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Who’s Right in the Salt Debate?

For decades, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption contributes to death, with one camp calling it a “public health hazard that requires vigorous attack” and another claiming the risks of dietary salt excess are exaggerated, even to the point of calling sodium reduction “the largest delusion in the history of preventive medicine.” The other side calls this denialism ethically irresponsible, especially when millions of lives are at stake every year.

To describe two sides of the debate may be falling into the trap of false equivalency, though. As the superhero-sounding “World Hypertension League” points out, there is strong scientific consensus that reducing salt saves lives, and—like the climate change debate—most authorities are on one side. On the other? Only the affected industry, their paid consultants, and a few dissenting scientists.

As I discuss in Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt, nearly all government appointed bodies and nutrition experts who have considered the evidence have recommended we collectively cut our salt intake about in half—a reduction described as extreme by those defending the industry. After all, just a small fraction of Americans actually get their sodium intake that low. Therefore, the salt skeptics say, the human experience for very low levels of sodium consumption is “extremely sparse.”

Extremely sparse? The reality is the exact opposite. The human experience is living for millions of years without Cheetos or a salt shaker in sight. We evolved to be salt-conserving machines, and when we’re plunked down into snack food and KFC country, we develop high blood pressure. But in the few remaining populations that don’t eat salt and only consume the small amounts of sodium found in natural foods like we had for millions of years, our leading killer risk factor, hypertension, is practically non-existent. When you take people with out-of-control hypertension and bring them back down to the sodium levels we were designed to eat, the ravages of the disease can even be reversed (see my video Drugs & the Demise of the Rice Diet). So, why is there still a debate?                    

If salt hidden in food kills millions of people around the world, why are efforts to cut dietary salt being met with such fierce resistance? Salt is big business for the processed food and meat industry. So, according to the head of the World Health Organization’s Collaborating Center on Nutrition, we get the familiar story. Just like the tobacco industry spent decades trying to manufacture doubt and confuse the public, the salt industry does the same, but the controversy is fake. The evidence for salt reduction is clear and consistent. Most of the “contradictory research” comes from scientists linked to the salt industry. However, it takes skill to spot the subterfuge because the industry is smart enough to stay behind the scenes, covertly paying for studies designed to downplay the risks. All they have to do is manufacture just enough doubt to keep the so-called controversy alive.

The likes of the World Hypertension League have been described as a “mere pop-gun against the weapons-grade firepower of salt-encrusted industries” who look disdainfully at the “do-gooder health associations…who erect roadblocks on the path to profits.” Lest we forget, notes an editorial in the Journal of the Canadian Medical Association, high blood pressure is big business for the drug industry, too, whose blood pressure billions might be threatened should we cut back on salt. If we went sodium-free and eliminated the scourge of hypertension, not only would Big Pharma suffer, what about doctors? The number-one diagnosis adults see doctors with is high blood pressure, at nearly 40 million doctor visits a year, so maybe even the BMW industry might be benefiting from keeping the salt debate alive.

For another in-depth video on the so-called sodium controversy, see High Blood Pressure May Be a Choice.

I discuss hypertension in How to Prevent High Blood Pressure with Diet and How to Treat High Blood Pressure with Diet. But 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 (Flaxseeds for Hypertension) to your diet, and make sure you’re exercising regularly (Longer Life Within Walking Distance).

If you cut down on salt, won’t everything taste like cardboard? Your taste buds shift remarkably quickly, as I cover in Changing Our Taste Buds.

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

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.

184 responses to “Who’s Right in the Salt Debate?

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  1. So true Dr. Gregor. What’s really compelling for me is that babies given sugar want more sugar but babies given salt are either indifferent or repelled. High salt diets are something that is taught. I recommend the book “sugar fat salt” to see some of the unconscionable decisions by the food industry to put profit above health and compassion.

      1. Not quite true Nancy. Salt and sugar are parts of the SAD / processed food diet? Why? Because it makes foods taste better. And why they need to make the food taste better? It’s because of the low fat / saturated fat / cholesterol TAT theories that went on for the last 70 years and won’t go away for another century if ever.

        If one eats a meal with some fat then there is no need for salt and sugar for flavor.

        I am not sure if vegans necessarily eat low salt and low sugar, so don’t just zoom onto the SAD diet alone.

        1. Jerry – what’s a “TAT” theory? Feels like you’re in the camp that says low fat diets are a problem. Just jumping ahead here, but if your evidence for that is the fact Americans have been getting sicker since Ancel Keys et. al., you need to consider that Americans also, as a group, have never eaten a low fat diet. Folks go to Pritikin, and they get better. Folks eating fried chicken and no-fat cupcakes, well, that’s not the no-fat cupcakes’ fault…

            1. On the contrary, all he ever does is disagree and state his personal opinion. This is a science based web site where a lot of work goes into educating people for their best health, and he is an obnoxious egotistical know-it-all and an annoying distraction from any intelligent discourse.

                1. This claim is the usual misrepresentation of the research by cranks like the ludicrously self-styled authoritynutrition crowd.

                  Observational studies such as these referenced in your post are notoriously subject to confounding by uncontrolled variables like the choice of replacement nutrients. They do not prove anything and they are in fact contradicted by results from stronger forms of evidence like experimental studies.

                  Dr Greger has done videos on this topic eg

                  And a panel of expert scientists reviewed ALL the evidence on fats and cardiovascular disease, not just a few cherry-picked observational studies

            2. @Blue Moon- The remark was rude. It was also completely warranted. Jerry has been nothing but disrespectful, trouble, and undeniably stupid since he started posting in these forums. There have been dozens of complaints against him per week

          1. TAT is the ID used by TG and it fits him to a T.

            Top Definition
            Tat Noun. 1. Rubbish, junk. Abb. of tatty.

            Used to refer to the kind of junk sold by crafty Cockneys to unsuspecting tourists in central London.
            E.g. “You can’t wear that old cardigan, it’s tat.” {Informal}
            #rubbish #crap #junk #useless #cheap #crappy #naff

            Americans eat plenty of the wrong fats, which is TransFat. People who eat processed foods get a load of transfat and this is expoected. Unfortunately, a lot of health concious people including vegans, also eat a truckload of transfat because they eat vegetable oil that is damaged due to heat or rancidity.

            Have they eaten the right kind of fat such as saturated fat then it would not be a problem.

        2. Jerry

          Most foods naturally contain fats,sugar and sodium in varying quantities eg carrots

          Adding human-manufactured isolated and concentrated fats, refined sugars and salt to food is another matter. For most of our evolutionary history these weren’t available so they are clearly not a necessity. As for flavour, herbs and spices can offer this and a range of health benefits to boot. Isolated manufactured fats, sugars and salts may offer flavour but they often come with serious downsides too.

          And yes, we know all about the crackpot theories regarding dietary saturated fat blood cholesterol that you subscribe to. However, people here are too educated about nutrition and health to be taken in by that nonsense. Give it a rest. You are like a broken record.

    1. Ah, but that’s the good thing about salt. When we need it we crave it. Unlike sugar which is addictive.

      And … too little salt is more dangerous to health than too much!

      We need salt. Our brains and everything else thrive on it. It’s what our synapses communicate over.

    1. Some food labels only state the sodium content and not the salt content . Your salt shaker at home contains 40 % sodium and 60 % chloride plus is or should be iodized to give you a shot of iodine . Food manufactures don’t use iodized salt , so home cooking is the best .

  2. “not only would Big Pharma suffer, what about doctors? The number-one diagnosis adults see doctors with is high blood pressure,”
    It would defiantly put a dent in the extra boat payment.. As some MD’s espouse… Preventative medicine kills repeat business..
    To reduce my salt intake, I measure out 1000 to 1500 mg of salt in a saucer and that’s all I use for the day.. Many days I don’t even use that much.. After a while I think you become salt sensitive and don’t crave it as much… YMMV.. works for me…

    1. Mitch,

      You are exactly right. Cut down on salt and after a while you don’t even miss it. As a matter of fact, I don’t even think about salt anymore. I used to put salt and butter on my baked potato, but now, I just eat my baked potato plain and it tastes good even without the salt and butter.

        1. That’s right, Rozamund! everyone keeps talking about salsa… I went to the store and I cringed when I saw the sky-high amount of salt! No thanks! Will make it next summer when tomatoes are in season!

        1. Don’t be ridiculous Jerry.

          I eat potato all the time without butter. It tastes great with eg vinegar, pepper, turmeric, other spices

          Why do you come up with this stuff? Most people here have eaten potato without butter and know that your claim is false.

          And yes people in modern Ireland probably do eat potato with butter. That would partly explain why the modern Irish Republic had extremely high heart disease mortality rates

          However, I think McDougall was talking about poor people in the 18th and 19th centuries who subsisted on largely potato diets. They couldn’t afford butter – that was rich people’s food.

            1. Yeah, Jerry.they consumed a lot of milk. But was that healthy? According to recent research from Harvard (Buster will be familiar with this!)

              “When dairy fat was replaced with the same number of calories from vegetable fat or polyunsaturated fat, the risk of cardiovascular disease dropped by 10% and 24%, respectively. Furthermore, replacing the same number of calories from dairy fat with healthful carbohydrates from whole grains was associated with a 28% lower risk of cardiovascular disease.”

              1. If you look at the countries that consume milk the most and their longevity, it’s a mixed bag and you cannot say that milk is harmful.


                And then you dance around and twist your arguments to fit with your agenda. First you said that Irish drinks more milk today and have shorter life, Then I points out that it is the opposite that Irish drank more milk in the past and had shorter life than today. And then you change your tune and say it’s because Irish drank milk in the past that they were not healthy. Make up your mind, used car salesman.

                I think that the right kind of milk with CLA is beneficial but it depends on what kind of milk people drink and what else do they eat.

                Most milk sold in the U.S. is junk because it is heavily processed because of the low fat crap and because they are heated to homogenize to make the milk look nice and therefore destroying all nutrients.

                1. The last time I checked, Jerry , both butter and milk were classed as dairy foods.

                  The point is that the fact that the Irish then and now consumed lots of dairy does not prove that consuming dairy must be healthy.

                  Nor does the fact that people in many rich countries consume lots of dairy and have long life expectancies prove that consuming dairy is healthy. If it were, you would expect – using your absurdly simplistic logic – that people in Kazakhstan, Albania and Romania would enjoy longer life expectancies than people in eg Japan, Hong Kong and Singapore who consume so little dairy that they don’t even appear on your list.

                  And heat treatment of milk has nothing to do with low fat or cosmetic appearance. It’s to kill the pathogens that abound in cow’s milk. You just make up nonsensical claims like those to rationalise your own prejudices. Either that or you find them on the websites of hucksters and crackpots where you seem to obtain most of your “information”.

                2. Just a quick note Jerry . I think TG lives in Australia which is part of the commonwealth , which means if he became a citizen of that country he would have to have taken a oath to protect the Queen of England with his life .My point?
                  The Queen of England drinks raw milk and so do her grandchildren , even though most of the commonwealth countries do not allow raw milk consumption . Double standard ? also the milk does not seem to have hurt their life span .

                  1. I have dual British/Australian citizenship.

                    How on Earth does referring to the science showing that consumption of dairy fats is associated with cardiovascular disease and the Queen supposedly drinking raw milk, constitute a double standard?

                    The Queen Mother, who died at 101, was also reputedly fond of gin. Am I therefore guilty of a “double standard” if I refer to scientific evidence that consuming alcohol is unhealthy?

                    You seem to be clutching at straws here in your attempt to defend dairy consumption.

                    1. Her subjects are for the most part not allowed to legally drink raw milk and that is hard for you to understand ?

                    2. Buster

                      This is simply untrue like most of your other claims.

                      Drinking raw milk has never been illegal in the UK. This is possibly surprising given the number of people in the UK who died from TB probably contracted milk in the first half of the 20th century.

                      However, properly licensed and inspected dairies are allowed to sell raw milk in most of the UK. I gather distributing it is illegal in Scotland … but actually drinking it has never been illegal anywhere in the UK and selling it has only been illegal in Scotland.

                      This is just another idiotic claim (or lie depending on your point of view) by raw milk nuts and republicans with no concern for the facts – anything to promote their agendas. If you have any concern for the truth, you should really fact check these claims before you post them here no matter how convenient they are to your employers.

                  2. Sorry Jerry but you are simply deluded.

                    Your claim about people in the UK being slim is untrue. In both the UK and the Republic of Ireland, obesity claims 25% of the adult population:

                    And in the Philippines in the old days they didn’t eat tons of saturated fat and cholesterol. This is pure fantasy; they ate tons of rice and vegetables mainly plus fish. – although sweet potatoes and cassava dominated in some areas.

                    But I can tell you that Filippinos now do eat tons of saturated fat and cholesterol mainly from chicken and pork which previously were only eaten on special occasions and feast days. Perhaps that is why obesity is rapidly increasing here.

                    The figures for what the Chinese, Japanese and Okinawans used to eat are set out in government surveys and reports that Campbell faithfully reproduces in his book. You can shout all you want that those figures are wrong but you are confusing your own fantasies, and the absurd claims of charlatans and crackpots, with the documented facts. You are well into tinfoil hat territory with these ridiculous claims.

                    Keep calm and have a nice cup of tea. Perhaps rationality and reason will return one day.

                  3. Re: Your claim about people in the UK being slim is untrue. In both the UK and the Republic of Ireland, obesity claims 25% of the adult population:

                    And in the Philippines in the old days they didn’t eat tons of saturated fat and cholesterol.

                    This guy who “trusts the FDA as if it is God, does not know about his home country nor his wife home country. You can push a bottle of vegetable oil onto his face and he can still call it saturated fat. No wonder why he trusts the FDA to cook his liver and kidney. Good luck.

                  4. Re: didn’t tell you to use canola oil! Therefore, why look at it?

                    Lisa, because you showed me a chart showing that coconut oil has the most fat while canola had the least (but bad) fat.

                  5. Buster, you waste your time trying to explain to TG about raw milk. He only trusts in the FDA stuff, like pasteurized milk or statin drug.

                    Too bad we live in an industrialized and prone to lawsuit society. Everything has to be pasteurized because milk are collected like a year ago and transported for thousand of miles from the farm to your mouth. And then there is lawsuit if anyone gets sick for any reason. In my state, raw milk is legal but nobody dares to sell because they are scared of lawsuit. Whole Foods pulled raw milk from its shelves years ago. Now they sell a milk that is lightly pasteurized at low temperature for a longer duration of time to kill the harmful bacteria but not the enzymes. But most importantly, it is not homogenized which is the most damaging to milk and it is only for appearance.

                    There are a few farms around me that sell raw milk but they operate kind of in secret. You don’t know where they are and you have to contact them by email. I did but they never replied to me – I think my email somehow looks suspicious.

                    Anyway, I don’t drink milk often but whenever I do then it’s either non homogenized goat milk from Trader Joe or non homogenized light pasteurized grass fed cow milk at Whole Foods. I live in the city and has no choice.

                    The Queen and Royal family are lucky.

                    1. “Tuberculosis remains as the world’s biggest threat. In 2014, human tuberculosis ranked as a major infectious disease by the first time, overcoming HIV death rates. Bovine tuberculosis is a chronic disease of global distribution that affects animals and can be transmitted to humans by the consumption of raw milk, representing a serious public health concern.”

              2. Of course the above “study” is flawed and biased to get the result that they want. So they compare person A and B:

                – A drinks milk and eat no plant foods.

                – B drinks no milk and eats only plant foods.

                B is more healthy than A. Of course.

                Why don’t they compare B and C who drinks milk and eat plant foods. I bet that C is more healthy than B.

                It’s like comparing true vegan with SAD eater and conclude that vegan is more healthy. Or compare a Ford Pinto with an AMC Pacer and conclude that the Ford Pinto is he best car. Or compare TG with Ron in New Mexico and conclude that TG is a better TAT.

            2. jerry, are you kidden the people – you call a article in a paper as a source for a serious claim? Did you follow the “Link” to GWERIN and have read it?
              In this copy from a book from 1960 is much more the speach from grain, mostly oat then other things like milk from sheeps. Specialy from the 16 century, they speak much more from brochane or porridge, less from bread. And it makes sence – because most of the people has been poor and so they can affort one or two animals to feed. So the milk from this animals whould be more or in the first line for there puppies not for the people. Because this people hasn’t been stupid to cat there own food line for the future. Of course they used the lay overs of milk but only for special situations or partys. This is one reason, why people (monks) from a ohter place reported of this, because this was in this time a special situation for the family and so the visitor have had the best food, for his honour. This “habotus” I still know well from my childhood. We have had not to much food, we could’t afford meat, cheese and butter every day, because it was expensive and we have been 4 children. But if some visitor came over, my parents present the best what they had at this time to show the visitors: Look, you are very welcome…eat what you want.
              Sorry for some mistakes, I’m not a english man

            1. Jerry, of course they lived shorter lives a century ago. People in America lived shorter lives than today also. Pretty much everybody everywhere did. Health care is better in Western countries today than it was a century, ago, so are public health measure like clean water, effective sewage systems and pollution controls. Then there are modern vaccines and the availability of effective medicines like eg statins, antibiotics etc

              The Republic of Ireland is a rich First World European country today and it has a life expectancy on a par with other wealthy European countries. Dairy consumption is neither here nor there given that Japan, South Korea and Singapore have even higher life expectancies and consume little or no dairy.

              Why do you always get taken in by the arguments of hucksters and cranks with websites but resolutely refuse to accept the scientific evidence?

  3. I’m a 49 year old female with low blood pressure. In fact, sometimes too low. Might a little salt added to my home cooking be okay or even helpful for me?

    1. As far as I know, and I’ve done some research on this, the only known danger of too much sodium is high blood pressure (and the disease associated with it). Someone with low blood pressure may therefore benefit from higher sodium in their diet.

      1. Thank you for your reply, Joseph, I think I’ll relax on my salt in cooking a little bit. I’ve never been a huge fan of salty food anyway, so I don’t think I’m in danger of high blood pressure. I was just wondering if there are other health complications of added salt in food besides high blood pressure. Thank you again.

        1. Too much of anything is bad but that does not mean nothing is good.

          Use quality salt such as sea salt or Himalayan salt and avoid table salt.

          1. sea salt is full of micro plastics – stick with your raw/steamed veggies and be happy. If you feel fine with low blood pressure enjoy your long happy life.

        2. Meg

          You may want to watch this video

          Additionally, high salt diets can affect g kidney function. And sea salt and Himalayan salt are just marketing gimmicks – the problem is sodium and you are getting that from those just as you are from table salt. Save your cash and but iodised table salt if you want added salt in your diet.

          According to the World Health Organization report on salt:

          “There is conclusive scientific evidence of the adverse effect of excessive dietary salt consumption on health, particularly on blood pressure, leading to cardiovascular disease, gastric cancer, osteoporosis, cataracts, kidney stones and diabetes (Cappuccio & MacGregor, 1997;Cappuccio et al., 2000). ”

          1. Hi, I have low blood pressure (90/60) and low platelets, but it doesn’t seem to bother me – however, I also have osteoporosis, recently diagnosed. Does sodium increase osteoporosis if you don’t have high blood pressure?

            1. Corinne

              I am no expert but the papers I have seen appear to suggest that the problem is mainly with people who have high blood pressure.

              However the science on this is not settled and if I were in your shoes I would limit my salt consumption to safe levels.

              “The 2015-2020 Dietary Guidelines for Americans recommend that Americans consume less than 2,300 milligrams (mg) of sodium per day as part of a healthy eating pattern.”

              The World Health Organization goes even further and advises should consume less than 2,000 mg per day. Sodium constitutes about 40% of salt by weight and the World Health Organization therefore recommends that people consume less than 5 grams of salt a day from all sources (and most foods contain salt).

            2. Hello Corinnemc,

              yes, sodium has a impact of the calcium bone balance – no matter what kind of blood pressure you have. But there can be more factors which have influence to osteoporosis – even mental issus. To get a more sadisfying answer you must look on the whole situation of you (age, diet, movements, stress etc.) Take care.

    2. Some 50 years ago, when I was pregnant with my daughter, I had gone out for Mexican food the night before seeing my doctor. My blood pressure was a little high, so he asked me about salt. I admitted to having had a Margarita the night before. He warned me about the salt. I can’t believe, now, that he didn’t say a word about the alcohol! Anyway, I stopped salting food, though I still used it in recipes, and I never ate a lot of processed food.

      Fast forward 20+ years. My naturopath measured my blood pressure at 80/60. She was shocked and said I should be taking salt tablets! Well, that didn’t sound so good so I began salting my food. I suppose it raised my blood pressure a bit, but not a lot. I still don’t eat a lot of junk, but these days I do have a weakness for Trader Joe’s organic blue corn tortilla chips.

      Now, as I approach 75, eating a lot of salt can bring my blood pressure up to what the new guidelines would call too high. Solution? Drop the salt again and don’t bring those tempting chips into my home!!!

    3. Hi, Meg! Some people are more susceptible to the effect of dietary salt on blood pressure than others. Depending on how responsive you are, you may or may not notice a change in blood pressure from adding some salt in to your diet. It is important to note that salt can impact other areas of health outside of blood pressure as well. For example, salty meals can significantly impair artery function, even among people whose blood pressure tends to be unresponsive to salt intake. Additionally, high-salt diets have the potential to trigger inflammation and excessive immune response, which can increase the risk of autoimmune diseases. So while a little salt might be fine for you in terms of its impact on blood pressure, it can come with some other risks to consider. Unless your blood pressure is extremely low to the point of experiencing adverse symptoms (dizziness, faintness, etc.) it shouldn’t be too much of a concern. Of course, I would recommend having your blood pressure checked at every medical visit and discussing it with your doctor, especially if you do ever experience any symptoms.

  4. I had high blood pressure and my doctor wanted to put me on a beta blocker. Six weeks later it was 118/62 and he said, what happened? I stopped all salt on my home cooked food, stopped all canned and processed food, and upped my potassium by eating a banana every day. Problem solved in six weeks. Now my blood pressure runs even lower. I got this regimen from the book The High Blood Pressure Solution, but now I have Dr. Greger for the best research based information. Thank you Dr. G.

    1. Sally,

      Thank you for your testimony on eliminating salt in your diet and how it improved your blood pressure. Your testimony will help to motivate others to follow in the same direction and eliminate salt from their diet.

    2. Thanks for the tip about this book. I previewed it on Amazon and learned about the important k factor, potassium to sodium ratio. Very much better than just telling people to lower the sodium.

  5. Putting iodine in salt was both a good and bad move for the public.

    On the one hand it is a vehicle for getting iodine into the diet, while on the other hand, it provides an excuse to continue adding salt to our foods at the table.

    I tolerate salt in my otherwise unadulterated peanut butter for safety as a preservative… but I get my iodine from supplements and no longer need iodized salt.

    I have some pretty old unused salt in my cabinet.

    1. I use sea salt or himalayan salt and take an iodine supplement.

      Table salt is junk and should be avoided.

      Using himalayan salt has several advantages:

      – It’s a good and clean salt
      – It’s semi expensive and that gives you an incentive to use less
      – Himalayan salt is usually packaged in a salt bottle that is hard to get out and that will give you an incentive to use less.

      Having said all of the above, you need a small amount of salt in your diet for your well being. Eating no salt is like having cholesterol below 80 or even 60 and it is sickening.

      1. I agree. I use Himalayan and Celtic salt in small amounts daily. It is also good for hydrating your cells; ie, adding a pinch to water.

      2. Stable low cholesterol throughout life strongly reduces risk for cardiovascular disease. Even reducing it to very low levels late in life after disease has struck brings substantial benefits

        “The scientists found that dropping cholesterol to the lowest level possible – to levels similar to those we were born with – reduced the risk of heart attack, stroke or fatal heart disease by around one third.”

        As for all the marketing hype about overpriced salts

  6. This is a timely discussion for me. I’ve been a WFPB eater for years, so I haven’t been consuming the highly processed foods that contain destructive amounts of sodium. But I also haven’t salted my food, until very recently. I began getting muscle cramps regularly, and after some research I discovered that: “The human body can’t live without some sodium. It’s needed to transmit nerve impulses, contract and relax muscle fibers (including those in the heart and blood vessels), and maintain a proper fluid balance.” I also discovered that persistent low levels of sodium in the blood may cause muscle cramps or fatigue. Now I sprinkle a little iodized salt on my meals, about 1/2 teaspoon a day. And I continue to avoid processed foods.

    1. Yes you need salt just like you need fat, albeit not a large amount.

      Don’t listen to the no salt and low cholesterol craps from some people.

      1. Agreed. Some good quality salt is a must.
        And I am tired of hearing that people didn’t eat salt in the past. If you stop and think about it, before tin cans, fridges and freezers came along, the only way to preserve meat and fish was by salting it! In the past, people used to eat much more salt than we do nowadays.

        1. I suspect that there wasn’t a lot of salting of food occurring on the African Savannah during our species’ evolution.

          But if you don’t want to evidence on high salt consumption and health, I am sure that you can think of some plausible reasons.

  7. From my own anecdotal experience (and that would be only about 3 years worth doing I.M.) although salt restriction would eliminate most hypertension in the general population, much of the population does fine without salt restriction. It is similar to tobacco in that only 40% of the population who smoke have ill effects from tobacco. Not everyone who eats red meat develops colon cancer. Not everyone who goes to tanning salons develops skin cancer. Someday when DNA analysis is perfected docs will be able to figure out who can eat salt and who cannot. In the meantime, if one of your relatives has hypertension, you need to stay away from sodium, and you are taking a chance in any case. YMMV.

    1. The figures on this pdf from the American Heart Association show that by the time Americans reach the age of 55, the majority of them will have high blood pressure. However, cultures which do not consume salt don’t have any hypertension.

      1. Correlation does not equal causation. The American diet is far too unbalanced to blame high blood pressure on salt alone. Likewise, in a salt-free culture, there will be a lot of features promoting better health – far less processed food, for a start.

        1. Correlation does not disprove causation. As a matter of fact, correlation indicates causation and is used to guideresearch and experiments in the field of science.

          I never said that salt was the only cause of hypertension.

      2. Maybe being overweight and having metabolic syndrome due to poor diet is part of the problem in people over 55? Getting no cardio exercise? There are many problems with American lifestyles.

  8. Thank you Dr. Gregor for your candor, truth-telling and great research. How to chip away at the BIG $$$ keeping humans ill, in the health care system and providing work for doctors, big pharma, dairy industry, meat industry, and the businesses they spawn? How can we persuade, convince patients that those entities are trying to kill them simply to make money? That’s the kicker.

  9. I have cut down (not eliminated) on salt since going WFPB, which I have been on for about 4 months. My last blood test showed a sodium deficiency. My BP is only 104/64 at the age of 57. I assume the sodium deficiency is some sort of anomaly? I went back to adding it very lightly at the end of cooking. Supposed to have another blood test tomorrow.

    Just wondering if I am the odd man out, or does this type of thing happen every now and again?

    1. Hi, Mayavata! There are many possible causes of hyponatremia (low sodium). They include heavy sweating (such as from high-intensity exercise), GI fluid losses (vomiting or diarrhea), use of diuretics, very excessive water consumption, and kidney problems, among others. You may also experience a small dip in sodium if your body is fighting off a virus or other illness. You’re on the right track by getting follow up blood work done. If the low sodium was a one-time test result, and was not dramatically low, it likely could have just been an anomaly, like you said. I would recommend discussing your blood work results with your doctor, along with your health history. He or she should have better insight into what may have caused the low sodium, and if it is any cause for concern. Best of luck to you!

  10. are these authors linked to salt industry? — Mente, A., O’Donnell, M., Koon, T. & Yusuf, S. (2014) Association of urinary sodium and potassium excretion with blood pressure. New England Journal of Medicine, 370, 601-611. If not, we need to figure out why their study suggests that salt is not a problem.

    1. B e careful Rob your thinking outside the box you will have the NFO police (TG) on your case if you don’t mindlessly follow whatever is presented here on a daily basis .

      1. buster, I think you will find virtually zero long-time fans of NutritionFacts that follow blindly, or ever encourage that of others. From what I have seen, (and what I personally do,) most take the time and trouble to click on source links below videos and in articles to read for themselves. Many investigate further as their research leads them.

        And if you have noticed a large number of people that frequent this forum have actually tried eating plants for themselves ie did not take anyone’s word for it. This is as it should be. Try it buster, you too might be amazed.

    2. They probably are connected to the industry. After all, excretion isn’t a cause of hypertension, intake is. Cultures which do not consume salt do not have hypertension. Cultures who consume salt (the rest of the world) do get hypertension.

    3. Buster is employed by a dairy company to promote dairy products in online fora like this. He usually also attempts to undermine the credibility of those who, like Dr Greger, point to the scientific evidence that dairy consumption carries health risks. He usually fails to mention this when he posts here.

      Dairy products are relatively high in sodium so attempts to reduce sodium are not always welcomed by dairy companies. Dairy product are also high in saturated fat and ditto there.Cutting sodium and cutting saturated fat would translate to lower dairy sales.

      As for that report, there are apparently no direct links between the authors and salt and/or dairy industry interests. None were disclosed in the article for example. However, individuals at McMaster University do have a reputation for defending dairy, saturated fat and salt consumption. And Dairy Farmers of Canada describes McMaster University as a “partner”

      In any case, the report does not show that salt consumption is harmless It states
      “In this study of 102,216 adults from 18 countries and 5 continents, we found a positive but nonuniform association between estimated sodium excretion and blood pressure. We found a steep slope for this association among study participants with sodium excretion of more than 5 g per day, a modest association among those with sodium excretion of 3 to 5 g per day, and no significant association among those with sodium excretion of less than 3 g per day. Furthermore, the slope of the association was steeper among persons with hypertension than among those without hypertension and was steeper with increasing age.”

      it does however argue that salt consumption limits should be higher than they currently are This is contrary to most other evidence and disputed by experts

      1. Thanks Tom. I also did some digging after my post and found criticism with the study, including this:

        The biggest issue singled out by experts is how sodium levels were measured. Instead of doing a 24-hour urine test, which allows researchers to get a fairly accurate picture of a person’s sodium intake in a day, researchers relied on a spot urine test – a single sample – and used a formula to then estimate sodium levels. Researchers also didn’t collect data on what people had eaten the day the sample was taken. Dietary histories are often collected to help experts get an accurate picture of an individual’s sodium consumption. Mente said that this method is accurate.

        But Dr. Elliott Antman, professor of medicine at Harvard Medical School, said using a spot urine test is an extremely unreliable way to estimate an individual’s overall sodium intake. For instance, a woman who eats a healthy diet may have indulged in a salty meal the previous night, which could skew the results. While the researchers used a formula to get a more accurate 24-hour measurement, Antman analyzed their data and found their estimates weren’t accurate in many instances.

      2. I think it is about time that TG told how he gets paid , is it per comment or is it per column inch like the old time newspaper reporters ? It’s ok I don’t expect an answer .
        For me while I am employed on a contract basis , it is just my opinion not anybody else . So no I don’t get paid to comment . If it was a requirement to comment on here to disclose your employment status , then everyone else is sorely lacking in their duties .
        To me it is interesting that Dr. Greger choose the money angle of salt as if it was some dirty deed to put salt in processed foods . Some foods need the salt and not just for taste but for safety . Most processed foods can be found with either low salt or no salt versions .The market place is far more democratic than the political system . Almost any product you have you would be able to convince a supermarket to put it on their shelves , just to see if there is an interest in your product . Politics ? You will need some major coin ?
        Here is the deal ,you or we or all of us would be more correct decide what sells and doesn’t sell , nobody forces you to that fast food place with the high salt, high fat foods . We came there looking for a quick , cheap meal . Your fast food joint would not be there unless the majority wanted it . Stop blaming farmers for producing what the majority of people want . Almost every where I have gone farmers are the lowest paid , hardest working people who really care about the welfare of the land and animals they keep .
        One of the most successful marketeers of a long string of marketeers ever has to be Kevin Trudeau , it is estimated he pulled in as much as 100 million with his books and internet site .
        The sub titles of some of his books would go something like this “the diet they don’t want you to know about ” it was not always clear who “they” were . It built mistrust in people and sold books .
        Dr. Greger in a similar fashion is blaming big salt . Not even sure there is such a thing . Maybe big pharma which benefits from big salt ,which benefits Dr;s which now benefits NFO , which is probably going to eclipse Trudeau in earnings with 2 best selling books .

        1. “Dr. Greger in a similar fashion is blaming big salt . Not even sure there is such a thing .”

          Yeah Buster, big salt is a figment of our imagination and it doesn’t try to influence people’s perceptions or government decisions

          We don’t want government or anybody else like Dr Greger offering advice on nutrition , let alone actually regulating industry and food safety. Interfering busybodies. Let’s rely on the free market to ensure we get safe foodstuffs and honest disinterested advice on nutrition and health. What could possibly go wrong with that approach? Thousand of years of history tells us what could go wrong with that approach

          “During the 18th and 19th centuries, as the United States shifted from an agricultural to an industrial economy and urbanization disconnected people from food production, the debasement of food for profit became rampant. Milk was often watered down and colored with chalk or plaster—substances which were also added to bulk up flour. Lead was added to wine and beer, and coffee, tea and spices were routinely mixed with dirt, sand or other leaves. Although a number of laws forbade harmful substances from being added to food, they were tough to enforce since there were no dependable tests to prove the existence of pollutants.”

          As for taking nutritional advice from the Salt Institute, the Dairy Alliance or people employed to promote dairy products in discussion groups like this, i can think of a few potential downsides.

          Yes, Buster you definitely do appear to be what you are – an employee of the dairy. industry.

          As for me, I am retired and live on pension income and some dividends from shares. I don’t get a penny for commenting here. I do it because I have an interest in the subject and am horrified by the misleading statements made by vested interests like your own industry, and by individuals like Jerry here, which seem designed to encourage people to consume unhealthy diets.

          1. Tom Goff,

            Thank you for that insight into the history of food manipulation in the United States especially during the industrial revolution. I had no idea that this kind of malfeasance was going on back then. And, of course it is still going on. I just read where commercial providers of tumeric in India add lead to the tumeric in order to make it more YELLOW and to weigh more per pound. After I read that, I threw a few bottles of tumeric into the trash. However, I can go to the grocery store and buy the raw root of tumeric. Also, I understand that it is easy to grow tumeric inside your own house. Thanks again for that historical insight….and of course this same kind of criminality is going on everywhere even today. You can NOT trust supplements. You can NOT trust commercial foods…..and what about the foods in restaurants. The only safe thing to do is to buy produce in the vegetable and fruit department of your grocery store and eat a WHOLE PLANT BASED FOOD DIET. Even then, you still have to be aware of pesticides and GMO’s.

          2. I guess if you wanted a expose on the food industry a good place to start would be the Jungle by Sinclair not sure if that ties in with salt , but a good book in any case .

  11. I like Dr. Greger’s funny comment that doctor’s financial ability to purchase fancy BMW cars may partly be connected to the idea that the public needs to eat more salt. “Here Mr. Jones is a prescription for more salt… know…..I just bought a brand new BMW sports car”. But, in reality doctors do tell patients to reduce their salt intake. However, in the back of their minds they know that very few patients will actually do it, because salt is addictive.

  12. My family, for four generations, has essential (primary) hypertension. As a teen we ate a salt free diet to accommodate our grandfather. The net change in all our blood pressure was zero. I found out I could drink a pot of coffee and it wouldn’t raise my blood pressure. Daily exercise, plant based eating, hibiscus tea and ground flaxseed consumption hasn’t budged my blood pressure, but my PSA score has dropped 20% in less than a year. Sometimes the answer isn’t there. Daily prescriptive medication keeps me at 120/80. Salt? Whatever.

    1. What about the addition of eating one Brazil nut a week? That must be the magic answer for you! Just kidding.

      I do wonder about claims of dramatic turn arounds with a plant based diet—hasn’t helped my bp. While it is my diet of choice, it appears not to be lowering my blood pressure. At 55, my bp maintained a constant 120/80 with a resting heart rate of 60. A decade later, even with bp meds, it sometimes peaks at 160/95 with my resting heart rate hitting 80+.

      1. Bryan, I am 73 and I have to deal with high blood pressure also. I was wondering if you include exercise in your fight against high blood pressure.
        I have turned my garage into a gym and I work out almost everyday, and it helps a lot. Also, taking epsom salt baths help. Walking a half mile every day helps. As you get older you have to really WORK hard at staying healthy. Then there are spiritual things that one can do.

    1. Hi, Anne! Since your blood pressure is already low, keeping some salt in your diet would likely not be an issue in regard to blood pressure. However, there are other health implications of consuming salt that are important to consider. For example, salty meals can significantly impair artery function, even among people whose blood pressure tends to be unresponsive to salt intake. Additionally, high-salt diets have the potential to trigger inflammation and excessive immune response, which can increase the risk of autoimmune diseases. Therefore, I would recommend limiting dietary salt, even if your blood pressure is low. I would also recommend talking with a medical doctor if you experience any symptoms of very low blood pressure such as fainting.

      1. Wow. Thanks so much for that info. I guess I will continue to watch my salt intake. I don’t eat processed food, so I’m off to a good start.

      2. I think people forget that where you live matters. As a desert dweller and a runner, and as someone who gets lots of potassium in my diet, I can pass out if I don’t get enough sodium. People need to take their lifestyle into account.

  13. When a body is deficient in minerals, it craves “salt”, for it knows that what it needs can be found in “salt”… but “table salt” is not “real salt”. The salty flavor in nature comes packaged with all the minerals in the periodic table of elements, whereas table salt contains only sodium and chloride (NaCl). A little bit of REAL salt, full-spectrum salt, goes a long way; it doesn’t require much real salt to satisfy an honest, healthy craving.

    When the body consumes too much salt, it craves sugar… and when it consumes too much sugar, it craves salt… It is looking for is balance on the acid-alkaline scale. But sodium chloride – without the other minerals – keeps the body in a perpetual “desperate for minerals” condition and therefore on a constant roller coaster. It is honestly seeking for balance, but is “looking for health in all the wrong places” – looking to feed itself the minerals it needs where they do not exist.

    Table salt (NaCl) is the ingredient used in most manufactured foods. NaCl is a byproduct of the mining industry, because some clever person found that it was cheaper to mine the sea and remove the precious minerals from seawater, than to mine the land. Of course, once the precious minerals are removed and sold to pharmaceutical companies, then they sell the dregs – mineral free sodium chloride – that white, sparkly stuff to us. Sodium chloride is also sold in “health food stores” as “sea salt” and that is truly a crime because people who are trying to eat well are tricked into buying it. Other uses for sodium chloride include: tanning hides, melting ice off streets, RoundUp, and so on.

    Pretzels, soda… french fries, catsup… sweet & sour & salty… a yoyo effect occurs between sweet and salty flavors. Sodium chloride sets up cravings that can’t be satisfied.

    Other problems we KNOW about – of mineral deficiency. (There are undoubtedly many more that have not yet been identified.) Mineral deficiencies can have very subtle effects. For instance, bipolar disorder is treated with lithium. Lithium is a naturally occurring mineral, present in real salt. It required some real digging to discover lithium was the problem in bipolar – congratulations to that discovery. Anyone who had been consuming real salt their entire lives would never have a lithium deficiency. But even now that the remedy is known, there is a problem in dosage because even the most miniscule pharmaceutical dose can be fatal. When sea salt is consumed, however, nature’s delivery system is in nano particles and each mineral is in balance with all the minerals and the correct dosage is easy to attain.

    Most people do not know they need more than table salt to satisfy the craving for salt. The good news is, there is such a thing as salt that contains all the elements they need to function correctly – only you have to look deeper than the grocery shelves to find it.

    Our intercellular fluids are identical to seawater, so it’s not that difficult to nourish ourselves with full-spectrum, sun-dried, grey, yellowish, sticky sea salt. The question is, how to find it. If you live near the ocean, you can bring home ocean water or seaweed, the white stuff at the edge of the seashore, and use that in your daily diet… and if you live inland, you can go to the “health food store” and find a few varieties of salt that are “more” full-spectrum… like himalayan salt or redmonds salt or, best yet you can choose sun-dried celtic salt or hawaiian sun-dried salt. The idea is to get salt that is simply dehydrated ocean water. But beware… remember you can also find a “sea salt” in most health food stores that is a stripped-of-minerals ocean water mining byproduct that does not contain any more minerals than table salt. Don’t settle for less than the real thing.

    1. GREAT RESPONSE..! You saved me the effort. I have been delivering 3 hour lectures on the health benefits and consequences with different types of salt for many years and agree with you completely. Certainly, the subject needs to be researched more thoroughly. I understand that Nutrition Facts has grown in leaps and bounds, and many volunteers are being utilized for research, however rushing a video or post on any subject that has not been completely researched will only discredit this FABULOUS site. (ex: Microwave Safety needs to be revisited) When apparent healthcare practitioners tell their patients that “salt is salt is salt” they really should be saying “sodium chloride is sodium chloride..” They are simply missing the point that when you remove minerals/trace elements from sea salt or mountain salt, it is no longer ‘salt’. “The whole is greater than the sum of it’s parts.” There needs to be more research on the intricate differences between mountain salt, sea salt, processed salt and the beneficial electrolyte story. Example: Sole (brine solution from Himalayan Crystal Salt)

  14. It seems to me there is a lot more to the salt debate then you covered today.
    How about the kind of salt you intake?
    How about the suggestion by some doctors that Americans need to up the potassium intake to balance the salt because we do not get enough Potassium and that can lead to elevated blood pressure?

    The table salt most have is not considered to be a natural salt because of processing it primarily for industrial or commercial purposes.

    Also, sea salt is not necessarily the answer because some of it comes from contaminated areas.
    And since every person is not identical to every other person, cutting back on salt may not be the best answser.

    1. Humanity did not evolve with salt shakers on their tables. All the sodium a person needs can be gotten by eating plenty of vegetables.

  15. Just relaying my personal experience here: I went WFPB a number of years ago which included cooking my own food. Not only did my weight drop 30 lbs, but my hypertension stopped, as well.

  16. High five Dr. Greger for revealing the money stream sitting on top of everything our modern world (New World Order) is following, especially in the “FREE” enterprise system (a system making enterprise out of everyone’s life for the profits of the controllers of the big corporations).

  17. I tend to use lots of salt when cooking. Can I reverse the effects of excess salt in my diet by drinking lots of water and exercising everyday?

  18. My wife actually has low pressure and had been advised by several docs to use salt “plentifully” to combat this problem(which she does to eye popping levels). They have said she could either use plenty of salt or take salt pills. I wonder if there is another way to get her BP up without all of the salt. I have always been concerned with what that excess salt may be doing besides keeping her BP high enough to not feel the dizziness that comes with it being low. I would be interested in any feedback on my concerns.

    1. There’s a correlation between high sodium intake and stomach cancer. Exercise is a good way to equalize blood pressure, but has she shown any ill symptoms from her low blood pressure? Does she faint or show a lack of energy? If there are no overt symptoms, then the doctors are full of prunes.

    2. It sounds like bad advises from the me.

      First of all, if your wife does not eat salt then she needs to eat some to charge her electrolytes. But it sounds like she already does, albeit too much.

      Secondly, you don’t just eat salt to raise your blood pressure artificially. By the law of physics, salt will increase the viscosity of liquid, in this case blood, and so eating salt will raise BP by the law of physics, but that by artificial means which mean nothing.

      Low blood pressure is caused by a number of reasons and some are very critical. You need to fix the root cause of low blood pressure rather than just artificially raise it with salt.—When-Blood-Pressure-Is-Too-Low_UCM_301785_Article.jsp#.WmEvzmeVivw

    3. Jerry is right that there are various possible causes of low blood pressure and you should ask your doctor or other licensed health adviser to check them out.

      For example, you do not say how old you and your wife are but many people over 50 find it difficult to absorb B12 from food and this can cause anaemia and low blood pressure. The NIH recommends that all people over 50 should take a B12 supplement or eat B12-fortified foods.

      But, really, relying on advice from unqualified people on the internet isn’t wise. You should instead consult professionally qualified medical advisers. Here’s what the Mayo Clinic has to say. It may help your wife when she next discusses this matter with her doctor

  19. Are there actually any studies comparing a healthy plant based diet both with and without mineral/raw sea salt or even table salt? If you compare pre-industrialized diets to modern American diets, of course there is less hypertension in the former; but there are a lot more factors that differ in those two ways of eating. In other words, salt isn’t the only thing that has changed so it’s not a fair comparison.

  20. Isn’t that “cut in half” theory pretty relative? I am 60 years old, have cooked from scratch my whole life always grow my own vegetable, never eat snacks salty or sweet there is no packaged/processed food in my house. My mother at age 83 has lived, and taught me, the same, yet both of us have high blood pressure. I have used kosher salt for a long time now but rarely use more than a Tblspoon, usually a lot less, more like a pinch here and there, per day in my cooking and that is to be divided by the 6 people I feed. So cutting it in half assumes that I and my family eat fast food and processed food, that is no longer true by many people who are health conscious.

    1. Heidi, you didn’t state how high is your blood pressure. How high is high?

      The normal range is 120/80 for older people but you can go uo as high as 140/90. It’s not ideal and you should try to get it to go lower with nutrition but avoid taking medication as much as possible.

      For me, eating any type of squash or zucchini will make my blood pressure drop like a rock. If I see my BP creeping up then I eat some squash – right now winter squash is in the season. The other vegetable is okra, it lowers my BP too.

  21. I am 65 years old, 5’ 4” tall, 101 pounds, following a wfpb diet for about 25 years. I have been an athlete all my life, playing basketball, tennis, running, weightlifting, dancing, aerobics, and yoga. My blood pressure runs about 105/58. I have low cholesterol levels and take zero medications. Recently, I started eliminating salt from my foods, based on recommendations from Dr Greger, but began having the worst cramps in my legs and feet I’ve EVER had. My salt intake was never high…just a sprinkle on oatmeal, veggies, and legumes. I had to put it back in, and my cramps disappeared. I use Himalayan pink salt. According to Dr John McDougall whose advice I also follow, a small amount of added salt is okay to make food palatable. It’s the processed foods, meats, cheese, breads, canned foods, etc. that are loaded with sodium which cause the problems in the SAD. My 2 cents. p.s. I LOVE the How Not To Die cookbook. I received it for Christmas and have been trying new recipes every day! YUM!!

    1. Don’t listen to the no-salt low fat crowd. Do eat some salt because you need it for your electrolytes. The ball part quantity is 2 teaspoons per day or a little bit more if you exercise or sweat a lot.

  22. Yes, she has nearly fainted and especially late at night when using the bathroom during sleeping hours. That is why she raised the question with the docs. The salt does seem to mitigate that issue but it scares me for her health otherwise.

  23. Right, but many people following you don’t eat or limit processed food so although this confirms that processed food is junk, it gives no indication whether of us on whole food diet should add salt and to what extent.

    1. Perhaps this will be discussed in a latee video.

      However, according to the World Health Orgaization “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)”

      This is sodium of course (which translate to about 500 to 1,250 mg of salt per day. However, a tabklespoonful of soy sauce delivers a whopping 900 mg of sodium while 100 grams of wholemeal bread (a little less thatn 4 slices) delivers 472 mg of sodium. So eating 4 slices of wholewheat bread delivers the 500 mg per day discussed above and soy sauce will overdeliver,

      add that to the sodium in other foods – half a dozen green olives will give you over 200 mg of sodium while a cup of chopped carrots delivers 88 mg – and most people shouldn’t need to worry.

      Of course if people are strict about limiting thmselves to unprocessed whole foods, then wholewheat bread, soy sauce and olives will be out and obtaining the higher estimated minimum requirement may demand some careful planning.

  24. Some salt is essential for life, the discussion is about how much (and to some extent the quality).

    I live in a very hot climate (108 yesterday) and you absolutely must consume some salt to survive. In the heat if you find yourself thirsty but drinking any amount of water does not satisfy it is one sign of a salt deficiency which is easily rectified with a salt tablet etc.

    Thanks Dr Gregory, your articles are very good however can I suggest this one could have done with some more detail and dropping the ‘climate change’ reference which didn’t help as an analogy.

  25. I have heard that sea salt does not cause high blood pressure due to all the minerals that are in it. Is this true? I would really like to know.

    1. Sandra

      Not that I am aware of – this appears to be just a cynical marketing claim or wishful thinking at best

      The problem is not salt as such, it is the sodium content of salt that is the issue. Paying a high price for sea salt won’t affect the amount of sodium you consume. The US dietary guidelines discuss the sodium issue here.

      The ratio of sodium to potassium consumption also seems to be important eg

    2. Hello Sandra, where have you heard that? Of course sea salt has more minerals inside comparing to table salt and it has less chemical additives compared to sea salt – but nevertheless this things is it valid the old sentence of Paracelsus: “The dose makes the toxin”
      And so I understood the article from Mr.Greger, the dose, the kind of salt, your life circumstances (I mean are you a couch potato or a sportswoman) makes together the toxin or not. Generell can be said, most people today consume to much salt and so salt is (! together with other puzzle parts) responsible for more blood pressure during the western people. Dr. Greger and all the other Dr. never said – reduce only this or or this and all chronic diseases will disappear – the say always please take in consider to change (a lot or as much as you can of things in) your life. For example, you can use no salt and you can have despite a high blood pressure only because you have a lot of mental stress – have you ever measured you blood pressure before, during and after the NEWS or a scare movie? ;-)

  26. “World Hypertension League” points out, there is strong scientific consensus that reducing salt saves lives, and—like the climate change debate—most authorities are on one side. ”

    I do follow a low salt diet as I feel the evidence is fairly solid.

    However I’m just sick of this “scientific consensus” nonsense. The scientific method which got us everything we have (good, bad & ugly) does not include the phrase “and consensus was reached”. The more I hear that the weaker I think their arguments must be (in the case of salt I think they are correct).

  27. Dear Doc,
    I am a 37 year veteran vegan. I think my diet keeps the blood pressure low. Plus i don’t have any of the allergies that are fruitful causes of high blood pressure (read Dr Roosenfeld’s “Drop Your Blood Pressure”, with it’s 1930’s peer reviewed research on the allergy- blood pressure connection, long ago swept under the rug by modern medicine with it’s desire to “cure” everything with a pill (Dr Roosenfeld did recommend decreasing salt intake also if you have high blood pressure). I have no problem getting up on the roof of my house and shoveling 2.5 feet of snow in 3.5 hours of 18 degree temp, and I’m 61 years young. My blood pressure was 94/52 on monday at my doctor’s office, but can get as “high” as 125/79, though very rarely. I have never had to curtail my healthy salt intake; I like it with olives, avacado and rice. I’m convinced my low fat vegan diet is the protector of my health (low fat like usually up to about 40 grams a day or less).

  28. I just came across this great video of Dr. being interviewed by two television hosts on the topic of his book, “How Not To Die”. Dr. Greger shows his hosts actual plates and bowls of his daily dozen. Dr. Greger does a good job kidding around with his hosts and promoting the daily dozen. It’s good to actually see the daily dozen displayed out on the table and listen to Dr. Greger’s comments about each food. This is one of those rare times when you get to see the ENTERTAINER – Dr. Greger. Check it out. Here’s the LINK:

  29. Has anyone looked at studies or other sources concerning sodium metabolism? As others have noted the role of potassium, I’m wondering if there’s more to it. I do note that at times I eat food not made myself, and sodium intake is higher, I pee more afterwards until it seems return of equilibrium. I tend to daily eat foods that are considered diuretics such as dandelion and nettle (when in season), and occassionally burdock (gobo) and other non-common greens or plants that might be considered as such so perhaps that has an effect.

    As for potassium intake, when I did calculate nutrient intake for a few months since I was curious, I found than the recommended ~4700 is attainable with a mid-sized meal plus some snacks (fruit, nuts, seeds). I possibly currently average lower, somewhere in the 4000 range following following one meal + snacks, since I no longer often consume some of what’s higher such as blackstrap molasses or tomato paste. Indeed perhaps just daily consuming the RDA of all vitamins + minerals within 1400-1600 calories might not be ideal, but if I can get that from one meal and snacks, I consider that good enough and perhaps it contributes to longebity.

  30. Personally, not adding salt to food has me feel somewhat better for a few days (maybe) and then develop SERIOUS neck and back pain because of lowered muscle tone (it’s a struggle just to sit up straight), which is alleviated by taking salt. Similarly going too low in fat / taking no oil has my skin dry up and mental capabilities diminish as well as feeling the need to breathe more. Easily fixed by taking some oil. Be careful people, what is best for most may not always be best for you personally.

  31. You are right Mr.Greger and for anyone who has still doupt about the ways of the industry should read Michael Moss’s book “SALT, SUGAR, FAT. How the Food Giants Hooked Us by Random Hause, New York.
    I read it in German – very good work, especcialy because he indicate sources.

  32. I can’t refute the fact that salt intake is bad, I think we should all agree to that. But we must also look at every situation differently and treat everyone as an individual. If you look at the elderly, or someone who may have been eating a salt laden diet for a number of years, there are potential genetic issues that must be addressed. There are three distinct genetic mutations that can occur to the sodium ion pumps of individuals who have been eating high sodium diets for some time. These genetic mutations lead to varying degrees of sodium leaching which causes a decrease in sodium levels. A reduction of sodium for these people could actually cause physiological problems. This can also be seen in younger people also. The reality is that these people need to change their dietary habits and just reducing sodium levels isn’t the answer. Testing the sodium levels of these “leachers” usually does not indicate low sodium levels as their diet rich in sodium keeps their daytime sodium levels normal. Their reduction of sodium occurs at night and their poor diet replenishes their sodium levels during the day. Constipation is often the result of such sodium fluctuations and their elevated nitrogen intake from animal protein consumption increases water loss to compound their problems. Water is utilized in the body to eliminate nitrogen so a reduction of water and inconsistent sodium levels contributes to their problems.

  33. I’ve already said it before but I’ll say it again. I tried not consuming any salt at all for a while but I ended up having issues with sex and my athletic performance (I train almost every day), my blood pressure was also extremely low (90/60). Since then, I now and then add about 1/8th of a teaspoon to my food and I’m doing much better.

  34. One could also accused this article of “false equivalency” as it doesn’t distinguish between processed table salt, which is stripped of 80+ nutrients, and sea salt, which contains 84 nutrients, give or take a couple, depending on the sea salt.

    1. One could also say that you are missing the point. The point is not salt as such or the minusculem amounts of micronutrients (AND toxins and radioactive substances) contained in high priced salts. The issue is sodium – that is the nutrient of concern. Salt is almost 40% sodium which is why health experts are worried about it. The added minerals and other elements in Himalyan etc salt are simply a distraction

      All the hyperbole about Himalyan salt and sea salt, is just marketing bs to get people to pay astronomical prices for salt.

  35. I’m a full-time adherent of the whole-food plant-based regime but I must take issue with some of Dr. Greger’s logic here.

    He says essentially that humans for “millions of years” did not use added salt.

    Our species, homo sapiens, has existed only for about 200,000 years, not millions. To make sense, this “millions of years” idea must include earlier “homos” (hominids) such as our cousins the Neanderthalers.

    But earlier hominids might have differed from us biologically, even if we share 99% of their DNA. Thus even if we knew what their diet was (and we don’t know much), it not necessarily useful to extrapolate from that to our own biology. In the same sense, it is not necessarily useful to extrapolate about our diet from observing what chimpanzees eat, even though we share 99%+ of DNA with them.

    On the other hand, maybe Dr. Greger meant to refer only to homo sapiens, and just made a mistake as to time frame. In this case, I suggest this line of reasoning is unconvincing for a different reason:

    Many paleolithic human groups lived near an ocean, and they would have had abundant access to salt water and salty seaweed to use in their cooking. Others who were migratory might have had salt from such sources part of the time, and if so, they possibly knew how to dehydrate it and carry it with them. Other groups far from the sea may have traded with coastal groups, so they might have had access to salt also. And various inland locations have salt deposits too. Of course there also probably were many groups that didn’t have salt, maybe even the majority of them. But all in all, I think the assertion that paleo humans didn’t eat added salt, is on shaky ground, and thus so are any lessons for today drawn from it.

    I suggest that any advice about salt should be based on modern nutritional science, not on suppositions about prehistoric human diets. Dr. Greger, are you listening?

    1. Interesting thoughts but you may be misinterpreting what Dr Greger has written.

      For example, you are thinking about modern humans when you talk about the last 200,000 years.. However, in scientific discussion, the term “human” can also refer to “A member of any of the extinct species of the genus Homo, such as Homo erectus or Homo habilis, that are considered ancestral or closely related to modern humans” (page 303, American Heritage Science Dictionary).

      There is no evidence that early humans ate added salt or even had the technology to manufacture such salt hundreds of thousands of years ago, let alone millions of years ago. The idea that homo habilis, homo erectus and even earlier human ancestors did not conume added salt seems entirely reasonable

  36. My question is what is the heart attack and stroke rate in Germany where they consider 140 over something low BP?

    I am pondering this subject, because none of my family had issues with salt and BP, except for someone who married in, and everybody loves salt. My closest friend’s family is the same. She is 65 and triples on the salt, but doesn’t have any hypertension or heart problems. She gets checked every year and hasn’t had any problems with either and neither did my elderly relatives, who most lived into their early 90’s.

    I think it was Dr. Bergman who did a video on the Helsinki study and about how we are the only country who worries about BP in the first place.

    He isn’t worried about cholesterol either, based on a different take on the same studies Dr. Greger uses, but I guess there are other things than BP related to cholesterol intake, so there is a good enough reason for me to watch cholesterol.

    I just am not surrounded by people who salt is an issue at all and the one who has BP issues, hasn’t had salt in years. My coworker also has BP issues and also hasn’t had salt for years, but both of them eat meat and I am not a doctor, but I thought it was the clogged arteries, which made their BP raise, rather than using salt years ago and Dr. Bergman said that Germany and Japan and England believe that the raised BP is more related to the BP needing to be higher once your arteries are clogged.

    He said that England only measures BP once every 5 years and other countries only treat low BP, because they are afraid that if it is too low that the blood isn’t circulating properly.

    1. Deb, yes we are a country obsessed with cholesterol and blood pressure so that Big Pharma can sell more drugs and Big Foods can sell more low fat foods, even when you eat meat or dairy. It is big money and all the so called researches are geared to get the results that they want so that the researchers can get grant money.

      Recently the new guidelines even calls BP of 120/80 high so that more drugs can be sold.

      Back to BP and cholesterol, they are indicators to watch but it is not absolute. And so if your TC is above 200 – 220 or your BP is above 140 then you need to watch and possibly take other measurements such as CRP which is a measurement of inflammation.

      My own BP is normally around 110-120 and I measure it every morning. Sometimes it jumped to 140-150, perhaps because I didn’t have a good sleep or I ate something the night before. So my natural remedy is that I eat some squash such as butternut squash or even zucchini. My other food that I can only find at Asian market is Okra. Cabbage works sometime too. Try those foods and you will see your BP drop like a rock. Winter squash is now in the season.

      1. Jerry,

        I am amazed at how much time you spend on the computer and debating on this forum. A person who is a paleo guy or a meat eater, or even a person who dislikes Dr. Greger like you would never spend this much time on any blog, forum, or website unless he was getting PAID to do it. The amount of time you spend on this forum is not normal. This must be your full time job, because TIME IS MONEY.

    2. The idea that the USA is the only country in the world that worries about high blood pressure is simply preposterous. If it were true – and it isn’t because I live outside the US and know that it isn;t true – then the World Health Organization has been labouring under a serious misapprehension for decades.

      Clogged arteries can be one cause of high blood pressure. However, Bergman is a chiropractor not an MD. and is probably not a good source of advice on medical matters. I’d suggest that you need to be very wary about his claims and advice.

      Salt is only one risk factor for hypertension. There are others

      Also, some people’s BP levels are not affected by salt consumption. This doesn’t mean that all people are unaffected.

  37. Thanks Jerry.

    I am eating as many fruits and veggies as possible right now and beans and nuts and drinking tea.

    I am going to be fascinated to see what my next lab results will be.

    Your saying those sentences caused me to remember more of Dr. Bergman’s points about the Helsinki Study and about how we are the only country worried about BP.

    After watching his presentation, I think I just am more focused on keeping my arteries unblocked by lowering my animal products.

    I am not using canned products with salt and I am not using salt, but if I ever eat a baked potato again, I probably will.

    Salt is a flavoring and preservative in the Bible, so it must have been being used for a while now.

    I am wondering if the Helsinki study measured sodium levels as part of it.

    I know they measured smoking and other risk factors. That might tell something.

    And, no, I am not arguing with Dr. Greger or Dr. Bergman.

    Dr. Bergman is talking to people who probably never will go vegan, so the question for them is whether they will use the meds for BP and cholesterol and whether the Helsinki study meant that they shouldn’t use those meds.

    I would want a study of whether salt / sodium is a problem for people who don’t have blocked arteries.
    (meaning is it the meat or is it the salt or the arteries/ genetics or is it all of the above)

    I watch Dr. Greger videos every day, but feel like the rest of the world not thinking the way the USA does about the subject means this topic is just beginning in my mind.

    1. Deb I eat very healthy but like I said, once in a while my BP jumped for no reason and so I eat the foods I described and my BP drops immediately, like within an hour or less. You need to have a home BP monitor to measure your BP regularly and find which foods or activity raise your BP or lower. If you see your doctor once or twice a year, there is something called doctor effect whereas people’s BP rises because they are worried.

      Just eat the foods I mentioned above and likely your BP will drop. I don’t know what cause it but kale for instance won’t affect my BP although it is nutritious.

      It could be the potassium content of squash,

      1. I have heard a lot of people say that they have that “doctor effect”, where they measure it every day and it is good and jumps at their appointment.

        I ponder whether it is the time of day of the appointment or fear of authority figures.

        Dr. Bergman said that when they do monitor BP in England, it is over a 24 hour time period and most people have dips and peaks in those 24 hours.

        1. Deb

          This is called ambulatory blood pressure monitoring.

          It is not unique to the UK and by and large is pretty uncommon there. They mainly use the standard techniques for measuring blood pressure that are used in the US and all other countries.

          In fact, it is not commonly employed in any country because it is expensive, requires specialist equipment and takes a lot of time. However, it is used in a proportion of patients in all (developed) countries.

            1. Thanks John but I worked in a Federal health department for over 25 years. You can’t help acquiring knowledge about a wide range of health issues and, even more importantly, about how to research them.

              1. Re: Thanks John but I worked in a Federal health department for over 25 years

                No wonder why TG trusts the FDA and authority so much. He has the kind of biased knowledge, like a good med school student who only learns what are taught in the textbook and has no critical thinking.

                That explains what we have witnessed.

        2. Deb, he best way is to have your own BP monitor and take measurement daily or twice a day. What you want to do is to measure BP at the same time everyday, even if it may fluctuates from day to day due to what you eat or do the day before. Because what you are looking for is the delta change. If your BP spikes for one day or a few days then it’s no big deal. But it goes up consistently for weeks then you have to look whether it is minor because it’s due to the foods that you eat, or is it an indication of a more serious medical problem? Try not to take any medication because you are just hiding the problem but try to exercise or eat foods with potassium like I described and see if the BP drops or not? If it does not drop yet then don’t panic but take other measurements such as CRP because BP is just one indicator. But don’t ignore high BP. You may have to see a doctor who can take EKG (ECG or 12-lead) measurements to see if there is any blockage. Don’t listen to the doctor if he/she just gives you medication. You may have to pay from your own pocket if your insurance does not cover but do you want to prevent a cardiac arrest and have peace of mind?

  38. For years, even though I work out regularly and live a very healthy lifestyle, I had high blood pressure. I consumed very little processed food, cooking my own healthy meals and not including much, if any, salt. I now have two cups of hibiscus tea daily as well as three tbsps of flaxseed in my cereal(with unsweetened almond milk of course), and my BP has improved greatly. I would like to get it down even more(it averages around 130/85 which is still a little high), but I have a feeling the tea has been the big difference. I have taken a couple of holidays in which I was not able to drink my tea, and when I returned home my BP was up again. Thanks Dr. Greger for the info on the hibiscus tea. I also very much enjoyed your book(and cookbook)

    1. There are other foods, which work similar to flax.

      Pomegranate juice
      beetroot juice
      tomatoes or other things with lycopene
      purple potatoes

    1. You don’t say what your blood pressure actually is. Scores from 90/60 to 120/80 are conventionally regarded as “ideal”.

      You also don’t say whether you have had stable low pressure throughout life or your blood pressure has recently declined for no apparent reason. Note that improving your diet, engaging in exercise or giving up smoking, caffeine and/or alcohol will lower blood pressure in most people.

      If your blood pressure has fallen for no apparent reason, this may be symptomatic of some underlying condition rather than very low salt consumption. You may want to discuss this with your doctor or seek a referral to a specialist.

  39. Salt doesn’t cause high blood pressure. In fact, I’ve read that only a small percentage of people are sensitive to salt in that way. Even the highly touted DASH diet achieves only very modest reductions in BP. I believe it’s highly touted because, “It’s all we have.”

    Hypertension is generally caused by elevated insulin due to insulin resistance. This has been known since 1991!

    Well, the DASH diet isn’t “all we have” – there’s carb restriction.

  40. Most scientists, researchers and physicians don’t seem to share your opinion. The evidence linking high salt consumption to high blood pressure is extensive and has convinced experts world wide.

    Crab restriction seems doubtful as a general principle since vegetarians tend to have lower blood pressure than other people. They usually eat high carb diets rather than carb restricted diets. Diets high in vegetables also tend tom be higher in potassium which helps with blood pressure control.

    You may be able to get some blood pressure lowering effect from low carb diets in the short term (but then just losing weight will lower blood pressure) but I don’t think that there is any evidence of a long term effect. There is also the point that low carb diets are associated with higher mortality.

  41. What is salt??? The “When it rains it pours” stuff? Sea salt? Himalayan salt? (= “Pink Himalayan sea salt contains over 84 minerals and trace elements, including calcium, magnesium, potassium, copper and iron, so it does more than just make your food taste better.”).

    I think we should talk about different types, origins, adulterations, and other qualities of varios salts. Not all salt is created equal, right?

  42. Refined, cooked or processed salt in foodstuffs is indeed a villain but there another type of salt that heals -the raw, organic rock or sea salt ADDED to food or dissolved in water.
    It’s the oldest remedy in the world.
    To know more about the healing properties of this type of salt refer to Dr Batmanghelidj’s book Water and Salt.

  43. My blood pressure is below normal. My sodium level is at almost too low. I need salt and sodium for my blood pressure to raise it or my organs will not get enough blood to work correctly. I also deal with being light headed, dizzy and cannot focus. I need sodium to feel half alive, lol.

    My friend on the other hand has high blood pressure, so he has to restrict his sodium. No two people are alike.

  44. Can you please comment or post about the recent PURE study from McMasters in Canada, published in the Lancet, essentially exculpating salt?

  45. Really? That’s it? I got to this article from a comment on a Jason Fung article on the benefits of salt. I was expecting a valid counterpoint, but all I’m reading here is “Government officials and doctors say salt is bad, big pharma says salt is good”, no evidence, studies, sources?

    Well, perhaps it’s a good thing that you writes these kinda of articles, “Doctor”, because it makes it very easy which side to choose.

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