Salt of the Earth: Sodium & Plant-Based Diets

Salt of the Earth: Sodium & Plant-Based Diets
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Is a plant-based diet sufficient to reach sodium goals?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Reduction of salt consumption by just 15% could save the lives of millions. If we could cut our salt intake by a half teaspoon a day, which is achievable by avoiding salty foods, and not adding salt to our food, we might prevent 22% of stroke deaths, and 16% of fatal heart attacks—potentially more than if we were able to successfully treat people with blood pressure pills. An intervention in our kitchens that may be more powerful than interventions in our pharmacies. One little dietary tweak could help more than billions of dollars worth of drugs.

What would that mean in the U.S.? Tens of thousands of lives saved every year. This simple step “could be as beneficial” on a public health scale “as interventions aimed at smoking cessation, weight reduction,” and giving people blood pressure and cholesterol-lowering medications. And, that’s not even getting people down to target.

Here’s the level everyone should get under, exceeded by most Americans over the age of three. And, here’s the recommended upper limit of salt intake for African-Americans, those with hypertension, and everyone over the age of 40. Processed foods have so much salt added that even if we avoid the saltiest foods, and don’t add our own salt, that would just get us down to here—but still, that could save up to nearly 100,000 American lives every year.

So: “Given that approximately 75% of dietary salt comes from processed foods, the individual approach is [described as] impractical.” We have to get food companies to stop killing so many people. And, the good news is “several U.S. manufacturers are reducing the salt content” of their foods, “but other manufacturers are increasing the salt levels in their products. For example, the addition of salt to poultry, meats, and fish appears to be occurring on a massive scale.”

The #1 source of sodium for kids and teens is pizza. For adults over 51, it’s bread. But, between the ages of 20 and 50, the greatest contribution of sodium to the diet is not canned soups, pretzels, or potato chips, but chicken—because of all the salt, and other additives, that are injected into the meat.

This is one of the reasons, in general, “animal foods contain higher amounts of sodium than plant foods.” Given the sources of sodium, complying with the recommendations for salt reduction “will require large deviations from current eating behaviors.” We’re talking a sharp increase in vegetables, fruit, beans, whole grains, and lower intake of meats and refined grain products. As might be expected, reducing the amount of sodium would necessitate a “precipitous drop” in meat consumption for men and women of all ages. You can see why there’s so much industry pressure to confuse people about sodium.

How do vegetarians do? Non-vegetarians get nearly 3,500 milligrams of sodium a day on average, the equivalent of about a teaspoon and a half of table salt. Now, the U.S. Dietary guidelines recommend getting under 2,300 a day, and the American Heart Association says, no way, get under just 1,500 a day. Vegetarians did better, but still double the American Heart Association limit.

In Europe, it looks like vegetarians do better, slipping under the 2,300 cut-off, but it appears the only dietary group that nails the American Heart Association recommendation are those eating the most plant-based of diets.

Please consider volunteering to help out on the site.

Image credit: Birte via Pixabay. Image has been modified.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Reduction of salt consumption by just 15% could save the lives of millions. If we could cut our salt intake by a half teaspoon a day, which is achievable by avoiding salty foods, and not adding salt to our food, we might prevent 22% of stroke deaths, and 16% of fatal heart attacks—potentially more than if we were able to successfully treat people with blood pressure pills. An intervention in our kitchens that may be more powerful than interventions in our pharmacies. One little dietary tweak could help more than billions of dollars worth of drugs.

What would that mean in the U.S.? Tens of thousands of lives saved every year. This simple step “could be as beneficial” on a public health scale “as interventions aimed at smoking cessation, weight reduction,” and giving people blood pressure and cholesterol-lowering medications. And, that’s not even getting people down to target.

Here’s the level everyone should get under, exceeded by most Americans over the age of three. And, here’s the recommended upper limit of salt intake for African-Americans, those with hypertension, and everyone over the age of 40. Processed foods have so much salt added that even if we avoid the saltiest foods, and don’t add our own salt, that would just get us down to here—but still, that could save up to nearly 100,000 American lives every year.

So: “Given that approximately 75% of dietary salt comes from processed foods, the individual approach is [described as] impractical.” We have to get food companies to stop killing so many people. And, the good news is “several U.S. manufacturers are reducing the salt content” of their foods, “but other manufacturers are increasing the salt levels in their products. For example, the addition of salt to poultry, meats, and fish appears to be occurring on a massive scale.”

The #1 source of sodium for kids and teens is pizza. For adults over 51, it’s bread. But, between the ages of 20 and 50, the greatest contribution of sodium to the diet is not canned soups, pretzels, or potato chips, but chicken—because of all the salt, and other additives, that are injected into the meat.

This is one of the reasons, in general, “animal foods contain higher amounts of sodium than plant foods.” Given the sources of sodium, complying with the recommendations for salt reduction “will require large deviations from current eating behaviors.” We’re talking a sharp increase in vegetables, fruit, beans, whole grains, and lower intake of meats and refined grain products. As might be expected, reducing the amount of sodium would necessitate a “precipitous drop” in meat consumption for men and women of all ages. You can see why there’s so much industry pressure to confuse people about sodium.

How do vegetarians do? Non-vegetarians get nearly 3,500 milligrams of sodium a day on average, the equivalent of about a teaspoon and a half of table salt. Now, the U.S. Dietary guidelines recommend getting under 2,300 a day, and the American Heart Association says, no way, get under just 1,500 a day. Vegetarians did better, but still double the American Heart Association limit.

In Europe, it looks like vegetarians do better, slipping under the 2,300 cut-off, but it appears the only dietary group that nails the American Heart Association recommendation are those eating the most plant-based of diets.

Please consider volunteering to help out on the site.

Image credit: Birte via Pixabay. Image has been modified.

166 responses to “Salt of the Earth: Sodium & Plant-Based Diets

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      1. What if you consume a high salt diet but still have very low blood pressure? Is it still important to cut down on salt? A person like this probably does not have to watch his/her salt intake as much as one with higher blood pressure? I have had doctors tell me to eat more salt because my blood pressure is too low, which is why I don’t even watch my salt intake, I just use it liberally.

      2. Is there any estimate of what percent of people with high blood pressure are actually sodium sensitive? There are many who have high blood pressure but very low sodium intake makes no difference because that is not the cause.

    1. hi plant_this_thought, after reading your post I went looking at the comment sections below the other salt topic videos linked above. I was looking for what the rough average sodium content of wfpb eating is, without the addition of pickled, preserved, manufactured processed food. It seems that the estimated consensus of opinion is that we roughly consume 500 to 600 or so mg sodium in our plant based diets. People plugged in sample menus to cronometer to arrive at those values. Then Joseph Gonzales RD responded to one question saying that adding a pinch of salt to food surface is reasonable. (1/4 tsp = 500 mg). I think many people get confused between salt and sodium and think RD values refer to added salt.

      1. Susan:

        Right. Table salt is about 39% sodium by weight. It is very common for people to get salt and sodium quantities mixed up and to use these terms interchangeably. It’s always better to be explicit ( i.e., 1/4 tsp salt = 500 mg sodium ). A tool like chronometer theoretically takes into account the many other sodium molecules besides NaCl in food and is thus more accurate than simply measuring how much salt we are sprinkling on top.

  1. Interestingly, I’ve recently discovered that I liven up when I eat more salt. I train heavily, so I might loose it again. Is it correct to state that salt intake is an instrument, but that the gauge to read to achieve a generally good health is blood pressure?

    1. Vanrein: My blood pressure is within the range but close to the lower end. i’ve tried to cut down on salt, which I eat moderately because I don’t eat junk food or restaurant food, but when I do, I feel dizzy, probably because my blood pressure gets even lower. You may be dealing with the same issue.

    2. @Georgo Thanks for confirming. Indeed my blood pressure is also very low (don’t remember numbers, but seen surprised faces). Is there a lower bound at all? I also cook my own food without added salt; what I get is from bread, occasional flavours like shoyu and soup stock.

      @Johanna There’s food that livened me up (Chinese, for instance) and I’ve been wondering if it might be meat, but it really seems to be salt — soup stock does it, shoyu probably too. Also, I had unquenchable thirst which is a sign of low total blood volume, which in turn is the result of little total salt. One cause of that has been heavy exercise, another was drinking a lot of tea — I recently learnt that diuretics make the kidneys loose salt [1], and water follows that. All these are signs that salt can be up- and downregulated.

      [1] In fact, they always loose it but normally re-absorp it before it leaves to the blatter.

          1. Don’t worry about the Suzies of the world, vanrein. Your English is well understood. Typos happen even to the natives!

            I too have a low (but healthy) blood pressure. I find that if it dips so low that I get dizzy upon standing, then most likely my blood volume is low and I’m dehydrated. It’s not always possible or practical to measure and tally what might be in everything I consume so I take my body cues. Slight dizziness? Darkened urine? Those are cues for me that my water consumption should increase without agonizing about sodium/salt overages. John’s comments below echo my experience too. Some days you just might need more sodium than others based on energy output.

      1. I haven’t searched the whole thread, but a discussion of the types of sodium and their differing effects is in order. MSG is commonly used in Chinese food and has some of the effects you mention. Also, claims are made for the benefits of high mineral content salts such as Himalayan pink, Lima gray, etc. Table salt is the equivalent of white bread from this point of view. I hope someone can point to the studies.

        1. playbook: Every time there is a video on salt, people ask questions about “natural”/pink/sea/Himalayan salt. Other times, people simply assert that sea salt is healthy or perhaps different enough to invalidate studies showing salt is bad for us. I’ll share a response that I first learned from poster Darryl some time ago:
          .
          When the analysis is done, it looks like sea/Himalayan salt is nothing more than slightly contaminated salt – contaminated with some good things *and* contaminated with some very harmful things. But none of the contaminated substances are there in such quantities as to likely affect health either way. Want to see the actual data? Check out these posts from Darryl:
          http://nutritionfacts.org/video/are-sugary-foods-addictive/#comment-1131297498
          http://nutritionfacts.org/video/are-sugary-foods-addictive/#comment-1131500235
          .
          Also, I can’t remember if anyone has referred to the article from Science Based Medicine yet or not. (Thank you Tom Goff for bringing this one to my attention some time ago.) The following site is not source that I generally consider to contain valid information. But no one is wrong about everything and she seems to get this one right. She explains the point Darryl raises so well, I’m going to quote it for you:
          .
          “They claim that two double-blind studies were done, but no such studies are listed in PubMed. There is no evidence published in peer-reviewed journals that replacing white salt with pink salt makes a shred of difference or leads to any improvement in health.
          .
          If you read down the list of minerals, you will notice that it includes a number of radioactive substances like radium, uranium, and polonium. It also includes substances that act as poisons, like thallium. I wouldn’t be worried, since the amounts are so small; but if anyone believes the trace amounts of “good” minerals in Himalayan sea salt are good for you, why not believe the trace amounts of poisons and radioactive elements are bad for you?
          .
          The claim that pink Himalayan salt contains 84 trace minerals may be true, but the claim that it “promotes health and wellness” is false until proven otherwise by legitimate clinical studies. While waiting for evidence, I’d just as soon my salt didn’t contain uranium.” https://www.sciencebasedmedicine.org/pass-the-salt-but-not-that-pink-himalayan-stuff/
          .
          Here is an article from Jeff Novick which hits the question from a slightly different angle, but comes to the same conclusion: “My recommendations, which are inline with the IOM, recommend a limit on total sodium, regardless of the source. If you choose to use sea salt as the source of your sodium (as some people prefer the flavor of these “gourmet” salts), that is up to you, but it is not any healthier, safer, and/or more toxic than table salt.” http://www.jeffnovick.com/RD/Blog/Entries/2012/3/29_Test_2.html
          .
          Makes sense to me! Does this help?

      2. The ‘livening up’ effect could be due to biogenic amines such as MSG naturally contained in soy sauce and typically used in Chinese cooking.

      3. Keep in mind that a lot of doctors will label people as having “low blood pressure” or “too low blood pressure” when really it’s just lower than average. E.g. when you look at the Amazonian tribes, who don’t eat salt, their blood pressure averages around 90/60 – even into old age. I eat no salt and my blood pressure is typically around 90/60-100/70 ). In other words, the blood pressure of a 12-year old. With salt it goes up to 120/100 (which the docs used to tell me was “low”).

        That said, if it’s going lower than that, it may be a sign of weak adrenal function. E.g., I’ve noticed that people in stage-5 kidney failure can drop too low on a no salt diet, and occasionally (e.g. once every day or so) need to take about 1/8 tsp of salt (or, better yet, some more natural source of concentrated sodium) to get it back up.

    3. That’s an interesting comment vanrein. When I work out heavily on Saturday, if I don’t get enough electrolytes, my body is in pain. I thought about Gatorade, but I think it’s mostly processed sugar. So I get potassium (beans), sodium and chloride (olives), magnesium (green leafies) and calcium (sesame seeds). Plus beets for energy. Thanks Dr. G. I have checked and if I don’t eat the salty olives, I get pain, so some may have more need of salt, especially after an extreme 3 hour workout. I do have low blood pressure. John S

        1. vanrein: I don’t know what you mean about NF authentication no longer working for you. Just in case this is something you would like help with, I wanted to point out that there is a Help Center page at the bottom of this page. If you have a technical question (like authentication), you can submit that question via link in the upper right corner. Hopefully someone would be able to help you.

      1. I, too, exercise heavily, but eat no salt. What I actually think is happening is not that your sodium levels are too low, but they dropped too fast. If you have excess sodium in your blood then sweating will bringing it down quickly. Any shift in sodium, up or down, will cause those types of muscle pains. E.g., when I ate salt, every night I would wake up with cramps in my calves. I think this was because, during the night, my kidneys would filter the sodium out of my blood. The first night I stopped eating salt, the cramps were worse than ever… and they were also the last cramps I ever had. One thing many people have noticed, and studies have observed, is that if you don’t eat salt, your sweat will no longer be salty. I think a lot of people are confusing a state of “low sodium” with what is actually now sodium level that have normalized too quickly due to sweating or large consumptions of water.

    4. I did the math [1], and found that an estimated 11% of the reported vegans are under the recommended minimum sodium intake of 500 mg/day that I found somewhere online. I should imagine that this is more the case for whole-food plant-based vegans than for vegans in general (certainly after having seen the figures reported elsewhere in this forum for high saline content of vegan junk food). So, a lack of sodium among whole-food plant-based vegans appears to be a lack of salt fairly often! And it’ll worsen when taking diuretics and enthousiastic exercise.

      In short, I think we should be talking blood pressure in these circles, not salt consumption!

      [1] According to the last source of this vlog, vegans get Na.mean=1316, Na.sd=666 mg of sodium per day; assuming a normal distribution, we can derive that P(Na<500) = 11% — scale to standard normal with (1316-500)/666 = 1.2, meaning that if X has a standard normal distribution we're looking for P(X < -1.2) = 11%

  2. So my buddy who had his BP slowly creep upward started making this smoothy.. Fresh Beetroot juice, hibiscus tea, fresh ground flaxseed and wakame seaweed. He also has limited his salt intake to no more than 1500 milligrams/day, no alcohol and no processed food.. He also has started a veg/vegan diet, upped his exercise to loose some weight.
    So far his BP had gone from 140/82 last month to 116/70 !! yesterday.. I’m impressed!!
    m

      1. Hi,
        He grinds his flaxseed in a coffee mill and just throws the dry seaweed in with the flax. It’s kind of a pain as he has to use a juicer for the beets/carrot/celery and then a mixer to whip all the other ingredients together. I suppose you could mix it some other way by hand.
        Hope this helps..

        1. Thanks – I have a high speed blender so I’d put the whole beets in with the seaweed and whatever else I’m using–no pain at all…. Easy…. Thanks!

          1. On my list of things I’m thankful for this year is my Vitamix. I bought it six or seven years ago, but I also have one I bought in 1975 which still works. It, however, is less powerful and noisier. I use mine many times daily. It was well worth the cost.

            I also love my Instant Pot and use it almost daily.

            1. I’m with you on the Instant Pot and the VitaMix (though I actually prefer my Breville Boss). The only thing I’d add to your list of beloved kitchen tools is my rice cooker. Sure the Instant Pot can do rice too, but it’s nice to have the rice and the “stinkin’ entree” (‘Lion King’ allusion) cooking at the same time

        2. I just throw the beet root and celery in whole, along with red/purple cabbage (great source of anthocyanins) and use water along with dates to sweeten, flax, seaweed, greens, berries, and many other things. It would be embarrassing to list my smoothie. I have too much free time, lol.

          1. I forgot the beets/seaweed this morning. I had a smoothie container full of radish greens, shoved down with a banana, 5-6 cranberries, a scoop of cocoa powder, 1 cup of pure soy milk, and half of a medium-sized papaya….

    1. That’s the power of plants! I see people looking for more exotic foods that are the magic in their smoothies, for example. Just a smoothie loaded with easy-to-find greens, a banana, some flax etc. would likely do the same thing. Not to say that some of these foods do not pack a punch, but people should not feel the need to feel discouraged if they don’t go all hibiscus, seaweed and…the fact of the matter is that even if we ate these foods instead of blend them, BP would likely come down. Chewing food provides an added positive effect of releasing nitric oxide. Eat plants and see the results.

      1. I agree. I get caught up in complexity sometimes, it can be very time consuming. Just keep it simple is good enough. Add a little purple cabbage for the anthocyanins if no blueberries are available.

  3. Feedback on your format: I like to see you on the screen, but do not like the pop up from the bottom and walking appearance. I would prefer you off to the left like you are presenting the material at a conference. Also do not like the head raising and lowering, more of a steady gaze between forward at the viewer and the content you are presenting like a weather reporter. Also really enjoy your humor (more please) and genuine caring comments. Thank you.

      1. Same. I love this guy. The pop ups bring a much more personnel level to the videos. I think it might help people to see him on his treadmill desk. Maybe they’d try to find out what he’s doing, and then when they do, it might get them to exercise a little. Dr. G walks the walk (literally).

    1. I find Dr. G’s popup presence to be distracting and . . . odd appearing. I like forwarding his videos to my physicians and believe the pop ups undermine Dr. G’s professionalism and credibility.

  4. It’s my understanding that potassium/salt are best at a certain ratio in the body. As an athletic vegan (thus getting high levels of potassium, and sweating a lot), might avoiding salt put me at an electrolyte imbalance and cause excessive urination/dehydration?

    1. Hello – I am a volunteer medical moderator with Nutritionfacts.org and I help out with answering questions. I am a plant based dietitian located in Scottsdale, Arizona.
      Nice to meet you, Brush!

      You are indeed correct that there is a ratio requirement for potassium and salt. Study findings show that people who eat a lot of salt and very little potassium are more than twice as likely to die from a heart attack as those who ate about equal amounts of both. This imbalance
      of nutrients poses a greater risk than simply eating too much salt.

      The good news is that this does not work in the reverse – the issues with salt and potassium are there when there is too much salt, NOT too much potassium (from food sources). Potassium-rich foods, including fruits and vegetables, are recommended as a dietary defense against heart disease and other chronic illnesses. A research study looking at the relationship of salt, potassium, and heart disease deaths
      shows that if you have too much sodium and too little potassium, it’s worse than either on its own. This is because potassium may neutralize the negative effects of salt, including the heart-damaging effects of too much salt in the diet. We know that sodium increases the risk of high blood pressure, a major cause of heart disease and stroke.

      If you are doing endurance athletics (running for over an hour, as one example), you might benefit from my own practice as a distance runner – I make my own “sports” drink. In a large water bottle, I add one pinch of salt, about 3 ounces of orange juice, then H20. This formula even helped me complete a marathon! it works great, and is super affordable!

      Keep on moving!

      1. Hi Lisa,

        I follow the daily dozen diet with only a few exceptions, like Ezekiel bread and cereal, canned beans and crushed tomatoes all without added salt except the cereal so my question is, ” Is a plant-based diet sufficient to reach sodium goals”?
        Thanks for your time and especially your contribution to the site as you do a wonderful job.
        M.A. Stilinovich

        1. hi Mike, I am not a health professional but I would just like to make a couple of brief comments. First, wow! You sure are doing great with your healthy eating. I dont consider canned beans, tomatoes, or any whole food commidity to be an exception to wfpb eating. Even oats (though flattened) are still the whole grain. I myself use some packaged commodities out of necessity and convenience. I have heard Dr Greger say the same.
          Next, Ezekial bread has a modest sodium content imo, http://m.foodforlife.com/product/breads/7-sprouted-grains-bread and is a great choice for the fiber ( though it always pays to read labels on beans , tomatoes and breads for example since they can differ greatly between brands) Best of luck to you Mike!

        2. Ezekial bread is daily dozen approved! Canned beans is too, but I know Dr. Gregor had that video where he showed that we can cut down on our BPA levels by 90% by eliminating canned goods. Maybe go to the carton beans and tomatoes? They have the carton beans at Target.

          1. It is a hard choice to make. I can find canned beans with no added sodium but all the carton beans I have found all have added sodium. So I can get the cardboard carton beans and avoid the BPA/BPS/etc but end up with about 450 mg of sodium per carton, or the naturally occurring 20-30 mg of sodium in a can lined with endocrine disrupting chemicals.

        3. Hi @nfdev-311c43da7910b53ffc4a4b0b94309c6c:disqus thanks for your question.
          Reaching sodium goals is indeed possible with dietary changes. Dr. Greger has talked about this when discussing the DASH diet – which if you do not know, is the most researched dietary intervention and consistently ranks by the US News and World Report as the #1 dietary approach. I often use a DASH or DASH “like” dietary approach with my clients in my private practice. You can view his video on this here. While viewing this video, you’ll have the opportunity to see Dr G’s other video: Having high blood pressure is a choice. Let me know what you think!

  5. The likely reason the vegans make it under the 2,300 mg sodium level and vegetarians don’t is that most vegetarians I know enthusiastically eat salt-laiden cheese. I know I sure was hooked on the stuff before I changed to a salt/oil/sugar-free, whole-food plant-based dietstyle

    1. That was hard to give up. It took me 5 years to wean myself off of cheese. I have been cheese and dairy free for 12 years. Greatest decision I ever made.

      1. That was me too! I was just thinking about how, say if I went camping for a weekend and then came home starving, how easy it was to eat a whole Little Caesar’s cheese pizza. They were only five or six dollars! Not to single them out –all pizzas have a lot of cheese and therefore a lot of sodium — but a whole one of their pizzas has 3360 mg of sodium!

        1. Yep, that sounds familiar! I seem to remember two for one deals on the Little Caesar’s. For me it was pizza and mexican food that made it so hard. I had to make a lot of vegan cheese. Now I have no urge, I don’t need it but on occasion I will splurge on a nut and nutritional yeast based vegan cheese.

    2. I’d say so, if anything when I was vegetarian, my cheese and egg consumption grew and offset my meat consumption. It probably was a worse diet overall now that I know a bit about what I’m doing thanks to this site :)

      Cheese is very hard to give up, but now that I have, the thought of real cheese makes me want to vomit, and even fake cheeses (some of which are better tasting than real cheese) I’m completely impartial to – Probably because they aren’t addictive like dairy cheeses.

      1. I had a similar experience… I had my heart attack while on the South Beach Diet which I loved because of the mozarella cheese omlettes, low-fat yogurt, and nuts.

  6. When I cut out sodium I always get too low and suffer problems. I eat only whole plant foods. But some are prepared, like canned tomato sauce or low sodium canned beans. Last month for the 8th time–you’d think I’d learn–I got too low on sodium again because I try to keep added salt low. After a few weeks, my shoulders get muscle pain 24/7, I feel sick, weak and foggy-headed. The times I’ve been lab tested for my symptoms my sodium levels are always low.

    As soon as I add a few shakes of salt I start to feel better (within 30 mins). It usually takes weeks or a month for all symptoms to disappear. So once again I’m sprinkling just a few light shakes of salt to my morning oatmeal. This time I think I’ll just stick with it.

    I mention this only so if it happens to others who go sans sodium they can be aware that it’s possible to get your levels too low, especially if you drink lots of water.

    Mark G

    1. Yeah, definitely listen to your body. I normally eat around 1,000 mg sodium/day but notice when it’s hot out and I sweat a lot I begin to want a little more salt. Maybe I add ~ 1/4 tsp of salt in hot weather to suit my taste, but I do feel it’s my body telling me that it needs more sodium.

    2. Same, always thirsty, it’s horrible. I drink loads of water & feel like it must leak out of me. sometimes after I’ve been out and I *feel* dehydrated & headachey the only quick recovery fix for me is high mineral water (European brand). I suspected it was the delivery of sodium and bicarb, but I just read it might be the high sulphates in it, (or magnesium?) Does anyone know? Are sulphates beneficial?

      That’s the 1st time I’ve read about unquenchable thirst, blood volume & salt! I was even tested for sjorgens years ago. What else could help if that’s the problem? I think it helps sometimes when I sprinkle salt into my water when it gets hot here, and add a bit on my dinner… but I’ve always worried I might get too much. Is BP a reliable guide?

      I think I get low blood pressure (dizzy sometimes especially afer standing from a crouch). Should I use that as a measure to experiment on myself how much extra salt I need? I hoped that whilever I have low BP I can use salt freely

      I eat whole fruit and veg not much prepared food (just bread, tempeh, low salt tamari, oat milk, hummous, -& pizza or dumplings every week or 2), no dairy. Thanks for any more suggestions or answers

    3. Wow, I think I am similar to you. I can black out and fall down if I get up too fast, if I cut too much salt out. I just salt liberally and don’t worry about it. And when I visit the doctor they tell me I need to eat more salt because my blood pressure is too low.

      1. Isn’t that related to adrenal function? I’ve read that somewhere. I used to get lightheaded if I stood too fast when I was a teenager. I’d have to quickly sit down and put my head down to my knees.

          1. I tend to have low blood pressure, too – very low at times – but I think it’s actually connected with adrenal function. Maybe both.

      2. You can also use the “straining” technique used by fighter pilots to keep all the blood from rushing to their legs when pulling a lot of g’s. Basically tighten up your leg and abdominal muscles immediately before standing up. After a while it becomes automatic.

    4. This is interesting to me, because I have been very dry feeling lately(but not thirsty)! I thought it might be the summer weather, but maybe I’m low in salt? (I don’t ever get light headed though).

      Sometimes I can’t sleep because I feel so dry in my throat, and sometimes no matter how much I drink my mouth/tongue is dry. Would that be from lack of salt? (I drink plenty, …….and pee plenty too)

      I’m not sure how much salt I eat, but I usually don’t add salt to anything. With salt only being from breads, or when I add (vegan) beef stock to my vegetable or pasta sauces curries. So I would definitely be under 2000mg a day.

      1. I’ve learned that for me the big sign that I am low on sodium is that I feel horrible, like I have the flu but without a fever. And my neck and shoulders are in constant pain. I also get leg cramps. It all starts to go away within minutes with just a little salt. But like I said earlier, it takes weeks to over a month to get over all of it.

        1. I am thinking maybe eating a lot of celery might help. Celery is a powerhouse source for sodium with everything else you need so you don’t get imbalanced. I can eat a whole head of celery in a day no problem. It’s great for dipping in hummus. Celery, carrots, snap peas and red bell pepper are my favorite veggies to snack on with hummus.

          1. nc54: A nutritionist once lectured to my college class back in 1976. He warned against eating too much celery because it is high in some mineral (can’t remember which) and therefore a carcinogen. I’ve always wondered if the info is correct. I don’t eat too much of it anymore. But like you, I love it, could eat a whole head of it while watching tv or a movie (and often have), and I also love the veggies you list with a nice bowl of homemade hummus. For hummus I like to pinch off the outer husks. It makes the pureed hummus super creamy. For a heartier hummus, I lightly season and just slightly smash a few times with a fork, then put it on a whole grain bread or cracker.

            1. Interesting …. when you look up celery in the USDA nutrient database there are about 50 mg sodium in one large stalk. I guess it depends on how many stalks a person eats to determine if it’s a significant source of sodium in a person’s diet or not, but I wouldn’t consider 1 or 2 stalks a high source by any means. The carcinogenic nutrient you are likely trying to recall is nitrate. Celery and some other vegetables are natural sources of this nutrient. We actually need some nitrates for overall health. Dr G. has many videos on this topic that can be found here: http://nutritionfacts.org/?fwp_search=nitrate&fwp_content_type=video

              The health concern with nitrates comes more with people eating deli meats that have nitrates/nitrites as preservatives. Sometimes this is hidden by the term “cultured celery extract” on the food label, as in concentrated form celery can provide a significant amount of nitrate. Just one more reason to enjoy a WFPBD! Enjoy your hummus and veggies….

              1. You’re right. It was nitrates. And I have seen those other doctor Greger videos before and I don’t worry about eating them. Glad I didn’t stop eating it. Also, thanks for the usda celery content amount. It’s always best to use known amounts instead of unquantified quantities, like high, low, a little, a lot, etc.

                Thanks for your post!
                Mark G

              2. That’s a good amount in a non-seaweed whole plant food. What source would be higher? Possibly tomatoes but nothing else. Higher source of sodium does not necessarily mean better source.

          2. I find it easier to use salt because I can really regulate hire much I want. Why use food when there’s nothing wrong with salt. We need it or we die.

            1. I just find celery a good source of added sodium. It doesn’t have that potential to imbalance the body like salt has. I still consume salt I just find supplementing with celery useful to get more sodium and other useful nutrients in. Tomatoes are another good source of sodium. My salads always have tomatoes and celery as do my soups. Plus, I am betting the sodium in food is more bio-available then the sodium in salt. I don’t have a study but I would be shocked if it weren’t true.

              1. I didn’t know that about tomatoes. That’s interesting. I have about a 1/4 – 1/2 cup of both celery and tomato sauce on most days. Tomato sauce also provides some natural sunscreen-like protection. But back to the salt question. I only put a few light shakes on my oatmeal in the morning. I don’t think there’s much risk of it throwing my levels off. And when I stop I always develop symptoms of low sodium. So for me, I’m sticking with it. But thanks for wanting to make sure I wasn’t harming myself.

                Cheers,
                Mark

                1. No problem, Mark. You are doing great. I need to cut down on my salt intake, I eat much more then you do. I don’t want to damage my endothelium over time. I just use normal iodine salt.

      2. Hello Hank! Interesting reflection about sodium and your level of thirst. I’m not a medical doctor but typically we associate too much salt with being thirstier and if anything it sounds like your sodium intake is on the low side. It might be helpful for you to know how much sodium you are consuming, since, as we learned from Dr. G’s video, vegans may consume only around 1300 mg/d. The DRI (dietary reference intake) has been set at 1500 mg/d for most people. To do a rough calculation of the average amount of sodium you consume each day I recommend using the USDA nutrient database (https://ndb.nal.usda.gov/ndb/search/list) or an app that’s based on it. Food labels of products is also an idea. Maybe do an average of 3 typical days and see where you’re at?

      1. Thirst is not always reliable. You can be dehydrated and not be thirsty. It can be tricky finding that happy medium between hydration and over hydration. I like Dr. Gregor’s daily dozen checklist phone app. You do that and you will likely be good and not have to worry about over hydration or under hydration.

          1. That’s just not true. It can happen with healthy people. It’s happened to me. If you wait for thirst it’s too late, you are already dehydrated. Ideally you don’t want to get thirsty.

            1. Lol no you are not dehydrated when you are thirsty, you have some reserve everywhere in the body just like you have fuel reserves once the led turns red but it just means its time to get some.

              Just like you are not malnourished once you get hungry, does it means we should eat before getting hungry so how do we know? cmon listen to the body and it will be better~

              1. Julot,

                Actually by the time your body is telling you your thirsty you can be in a very mild state of dehydration and yes taking the hint should be adequate.

                In an interesting study most of which are done on athletes, it was found that by the time we receive the signal of thirst your indeed falling behind the fully hydrated curve. https://books.google.com/books?hl=en&lr=&id=x9KYCgAAQBAJ&oi=fnd&pg=PA249&dq=thirst+and+delayed+dehydration+2015&ots=m7P-F_jI99&sig=g4zgVcJDt5YiP5GA5nMVJEBZ3Pk#v=onepage&q&f=false . Also it may be true that as we age our bodies feedback with thirst takes a bit longer…https://www.ncbi.nlm.nih.gov/pubmed/11528342 so just being aware and drinking a reasonable amount should work. Dr. Alan Kadish Moderator for Dr. Greger

                1. Yes but we cant know thats why there are signals of thirst and hunger, its not enjoyable to eat without hunger or drink without thirst, there must be reasons~

    1. We all need salt to thrive, because we lose some with our urine, and in the case of humans, through sweating (I started a topic on that below). So, many animals like to lick salt stones. Mountaineers know that the same holds for humans — and that, when you take in salt in pure form, you are going to dislike the taste at some point, which is the point where you should stop licking it. This control does not seem to work for added salt such as in processed food.

    1. Spices, and herbs. I have a habit of picking up a few bushes of green herbs every week, storing them properly [1] in my fridge, and cutting them up into my dashes pretty much on a daily basis. This gets me my green leaves in the most tasty manner possible. Examples are parsley, dille, cilantro, mint and seldery.

      [1] a container, not completely airtight, with a damp or moist atmosphere; the vegetables / herbs lie in there elevated from water that collects on the bottom, in this case because there is a pattern of ridges on the bottom;

    2. As @Julott:disqus says, there is some sodium in all whole plant foods because all life evolved in a salty ocean and so the basic biochemistry of life evolved in and depends on there being sodium present. Unless you eliminate absolutely every single packaged food item, it is very hard to completely eliminate added salt. So it is likely that you couldn’t ever get sodium intake to dangerously low levels even if you tried.

      BTW, interesting (at least to me) side-bar, the oceans of the world have over the billions of years our planet has existed become progressively saltier as more minerals are leached from the rocks and washed into the oceans. So several hundred million years ago when all life was still confined to the oceans the basic biochemical processes that support life evolved to function with the tissue salinity equal to the ocean at that time. When life left the ocean to live on dry land, it carried a bit of that ocean with it in the salinity levels all land animals maintain in their tissues. Thus in a very real sense we carry within us an echo of our ancient ocean home.

        1. Benefits are probably more from the potassium it adds than from the sodium it subtracts. A study using “lite” salt in the kitchens and at the tables of Taiwanese veterans homes found it reduced cardiovascular mortality by 40%, increased lifespan by 0.3-0.9 years, and reduced hospitalization expenses. Urinary sodium just fell by 17%, but potassium increased by 76%.

  7. I see you don’t have many videos on sugar, I’m talking about white sugar or brown sugar with molasses. When endurance athletes go for long distance races like bicycle riders they use gels and sugar for energy. Is that really bad or unhealthy?

    I add some sugar to oatmeal and sometimes smoothies and I feel good and energized. Low fat high carb vegan.

    Maybe sugar with high fat is a dangerous combo or is it just bad anyway?

    1. I can’t remember the exact details, but in the Dr.G’s book he mentions that highly refined sugars aren’t great(there isn’t any significant nutrition in brown sugar, molasses or maple syrup, they’re only slightly better than white sugar). The less refined the better, but it’s always best to get your carbs from whole foods – so you get some actual nutrition out of them as well, and because all of those anti-oxidants are very important when exercising, because exercise creates oxidation, and that creates free radicals, and those damage your body and do all sorts of bad things from rapid aging to cancer cell creation.

      I think fruit smoothies would be the way to go if you were to do endurance races, because it’s an easy way to consume a lot of calories, but they are still healthy calories(that’s what vegan strongman Patrick Baboumian does). Perhaps even eat some beans a few hours before the race as they slow digestion down to allow for a sustained energy release(the effect lasts for up to 12hrs I think). But I guess maybe it’s hard running on a full stomach? So maybe it’s easier to keep sipping on a smoothie throughout rather than filling up at the beginning. Certainly worth experimenting with :)

      (It also says in the book that a daily tablespoon of nutritional yeast helped endurance athletes with recovery)

      If you do eat refined sugars you could try eating with at least some fruit because it helps dull the insulin spikes, and hopefully would feed your muscles over a longer period instead of all at once – I guess with enough experimentation you could have a system where you use those glucose satchels in time for a particularly energy demanding portion of the race (if you know how early before you had to eat them).

      I think however, unless you are (or aiming to be) a professional level athlete there is no need to stray from Dr.G’s Daily Dozen, and put health as your priority rather than optimal race performance. (I know a lot of people get carried away with protein powders, creatine, BCAAs and pre-workout supplements, but my opinion is that it’s unnecessary if you are exercising just for health or to just improve yourself, that 5% extra performance doesn’t matter when you are just trying to beat your own best.)

    2. Great question — Hank responded with a number of good ideas.
      Dr. Greger advocates for Whole plant-foods.
      Dates are a whole plant food that has nutrition that table sugar does not.

      More broadly speaking, there complex carbs (whole grains, etc) need to be separated from the empty calories of refined sugar, etc.

      You may find this video on sugar interesting — it has gotten a lot of attention; Generally speaking, American’s consume way too many simple empty-calorie carbs. Video: Sugar: The Bitter Truth

      To health!

  8. This is so timely for me, thanks. I’ve just returned from a USA trip. I had to eat a lot of restaurant food…learned to ask for the vegetable side and “please hold the salt and butter”. It really is overwhelming to eat any kind of take out when you are used to no-added-salt eating. And YES indeed it did show up in my BP measurements.

    Hey umm, I would put on a fake beard with candles in it…you know, like Edward Teach. People would pay attention to a bloke with flaming candles in his beard. Just sayin

  9. At first look, this video by Dr Greger is non controversial because everybody would agree that salt will increase blood pressure. But on closer look, one can see that Dr Greger has a hidden message as usual and not surprising, which is:

    “The #1 source of sodium for kids and teens is pizza. For adults over
    51, it’s bread. But, between the ages of 20 and 50, the greatest
    contribution of sodium to the diet is not canned soups, pretzels, or
    potato chips, but chicken—because of all the salt, and other additives,
    that are injected into the meat.

    This is one of the reasons, in general, “animal foods contain higher
    amounts of sodium than plant foods.” Given the sources of sodium,
    complying with the recommendations for salt reduction “will require
    large deviations from current eating behaviors.” We’re talking a sharp
    increase in vegetables, fruit, beans, whole grains, and lower intake
    of meats and refined grain products. As might be expected, reducing the
    amount of sodium would necessitate a “precipitous drop” in meat
    consumption for men and women of all ages. You can see why there’s so
    much industry pressure to confuse people about sodium.”

    So according to Dr Greger, non vegans, i.e. meat eaters, eat a lot of salt. If you eat plant foods then you are OK.

    Let’s see:

    – Trader Joe’s Refried Beans – Fat Free Traditional Style: 23% sodium
    http://www.fooducate.com/app#!page=product&id=BC3E45F0-169F-11E0-BF92-FEFD45A4D471

    – Trader Joe’s Green Beans – Blue Lake Cut: 17% sodium
    http://www.fooducate.com/app#!page=product&id=B30834D4-8772-11E0-86F7-1231380C180E

    – Tyson Chicken Breast Tenderloins, Breaded: 19% sodium
    http://www.fooducate.com/app#!page=product&id=18C08AD2-2689-11E1-AFF9-1231380C18FB

    – Amy’s Pizza, Margherita: 24% sodium
    http://www.fooducate.com/app#!page=product&id=B2D3050C-E10A-11DF-A102-FEFD45A4D471

    I bet that my filet mignon steak has ZERO sodium.

    I bet that all vegans are healthy because they eat plant foods and there is no sodium according to Dr Greger. Not.

      1. Broccoli – your daily rants have simply become old and boring. We all understand your position. We get it – you don’t care for Dr. Greger’s position to remove meat from one’s diet. Can’t we please, now, just agree to disagree?

        Can’t we just have some peace? Please?

      2. Broccoli:
        There is a diversity on Nutrition Facts. org. Some are vegetarians, some are vegans, some eat small amounts of meat. Some do almost no fat or oil, some eat avocadoes, olives, hemp seeds, nuts, etc. I am ok with disagreeing with Dr. Greger, and I do sometimes, but when the tone is so negative, it feels attacking. Try to acknowledge some of the positive things that Dr. G is giving us for free, and there are innumerable positive contributions that he makes. Then when you disagree with him, it feels like it’s about the ideas, rather than attacking him. For example, I like the information in these posts you just made, but I wish it were said in a way like, “Perhaps Dr. Greger could include these other foods in a warning about high salt or sodium”.
        John S

        1. John – broccoli likes to argue just for the sake of argument. Not to constructively contribute to a shared conversation. I agree with you – s/he is negative and just a downer to deal with.
          Since it’s Thanksgiving today, let me just say I am thankful that I don’t have to live with or be around broccoli in real life. I am grateful, today, for that.
          Gobble, gobble :-)

    1. Dr G is quoting official data.
      We all know you do not like Dr G pointing out the facts that contradict your fantasies. But isn’t it time to start dealing with the facts of life instead of just trying to shoot the messenger?

        1. Hi Blair.

          To be honest, I doubt this.

          I am sure that all industry associations have media management professionals on the payroll and social media strategies. So does NF for that matter. However, I don’t think that paying an army of people to act as trolls makes any financial sense – especially given the countless number of conspiracy nuts and enthusiastic meat eaters and hunters out there who will happily do it for free. Not to mention people who just think trolling is more entertaining than watching tv.

          The idea reminds me of a (fairly well-known in the UK) poem:

          You cannot hope
          to bribe or twist,
          thank God! the
          British journalist.

          But seeing what
          the man will do
          unbribed, there’s
          no occasion to.

          HUMBERT WOLFE, The Uncelestial City

    2. You shouldn’t eat meat because it supports the unnecessary suffering of animals and in today’s modern world people can have optimum health on a vegan diet.

      So that means we are no longer consuming animal products to survive, but for personal pleasure. This is wrong because as an intelligent species we have ethical responsibility towards other beings with the capacity to suffer – especially when we have simple and economical alternatives.

      The health benefits of not consuming meat and dairy are a pleasant coincidence.

    3. And I bet that you are a troll who comes here stroke a fragile ego by offering up red herrings and straw man arguments and think that you have said something meaningful. Go away troll.

      However, to everybody else, we can learn from the troll’s posting that even if the major ingredient in a packaged food is a whole plant food it still comes with a label thus is immediately suspect. The solution of course is to READ THE LABEL. It takes more effort to find packaged foods that don’t have added sodium, but it is possible. Our regular grocery carries a line of canned beans that have no added sodium. Most frozen vegetables are just vegetables that have been frozen. So we don’t have sacrifice convenience in order to be healthy.

      As to whether the troll’s steak has sodium, of course it does. At a minimum it has the amount of sodium that every animal has in its tissues since in our distant evolutionary past we. More likely it has much more since meat packers have taken to injecting meat with brine to tenderize it and add cheap water weight for which they can charge filet prices.

    4. Broccoli, you list sodium for processed foods, which usually have lots of added salt; unprocessed whole plants don’t have those sodium levels. As Dr G says, WFPB is not the same as vegan.

  10. We eat primarily whole plant foods with little processed food. My blood tests show sodium nicely in range. We don’t do any added salt, remove salt from recipes, Why is there carloads of salt in Food, Inc. processed foods? U.S. Food Industry used Salt, Sugar, Butter which are are “cheap” compared to say traditional Italian or Mediterranean servings which use herbs and spices.
    Maybe half of people with high blood pressure are salt sensitive. At age 58 with traditional foods such as hamburgers and pizza and bacon my blood pressure was creeping up. Cut down on salt and blood pressure came down now at 81 blood pressure is O.K. Even my wife found that one vegan breakfast sausage a day was raising her blood pressure.
    Sodium level in whole foods nothing added is quite adequate for us. Yes we exercise, bike, etc.

  11. This video is a good topic for my question to this community. I am generally very good about my diet and salt. However, every once in a while I have a . . . .let me just call it a “food episode” where I have had too much salt. Could be a bowl of chips, perhaps a salty margarita or two. . .who knows what. I know that i consumed a concentrated amount of salt for that meal (or day, or whatever). My question is, . . When one has over consumed a bunch of salt, is there anything that I can do to help it leave my system? Is the only way out for salt through our pores or is there any other way to help salt move through the system?
    I know, for example, if I have accidentally over-salted a soup (let’s say), then I can put potatoes in the soup and they will absorb the salt. Then the potatoes can be removed from the soup if desired. So does anyone know how to remove salt from our bodies once we have over consumed it?
    Thanks a lot!

    1. Thanks for your comment Rachel.

      For sure, the first thing to do would be to avoid or reduce the amount of salt. Having that said, I highly recommend you to watch this video as Dr Greger explains how to attenuate the negative effects of high salt intake.

      Hope this answer helps.

      1. Hello Darchite and thank you for your response. I went ahead and looked at the video you suggested (twice :-). The video mentioned only injecting Vitamin C as a part of its experiment to see what might affect the salt in the system. (And the Vit C did return the brachial artery function that had been salt-impaired, very interestingly). However, I don’t have the tools in my home to inject myself with vitamin C after an episode of high salt-intake. As well, . . that’s not exactly the solution I was wondering about. I’m not really interested in injecting myself over a moment of salt-weakness – that’s more extreme an action that I feel comfortable with.

        Perhaps, my question to the community wasn’t clear enough. So I’ll try again. I am wondering if there is something that one might consume or do to assist the removal of salt from the body after having had one episode of weakness and consumed a high amount of salt. Ninety-five percent of the time I am very good to excellent in my WFPB SOS diet. I’m not looking for lifestye-changing advise as I already concume a no-salt-added diet.

        Upon occasion, however, I have done something akin to consuming a couple of salty margharitas and salted tortilla chips which I know is not good for my body. So the question is: how does one facilitate the removal of the salt from one’s body after having consumed a more concentrated amount of salt. Does anyone have any knowledge about that topic?

        Some people swear by chewing parsley after consuming garlic to combat garlic-breath. This is the level and type of information I’m wondering about.
        thanks!

  12. A lot of people use sodium chloride as a flavour enhancer. However, I am quite the opposite since I do not consume foods containing added salt. I do not eat at restaurants because many prepared foods by restaurants contain added salt. (or would it be more accurate to say that almost all restaurants use added salt in some form or another?) It is also why I find it difficult to eat outside with my friends. I prepare dishes which I find tasty myself, but others may find my cooking bland. Perhaps pursuing a low sodium diet will be a lonely journey for me.

    I would encourage people to use less salt in their cooking since sodium is naturally found in many foods. For example, just 100 g of artichokes contains 94 mg of sodium.

    1. Satsuma: Maybe you could find some people who eat like you and do some potlucks or something for moral support and making some healthy-eating friends. If you haven’t checked out the website meetup.com yet, you might do so. It is a way for people to find each other who have similar interests. There’s usually a vegetarian or vegan group in most cities and you might be able to get them to have some low salt events.
      .
      Just an idea. Thanks for sharing.

      1. Thank you for the suggestion! I have previously visited meetup.com before, but some of the food featured in some vegan groups really surprised me. For example, I hadn’t heard of vegan hotdogs back then! One of the events I came across only had food trucks with vegan junk food, so I decided that looking on meetup.com wouldn’t be a good idea. But you have a good idea – maybe I could get them to have some low salt events!

        1. Satsuma: I know what you mean. My meetup group tries to vary the type of events we have to meet everyone’s needs. That means that we have plenty of junk food events, because there is a big interest for that. But other events we have focus on healthy eating, though we haven’t specifically tried a low salt one. That’s a good idea. Good luck! I hope it works out.

        2. Satsuma: One more idea you could pass on to the group. Every year, one of our events is to show Dr. Greger’s annual summary video combined with potluck. Potlucks can be hard on some people who aren’t used to cooking vegan. So, we encourage people to bring healthy food to that event, though we don’t require it. We do require that people bring ingredient cards. That way you can self-select dishes that are appropriate for you. If your group did something similar, part of what they could do to define a healthy dish is to stress low-salt or no-added salt if you want to go that far. Again, just sharing another idea. :-)

          1. Thank you, that sounds like a good idea. A low-salt potluck could be good for a start as I don’t want to make it too difficult for them. Maybe they will start to eat more healthy food after watching Dr. Greger’s videos. :)

      1. Sorry for the confusion. Lacto fermentation refers to the bacteria used for the fermentation process. There is no dairy in it. Only fermented veggies like sauerkraut and others

        1. Thanks – my fault entirely. In my defence though, I would say that fermented milk products are also, as one would expect, mainly lacto-fermented

    1. I am assuming you are talking about the use of salt when making your own fermented foods? Probiotic starters are necessary for culturing yogurt but other vegetables will ferment with just the commensal organisms that are on the vegetables themselves. Salt is usually used to bring the liquid out of the cells of the vegetables which also keeps the fermented vegetables from growing mold. When I have made sauerkraut the only thing I’ve added is a small amount of salt which then enhances the “weeping” of the cabbage. Keeping the shredded cabbage submerged is key to circumventing mold growth. Some cabbage I’ve found creates less liquid so I’ve been advised to juice some of it to pour over the cabbage and that works great, too. There is very little salt in this sort of fermentation process.

  13. Hi! Great video as always!
    However made me think about the opposite.What about people who have really low blood pressure? I am one of them and already had a doctor stating I am “too healthy” (if there is such a thing) and that I have to consume more salty foods and add more salt into my diet.
    What do you think about this?

    1. Marta,

      Great to hear that your “too healthy” and I would agree with you, it’s an oxymoron. With that said, what is your really low blood pressure ? Since I have no B/P numbers may I suggest that you evaluate with a check of symptoms and check in with your physician if any are present. Do you feel faint when you get up quickly from a seated position ? Are you feeling faint when working out or notice any symptoms of blacking out or needing to slow down when active ? These are some of the common signs of too low a blood pressure and there are more. Most low blood pressure patients who are not “ill” don’t have any symptoms and do not need any additional salt intake.

      A simple blood test, using a few drops of blood, which you can do without physician input, will verify if indeed your sodium or other electrolytes are amiss. You might also consider doing a diet diary and checking your intake of salt. For all but a few it’s typically more than adequate…. see the last slides on: http://nutritionfacts.org/video/salt-of-the-earth-sodium-and-plant-based-diets/ for a comparison Dr. Alan Kadish Moderator for Dr. Greger

      1. Hello again Dr Alan,
        Yes, you are right, without numbers it’s hard for you to give a proper answer. Whenever I do exams again I will come back with those numbers.
        I do have some of the symptons you mentioned sometimes, from time to time. Used to be more often. Actually i heard this ‘ advice’ from this doctor after having to see him because I felt extremely weak and feeling like fainting for no reason. I was very pale and shaking. I wasn’t ill. The doctor then said it was due to my very low blood pressure, that it happens sometimes if you have it.
        I do have the need to slow down when exercising, however that’s also linked to me having asthma.

        I will try to do the diet diary and come back with numbers.
        Thank you so much for helping and being so prompt to answer!

        1. Marta,

          Your welcome. Please make certain that your physician also checks your cortisol levels (via 4 saliva samples) to make certain that your adrenals are working up to snuff…..

          Dr. Alan Kadish Moderator for Dr. Greger

    2. You may also want to discuss with your doctor other options besides increasing salt consumption.

      An old friend of mine has just been diagnosed with stomach cancer and there is some evidence that salt increases gastric cancer risk. The World Cancer Research Fund (WCRF) found that there is probable evidence that both salt and salt preserved foods are associated with an increased risk of stomach cancer
      http://wiki.cancer.org.au/policy/Position_statement_-_Salt_and_cancer_risk

    3. Usually there is not much problem with blood pressure being too low unless you have an autonomic problem that prevents your body from appropriately responding to situations where you need higher blood pressure such as standing up, etc.. If this is a recurrent problem for you a cardiologist or neurologist (depends upon the region who does the work up) may have to do some testing. Interestingly, my brother in law has a similar situation wherein he was told he was “too healthy” and indeed had trained so vigorously his resting heart rate and blood pressure were extremely low. After months of testing they finally did put him on medication to increase his blood pressure but this is an extremely rare occurrence and hopefully not what is going on with you.

  14. I was shocked to find that with my very fine WFPD, on a recent sample day evaluation, I consumed at least 3649 mg of sodium. I happened to be focusing on making my own pizza though using prepared dough balls. Very clean! Just sauce, veggies (mushrooms, onions, peppers)… Ooops, forgot to include the 1/2 cup of sliced black olives. Add 594 mgs.

    I’m in a cardio Rehab program where they take my blood pressure every visit, twice a week. So, once I’d realized the above, I spent merely the next 18-24 hours systematically avoiding salt. At yesterday’s exercise session, in contrast to my normal post-workout blood pressure of 125-135 (wherein they always fail to take the measurement correctly, with me standing and without lifting my arm properly to the cuff is parallel with my heart), I had an astonishing result of 104. Maybe this was a fluke. (I’m on blood pressure medication, hopefully short term only.)

    I will continue to test this. If this is for real, this would be a major health revelation for me. I’ve been strict healthy vegan for 4+ years.

    1. Tobias Brown: Thanks for sharing this story. It goes to show that sodium can sneak in there in large amounts if people are not careful.
      .
      There is healthy and then there is healthy… I often describe eating healthy as a path. When people are ready, they can take that next step down the path to tweak their diet to make it that much healthier. Looks like you are ready to take the salt step. I hope it helps!

      1. Very well stated there Thea. Thanks.

        Some of us should lobby Pam Popper to reconsider her videos where she states that salt consumption isn’t something to be concerned with. She’s a fairly close associate with Dr. McDougall and in general is very good…

        1. Pam Popper says that the studies show that salt restriction is counter productive for most people. That does not mean that there aren’t some people that are salt sensitive and need to restrict it.
          I just listened to her video to remember what she does say. She does warn that some people do need to restrict it

          1. This contradicts what Greger says here. It’s not merely a recommendation for a few but a universal concern where he suggests that everyone benefits from the absolute minimization of sodium intake. Popper leaves one believing it’s not a concern at all in general.

  15. So a good “Ask the Doctor” question. Yesterday I had a great vegan meal at a local restaurant. The downside is that there was too much sodium in many of the dishes, e.g. too much in the hummus, too much in the olive tapenade too much in the harrisa, too much in the pistachios, you get the idea. I awakened 1.5 pounds heavier as did my wife, and along with huge nasal labial folds thanks to my face being swollen from the water retention. Is there anything we can take after the meal, such as potassium chloride tablets, to offset this rather heinous effect? thank you!

    1. Hello! Eating out can be tough. Even when you think you’re ordering a “healthy” meal it can still be loaded with salt. The best advice I have is to hydrate, hydrate, hydrate! Making sure you’re drinking plenty of water. Also, here’s a site that might be helpful in the future HappyCow.

  16. doesnt this study suggest one should eat way more salt?

    Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events
    http://www.nejm.org/doi/full/10.1056/NEJMoa1311889#t=article
    see figure one, all cause mortality vs sodium intake?

    “The lowest risk of death and cardiovascular events was seen among participants with an estimated sodium excretion between 3 g per day and 6 g per day. Both higher and lower levels of estimated sodium excretion were associated with increased risk, resulting in a J-shaped association curve”

    as sodium is maintained in balance, that what you excrete reflects the sodium intake

  17. Is there really any medical need to add salt to one’s diet if he/she is following a whole food plant based diet? It seems like much of the literature uses a low sodium diet to be one that contains somewhere between 1,500-2,300mg sodium/day– but on a true plant based diet you’d be getting much less than that if you’re not adding salt to your diet. Is there any research suggesting that you could be fine on less than 1,500mg/sodium a day? Is there a true “lower limit” on how much is needed for regulatory bodily functions?

  18. No, unless you’re taking diuretics or have kidney disease. Those 1500-2300mg guidelines are maximums, not minimums or requirements, and nowhere near the minimum. For sodium sensitive patients with high blood pressure, even these guidelines are excessive. If you’re otherwise healthy, a WFPB lifestyle will supply you with all the sodium you need.

    From this WHO summary of the research, they state this: 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).

    http://www.who.int/nutrition/publications/guidelines/sodium_intake_printversion.pdf

    Dr. Ben

  19. my sodium level is always low when they take my blood, is that Ok? We are on a plant based diet and no salt in our house, but mine is always low.

  20. Hi Susan- There are ranges for sodium levels and discussing with your doctor if yours is in the low normal range or truly low is worthwhile. This could be a function of different medications that you might be taking and less likely related to dietary intake as our kidney/adrenal/hormone systems are quite smart and keep these vital electrolytes in balance.

  21. Hello !

    I do vegan diet that consists of 60% cooked and 40% raw.

    In a typical week, I never consume processed food, and I do not use salt in the food that I prepare in home.

    Today, I did a test on cronometer and saw that “sodium” value was at 296 mg, which is 20% of the recommended value, and it show a yellow bar, meaning that I should increase my sodium value

    Does this mean that I should add salt to my foods ?
    Or, regarding the sodium value, the lower is the better ?

    I am very confused about this topic because the above useful video does not tell if it is optimal to use salt or not, and have as a resource only the sodium that naturally exists in plant foods

    Thanks in advance for your time

    Best regards

  22. Unfortunately, the advice in the video has a serious problem. As an admirer of Dr Greger I would love this issue to be addressed openly.

    The study mentioned by Tester, above, and others like it, is the elephant in the room. Very low salt diets, which most diets without added salt probably are, do not support, and appear to harm, cardiovascular heath. The message is unpalatable but it is what the research says. (There are links to some other relevant papers at https://www.healthline.com/nutrition/how-much-sodium-per-day#section6).

    The fact that no one has responded to this massive problem with the advice on salt which is being provided here is understandable, because the science appears to undermine the message. It is also frustrating, because this is an area where I fear Dr Greger, whose guidance I rely on and respect, is cherry-picking research. To be clear, I am still trying to follow Dr Greger’s advice although the balance of research shows that in this area his advice is bad, on the basis that he is right on so many things that he may have some good but undisclosed reason why he persists with this message in the face of research results to the contrary.

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