Sodium & Arterial Function: A-Salting our Endothelium

Sodium & Arterial Function: A-Salting our Endothelium
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A salted meal can impair artery function within 30 minutes by suppressing a key detoxifying antioxidant enzyme in our body.

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If you put people on a low-salt diet (meaning only getting twice as much sodium as they need), as opposed to a usual salt diet (where they’re getting five times more), you get a significant improvement in arterial function. Lower salt, better arterial function, suggesting heart-protective effects beyond just blood pressure reduction.

Now, this was after dropping people’s salt intake by about a teaspoon a day for two weeks. What if you only dropped salt intake by like a half teaspoon a day? You still get a significant improvement in arterial function, and it happens within just two days of reducing one’s salt intake. Or, even after a single meal.

A high-salt meal, which is to say just a typical amount of salt consumed in a commonly eaten meal, can significantly suppress artery function within 30 minutes. Here’s what happens 30, 60, 90, 120 minutes after a meal with just a pinch of salt in it. Here’s what happens after the same meal, but with a quarter teaspoon of salt in it. A significant suppression of arterial function. Now, is this in addition to the spike in blood pressure from salt, or because of the spike in blood pressure?

If you take people with normal blood pressure, and give them a bowl of soup containing how much salt a regular meal might contain, their blood pressure goes up over the next three hours, compared to the same soup with no added salt. Now, this doesn’t happen to everyone; this is just the average response.

Some people are resistant to the effects of salt on their blood pressure. So, what if you repeated the artery function experiment on them? Unfortunately, the title kind of ruins the suspense and gives it away, but as you can see, even in people whose blood pressure is unresponsive to salt intake, they still suffer significant suppression of their artery function. So, even independent of any effects on blood pressure, salt hurts our arteries, and that harm begins within minutes of it going into our mouth, for our major arteries, and even our itty bitty blood vessels.

Using something called laser Doppler flowmetry, you can measure blood flow in tiny vessels in our skin. Here’s blood flow at baseline. Now, to get the blood vessels to open up, they warmed up the skin. The reason we may turn pink when we get into a hot bath is that the blood vessels in our skin are opening up. And that’s what happens, big increase in blood flow with the warming; but that’s on the low-salt diet.

A high-salt diet starts out the same at the beginning, but after the same heating, there’s significantly less blood flow. The arteries just don’t seem to open up as well on a high-salt diet, unless you inject vitamin C into their skin. That seems to reverse the salt-induced suppression of blood vessel function.

So, if an antioxidant reverses the salt effect, then the way salt may be damaging our artery function is through oxidative stress—the formation of free radicals in our bloodstream. But how? Well, there’s an enzyme in our body that can detoxify a million free radicals a second, 24 hours a day, seven days a week. But compared to a low-salt diet, if we consume a normal salt diet, we suppress the activity of this detoxifying powerhouse of an enzyme.

That may help explain why “this is your artery function; this is your artery function on salt.” With our antioxidant enzymes crippled by the salt, all the excess free radicals may be crippling our arteries. But mop up those extra free radicals by infusing vitamin C into the bloodstream, and artery function returns to normal. Whereas, on a low-salt diet, if you drip vitamin C into people’s veins, nothing happens, because our antioxidant enzymes are already taking care of business, and haven’t been shackled by the sodium of a normal-salt diet.

Whereas potassium, concentrated in fruits and vegetables, softens the cells that line our arteries, and increases the release of nitric oxide that allows our arteries to relax, sodium in our blood stiffens the cells lining our arteries within minutes, and reduces nitric oxide release. The more salt, the less nitric oxide is produced.

One salty meal, and not only does our blood pressure go up, but our arteries literally stiffen. That’s why we could figure out that too much salt was bad for us 4,000 years ago. Maybe we don’t need a double blind trial, maybe we don’t need to follow people for a decade; you may just have to feed someone a bag of potato chips, and take their pulse.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to condesign via Pixabay.

If you put people on a low-salt diet (meaning only getting twice as much sodium as they need), as opposed to a usual salt diet (where they’re getting five times more), you get a significant improvement in arterial function. Lower salt, better arterial function, suggesting heart-protective effects beyond just blood pressure reduction.

Now, this was after dropping people’s salt intake by about a teaspoon a day for two weeks. What if you only dropped salt intake by like a half teaspoon a day? You still get a significant improvement in arterial function, and it happens within just two days of reducing one’s salt intake. Or, even after a single meal.

A high-salt meal, which is to say just a typical amount of salt consumed in a commonly eaten meal, can significantly suppress artery function within 30 minutes. Here’s what happens 30, 60, 90, 120 minutes after a meal with just a pinch of salt in it. Here’s what happens after the same meal, but with a quarter teaspoon of salt in it. A significant suppression of arterial function. Now, is this in addition to the spike in blood pressure from salt, or because of the spike in blood pressure?

If you take people with normal blood pressure, and give them a bowl of soup containing how much salt a regular meal might contain, their blood pressure goes up over the next three hours, compared to the same soup with no added salt. Now, this doesn’t happen to everyone; this is just the average response.

Some people are resistant to the effects of salt on their blood pressure. So, what if you repeated the artery function experiment on them? Unfortunately, the title kind of ruins the suspense and gives it away, but as you can see, even in people whose blood pressure is unresponsive to salt intake, they still suffer significant suppression of their artery function. So, even independent of any effects on blood pressure, salt hurts our arteries, and that harm begins within minutes of it going into our mouth, for our major arteries, and even our itty bitty blood vessels.

Using something called laser Doppler flowmetry, you can measure blood flow in tiny vessels in our skin. Here’s blood flow at baseline. Now, to get the blood vessels to open up, they warmed up the skin. The reason we may turn pink when we get into a hot bath is that the blood vessels in our skin are opening up. And that’s what happens, big increase in blood flow with the warming; but that’s on the low-salt diet.

A high-salt diet starts out the same at the beginning, but after the same heating, there’s significantly less blood flow. The arteries just don’t seem to open up as well on a high-salt diet, unless you inject vitamin C into their skin. That seems to reverse the salt-induced suppression of blood vessel function.

So, if an antioxidant reverses the salt effect, then the way salt may be damaging our artery function is through oxidative stress—the formation of free radicals in our bloodstream. But how? Well, there’s an enzyme in our body that can detoxify a million free radicals a second, 24 hours a day, seven days a week. But compared to a low-salt diet, if we consume a normal salt diet, we suppress the activity of this detoxifying powerhouse of an enzyme.

That may help explain why “this is your artery function; this is your artery function on salt.” With our antioxidant enzymes crippled by the salt, all the excess free radicals may be crippling our arteries. But mop up those extra free radicals by infusing vitamin C into the bloodstream, and artery function returns to normal. Whereas, on a low-salt diet, if you drip vitamin C into people’s veins, nothing happens, because our antioxidant enzymes are already taking care of business, and haven’t been shackled by the sodium of a normal-salt diet.

Whereas potassium, concentrated in fruits and vegetables, softens the cells that line our arteries, and increases the release of nitric oxide that allows our arteries to relax, sodium in our blood stiffens the cells lining our arteries within minutes, and reduces nitric oxide release. The more salt, the less nitric oxide is produced.

One salty meal, and not only does our blood pressure go up, but our arteries literally stiffen. That’s why we could figure out that too much salt was bad for us 4,000 years ago. Maybe we don’t need a double blind trial, maybe we don’t need to follow people for a decade; you may just have to feed someone a bag of potato chips, and take their pulse.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Image thanks to condesign via Pixabay.

Doctor's Note

This is part of an extended video series on sodium, trying to set the record straight on the “controversy” manufactured by the processed food industries.

Check out the previous installments:

Other salt-related videos include:

I touched on potassium in Preventing Strokes with Diet and Lowering Our Sodium-to-Potassium Ratio to Reduce Stroke Risk, but looking forward to doing a deep dive into the mineral when I get a chance.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

259 responses to “Sodium & Arterial Function: A-Salting our Endothelium

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  1. So obvious question, would vitamin c need to be injected, or would a kiwi after a salty soup negate the artery stiffening effects?

    1. I would eat a kiwi. Vitamin C is one of the vitamins that you should get through foods and not through supplement or injection. Also, the practice of eating dessert with fruits after a meal is a good one because not only of the vitamin C but also of the prebiotics and probiotics that will help digestion and absorption of nutrients. That’s why the old practice of eating fruits for dessert (not a sweet cake :)) is a good one to keep.

    2. Vitamin C was used in this study as a biochemical intervention to investigate the role of oxidative stress in the attenuation of vasodilation with high salt consumption. The study does not suggest that you can protect against the deleterious effects of salt by eating food high in vitamin C or by swallowing vitamin C tablets.

      For example, 20 mmol/L (mM) of vit C was infused. Vit C has a MW of 176 g/mol. The average human has a blood volume of 5 L. You would have to take (swallow or eat) 17,612 mg (17.6 g) of vit C AND 100% of that would need to get into the blood (which is unlikely) to equal the 20 mM used in this study.

      1. At about 3:50, Dr. Greger mentions how vitamin C in the blood stream negates the harmful impact sodium can have on arterial function… Obviously we get vitamin C in the blood stream from ingestion, not just injection, but I would like to know how much as Dr. Greger did kind of make it seem like a general thing that occurs from significant vitamin C intake. I didn’t read the study, I only watched the video so I’ll take your word for it on the numbers, but did they not test for lower amounts of vitamin C? Did they immediately start with such high doses? If so, that wouldn’t necessarily mean such high doses are needed because lower wouldn’t have been tested. However, regardless of that, it’s my understanding that our bodies can only absorb up to 200 mg of vitamin C at once, but I guess injecting directly would surpass what our bodies can normally absorb on their own? Why not start off at 200 mg, though, to see what an ATTAINABLE amount of vitamin C in our bloodstream could do?
        And what about other factors such as other antioxidants we eat from food or other foods that improve arterial function such as garlic, raw onions, spices, etc.? It seems like this kind of stuff should be looked into because while I know a lot of people are fine with adding no salt to food, most people are not so knowing practical solutions while simply minimizing salt intake would be useful.
        Also, can anyone who read through the whole study tell me how this was done. Was the group given a meal containing said amounts of sodium, or were they simply getting the sodium? If in an actual meal, what did the meal consist of? And what type of salt was used? I realize sodium is sodium but am curious about the impact unnatural table salt (or rather the additives within it) has separate from a purely natural form of salt.

        1. Also, how long did the restricted arterial function last? Were potassium levels taken into account? Fiber? Etc.? And was the amount of sodium already present in their blood from previous meals measured beforehand? Most people consume salt with every meal and even snacks.

          1. Oh, and what impact would hydration possibly have? Isn’t water effective at flushing out excess sodium? Is this true? So would a mostly dehydrated person vs. a well hydrated person be more prone to restricted arterial function by any significant difference? I also read that hibiscus tea is able to lower sodium levels, I would like to know if there’s any truth to that and know more about different foods/drinks that can lower sodium levels if indeed what I read were true.
            I wish when they did studies like this that they just went all out and learned every possible aspect… that would be awesome. I also wish I were a trillion are so I could fund these studies. Sigh… that would be nice.

    3. And another obvious question: Have any studies compared people on WFPBDs with people who don’t eat a lot of plants? Does sodium have the same damaging effects in people who eat lots of plant foods containing potassium, nitric oxide, vitamin C and/or other anti-oxidants?

      1. Great question Harriet!! I would really like to know this as well. This is definitely some important info, but there are so many other questions that need to be answered. I posted some similar questions above as well that I think should really be addressed if they haven’t been studied yet, and if they have, hopefully someone can answer them.

  2. Excellent video! I have reduced my salt intake since going PBWF several years ago and my BP is now normal. But this information gives me another reason to further reduce my salt intake. I still like a salty meal every so often, but now I’m going to make a better effort to cut down even more.

  3. Are we talking about common refined salt? I understand whole marine salt or Himalayan salt don’t cause the same effects. Is that true?

    1. I don’t believe that is the case because the only difference with those salts is the presence of some extra minerals. I believe the presence of sodium chloride is the main cause of this decrease in antioxidant scavenging activity. So it would be assumed that if both refined salt and Himalayan salt contain equal sodium chloride, they would most likely have the same effect.

      1. Thanks for your reply, Dylan and Julie. However, I am reluctant to believe that whole salt is the same as refined salt. As with anything, any ingredient that is whole, is always better than its refined version. The same as fruit juice is nowhere near as good as eating the fruit whole, won’t it be so much better to have whole salt, with all its minerals, than just the sodium chloride? After all, sodium plays an important role in many metabolic processes in the body, like keeping the acid-base balance, makes hydrochloric acid, and carries nutritional elements to our cells. And yes, the mineral conent in whole salt is small, but then again we only need trace minerals in a very small amount. It is precisely the extra mineral content that makes it so much healthier. That doesn’t mean we can abuse it, obviously, but the harm is greater with refined salt. I just don’t think we can consider the two as the same thing. We don’t do that with refined sugar, refined flour, etc. Why would salt be different?

        1. Maria C, I don’t use refined salt, only unprocessed sea salt or Himalayan because I do believe that salt is harmed during processing. I’ve heard they heat salt up to 1000 degrees; that can’t be good. That being said, salt, whether unprocessed or processed, still contains loads of sodium so should be used sparingly.

      2. Dylan, that is not the only difference between those salts. Common table salt has anti-caking agents added, is often bleached, and undergoes processing in order to add (a small amount of) iodine. I would imagine due to all the above factors that they act significantly different within the body. I would think they’d want to test with a pure salt otherwise the above mentioned factors could interfere with results and make it harder to pinpoint the cause, so I would also like to know what type of salt they used in this study.

      1. Wow, that is a brilliantly written article! I’ll recommend it to my health-motivated friends who may be inclined to buy these salts. I think iodized salt is also important in the prevention of hypothyroidism, which the RD does not address. It is a tough balance, but vegans may be at risk for low iodine. I’m not sure how people on WFPB get iodine if not consuming seaweed regularly.

        1. I love Jeff Novick’s work! Glad I could help! I’m pretty sure beans and potatoes and veggies still have some iodine, but yes… it’s definitely an up and coming area that probably needs more research and answers!

    2. It doesn’t make any difference
      whether you use plain salt, sea salt, pink Himalayan salt blessed by buddist
      monks on a mountain top in Katmandu, or some ancient sea salt from a dried up
      underground lake in the deserts of Utah. It’s still all sodium
      chloride…though some of those fancy salts and especially gourmet salts, may
      also contain unwanted other components like heavy metals.

      Jeff Novick referred to a study
      on the presence of heavy metals in gourmet salts:

      “Abstract:

      Salt has been a common commodity and household
      staple for thousands of years. Over the past decade salt has transformed from
      common product into a gourmet item with various origins, processing methods,
      representing all the colors and flavors of the gourmet spice market. Gourmet
      salt sales exceed $250 million dollars a year. Some exotic varieties are luxury
      products retailing for more than $20 an ounce compared to regular table salt at
      $0.02 an ounce.

      This study examined a variety of
      gourmet salts for the elemental composition and for the presence of heavy
      metals. The salt samples represented many different colors, production methods,
      textures and price points

      Conclusions:

      This study shows that the highest
      concentration of elements were found in the darker or deeply colored salts. The
      Kala Namak Black mineral salt (#11) had the highest concentration of Arsenic,
      Mercury, Vanadium, Potassium, Zinc and Iron. The reagent grade NaCl and generic
      table salt contained the least amounts of the elements examined.” I personally
      don’t use salt because it makes my BP go up, but if I did, it would be for
      taste, and I would use the one with the least heavy metals.”

      Jeff Novick says: “A tsp of table salt is 2200 mgs of
      sodium. A tsp of Sea Salt is around 2000 mgs. Less, but as you can see, still a
      lot of sodium.

      Now according to the company
      Celtic Salt, a very popular promoter of sea salt, and based on the percentages
      they post on their website of the analysis of their product, a tsp of Celtic
      Sea Salt also contains

      12 mgs of calcium

      7 mgs of
      potassium

      27 mgs of
      magnesium

      The recommended amounts we need
      are

      1000 mgs of
      calcium

      4700 mgs of
      potassium

      400 mgs of
      magnesium

      So, in order for us to get in any
      significant amount of (less say 25% of the recommended amount)

      Calcium, we
      would need to also take in 41,000 mgs of sodium

      Potassium, we
      would need to also take in 335,000 mgs of sodium

      Magnesium, we
      would need to also take in 7,407 mgs of sodium

      So, in other words, the amount of
      sodium in the sea salt we would take in to get any significant amount of those
      minerals, would be extremely dangerous if not toxic. And, small amounts of sea
      salt, would offer no benefit from the minerals. If you choose to use sea salt as the source of
      your sodium, that is up to you, but it is not any healthier, safer, and/or more
      toxic than table salt. “

  4. Make sure that you are still getting the minimum sodium requirement if you exercise heavily. I went for a 30 mile bike ride a week ago consuming nothing but approx. 4 liters of water all day. By evening I had a splitting headache and a truly unpleasant encounter with hyponatremia (sometimes called water poisoning).

    1. I have to watch my symptoms closely. If I start to fall low on salt I get a stiff neck. If I think it’s stress or don’t take in some salt I then get pain in my shoulder blades and then further down my back. I’ll also start to feel like I have the flu. As soon as I have a little salt it all starts to reverses within just an hour or two. But it can take several weeks before the pains are fully gone. I’ve also cut back on over hydration, which I think was flushing too much salt out of my system.

        1. For me? I don’t think so. As I mentioned somewhere else on this discussion today, I sprinkle some kelp flakes on my food daily to get iodine. No, it happens that if you over hydrate (too much water) and don’t use salt that are likely to get low in sodium because it gets flushed out.

      1. Yes, I play baseball for 3 hours with guys in their 20’s on Saturdays. I am twice their age. I can often feel the dried salt on my skin, and I’m sore, so I’m building a procedure to put electrolytes back into my body. Apparently sodium, magnesium, potassium, chloride, calcium. I’m just eating whole plant foods that have them, like olives, sunflower seeds, pistachios, green leafies. It takes away a lot of soreness and just gives you that “great workout” feeling

    2. As a recreational bicyclist and backpacker I am curious about this topic, too. The effects of chronic exercise (training) and acute exercise on sodium homeostasis is complex and I don’t pretend to know the answers especially with regard to “low” salt consumers. That said, I am currently self experimenting by foregoing salt replacement during 40+ mi bike rides. So far I haven’t noticed any problems.

      A low salt diet results in an increase in renin and aldosterone plasma levels which leads to greater salt reabsorption by the kidneys and lower salt loss via sweat. One paper I just found for this comment (after a quick search) found no difference in exercise task completion in a hot environment between a low salt group and a “normal” salt group. The sweat rates were similar but the low salt group has lower sodium in their sweat. http://www.ncbi.nlm.nih.gov/pubmed/2656071

      1. The lower salt in sweat makes sense because the body is trying to conserve it and doesn’t have it to give. Times when I have been too low on salt my tears and mucus didn’t taste like anything; no salty flavor.

        1. Saw that a long time ago. Too many flaws, not taking into account life habbits, diet and etc. He makes the common mistake 99% people (including MDs) do : exercice IS destructive (catabolic) and sleep (not rest but SLEEP) is constructive (anabolic). And enhancing your body need an alternance of destructive (of weak parts) and constructive times. It is what enhance you. But if you dont get what your body needs to recover properly from exercice, if you feed your body with improper thing, you just fasten the aging. If you balance properly destructive/constructive the good way, the more performing your body is and the longer you’ll live.

          Studies right now are not even taking into account that reality that chronobiology is one of the key and thus are biaised. Well, not all them but the vast majority, cause I do remerber one video of nutritionfacts about vitamin C during exercice impairing the destructive effect of it. Sadly it didn’t go further into conclusions that maybe IMHO : no vita C if that is a training exercice but vita C if that is a far longer/more intense session/race and if you don’t want to have to much destructive effects on your body (no injuries).

          1. It’s worth engaging with articles Dr. O’Keefe has contributed to (1, 2, 3, 4, 5), which do a better job of highlighting the thresholds where increasing endurance exercise has diminishing returns, and the specific pathologies ultraendurance athletes exhibit. Bear in mind the emphasis (and word count) for exercise recommendations in the last paper:

            The current recommendation of 150 min/wk of moderate or 75 min/wk of vigorous aerobic physical activity by the US physical activity guidelines seems to be sound, realizing that with running, which would be considered a vigorous
            aerobic physical activity, significant, and possibly maximal, health benefits may occur at levels well below this recommendation, supporting the idea that some physical activity in the form of running is considerably better than no physical activity. In addition and specifically with running, maximal benefits appear to occur at quite low doses. In general, running for 5 minutes may equal approximately 15 minutes of walking and 25 minutes of running may equal approximately 105 minutes of walking, suggesting that 3 to 4 times the duration of walking is needed. Therefore, extreme exercise training is not needed to maximize protection against CVD and all-cause mortality. In addition, extreme exercise training at levels of running well above 40 min/d is associated with some risks, although these risks appear relatively low.

            1. Repeating what is said before my comment doesn’t gives answers to my comments and questions. Reapeating won’t make it true. And that’s denying tons of testimony around to make recommandations without taking into account what I pointed (I didn’t invented my arguments, and I also experienced them).
              Statistics is just the 3rd level in the art of lying.

              1. Is there published evidence that vitamin C prevents hyperexertional injury? In the one small study I could find, there was no reduction in postexertiaonal creatine kinase with high dose C, “this suggests the extent of damage within the muscles probably was not attenuated with this 3 g/d dose of vitamin C.” Does sleep influence muscle recovery? Probably, and sleep deprived rats suffer muscle atrophy. These results say little about the fibrosis, ventricular hypertrophy, arrythmias, and increased atherosclerosis seen in the hearts of some ultraendurance athletes, and given that the pathologies take decades to become symptomatic, its hard to imagine a feasible trial that could test assertions that vitamin C or adequate sleep are protective,

                1. You know, people going into ultra sport are just scouting for science because the little imbalance results in injury, far faster than what could occur to a sedentary guy. Their experience is what is later on taken into account to build some experiment and to draw conclusions. And when they pinpoint an incoherence, the truth might be that the BOTH hypothesis are wrong only because some crucial parameter is eluded. (And some are reporting benefit of vit C during competition.)

                  That’s my guess right now : most science studies, even interventionnal ones, are not taking into account the “WHEN is some event occuring”. You could even say that the “WHEN the data is recorded” (even after months of interventionnal study) has a significant impact on the conclusion.

                  That’s not “hard to imagine”, that’s just what future science will have to do, there is no dodging it as there was no dodging “double blind placebo controled interventionnal studies” or whatever method too complicated in the eye of a scientist a century ago. The sooner the better.
                  (btw, arythmias are strongly correlated with bad/lack of sleep. athletes going for ultra know that)

  5. There’s two other considerations though: I recently looked at my daily salt intake on cronometer.com and realized that it is so low that I was at only 500 mg/day or less, way lower than minimum needs levels. In addition, my iodine was darned-near zero. So, those of us who eat a lot of salads and raw plants, or use salt (or sea salt) sparingly in our foods need to be mindful that we don’t go too far in the other direction.

      1. Yes, I’m aware of iodine in sea vegetables, but don’t really like them much. But maybe I should try to remember to eat a sheet or two of nori seaweed every day. Frankly, having iodine-treated salt is probably easier, and certainly easier to remember to do since I’m low in sodium intake anyway.

        1. Oh, sorry. I should have been more clear. I wasn’t trying to suggest that you take sea vegetables. I currently sprinkle a little bit of kelp granule salt replacement on my food once a day. But when it’s done, I’m going to just take a pill. I couldn’t find Dr Greger’s recommendation for daily supplementation before, but I found it in an email I sent someone so I’ll include it here, in case you’re interested.

          http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

      2. Iodine is needed in small amount. That why it is added in salt. But if you don’t eat iodized salt because you try to avoid salt then you need to take an iodine supplement. Same goes with Vitamin B-12 for vegan because you are not getting enough from plant foods.

        Iodine is also found in seaweeds but seaweeds have a contamination problem. So it’s the same as Vitamin D, get it from supplement or get it from the sun that can give you also cancer as a bonus :)

        So take your iodine supplement or eat a little bit of iodized salt.

    1. 500 mg/day sounds great to me. It would put you roughly equal to the Yanomami people who exhibit no hypertension. These low salt consumers excrete less sodium than higher salt eaters so they hold onto their salt better. See all this in the video http://nutritionfacts.org/video/high-blood-pressure-may-be-a-choice/ (if you haven’t already). To sum up, Dr Greger would probably say that you (specifically) don’t need to worry about your sodium intake, but you should elevate your iodine levels.

      1. The Yanomami Indians take in a factor of ten less salt:

        http://www.ncbi.nlm.nih.gov/pubmed/12856272

        “The findings in the Yanomami population were as follows: a very low urinary sodium excretion (0.9 mmol/24 h); mean systolic and diastolic BP levels of 95.4 mmHg and 61.4 mmHg, respectively; no cases of hypertension or obesity; and they have no knowledge of alcoholic beverages. Their BP levels do not elevate with age. The urinary sodium excretion relates positively and the urinary potassium excretion relates negatively to systolic BP. This correlation was maintained even when controlled for age and body mass index.”

        0.9 mmol sodium/day is about 50 mg of salt per day.

        1. You are correct, about 50-70 mg NaCl per day depending on the study and the fact that a 24 hr urine collection misses 10% or more of the sodium excreted (urine, stools, sweat). I thought I had heard 500 mg NaCl per day for the Yanomami in one of Dr Greger’s old videos, but I am probably mistaken about that. So even less worry for Russell.

  6. WOW ! What a fantastic video. I wish I had known this information a long time ago. I am angry that I fell victim to several quack doctors who portray themselves as national nutritional gurus. I listened to Dr. David Brownstein, MD on YouTube. He was preaching on the benefits of adding Celtic Seat Salt or Himalayan Pink salt to your diet. I bought his book, “SALT Your Way To Health”. After reading his “spin” on salt I start consuming around 3600 mg of salt everyday. And, my blood pressure started going up. I was under the delusion that adding this salt was going to benefit me after reading his book, and watching his YouTube video. Oh…how I was wrong. Thanks to Tom, who always has a post on this forum, his references helped me to “see the light” on the topic of salt intake. I now NEVER add any salt to my food. NEVER. Thank you Tom and Dr. Greger for all of your scientific support to help us to regain our health.

    1. Yes, I agree it is a great video and great reliable information for us all. Well done for getting control of your health by using Dr. Greger site as your source of reference.

    2. Dr Brownstein is a quack doctor. He is big on thyroid cancer and intake of massive amount of iodine. In rare case thyroid cancer needs to be operated but in most of the case just like prostate cancer, people die with it and not because of it.

      1. I also bought his book on iodine. I am thinking that people do not really need all the iodine that he prescribes, because there are millions of people around us who take NO iodine supplements whatsoever, and seem to live healthy lives. However, I do take a real small amount of iodine just to be on the safe side, but nothing in the huge doses that he advocates. You see, this is the problem, all of us who are trying to improve our health get on the internet and look for answers to our problems and we get side tracked by people like Mercola and Brownstein, and we start doing things that they advocate that hurt our health. Like Mercola advocates eating eggs, and he brags about eating a whole lot of eggs everyday. For years, I avoided eating eggs because of the warnings from mainstream media from way back in time. But, then when I started reading Mercola’s “stuff”, I became convinced eggs are actually good for us. So, I would eat 3 to 4 eggs everyday, and as a result over time my cholesterol went up. And that’s another thing, there are other doctors like Dr. Sinatra who get on YouTube and say that we don’t have to worry about our cholesterol. He said that cholesterol had nothing to do with heart attacks. You see, there it is ….. more misinformation. You have these few doctors that go against the grain of all the research on cholesterol over the past 30 years and they tell you not to worry about it. OK…so, I didn’t even bother to get my cholesterol checked for years and years and years and finally after watching multiple videos from Dr Greger’s website I got my cholesterol checked and it was HIGH. Luckily, I have found this website in time, to hopefully turn my health around in the right direction.

        1. It’s quite scary really.. catch 22 of the internet and freedom of speech… have to balance website like this with ermmm others….

        2. Dr. Mercola is not a “quack Dr.”, just because he steers away from conventional/mainstream ways – which is primarily based on pharmaceuticals, frequent unnecessary tests and surgery. The majority of health information he provides is useful, cutting-edge and makes perfect sense; advocating a WF organic diet and exercise. I have followed him for years and he has changed dramatically changed my health for the better. Dr. Greger has been a guest numerous x on Mercola’s site.

          1. Mercola is a good advocate against GMO’s, he advocates exercise, fresh air, sunshine, he fights against pollution. He advocates techniques that bring calmness and emotionally health. BUT, he has failed me on the basics. The very basics which are the core of good health. He goes against all of the research from mainstream medicine on the necessity to avoid saturated fats. This is a BASIC. Saturated fats will kill you. They will damage the endothelial function of your arteries. He advocates eating MEAT. Meat causes colorectal cancer, increases homocysteine levels which damages the arteries, feeds the bad bacteria in your gut, causes the liver to increase IGF-1 levels, adds dietary cholesterol to your blood stream, and the list could go on and on. He SELLS powdered whey which is a dairy product. Research shows that dairy products have a host of negative effects on human health. He advocates eating eggs. Eggs overload your body with more dietary cholesterol. The scientific research shows that the choline in eggs can cause plaque to spread in your carotid arteries. His entire operation is profit motivated. He sells vitamins, sun tanning beds, and many other health related items. On the other hand, Dr. Greger’s operation is not profit motivated by strictly scientific based with the motivation to understand and spread the truth about health. You can google image Mercola’s huge mansion on the internet. He sells vitamins. Vitamin theory is a reductionist theory that is connected to money making enterprises. True vitamins come packaged in fruits, and vegetables that are bound up in enzymes, co-factors, antioxidants, and fiber. Millions of people on earth down through the ages never took vitamin tablets and lived healthy lives from just eating natural food. Case in point, are the Okinawans who eat 99 percent plant based food. They are one of the longest lived and healthest people on earth. They do not take vitamins.

          2. He does have some good common sense advice, but overall he likes controversy to promote his many products. Not to be trusted.

            1. Controversy? As in speaking out against corruption within our government; the FDA, USDA, BigAg, BigPharma and other big corporations? I understand that it’s difficult for most people to believe that these systems in place – which are ultimately supposed to be protecting us – can do no wrong; but there is much cover-up and corruption at these levels. Mercola is one of the few sites which brings this information to light – always with sources and references I might add; among daily articles about healthy living which he publishes at no cost to anyone. Yes, he sells a line of products on his site to “pay bills” so-to-speak, and like any business, to make a profit; but you don’t have to buy them! He has also donated immensely to the GMO Labeling campaign, as well as other greater good projects. “All truth passes through three stages: 1- It’s ridiculed 2- It’s violently opposed 3 – It’s accepted as being self-evident” -Arthur Schopenhauer (1788-1860)

              1. Uh, no, the lies of gov. and industry aren’t questionable nor controversial, they are factual, but the fact that Mercola IS an industry, however, puts him in the same category! Most of the good doctors have no personal financial agenda other than covering costs at best. He is Dr Oz on a different platform, his products are a travesty to what the good doctors are trying to teach…FOOD is the medicine, not invented snake oil products. I’m not saying ALL his advice is BS, but his motives are selfish considering there are others who offer all their hard won factual advice for free and even donate any proceeds they acquire to charity. As if I need to mention names, but thanks as always Dr G!

                1. NO …. Dr. Mercola is most definitely NOT in the same category as the FDA. USDA and other humongous corporations that I mentioned …. that is absolutely nuts. “Invented” snake oil products? The products he offers on his site are products that have been proven to help, lessen, or even cure health issues. His motives are anything but selfish – educating people about issues that directly affect their health; and at NO COST, as I mentioned in my previous post. He doesn’t charge ANYTHING for his newsletters or information (also as I stated in my previous post). He donates immensely (even matching) to the labeling of GMO’s and other worthwhile projects i.e fluoride network and others. Before you spew off personal opinions, it would be more advantageeous to get your facts straight.

    3. Very sad really how convincing some people can be with so little evidence to support their claims!

      Tom makes some great posts agreed!

  7. My husband has more salt than anyone I’ve ever met but he also drinks orange juice at almost every meal, plus has lots of berries. Is this saying that Vitamin C with a meal counteracts the effects of the salt on blood flow?

    1. It indicates the protective effect of fruits and vegetables intake with high vitamin c. In another Copenhagen General Population Study and risk of ischemic heart disease and all-cause mortality was looked at plasma vitamin C also showed signaficant association in protection of arteries function.

      Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality: a Mendelian randomization study1,2,3,4

    2. Some salty foods such as miso counteracts with salt.

      http://www.whfoods.com/genpage.php?tname=foodspice&dbid=114

      However, recent research has shown that in spite of its high-sodium
      content, miso does not appear to affect our cardiovascular system in the
      way that other high-sodium foods sometimes can. In recent animal
      studies, for example, identical concentrations of salt (sodium chloride)
      obtained from miso versus table salt were discovered to have very
      different impacts on blood pressure. High-salt diets that derived their
      high salt level from table salt raised blood pressure in these animal
      studies, but high-salt diets that derived their high salt from miso did
      not. Recent human studies on miso intake among Japanese adults have also
      shown that miso-containing diets tend to lower risk of cardiovascular
      problems, despite the high-salt content of miso. Reasons for this unique
      relationship between miso and our cardiovascular system are not yet
      clear. However, some researchers have speculated that the unique soy
      protein composition of miso (including peptide building-blocks of
      protein that get formed from soy proteins when the beans are fermented)
      is one of the key reasons for the cardiovascular support provided by
      miso.

    3. The study used IV vit C, but is suggestive that wholefood sources could have at least some negating effects. But it still seems a wise idea to minimise salt in the diet for optimal health.

  8. Does this mean that supplementing vitamin C with a salty meal would counteract the suppressing effect that salt has on arterial function?

    1. Hi, I am not going to make recommendations as I am not an MD however, this study indicates that high intake of vitamin C does have the effect of lowering blood pressure. I would advice you checking with your physician or the great community of volunteer physicians in this website before taking high does of any vitamin or minerals. Supplemnting with food that is high in vitamin C for example adding lemon to food is great as it enhances the flavour and lowers the need for adding extra salt to food and it increases the vitamin C content and protects the arteries.

      The acute effect of high-dose intravenous vitamin C and other nutrients on blood pressure: a cohort study

    2. The study used IV vit C therapy, but would suggest that at the very least adding high vit C foods- berries, bell peppers, leafy greens, broccoli, strawberries, kiwi fruit, citrus, tomatoes… couldn’t hurt!

  9. Supporting the hypothesis that the potassium / sodium balance is paramount, higher potassium diets or supplementation improved endothelial function in five of eight studies through 2015, with the inconsistency in results attributable to dosage (significant in trials with > 1600 mg K/d, but not with lower doses).

      1. After encountering a number of studies which showed a more consistent effect of potassium/sodium ratio than of sodium alone upon blood pressure (a sampling: 1, 2, 3, 4, 5, 6, 7, 8) I became fascinated the mechanism, and curious why this story was so little heralded in the general media. (Of note, a few of those looked for clues to the higher hypertension risk of African-Americans in their salt intake, only to discover that their salt intake was lower than that of whites and it was their lower potassium diets that could account for much of their increased risk). A metaanalysis found that supplementation trials using an average of 3.5 g K / d lowered BP by -5.9/-3.4 mmHg, and -8.2/-4.5 mmHg in hypertensives. The effect size is similar than that seen in the aggregate of sodium reduction trials on a per wt basis and greater on a per mol basis.

        Relating to this video, just as high plasma sodium stiffens endothelial cells and blocks nitric oxide synthesis, high plasma potassium levels soften endothelial cells and activate NO release.

        Importantly, an emphasis on potassium is a message that needn’t divide plant based dieters into camps. Whole plant based diets compare favorably to the SAD in potassium content, especially whole plant diets which emphasize tubers and greens.

  10. In yesterday’s blog post about preventing Alzheimer’s with lifestyle changes, Dr G mentions that dietary impacts are too numerous to factor. But, if a primary cause is lack of blood flow to the brain, then wouldn’t salt’s arterial stiffening be a big contributor? Plus, high blood pressure and the increased risk of stroke that comes from high blood pressure can’t help.

    (Yesterday’s blog post: http://nutritionfacts.org/20 16/07/21/preventing-alzheimers-lifestyle-changes/ )

    1. A remarkable result of long term prospective studies on Alzheimer’s / dementia is an inverse association between blood pressure and Alzheimer’s incidence in the general population. Ie, higher BP is associated with reduced risk, though this may be expected to be accompanied with higher risk of stroke. Claudia Kawas, who studies the Leisure World cohort, speaks about her results in this video. These results have been influential in the relaxation of blood pressure targets for older patients in updated hypertension treatment guidelines.

      1. Thanks for that. At an hour long, I don’t think I”ll watch the video, but I wonder if the higher blood pressure helps blood get past clogged arteries. Assuming that’s so, then shooting for a WFPB diet that keeps arteries open and a low salt diet seems like it would provide the best of both worlds.

        1. If the pressure is high and the arteries are clogged the risk of stroke is greatly increased. Keep in mind high blood pressure is often a response to demand. If the blood flows freely through the arteries as they aren’t stiff and clogged, then the pressure can be much lower…You are exactly right in terms of the double benefit :)

  11. Dear Dr. Greger,

    My son and I have been following your scientific diet for almost 3 years now.

    In the last 3 weeks or so my bowel movements have been extremely loose, by this, I mean almost diarrhea; Few and small solid pieces. Not one solid bowel movement during this time.

    My diet consists of a morning apple, a psyllium fiber supplement, and water. Throughout the day, I eat mixed greens and/or spinach, tomatoes, carrots, and peppers. I eat both white and brown rice prepared in a rice cooker and microwave baked red potatoes along with good amounts of walnuts. I eat a fair amount of black beans (yes, lots of gas). I also eat a fair amount of whole wheat bread and wheat tortillas. I eat a lot of avocado almost every day. I tend to use a lot of salt and am working on cutting way down on it.

    I will take anywhere from 2 to 8 tablespoons of freshly ground flaxseed per day.

    My bowel movements, once well into this diet, have been quite amazing (Usually 3-4 a day). But the last month, like I said, have been very loose and almost diarrhea.

    I am a male, 55 years old, and in good shape, exercising almost everyday. My son and I are both strong advocates of you and your website. My son being an actor has spoken with your staff before and was even asked to be highlighted on your Facebook page.

    Please tell me what I’m doing wrong and what I might need to change.

    Thank you very much,
    Hal and Luke Davis

    1. Some people have a reaction to lettuce (who knew). I’ve heard it can be caused by a latex sensitivity, but I don’t know. But my experience is that if I eat too much romaine in a day or too many leafy greens in general, I get watery stools. So I still eat greens but I keep it at the level that I have found isn’t a problem. You might want to eliminate a few things for a few days and see if that makes a difference between days you eat it, days you don’t and how much triggers a response, if it is from one of your frequent foods.

      BTW, some people have a sensitivity to psyllium and some are very allergic to it. Overnight I developed an allergy to peanuts and I was told at that time that it’s fairly common that some people who consume psyllium can also quickly develop an allergy. If you’re eating a WFPB diet, especially if it’s vegan and free of dairy (which binds) you might not need to add fiber. You might want to stop the added fiber for a few days and see if it’s actually irritating your system and causing a counter reaction. If you’re on a WFPB diet it seems like should should be ok for a few days.

      It took me a long time to figure it out my trigger, but I got it resolved. I hope yours is also just an easy diet adjustment.
      Good luck.
      Mark
      PS, I’m 60 and my situation started when I was in my early to mid-fifties too.

      1. Thanks for the great advice. I would also suggest adding some fermented foods that has the good bacteria such as lactobacilus and befidobactor to stabilize your gut. Since you don’t consume any dairy there are non dairy based fermented foods in the supermarket as well. I hope that helps and you get back to your good healthy self.

        1. Thanks for the tips. I do have some fermented foods from time to time, but not a lot. But I think that things are stabilized because as long as I don’t over consume lettuce (particularly romaine) or greens (and I should have said raw greens) I’m fine. I can eat regular serving sizes just fine. If I tried to have double or triple servings in a day I start to get symptoms again.

          1. For me the trigger was insoluble fiber (so lettuce and anything else incl. psyllium). Raw kale was also out of the question. The only way to ingest it was to blend it and mix it with potatoes (or something else). Still, now I rather not eat it. At one time I was so sensitive that even (broccoli, radish) sprouts caused me trouble.

            I had mixed symptomes: diarrhea and constipation but apparently it is possible – there something called mixed IBS (IBS-M) which translates to irritable bowel syndrome with mixed diarrhea and constipation.

    2. I will cut down on wheat bread and wheat tortillas. But other than that, you are eating well. I don’t know how you eat your green, cooked or raw. Lately, I eat a certain amount of green raw but cook most of them. It is said that cooking will increase nutrition absorption contrary to most people think, and make it easy to digest. I blend my vegetables first, let is sit for 1/2 hour, and then cook it like a soup. Since I eat the cooking water too then there is loss of nutrition Some people cannot eat too much raw vegetables.

        1. Renea, I am not saying that bread causes loose stools although I said in the same post. I try to eat less bread because I am n0t sure about the wheat they use to make the bread (processed wheat).

          I went the other way from having loose stools at first when I started to eat a lot of raw vegetables to having solid stool a year later but it took me the whole year to get to that point. Now I eat more cooked than raw vegetables because it allows me to eat more although I no longer have a stool problem. Perhaps his eating of raw vegetables is causing the stool problem.

          1. Ah my mistake! Sorry! I thought that was your solution to loose stool!

            I think there is a lot to be said for changing the microbiome with dietary changes for sure and adjusting to increased fiber and water etc… however a sudden shift after three years seems unlikely without another cause to me….

    3. What changes have you made recently? If it’s just started it’s probably something new… Flax is a constipation remedy and you consume a LOT, so that would be my first thought if it’s a new addition… Changes in bowel habits are important to not ignore, any recent travel or infection? Have you tested faecal occult blood? Any new supplements, food changes, medications? I’d want to rule out a medical cause first… a diet followed for three years shouldn’t suddenly cause loose stools for no reason?

    4. If you have a smartphone you can download Dr G’s Daily Dozen app and try to eat all the recommended foods. Your breakfast wouldn’t be sufficient for me. Do you ever eat oatmeal? Dr Esselstyn recommends it highly, for lots of bennies. Also, you may need to cut back on the flaxseed. Dr G recommends a tablespoon daily, if I remember correctly.

      Is there any chance you have picked up a bug? A friend had diarrhea for a long time until she had a stool test and found she had giardia, which she picked up overseas somewhere. It would come on shortly after eating each meal.

      1. Thank you for your response. I just got back from Comic-Con in San Diego only to find the Sand Fire a couple miles away from my home, so forgive me for my slow response. I have now followed Dr. Greger’s Daily Dozen for two days. I have cut my flaxseed down to the recommended 1 tablespoon per day and eliminated the psyllium supplement. My bowels are still very loose. I have another question.

        As a vegan, should my bowels be hard or should they be so soft that when I flush they completely disintegrate?

        1. I’m sure one of the doctor moderators can be more specific, but I’d say they should be neither hard nor should they disintegrate. Copious, by all means, easy to pass, definitely, but intact and never hard.

          I hope your home isn’t in danger. Fire is so scary, and every year the West is hotter, drier and more prone to fires.

    5. Try omitting the flaxseeds for a few days. They are know to cause that kind of reaction, if you take it, never in high quantities. 8 tablespoons per day is far above of what Dr. Greger recommends.

    6. Thank you for your response. I just got back from Comic-Con in San Diego only to find the Sand Fire a couple miles away from my home, so forgive me for my slow response. I have now followed Dr. Greger’s Daily Dozen for two days. I have cut my flaxseed down to the recommended 1 tablespoon per day and elimibated the psyllium supplement. My bowels are still very loose. I have another question.

      As a vegan, should my bowels be hard or should they be so soft that when I flush they completely disintegrate?

  12. salt (sodium and chloride) + potassium = Hydration.
    Sure you know what is intravenous hydration (in ambulances and hospitals). We need salt in moderation and need potassium in moderation. We eliminate excess sodium and excess potassium.
    I think that many people think that the lower sodium the better, but this could be very dangerous.
    This video concludes that sodium in the blood damages the arteries…do you believe it?… Without Sodium you Die… Whole Plant Based Diet can be very salty without added salt: think of recipes with many tomatoes (and tomato paste or dried tomatoes), chards, spinachs, celery, leaves in general… So if you eat starches with little salt added, probably you eat less sodium than many vegan with tomatoes and leaves.

    1. Replacing IV volumes is a little different to diet. They need more sodium to hold water in the vascular space. They are not saying no sodium (as found in abundance in nature whole foods) for most people, just not adding refined salt. Salt, not sodium…

      Your comparison makes no sense-

      There is roughly 2,300 mg sodium in a tsp of salt, so about 575 mg in a 1/4 tsp.

      A kg of tomatoes has about 50mg… so less than 1 tenth…
      About 1/2 a kilo of celery, or a lb of chard is about equivalent to 1/4 tsp salt… and that’s natural sodium Vs refined salt… That’s a LOT of vegetables to come close to the amount most people add…

      1. Thanks Mr Greger for waste your time with all of us…
        Sodium in salt is the same as “natural” sodium in vegetables or fruits. I know that this article (video) as many other studies refer to the salt as dangerous in excess.

        So it depends on the food you eat:

        2 kg of baked potatoes (1800 Kcal) < 100 mg of sodium, so you can put 1/4 tsp of salt over the food and you have a total of 1800 Kcal and 675 mg of sodium.

        3 lb of baked sweet potatoes (1200 Kcal and 490 mg of sodium) and 2 lb of boiled beet (400 Kcal and 700 mg of sodium) and 500 gr of boiled Swiss Chard (about 1 lb and 100 Kcal and 900 mg of sodium) for a total of 1700 Kcal and 2090 mg of "natural sodium".

        For example many fruitarians have health problems because of minimun sodium in the diet (for example 2 kg bananas is about 1800 Kcal and 20 mg of sodium)… and you know very well the importance of mantaining the correct Volume and mineral density of blood to reach all the cell and perform a correct exchange of nutrients by osmosis.
        I know that the "process world" is full of salt and consume more than 2 tsp a day (also included in the foods) and is enough about 1/2 tsp

        1. I appreciate your point, it just makes me think it’s a bit simplistic… as in… is the same amount of fat from oil the same as that contained in say avocado… the evidence suggests otherwise and can be correlated to what you are saying. I too am definitely curious too… I am yet to see an otherwise healthy person present with symptomatic, clinically low sodium though open to be wrong and I’m sure someone is extreme out there enough to try!

      2. There are at least two brands of sea salt that have 390-410 mg sodium per 1/4 tsp. Bob’s Red Mill and Eden. I won’t give up a little salt sprinkled on food when my taste buds are on strike and the healthy food is hard to swallow.

  13. Salt doesn’t affect my blood pressure, which tends to be normal at rest. So I don’t worry too much about a salty meal or snack (mixed nuts mostly) here and there.
    Still, there is no salt shaker in the house. Never salt my foods.
    But now, I will add potassium to a salty meal by sprinkling “NoSalt” salt substitute over it.
    And take extra vitamin C with it, too. Thanks for this report, Dr. Greger.
    If I remember my High School chemistry right, potassium has a higher valence than sodium. So the NoSalt might even block sodium uptake to some extent.

    1. I also thank Dr G. for bringing all these important nutrition and life style videos to us. Also wanted to share some information regarding salt substitutes.
      These potassium-based salt substitutes are not for everyone: Extra potassium can be dangerous for people who have kidney disease or who are taking medications that can increase potassium levels in the bloodstream. So check with your doctor before trying a potassium-based salt substitute.
      Shifting the Balance of Sodium and Potassium in Your Diet

      1. Right, but as I’m on no medications and don’t have KD – thank God – a KCl sprinkle here and there isn’t a concern.
        But yes, those two groups ought to do as you suggest. A warning is also on the NoSalt label.
        Good reminder though, Foroogh – thanks!

    2. This video illustrates though more detriment than just BP. It was this research than made me (also with low BP) realise the importance of minimal added salt.

  14. Are the effects of salt over time permanent? I’m getting way to close to 60 and am just now embarking on a salt free diet after years of high salt diet.

    1. No, it’s not permanent unless already have an onset of disease which can also be fixed with diet. But you have none yet then there is no permanent effect.

  15. I was listening to a russian doctor who said that refined salt is worst for us, it is like ground glass cutting, damaging our arteries, when cholesterol is rising as if rushing to repair arteries, as for sea salt, not refined, it is necessary for our health as well as cholesterol is no danger. Sugar, salt, grains main danger as I know though dr. Greger says grains are ok, but he says cholesterol levels means a lot. Not all doctors say the same. As for eggs and cheese, youghurt, can we stop eating them? Sure meat is no food, it is so unhuman to eat other live creatures

    1. Who’s this crazy Russian? As the say in Mexico, “Each Crazy person with his own theme.” Instead of listening to this person or that, just listen to the science, the best of which is summarized on this web site.

    2. Sea salt has the same effect… it’s concentrated and refined sodium…. whenever humans refine and concentrate foods (sugar, oil, protein)… it tends to be to their own detriment…

      Of course you can stop eating eggs, cheese and yoghurt… just stop buying them…. If you think it’s un-human to eat meat, how does that not extend to eggs and dairy?

    1. Nonsense! by the time the salt reaches your bloodstream, it’s already dissolved. Sea salt is at least 99% salt, about the same as regular salt when you consider the small amount of anti-clumping minerals that are added to it. So, salt is salt, no matter what kind you would use.

    1. Will: Dr. Greger plus several other experts and NF community members have thoroughly debunked it. Bottom line: Basically, that article is criminally misleading “journalism”–not an understanding of the
      actual study.
      .
      Dr. Greger: http://nutritionfacts.org/video/plant-based-treatment-for-angina/#comment-2597611517
      Dr Katz: https://www.linkedin.com/pulse/vegetarianism-nutrition-science-meets-media-nonsense-davidDr
      Garth Davis: https://www.facebook.com/drgarth/posts/1126374594050114?hc_location=ufi
      NF Moderator Dr. Jon: http://nutritionfacts.org/video/plant-based-diets-and-artery-function/#comment-2596819840
      NF Moderator Renae: http://nutritionfacts.org/video/almonds-for-osteoporosis/#comment-2601476959
      NF Moderator Dr. Jen: http://nutritionfacts.org/2016/03/31/dr-gregers-new-google-talk/#comment-2599942486 and http://nutritionfacts.org/2016/03/31/dr-gregers-new-google-talk/#comment-2601267177
      NF Moderator Dr. Alex: http://nutritionfacts.org/video/plant-based-treatment-for-angina/#comment-2597863794

      ​Tom Goff: http://nutritionfacts.org/video/gut-dysbiosis-starving-microbial-self/#comment-2734176559​
      ​Jim Felder: http://nutritionfacts.org/video/gut-dysbiosis-starving-microbial-self/#comment-2734894622​.
      Here’s
      how I put it all into perspective in my head: *Suppose* someone found
      out that descendants of *some* healthy people have developed an
      adaptation where consuming table sugar is even more unhealthy than it
      already is for everyone else. Thus, future generations might be even
      more sensitive to the negative health impact of eating Twinkies than we
      are today. Does that mean we should all eat a bunch of Twinkies today
      so that our descendants aren’t worse off eating Twinkies in the future?
      Of course not. That would be absurd. And that’s essentially (as I
      understand it) what the article you are quoting is saying in regards to
      eating meat. What’s more, that claim is a complete twist of what the
      actual study is actually saying.
      .
      Make sense?

    2. Thea’s answer is great…. in short almost anything is better than a SAD diet… there’s a spectrum from SAD to ‘healthy’ or ‘paleo’ to say Mediterranean, then vegetarian, then vegan, then wholefood plant-based SOS free…. these step wise improvements can be seen in Adventist health studies. It just depends if you just want ‘better’ or optimal :)

    1. See the beginning of this blog post by Jeff Novick MS, RD who is regarded highly by Dr Greger.
      http://www.jeffnovick.com/RD/Blog/Entries/2012/3/29_Test_2.html

      The bottom line is that 500 mg/day is enough and probably more than enough (although in the “civilized world” it is hard to get your sodium intake that low without great effort since most of us tend to eat at least some processed food). Just avoid processed food with lots of added salt and don’t worry about it. Jeff Novick says that when buying processed food read the Nutrition Facts label. In general the salt in mg should be equal to or lower than the calories. This way your 2000 calorie per day diet will contain 2000 mg of sodium or less.

      For calorie sparse food (e.g., an item containing just vegetables) you may have to relax the rule or you won’t be able to find anything buy. For calorie dense food (e.g., nuts) try to make the rule more strict.

      1. Thanks for this. I just checked my jar of great northern beans that I used for the baked beans I ate while I was reading these posts. The sodium was triple the calories. (Not to mention the ketchup and mustard I added.) Good to know. (The more I read, the saltier my beans tasted.)

  16. Are your studies with regular table salt or Sea Salt? I’ve been using Himalayan Sea Salt and have increased my salt intake, knowing it has important minerals. What can you share regarding the quality of salt? Thank You so much!!

    1. Like somebody has said down below, Himalayan salt is a good salt because it contains minerals but you don’t eat salt to get the mineral but you use this salt when you have to use salt. Same goes with honey for sugar.

        1. Megan, high salt intake can raise blood pressure but it also has other bad health effects. So it’s not because you don’t see high BP that it’s OK to eat high amount. Having said this, I am not too hard on salt because salt is needed as an electrolyte but in small amount. Some people may go to the other extreme of not consuming salt at all which is not good also. I always sprinkle a little bit of iodized salt in my food.

          https://en.wikipedia.org/wiki/Health_effects_of_salt

          1. I thought the same until watching videos like this one… I feel now *most* people can get enough from the sodium in whole plant foods… the risk seems to outweigh the benefits…

            1. Renea, I have a question for you. OK so normal salt contains 2 things: sodium and Chloride. Chloride has a role in heart health. Whole plant foods only contain sodium but no chloride. So OK, you don’t need a lot of sodium and so you can get from plant foods. But where do you get your chloride if you don’t eat real salt?

  17. Processed foods often contain excessive salt which is a good reason to choose whole foods instead. One common processed food that we miss and may still eat even if we’re health conscious is bread. It also has a bit of added salt that we likely don’t need. Wheat bread is also has a high glycemic index score, even whole wheat bread. And most people get a good part of their calories from bread- often more than they need. Perhaps that book, Wheat Belly, that nutritional doctors condemned had a point.

    1. Right! Also they put high fructose corn syrup in most bread and a whole bunch of other chemicals we don’t want. Once I actually bought a loaf of what I thought was whole wheat bread, but when I got it home, it turned out to be made with refined flour and then colored with caramel. I’ve tried to phase out bread from my diet, but it seems to be addictive and everywhere I go, people offer it to me.

      1. Bread needs little more than 3 ingredients- wholegrain flour, water and yeast/sourdough culture…. unfortunately some on the shelves have 20+ ingredients!

    2. You can easily make bread without salt. Glycemic is largely irrelevant in a non diabetic… a chocolate bar has a low GI Vs say watermelon.. which is healthier??

      This is an interesting study on bread-
      https://www.drmcdougall.com/misc/2011nl/dec/111200.pdf

      Whilst whole foods are the best, I feel bread is condemned far too often…. it’s usually the bacon and eggs on the bread causing the bread problem…

      1. Moderator Renae: re: “Glycemic is largely irrelevant in a non diabetic… a chocolate bar has a low GI Vs say watermelon.. which is healthier??” I LOVE it! I have not seen it explained so succinctly and so clearly before. Nice.
        .
        Though, I’m sure you will find people who are fructose/fruit-phobic and fat-fans who say that of course, the chocolate is healthier. :-O
        .
        On the bread topic: While I’m totally on board with the whole GI point, I do think that even at it’s simplest (flour, water, yeast), bread is a relatively high processed product and relatively high calorie dense. This page (http://nutritiondata.self.com/facts/baked-products/4878/2 ) puts whole wheat bread at 78 calories per ounce, which is 1,248 calories per pound. To put that into perspective, watermelon is 128 calories per pound. Dark chocolate is 2,592 calories per pound. Chef AJ recommends that people who try to lose weight stay at 600 or less per pound. (I *think* that’s the number anyway.)
        .
        I glanced at the Dr. McDougall article you linked to, but I didn’t find it compelling. To me, it is like the studies Dr. Greger found where people did not gain any or as much weight as would be expected when they ate nuts. We know from experience and from reputable examples like Chef AJ, that some people have to cut out nuts in order to lose weight.
        .
        That said, I would certainly agree with you that if someone is eating eggs and whatever on their bread, then bread is the least of their problems.

        1. Haha thanks Thea!

          And yes… sadly….

          Yes of course, I do. But it’s all a spectrum imo, from SAD to WFPB SOS free, there’s a lot in between and every step in the right direction is worth doing in my opinion!

          So if someone is eating bacon and eggs on toast for breakfast, switching to say a soy sausage on white bread, then switching to whole wheat bread with scrambled tofu, then say avocado and tomato, then maybe trying potatoes, or oatmeal instead of bread…. step wise improvements…

          I don’t think bread is the pinnacle of health, but certainly better than many other choices- I always say unprocessed, intact whole grains first, then lightly processed (like rolled oats), then a bit more processed but reconstituted with water (wholegrain pasta) etc… More clearly explained here-
          http://www.jeffnovick.com/RD/Articles/Entries/2011/1/8_Clarify_Carbs__Making_The_Complex_Simple.html
          For some people though bread, when consumed with say a soup, tends to swell in the stomach and cause satiety, similar to the justification of pasta or oats absorbing a lot of water back when cooking.

          I agree it’s not the best study ever, but it does prove a point, that almost anything can improve on the SAD!

          I put (homemade, wholegrain) bread the same way as pasta- if otherwise healthy and maintaining healthy weight and other health markers, then mostly fine as a say neutral food- not overly health promoting but not harm-causing either. For those with more serious health concerns, I push for WFPB…. but that’s only once everything ‘worse’ than bread is gone, and the issue still remains if that makes sense!

        2. I have heard AJ say 700 calories per pound. Is there a list somewhere of foods that would comply? Dr. Fuhrman has issues with that approach though in his book “the End of Dieting” He is in the somewhat higher fat camp.

          1. Wegan: Thanks for that 700 number!!! I heard Chef AJ say one time in a talk and I didn’t write it down. I tried to find the number on-line one time and could not. Thanks for letting me know.
            .
            re: Dr. Fuhrman: I have a lot of mixed feelings about Dr. Fuhrman. I think he has a lot of good things to say and he helps people move in the right direction. But he’s not in my top set of experts when it comes to conflicts of information. That’s just sharing where I come from.
            .
            re: a list of foods that would comply. Jeff Novick has an article on this subject that lists foods by food groups to get a general idea. http://www.jeffnovick.com/RD/Articles/Entries/2012/5/20_A_Common_Sense_Approach_To_Sound_Nutrition.html Basically, the main four food groups of whole, intact food meet the criteria: fruit, veggies, beans, grains (and FYI: mushrooms)–especially if the number not to exceed is about 700. You can also use the following site to look up individual foods. Most foods on that site have a 1 ounce option. So, you can get the calories for 1 ounce and then just multiply by 16 to get the calories per pound. http://nutritiondata.self.com/

            1. Thank you that helps. I believe a few nuts and seeds with meals are a good idea even if you are trying to lose weight because of the health benefits we learned about here.

              1. Sounds reasonable to me! I think a reasonable approach would be for someone to start with that plan and if it didn’t work, try it without the nuts.

    3. Ron: I appreciate the point you are trying to make and am generally with you, but your conclusion about Wheat Belly does not follow from the earlier points in your post. Wheat Belly is not about bread. The author maligns whole grains in general, even intact grains. And he promotes meat. That Wheat Belly book is a sham and a shame. While the author cites studies, the studies do not often support his claims. The following is a link to an article showing how the science does not back up the claims in Wheat Belly. (And this is from an anti-gluten site!)
      http://noglutennoproblem.blogspot.com/2012/03/wheat-belly-busted.html
      .
      I think this is important point, because Wheat Belly has been doing a whole lot of harm. Even if bread may not be the ideal food, saying that Wheat Belly “had a point” would be misleading people, in my opinion. That’s just my opinion of course.

  18. I personally think salt is needed in macro amounts by the human body. Doctors have said for years that salt is bad, and I think that might be a poor convention. Salt is the most traditional spice.

    1. Sodium yes…. as found in whole foods… salt however- need some convincing evidence? Just because people do things, doesn’t always mean they are best…

      1. If you lick your palms you can get an idea of the foods you need by taste. Mine always tasted real salty. I think it is possible to have a salt deficiency.

        1. On the contrary, it means your body is trying to rid itself of excess, lacking saltiness would be a more likely indicator of deficiency. Not a particularly good method for measuring what you need foodwise in any event.

          1. This is from a speech by Dr. Gerson, who abhors salt. “One of the physicians asked me once, “Are you crazy? With the potassium above normal, you give such big doses of potassium?” And I said, “Yes, sir, I am not crazy. The patient is losing the potassium. (12) That is how it is increased in the serum.”” I think this is true of Sodium too, and can be tested by the hands. Do you taste salty? I had some salt and it made the right top of my brain very large. I used to taste salty before I had salt. People with type A schizophrenia have depressed levels of salt and potassium in the blood. I think that’s what I have.

          1. No, I am not a clinician. However, almost everyone probably has an iodine deficiency because of the war on salt. You make me so hopeful. You do such a job good. You are great.

            1. Having tested many people for iodine levels I can assure you, it’s not that common…

              Thank you for the kind words :)

            2. Thank you for your kind words, but having seen results of many iodine tests, it’s not that common, and usually NOT from not eating enough salt.

  19. I have not added salt when cooking or to home made meals for over 4 years, allowing me to lower blood pressure, and eliminate blood pressure meds. All is well as long as I don’t eat out or use on processed foods. Unfortunately a highly salted restaurant meal makes me feel unwell almost immediately. As a result, I avoid eating out as much as possible, however that is not as easy to do when traveling; vacations become nightmarish. Understandably, I am very interested in mitigating these sodium induced BP spikes with Vitamin C. Could including a food high in Vitamin C before, during or after a meal help? I know that whole foods can work best for us, but would a Vitamin C supplement also work in a pinch?

    1. Great testimonial! Sorry to hear you feel unwell when eating restaurant foods.. it’s the curse of good health sometimes! You are used to feeling so good that changes that don’t affect others you may feel a lot! Based on the study above, whilst they used IV, it makes sense it would be at least worth a shot! I’m always cautious with recommending supplements… I’d prefer a concentrated whole food first, such as bell peppers, leafy greens, broccoli, strawberries, kiwi fruit, berries, citrus, tomatoes etc…. but you can always weigh the pros and cons! I feel anywhere you can purchase vitamin c supplements, you should have access to some kind of fresh fruit or veg! But then depends how high you need the vitamin C dose….

  20. Well, sorry but I had to skip to the end to see if this was going to be another evermore-forever-dragged-out-three-minutes-every-other-day series of videos.

    Appears that it’s not. Okay then, I’m going to do just that. As one who has never experienced or measured any negative response to salt intake, I’m going to take the “bag of chips challenge” and use my parents’ pulse/BP station to see if I can get a response. Another reason it’s good to have a “flexible” food plan eh?

    But also I don’t eat as much as the SAD eater.

    Example: just these last two weeks (I’m working outside in the Southern US) my work mate has been complaining of the sweat burning his eyes (despite us using bandannas and rags and sweatbands) Sweat doesn’t burn my eyes or salt-stain my shirts/pants/hats (like it used to). But I’m not “shy” with the seasonings, including salt (almost always a mix of salt/spices), when cooking. I do cook the majority of my meals.

    I’ll watch the full video later when I have a few more minutes.

    1. WHOOO HOOOO! FINALLY, a doctor speaks openly about folks whose blood pressure is NOT salt sensitive. Thank you very much. I kept thinking I was the only one.

      1. Thank you Doctor G for this one!

        Finally get a MUCH better explanation and understanding of what is going on with the salt in my life.

        Which is: (Bless yo heart if you’ve read this far) Even though I enjoy and use salt in my food, because I consume very little “fully processed” or restuarant type foods, that my diet is functionally “low sodium” and that further reduction of my salt intake could affect vascular function, but maybe not much. Very enlightening. Thanks again, this has been such a difficult thing to reconcile.

  21. We do predominantly whole plant foods no added salt, not even in recipes. My blood test levels of sodium are a little above mid range. Real food has enough salt in it already. We do a little kelp for iodine.
    Food, Inc. uses salt as a very cheap spice, along with sugar and butter. Occasional home made pies for holidays we use a reduced amount of sugar.

  22. 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. There have been several great responses to this question/response on this page already. 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/
    .
    Makes sense to me!

  23. In times when I’ve had accidents in the distant past, which involved bone breaks or cuts, I’ve not had to take pain killers when I wasn’t eating salt. It seems there are bacteria that cause pain in unbaked salt. If I use any salt and mostly don’t, I have followed the advice of a friend and have baked it on a cookie sheet for 5 minutes at 400 F. to kill the bacteria. Is this a proper thing to do, or have I been misinformed. Otherwise, I don’t use salt; only dulse.

  24. Still, as a long distance runner I’m puzzled by the hyponatremia threat that seams very real and the salt intake that might lower the blood circulation. Or is it just that by doing sport our salt need is far above the sedentary one (just like B1) ? And then the standard salt intake might fit the very active people around ?
    And if that were the case, what optimisation is possible using chronocycles ? (same question for “vitamin” D, since videos didnt adress it).

    Regards

  25. ascorbic acid is not vitamin C ; this video is an infomercial for the vitamin industry . you want real vitamin C ? eat lemons , gooseberries ,acerola cherries and citrus fruits .scorbic acid simply cannot confer vitamin activity. This was taught by the discoverer of vitamin C complex himself, a Nobel Prize laureate, Dr. Albert Szent-Georgi.
    Szent-Georgi discovered vitamin C complex in 1937. In all his research, however, Szent-Georgi found that he could never cure scurvy with the isolated ascorbic acid itself. Realizing he could always cure scurvy with the “impure” vitamin C complex found in simple foods, Szent-Georgi discovered that other factors had to be at work in order for vitamin activity to take place. So, he returned to the laboratory and eventually made the discovery of another member of the vitamin C complex – rutin (also known as vitamin P). All the factors in vitamin C complex, ascorbic acid, rutin, and the other factors, were actually synergists. They were co-factors which together sparked the “functional interdependence of biologically related nutrient factors.” (Empty Harvest p120). The term ‘wheels within wheels’ was coined to describe the interplay of these co-factors.’

  26. ascorbic acid is not vitamin C ;. you want real vitamin C ? eat lemons , gooseberries ,acerola cherries and citrus fruits .Ascorbic acid simply cannot confer vitamin activity. This was taught by the discoverer of vitamin C complex himself, a Nobel Prize laureate, Dr. Albert Szent-Georgi.
    Szent-Georgi discovered vitamin C complex in 1937. In all his research, however, Szent-Georgi found that he could never cure scurvy with the isolated ascorbic acid itself. Realizing he could always cure scurvy with the “impure” vitamin C complex found in simple foods, Szent-Georgi discovered that other factors had to be at work in order for vitamin activity to take place. So, he returned to the laboratory and eventually made the discovery of another member of the vitamin C complex – rutin (also known as vitamin P). All the factors in vitamin C complex, ascorbic acid, rutin, and the other factors, were actually synergists. They were co-factors which together sparked the “functional interdependence of biologically related nutrient factors.” (Empty Harvest p120). The term ‘wheels within wheels’ was coined to describe the interplay of these co-factors.’

    1. Sorry but this sounds just like quackology. i do not know where you get it from (you provide no references) but it sounds like the ideology promulgated by the notorious dentist Royal Lee and enthusiastically endorsed by (whom else?) the self-styled Weston Price Foundation.

    1. There is likely a host of factors that contribute to how salt affect people differently (hormones, weight, kidney function, water intake, electrolyte balances)… However, “chronic high salt intake can lead to a gradual increase in blood pressure throughout life”. If you look at hypertension stats… the prevalence of hypertension increases with age. Even though some may appear to handle salt better, the chronic affects will eventually take over.

      http://nutritionfacts.org/video/the-evidence-that-salt-raises-blood-pressure/
      http://nutritionfacts.org/video/sprinkling-doubt:-taking-sodium-skeptics-with-a-pinch-of-salt/
      http://nutritionfacts.org/video/high-blood-pressure-may-be-a-choice

  27. I’m curious if there is research on how athletes should effectively replace electrolytes in high sweat situations? Just stick to non-sodium electrolyte replacement? Or is the sodium in electrolyte drinks somehow different than “salt”?

    Thanks for any input!

  28. A huge portion of these videos I watch and trust the research. When I hear Saint Michael say that the Yellow Emperor’s Classic is over four thousand years old, alarm bells start to ring. I can’t find any source which says it was written earlier than about 500B.C.

    1. Dr Greger merely quoted an article which stated this – this is obvious from the screenshot which accompanies the commentary.

  29. My husband’s blood pressure is down from 150/100 to 118/70 in the two months we have been following a WFPB diet, no medication involved. I’m so pleased as I was about to book him in with the doctor, no need now. Mine is down too although I’ve been getting really bad cramp in my thigh muscles at night.

  30. Unrelated question, but do whole food plant fats (like avocado, nuts, seeds) affect insulin function, sludge up the blood, etc.? I know these foods are healthful, but I’m wondering if there are any good reasons to limit them to small amounts instead of eating many servings a day. Thanks.

    1. I do not think that anybody knows for sure. It may depend in part on whether you are considering eating this way as a short term strategy or as a long term dietary approach.

      Some studies suggest that diets high in plant fats lower mortality. However, this is compared to people who eat diets high in saturated fats or high in refined carbohydrates.
      https://www.hsph.harvard.edu/nutritionsource/2016/07/05/different-dietary-fat-different-risk-of-mortality/

      The various PREDIMED dietary studies have been reported as showing benefits from plant fat consumption, specifically nuts and olive oil, but these were partly funded by olive and nut growers. Some caution is therefore warranted in interpreting these results.
      http://www.thelancet.com/journals/landia/article/PIIS2213-8587(16)30085-7/abstract

      The Eco-Atkins Diet has also been reported to deliver some benefits but this was compared to people eating a high carb diet but including eggs and dairy.
      http://bmjopen.bmj.com/content/4/2/e003505.full

      Issues to consider might include precisely what balance of macronutrients you might end up consuming, what are you giving up to increase consumption of plant foods high in fat, and what might be the resulting balance of eg omega 3 and omega 6 fats?

      McDougall is not in favour of this approach for various reasons and cites a 12-month study suggesting some slight adverse effects on bone health from increased nut consumption
      https://www.drmcdougall.com/misc/2009nl/nov/nuts.htm

      1. Thanks for your answer. Maybe Dr. Greger can scour the research for more answers if they’re out there. I think this is a question a lot of vegans and WFPB eaters want a definitive answer to!

        1. Yes but I suspect that the research is just not there.

          The current orthodoxy is that it is not the amount of fat that you eat that is a risk but the type of fat.

          However, I remain cautious. Long term, both human epidemiological studies and animal trials show increased mortality with low carb high fat and high protein diets. Of course, in most cases, the low carb diets examined contained a lot of animal fat and protein.

          In an interesting animal study, however, the main fat/oil used was soybean oil. They used casein as the protein however.
          ‘The team put mice on 25 different diets, altering the proportions of protein, carbohydrates and fat. The mice were allowed to eat as much food as they wanted to more closely replicate the food choices humans make.
          “The healthiest diets were the ones that had the lowest protein, 5 to 10 to 15 per cent protein, the highest amount of carbohydrate, so 60, 70, 75 per cent carbohydrate, and a reasonably low fat content, so less than 20 per cent,” Professor Le Couteur said.
          “They were also the diets that had the highest energy content.
          “We found that diluting the diets to reduce the energy intake actually made the animals die more quickly.”
          The mice that ate a high-carbohydrate, low-protein diet lived about 50 per cent longer than those on the low-carb diet.”
          http://www.abc.net.au/news/2014-03-05/low-carb-diet-may-shorten-your-life-study-finds/5299284
          http://www.cell.com/cms/attachment/2040700764/2054394752/mmc2.pdf

          So,for my part, I intend to stick with a high carb whole food plant based diet and not self experiment with high fat/high protein versions.

  31. if potassium is good for endothelial function, for now i’m believing that salting food with potassium chloride is a healthy thing.

      1. It’s a great start, but that study only compared NaCl to the 50/50 substitute. I’d be very interested to see further research that could compare these to a drastic reduction in salt altogether (be it from NaCl or substitutes), or to e.g. pure KCl as Fidel suggests. As the authors themselves write:

        “In conclusion, the present follow-up study showed that switching from regular salt to potassium-enriched salt reduced cardiovascular mortality, improved longevity, and cut down medical expenditures for CVD-related inpatient care in a group of elderly men in northern Taiwan. Additional studies are encouraged to demonstrate the beneficial effects of a reduction in dietary sodium and an increase in potassium intake in the general population and to clarify whether the effect comes from lower sodium intake or from higher potassium intake.”

        You never know, there may be an optimum composition for “salt” to shoot for, although of course you’d then run into the difficulty of having to take into account the other Na/K sources in your meals. But if I think of something like the so-called saltsticks marketed towards endurance athletes to counter loss of electrolytes, those seem to be mostly sodium whereas LoSalt is predominantly potassium chloride for instance…

  32. I have a question about this. I have a odd relationship with salt because I am deficient. My cortisol levels at last check were two (deficient is 1.99). My blood pressure is usually very low and when I was a teenager I would often pass out multiple times a day to the point that I was sent to Saint Jude Children’s Hospital. They said I have cardiovascular inhibitory syncapy and to increase salt and water intake. They said I lacked some sort of binder or there was a problem with my ion channels.
    Could this be due to lack of iodine perhaps? I would love to hear anyone’s thoughts or advice.

  33. I tried finding if Hypotension or orthostatic hypotension was mentioned in this discussion but it was not. At old age this is a possible disorder. My Geriatric physician recommended me to consume salted fish like salted herring! In view of the above findings, and as someone with some clogged arteries but lives well without any invasive treatment, will eating a very salted food might be now considered damaging?

    1. Hello @nfdev-d6dabcc412981d56c8733b52586a9d44:disqus I am a volunteer moderator for Nutritonfacts.org. Please follow your physician’s advice when dealing with your hypotension. If you are searching for different recommendations, I would encourage you to find a physician where you live (a Naturopathic physician, a Functional Medicine practitioner, or other more “integrative” physician) to support your medical care. Best of luck to you!

  34. Given that potassium and sodium seem to have antagonistic effects on endothelial function as well as blood pressure, what does that mean for those of us using salt substitutes or reduced sodium salt such as LoSalt (which off the top of my head is something like 33% NaCl, 67% KCl)? Should we still be worried about the absolute sodium content or is it the proportion that matters? I shake some on my cooked food at least once a day for the taste and the iodine, and I’m satisfied with the fact it helps reduce my sodium intake vs. ordinary table salt, but if the potassium offsets the sodium in some way that would be brilliant of course.

    1. Salt as such is not the problem – it is sodium. Celtic Sea Salt and Himalayan Salt all have wonderful marketing pitches. However, no amount of marketing can disguise the fact that Celtic Sea Salt, like other table and cooking salts, is high in sodium. Nor can marketing substitute for hard evidence. As Darryl summed it up in a previous post:

      “Forget Himalayan or sea salts. 50/50 NaCl/KCl “lite” salt is the only one that’s improved health outcomes, reducing CVD mortality by 41% in Taiwanese veteran’s homes in this trial.”
      http://ajcn.nutrition.org/content/83/6/1289.long

  35. Tonight I came across several websites and YouTube videos that describe how salt can deplete the calcium in your body. To much salt can give you kidney stones by drawing the calcium out of your bones and into the blood stream. At the same time, while your calcium is being excreted from the body by the kidneys due to high sodium levels, a person can develop thin bones or osteoporosis. Here is the link to just one of many articles on this topic:
    http://saveourbones.com/does-too-much-sodium-cause-osteoporosis/

  36. PLEASE…so now,,if NO SALT..I cramp up ALL OVER…so what/how do I use or NOT SALT..??? “HELP”…(vita. C added is the answer..?)

  37. so what would the implication be for endurance athletes who utilize salt tablets during activity? Seems to me you may replenish the salt loss but hamper the cardiovascular function?

  38. Can we definitely say that no salt at all is best? Because it’s not my case. I went more than 6 months without salt and had issues. So, I had to add salt to my diet. Now, if we add salt to our diet, how much is O.K. to add? I usually never eat pre-prepared food, I cook most of my food and I add one eighth to a quarter teaspoon of salt a day.

    1. Thanks for your question Sebastian.

      To better answer your question, I will quote the WHO report on guidelines for sodium intake:

      Requirements:
      “Sodium is the principal cation in extracellular fluid in the body, and is an essential nutrient necessary for maintenance of plasma volume, acid–base balance, transmission of nerve impulses and normal cell function. In healthy individuals, nearly 100% of ingested sodium is absorbed during digestion, and urinary excretion is the primary mechanism for maintaining sodium balance. Even in hot, humid climates, there are only minimal loses through faeces and sweat. Acclimation to heat occurs rapidly; thus, within a few days of exposure to hot and humid conditions, individuals lose only small amounts of sodium through sweat. Under conditions of extreme heat and intense physical activity that result in high sweat production, sodium losses in sweat are increased and appreciable; nonetheless, most individuals can replace the necessary sodium through food consumption, without dietary alterations, supplements or specially formulated products.”

      Sodium in foods:
      “Sodium and chloride are the chemical components of common table salt; however, sodium can be found in other forms, and the primary contributors to dietary sodium consumption depend on the cultural context and dietary habits of a population. Sodium is found naturally in a variety of foods, such as milk, meat and shell fish. It is often found in high amounts in processed foods such as breads, crackers, processed meats and snack foods. High amounts of sodium are also found in many condiments (e.g. soy and fish sauces). Thus, a diet high in processed foods and low in fresh fruits and vegetables is often high in sodium. Although the minimum intake level necessary for proper bodily function is not well de ned, it is estimated to be as little as 200–500 mg/day”.

      In practical terms:
      According to the NHS, “adults should eat no more than 2.4g of sodium per day, as this is equal to 6g of salt -– that’s around one teaspoon”

      Sounds like you have taken good steps in your diet to reduce salt intake.

      Hope this answer helps.

    1. Salt intake is only one risk factor for developing hypertension. It is a very powerful risk factor, but some people can get away with eating lots of salt, maybe because of good genes or good exercise habits, or young age.

      I often used to hear from some of my smoking patients stories like “my uncle smoked a pack of cigarettes a day his whole life and lived to be 85, so I’m not going to quit.” The point is that, when trying to assess whether or not risk factor A contributes to (or causes) disease B, it’s necessary to look beyond individual case reports, and look at population studies, animal studies, clinical trials, etc.

      1. I meant it like my friend has a problem with low blood pressure (that’s why he eats more salt) what could be the reason he has a low blood pressure? he is young, slim, sporting every day…

  39. I am continually amazed by the incredible information conveyed in these videos. Thank you Dr. Greger and the whole team at NF for all of your hard work. This is an excellent video that helps us sort out all of the nutritional noise out there.

  40. I have just read a large number of the comments, below, and realize that there is a lot of confusion about salt. Dr. G’s video shows that salt (NaCl — sodium chloride) raises blood pressure in most (not all) people over just a few hours, and also reduces blood flow/stiffens arteries within a short period of time.

    He is not saying that the body doesn’t need any sodium; sodium and chloride are the major electrolytes present in our blood. It is well known that athletes who sweat heavily need to replace some sodium as well as lots of fluids, so they don’t get dehydrated and hypotensive. Here is an article I came across from a very quick PubMed search (I think my search strategy was: “salt tablets athletes”) about needing to replace salt.

    For the great majority of us, though, we don’t need ANY added salt; as others have referenced, 500 mg per day is probably a healthy amount, especially for someone with high blood pressure.

    Despite the efforts of the fast food lobby to confuse the issue, it has been clear since at least the 1970s that salt plays a major role in causing both hypertension, and the inexorable rise in blood pressure with age that occurs only in people on Western diets. I know because I wrote a paper on salt and hypertension when getting my master’s degree in public health at Harvard (1978). I was particularly impressed with migrant studies such as
    this one, which document the rise in blood pressure of people who migrate from their home countries (in this case, Kenya), where they consume very low sodium plant based diets, to Western countries where they consume the S.A.D.

    Potassium (and chloride) is present in large amounts in plant foods. You don’t need to go out and buy salt substitute — which contains both potassium chloride (KCl) and sodium chloride (NaCl) — in order to get lots of potassium. Vitamin C is also present in large amounts in many fruits and green vegetables. Consuming salt plus a Vitamin C pill as a strategy to have normal arterial function is NOT what Dr. G is advocating, I’m quite sure. I hope this helps a few people.

    1. I can only speak for myself obviously but my question was not whether I “need” to buy salt substitute, I knew that much already. The question is rather whether it’s a (relatively and/or absolutely) harmless source of salty taste (and in my case, iodine). If not then I guess I’ll stop salting any of my food altogether and find another source of iodine, and maybe some more spices to play with.

      1. Sorry for delayed reply. The quick answer is that salt substitute contains a lot of sodium and is certainly not harmless for most people — due to what Dr. G’s video teaches us. Relative to plain NaCL, salt substitute is an improvement, because it contains less sodium. But yes, your best strategy is to stop salting your food altogether.

  41. Dr. Greger,

    One or two years ago you released a video with a study showing that eating meat caused arterial shock for 6 hours after eating it.
    Could it be that it was not the meat, at least in part, but the salt in the meat, at least in part, which caused the arterial shock?- and that this was not taken into account in that study other such studies? Could it be that salt is the real or largest culprit here and that meat is not quite the super-villain thought?

    Just Pondering,
    JM

    1. Thanks for your question JM.

      I am not sure which post you are referring to but it might be this video regarding fat and arterial function.

      Whilst you do have a point, I think it’s important to acknowledge that there may be other components in meat apart from salt that make it not so friendly to our arteries, especially the fat content of meat and the lack of vitamin C to counteract the negative effect of salt on endothelium function. The video I attached on this comment explains this point in further detail (here)

      Hope this answer helps.

    1. Brenda: Doctors will not tell you to use Himalyan salt, because it’s nothing but slightly contaminated salt. It’s still going to hurt you in the same ways that non-pink salt will hurt you. The following link should take you to a comment of mine that covers details like what is really in Himalayan salt (and what is not). I highly recommend you check it out and think about what it says: http://nutritionfacts.org/video/sodium-and-arterial-function-a-salting-our-endothelium/#comment-2798658337

  42. I am assuming the results on FMD are the same for refined and unrefined salts? Are there any studies differentiating between refined salt and unrefined sea salt?

  43. I have high blood pressure yet I have low sodium levels. Before learning of low sodium levels, I had cut out nearly all salt from my diet and was taking a diuretic as a means to control hbp. Now I’ve dropped the hctz from my regimen and started drinking a glass of v8 or eating a small bowl of cottage cheese daily. Sometimes a little Gatorade, though the sugar tastes and is awful. I suspect my salt intake is still way below national recs.

    I’m eager to see what my numbers are when I next see doc. This is all very confusing to me. Not sure what to do or if what I’m doing makes sense. I’d ask doc but he remains as inaccessible as most docs I’ve dealt with over the years. So I’m asking in this forum.

    1. Certainly we’re all different, but I use neither salt nor processed foods, just WFPB, and I get along fine, including on long and very tough days backpacking in the Sierra.

      1. And mostly I’m on steep off-trail routes with a 45-lb pack, so I work very hard. My body always hangs onto every bit of sodium I get from natural foods, unfortunately. Salt added to food sends me around the bend. I can’t stand the way it makes me feel. Frantic, for one thing. It also makes me swell and keeps me much too hot. Salt is very bad news as far as I’m concerned.

    2. I’m new to this issue as I was hospitalized this month in Fl, Mostly started as bad constipation and abdomen discomfort. Was thought to be due to dehydration. I received an iv of saline and medication on a clear liquid diet, miralax, supositories, fleet enema. My blood sodium was down to low 130, chloride low, very tired, weak and almost 83 years old. It was important to get sodium up and after 2 days was realeased. However, after 1 day home, my wife called 911 and I ended up at another Hospital and more of same. But back to real home and a visit with my Dr. with objective to feel better and get sodium up from 132. Potassium up tp 5.3 and glucose was 100, now 92. Been on Miralx, 1/2 water and 1/2 gatorade. Not great confidence in Dr. Yesterday first day feeling better. Cut back on using gatorade and limirted water but some Veggie juice. Same today. I hate the high sugar in gatorade but other are high potassium, evern at 1/2 dose. Today I discovered pediatlyte children and adults. Eating more food with salt even pickles and sauerkraut. Hard bowels been on a few days now. on we go.

  44. Hi Dr. Greger! I am a vegan and I have been diagnosed with Postural Orthostatic Tachycardia Syndrome. Both my cardiologist and neurologist have recommended a high salt diet to help with my symptoms. What would you recommend for a patient with POTS?
    Thanks so much for all you do!

  45. So if i eat a teaspoon of salt with
    a mash of Sweet Potatoes , Or eat kiwi right after lunch with salt, What the problem then?
    (They contains vitamin C And i’m resistant for increasing blood pressure due to salt intake.)

    1. Hi, I am a volunteer for Dr. Greger. Using vitamin C-rich foods can help to overcome the negative effects of consuming salt. However, there are likely added benefits to eating the vitamin C-rich and other whole plant foods that can be negated by adding salt. The best way to eat plant foods is with no salt at all, if possible.

  46. So dietary potassium is good for arteries. What is the view of Dr Gerber and other experts on whether salt substitute with ~50% potassium chloride is a good (or less bad) alternative to table salt?

    There is also a lot of praise out there for various sea salts and mountain salts with trace elements, and criticism of MSG. It would be useful to have authoritative guidance on these issues too.

  47. I’ve always had low blood pressure so I ate a high salt diet for years, thinking it wasn’t impacting me. But now I’ve got an autoimmune disorder, and in my research discovered this paper indicating that high salt intake might actually cause autoimmune disorders! Needless to say, I’m finally on the “low salt” bandwagon and hoping it will decrease my symptoms. Since autoimmune disorders appear to be on the rise, I think a lot of people could be helped if you would consider doing some more videos that focus on autoimmune disorder prevention and treatment. Here’s a link to the journal publication I found regarding the link between salt intake and autoimmune disorders:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746493/

  48. Is it ok if I cut out salt completely? I cut out salt completely for few months and my blood pressure seems too low that I’m not allowed to donate blood. What should i do now?

    1. Tuyet, this is something that should be addressed with a health professional.

      That said, the amino acid taurine (often found in energy drinks like 5 hour energy) is known to increase the output from your heart.

      Taken in moderation, it may increase your blood flow without having to resort to upping your salt intake.

    2. My problem is totally different since I became hospitalized in February was in a hospital 3 days, sent home and back to another hospital 1 day later for 3 days. All started with constipation and low sodium. We were on vacation in Fla. and after returning home have seen my primary care physician who sent me for a number of blood tests, x-ray, and cat scan.
      While my sodium and chloride have increased, I am still on low side even after drinking Gatorade 50%with water.My walking and energy are not good but better. I am 83 and health not terrible but nothing too serious. I’m using a little more salt. Stay tuned.

      1. So you mean you still USE just a little sodium, right? I didnt use much sodium in the past cause i dont like the taste of salt in my food at all and i can’t eat the salty food. So it’s so simple for me to quit sodium COMEPLETELY since i know sodium is not good for my health. I only eat food i cook at home, no junk food and even canned beans, store-bought tahini or peanut butter. It’s all home made and NO SALT AT ALL. maybe i should add a little bit of salt in my food even though i hate it :( I’m so confused cause even though my blood pressure is low but i dont feel tired at all.
        Since i follow WPPB i feel so strong, never feel exhausted even in high intensity exercise. I exercise every day, schedule 40 min of cardio, HIIT or yoga on six of the days and walking alot.

    3. Hello Tuyet,
      I’m a family physician in private practice and also a volunteer commentator for this website. First, congratulations on having such low blood pressure! That makes you much less likely to die of a stroke or heart disease. Do you know how many mg of sodium you consume per day? (It is virtually impossible to completely cut sodium out of your diet). Your body only requires about 200 mg of sodium per day. A “very low sodium” diet is less than 500 mg per day. Just one teaspoon of table salt has 2,325 mg of sodium.

      The reason that the Red Cross has a lower limit for blood pressure (BP) for blood donors is because donating blood decreases your blood volume which puts you at increased risk of dropping your BP and passing out when you stand up; and if you start out with a low BP then passing out is slightly more likely. Their lower limit is probably a little too conservative (high), in my opinion.
      Athletes, who sweat a lot, may need to consume more sodium than others.

      All this is just background. To get back to your question, you are probably consuming a very healthy amount of sodium, even though you “cut out salt completely for a few months.” If your blood pressure is often too low to donate blood, there are several things you can do. One is to think about something really worrisome just before they take your blood pressure — it will probably go up to at least the cutoff. Or, IF you are consuming under 500 mg of sodium per day, if would be fine to increase your sodium intake somewhat. From what you say, I’m guessing that your systolic BP (upper number) is often below 90. Remember that the lower your BP, the better. But anything below 110 is considered optimal.
      I hope this helps.

  49. Just read a book by Daren Orlien and it discusses water. His recommendation is reverse osmosis water and then add sea salt. I’m wondering if it’s health prmomoting to add sea salt to RO water? His reasoning is that water without trace minerals will drain minerals from your body. Thanks.

    1. Corey, First of all, take everything I say here with “a grain of salt” so to speak ‘-)

      I personally and without anything other than my intuition to guide me, buy RO water from a machine, bring it home and run it through a distiller, store it in glass bottles, and drink and cook with that.

      I’ve recently started putting two drops per gallon of some watered down food grade hydrogen peroxide. I guess the strength of the H2O2 to be about 7 or 8 percent. I feel safe doing this as I take many, many anti-oxidant supplements throughout each day which I feel offset any ROS from the Hydrogen Peroxide. I also use this mix in a glass spray bottle that I spray on my skin, being careful to avoid getting into my eyes.

      On some occasions, if I’m working and sweating a lot, I add a small amount of liquid minerals to the distilled water but never salt. The only time I add salt to anything is when I’m eating watermelon… and then I salt sparingly.

      My bi-annual and annual blood test has yet to show my sodium levels being too low.

    2. Hi Corey,
      I did a little research and reverse osmosis does take quite a bit of minerals out of the water and some people have reported feeling sick after drinking it long term. I wouldn’t recommend adding salt to your water because it could upset the balance of water in your cells and cause dehydration. You can buy a mineralizer that puts minerals back in your water which might be a better option.

      1. I believe most reverse osmosis water filters have a part of the system which ADDS BACK minerals. But reverse osmosis water is the purest water you can get as it is able to take out all impurities even the added fluoride (it’s actually a synthetic fluoride that they add to our water). Anette Larkin swears by distilled water.
        I didn’t used to have the addition to the filter which adds back minerals, I do now, but I never felt sick on my water at all and find that hard to believe unless someone is not eating a sufficient diet. We get most of our minerals from food, so I can’t see how it would be an issue. In any case, I’d say it’s a good idea to get a system which adds back some of the minerals taken out.

        1. But reverse osmosis water is the purest water you can get as it is able to take out all impurities

          I think you misspoke. That is, distilled water is the purest water. And while RO water does a pretty good job of removing impurities, it is susceptible to allowing bacteria through an imperfect filter. Some systems combine UV light with RO to kill any bacteria that get through. And even boiling the water can kill off any escaped bacteria.

          This is where distillation is superior to RO, because it boils the water converting it into steam and kills off both gram negative and gram positive bacteria.

          As a side note, I buy RO water by the gallons to bring home and run through my distiller. You wouldn’t believe the crud that quickly builds up in my stainless steel distiller.

          1. I use the Pelican reverse osmosis water filtration system, purest tasting water I’ve ever had (even my cats started drinking water more when I got it lol) and they actually do use UV light. I think a quality system is as important as the general filtration method. Anyways, you can taste and feel the purity, I was actually surprised at the difference because I had a really good filter before that which did get rid of most of the fluoride but not all of it. My concern about added fluoride was what drew me to do more research which lead me to go with a reverse osmosis filter.

            I don’t know that much about distilled water but I did actually quickly google it after I read your comment and saw this: “Unless volatile chemicals like chlorine are removed by carbon filtration before they enter the distiller, they will be released into the room air or they will end up in the distilled water. But in general, distilled water is very pure, as is reverse osmosis water.” here: https://www.purewaterproducts.com/articles/reverse-osmosis-faq
            What are your thoughts on that? Does the water need to be filtered prior to distillation or are there systems that take care of that first step? Also, does it remove fluoride and would it remove other more difficult impurities to filter such as chloramine (which unfortunately some cities add to their water)?

            I love my reverse osmosis system, so I’m not asking for myself but I think it’s a great subject to be addressed and maybe the info will help others reading, plus it’s always good to know these things.

            1. Hmmm, wasn’t aware of the chlorine-in-the-air if the water used started with chlorine. Not sure if that is a safety concern or not, but in my case where the water has been RO-ed it shouldn’t be a problem. I’ve heard some say that RO water is best because it does leave some minerals in it whereas the distilled doesn’t.

              My personal experience as I alluded to in my post above is a stained distiller from the RO water, but that is RO from a commercial water machine and who knows how often they clean or change membranes in one of those, so that could be where my problem stems from. Sounds like you’ve got a primo setup with the UV system. I wouldn’t change a thing either.

              Heh, I also feed my two cats (momma cat and one of her female kittens I was unable to give away) RO water that I buy in town. They drink it but also drink the well water from my tap that I put out for birds or other visitors. I won’t drink the tap water as it tastes bad and probably is officially undrinkable, but I don’t know that for sure. Probably has a high pH as the sub-soil here is caliche (alkaline) with a pH of 8 or so and the water table rests between the calcareous type soil and redbed, that is, red clay. Oh, and the two cats have undergone cell division and will soon be eating and drinking for their families. But I digress…

              In re: the benefits of the two water cleaning methods… for me anyway, I think the distiller may be the best choice because 1. I would likely have to change filters pretty often due to my water source, and 2. I place a magnesium rod, stuck in a cork in my distilled water bottles for use as drinking water or tea-making hydrogenized water. Anything I’ve read said to used distilled water for this purpose. I’m sure because distilled water is a solvent and reacts with metals. I bought a stainless steel flask once to use as a movie prop and the instructions said not to put distilled water in it. I have a stainless steel boiler to draw water from to make tea in the winter and use the hydrogenized water in it to negate a reaction with the stainless. Distilled water is a neutral 7.0 pH. RO water should stay closer to the pH is was taken from, so it is probably not a problem of metallic reaction I’m thinking.

  50. I tried to find a research study comparing Himalayan salt to others, but other than marketing claims, the only study I found in Pub Med is this one:www.ncbi.nlm.nih.gov/pubmed/ It compared results after salting meat with various salts, including Himalayan and concluded:
    “There were no significant differences (P > 0.05) in sodium concentrations between salt treatments.” Dr Greger has several videos on the harm of sodium (search under “Salt”) so to answer to your question, NO, himalayan salt is neither safe nor healthy. The more we can train our taste buds to get along without added salt, pink of otherwise, the healthier we’ll be.

    1. Hello Louanne,
      Thank you for your question. I am a family doctor with a private practice in lifestyle medicine, and also a volunteer moderator for this website. Remember that 1 teaspoon of salt (sodium chloride) has 2300 mg of sodium. The American Heart Association recommends less than 1500 mg of sodium per day:
      https://sodiumbreakup.heart.org/how_much_sodium_should_i_eat?utm_source=SRI&utm_medium=HeartOrg&utm_term=Website&utm_content=SodiumAndSalt&utm_campaign=SodiumBreakup

      For children, I found this table from the UK. Interesting that for babies under 12 months, they recommend under 400 mg of sodium!!
      http://www.nhs.uk/chq/Pages/824.aspx?CategoryID=51

      For my patients with hypertension, I recommend that they consume under 1000 mg sodium per day, and preferably under 500 mg. This is very difficult to do. Our taste buds get used to lots of salt, and then we crave it. I personally have had high-normal blood pressure for much of my life, so this is something I’ve studied quite a bit. It turns out that some people are very sensitive to sodium, and others much less so. In case you’re interested, here is an article about that: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089903/.

      There is also the issue of athletes who sweat a lot and lose sodium: they may have somewhat increased requirements. So, there is not a “one size fits all” answer, BUT, if everyone in this country ate less than 1000 mg of sodium per day, we would be a LOT healthier!

      I hope this helps.
      Dr.Jon
      PhysicianAssistedWellness.com

  51. Hi Dr. Greger! First off, I just wanted to say a big thank you for all the work you do. My husband and I are always watching your videos, reading How Not to Die and love making delicious vegan food together. I am super curious to know what your thoughts are on postural tachycardia syndrome (POTS) and salt. I was diagnosed with POTS in 2015 and noticed a big difference in the severity of my symptoms when shifting from a vegetarian to vegan diet. I feel so much better on the vegan diet. However the standard right now for POTS treatment is lots of salty fluids and I just feel so conflicted about that. I exercise faithfully and always eat vegan, but lately with the heat I still find myself struggling with symptoms. Do the benefits of salt outweigh the risks for someone like myself with autonomic dysfunction? Or are there other foods that would be more healing for me?

    I have been treated by Mayo Clinic and follow with my PCP and neurologist locally but not much is known about POTS and there are no plant based doctors where I live so I was really hoping to get the perspective of someone who believes in the power of food. Thank you again!!

  52. I am terrified; please help. After following a WFPB diet including added salt for the past year and a half, I excluded added salt for the past month and a half, with the past week or so being a hundred-percent free of added salt, and this is when I began exhibiting symptoms of sodium deficiency: headaches, severe mental fog, irritability, and fatigue. I am young and otherwise healthy. I am now introducing salt back to my diet, but I am afraid that I still feel unsharp, mentally impaired and unlike myself. When does hyponatremia result in brain damage? Is it possible I damaged my brain irreversibly?

    1. I got in trouble drinking too much water etc. Includes soups, tea, coffee, juice. A Dr. recommended less water and more protein. Ok since.

  53. Hello! No need for terror! Hyponatremia is not a result of low dietary salt. The sodium level in the blood is very tightly regulated by a complex system. It is caused by a variety of medical conditions, most commonly heart failure. It would easy to assure your sodium level is normal with a blood test. It’s not likely it’s low in the absence of one of the generally serious medical problems that cause it.

    Your symptoms are very general and can be seen in many, many conditions. I’d suggest starting with your doctor, who can talk with you, examine you, consider your past history, and consider tests as appropriate.

    FYI, there’s plenty of dietary salt in food. I’m assuming you’re eating sufficient calories and drinking a normal amount of water. Adding salt to the diet almost always results in excessively high consumption of sodium.

    Best luck! Dr Anderson, volunteer

    1. Dr. Anderson, thank you for your reply. I agree that the symptoms I described could be attributed to various other medical conditions, but as I noted before, they only appeared as I lowered the consumption of table salt until I did not consume it at all. I am young and in good health, excluding this incident. As I began reintroducing salt into my diet, my condition improved immediately. I turned to an emergency unit two days after reintroducing salt and in an already-improved condition, therefore it is not surprising that the sodium level in my blood was normal. The doctor who treated me did not see fit to examine possible causes other than the one I provided. Unfortunately, my cognition still seems to suffer the consequences of this recent incident.

      I do wonder what differentiates myself and others who developed hyponatremia after eliminating table salt — some could be found in comments to NF.org videos discussing salt — from those for whom such dietary change was successful. After eliminating salt and until symptoms appeared, I enjoyed improved mood and energy. I also became radiant in appearance, and the oiliness of my scalp reduced, and this persisted even after symptoms appeared.

  54. Hi, what about Himalayan pink salt? Do you think it’s ok to use that? I got rid of my goiter using it. I had a hyper thyroid and the docs were going to put me on meds. I asked to wait so I could try it. I went back to the docs, and at that point, I was using quite a bit to reverse the thyroid. I went back and he said whatever I was doing, stop because it worked, but it was about to go the other way. I said. ok because I would rather be skinny than fat lol. Now I just use it on occasion. I don’t like regular salt because it makes me swell up, but for some reason, the pink salt doesn’t.

  55. Read some articles on GreenMedInfo that suggests long term sodium level that were considered excessive a few years ago are protective from hypertension and heart diseases.

    Been a WFPB eater for four years, did a clean Paleo diet for a year before that, on week 3-4 of eating only plants felt my kidneys and liver for the first time in my life. Increased my water intake to help them out. Lost 8 lbs that week and my bp dropped from120/70 to 96/55. Completely sold on enjoying a whole food plant based diet!!

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