years the first question, after the tests….what’s different….this includes lifestyle, exposures to exercise, stress to ……. So see a physician and take the time for a deep dive history…..things change over time and with some detective work you can get answers.

    Keep up the great diet, but please check out what’s driving the b/p and don’t let it persist.

    Dr. Alan Kadish moderator for Dr. Greger

    1. Thank you so much for your reply. No I haven’t had an ultrasound done but will pursue that, thank you. No change in lifestyle. Aerobic exercise 1-2 hours a day plus Yoga. My best guess is the hot flashes that wake me up nightly don’t allow for the most restful sleep. Taking a boat-load of supplements to try & help the hot flashes, but not a whole lot of progress. Thank you again!

  29. Hello. Love your information. I’ve bought the book and the recipe book as well. One note: when you mention Dr. Greger’s speaking schedule you mention a place but not city or state. I live near San Francisco, California. Nearly all of his speaking engagements are East Coast. It would be great if you could mention at least a state.

  30. I was following Dr. Greger’s diet, but about a year later I had a compete blood count test that showed my blood sodium is somewhat low. I don’t have the exact figures with me — 131 is the number, but my doctor told me it ‘s not serious, but that I should eat more salt and drink less liquid. Does anyone here know anything about this?

  31. Hello Susan and thank you for your question,

    I am a family doctor with a private practice in lifestyle medicine and also a volunteer for this website. Your question is not possible to answer, unless I know a lot more about your other blood tests and also about your medical history.

    Having a low sodium level in your blood is called “hyponatremia.” Here is a link to an article about this by the Mayo Clinic:

    Anything less than 135 is considered low. It is doubtful whether eating more salt would raise your blood level of sodium at all. There is a very complex mechanism involved in regulating your sodium level.

    There are lots of possible causes of hyponatremia: certain drugs — especially diuretics, drinking excessive amounts of water, congestive heart failure, certain liver and kidney diseases, chronic severe vomiting or diarrhea, hypothyroidism, certain types of cancer which produce something called “ADH” (anti-diuretic hormone).

    Hyponatremia that develops quickly (“acute hyponatremia”) usually comes with symptoms such as headache, fatigue, nausea, and confusion. You most likely have “chronic hyponatremia”, which develops more slowly and may have no symptoms.

    I would recommend first getting your blood tests repeated, because lab error is one cause that I forgot to mention, above. If it’s still high, you might want to contact a specialist such as a nephrologist (kidney doctor) or endocrinologist. However, I doubt that eating too little salt has anything to do with this. And if you have high blood pressure, then restricting salt is very important for you.

    I hope this helps.
    Health Support Volunteer for

  32. So, I’ve been vegetarian for ~28 years. I’ve been vegan on and off during that time but made a re-commitment to veganism/whole foods, plant-based about 1 year ago. Nonetheless, I was still eating too much salt, sugar, and processed food. I noticed my BP was creeping up toward 130/85 — way too high for someone 44 and way too high for a vegan!! So, I started preparing VERY low sodium black beans, eating no-sodium rice dishes, and just plain ol’ fruits and vegetables. Within just a few days, my BP is down to 117/74!!! I’m too busy to season my food and I just hate the complexity of figuring it all out. I’m totally fine with rice cereal (I can’t eat whole grains :-( ), banana, gogis, flax seeds, and raisins for breakfast. Lunch is usually a salad with lots of fruit and veggie add-ins (apple, pear, pomegranate, raisins, tomato, mushroom, etc.). Dinner is usually plain white rice and more fruits and veggies (roasted broc, brussels, sweet potatoes with just cinnamon, corn, apple, etc). I snack on dried fruits, like blueberries, cherries, and dates and also nuts like cashews for snacks. I love eating WFPB! It’s truly a life-saver!!

  33. Hi,

    sorry for grammar or spelling mistakes – I am a 28-year-old from Austria. Ever since I have read How Not To Die my diet has changed completely and a chronic deseased healed thanks to a healthy vegan diet. Regarding my blood pressure however, I am a bit worried. Its around 80/50 – sometimes even lower, which here is considered as dangerously low and can also cause blindness. Do I have to be worried? Would more salt be good for me? I already do 15-20min Sports on weekdays + 30mins walking and more on weekends. Generally, I feel great, but on some days (often depending on temperature and weather) I feel quite weak and dizzy. Is salt my solution (I already cook with a bit less than one tablespoon a day)? Or doesn’t it really matter how low my bloodpressure is?
    Thanks in advance

  34. Your blood pressure is low but the fact that you’re becoming weak and dizzy is a sign that you need to see a doctor to make sure there is nothing wrong. I suggest you appoint with a doctor that is familiar with Dr. Greger’s, Ornish, Esselstyn’s work, otherwise they might try to get you to start eating animal products. And don’t forget, all these docs are proponents of UNPROCESSED vegan diets, not any vegan diet.

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