Salt and High Blood Pressure

CDC Guidelines: 1,500 mg of Sodium a Day

Salt (sodium-chloride) is everywhere, and high blood pressure (the result of too much sodium consumption) is an American epidemic. According to recent recommendations by the Centers for Disease Control and Prevention (and decades-old Pritikin Program guidelines), the majority of Americans should consume no more than 1,500 mg of sodium a day.

Salt and High Blood Pressure

With the average American ingesting more than double that, it’s no wonder that more than 90% of Americans will develop high blood pressure in their lifetime.¹ High blood pressure can, most infamously, lead to cardiovascular diseases such as heart attack and stroke, and treating it is a drain on our nation’s healthcare system.

Cutting nationwide sodium consumption down to the levels recommended by Pritikin and the CDC would cut healthcare costs by 26 billion dollars annually, according to new estimates by scientists at the RAND research institute in Santa Monica, California.² Dr. Bibbins-Domingo, research scientist at UC San Francisco, recently stated that even just a 400 mg drop in sodium consumption would prevent about 200,000 deaths from cardiovascular disease over the next decade.³

Unfortunately, despite all the research showing the dangers related to our current levels of sodium consumption, most Americans have done little to change their diet. Why?  Who’s at fault?  And can we – and the U.S. food industry – change?

We as individuals are the first guilty party. We have been using salt as a flavor enhancer every day for our entire lives, and even though many of us may want to lower our sodium intake, we aren’t sure we can. And there are always the naysayers, such as Michael Alderman, a professor at the Einstein College of Medicine, who wrote an op-ed piece in The New York Times in 2009 declaring that he is wary of the drastic cuts in sodium intake necessary to improve our nation’s health. Alderman cautioned New York City health officials, who embarked on a campaign to cut salt content in processed foods by 40% over the next 10 years, to slow down. He did not see the current research as a compelling enough impetus for substantially decreasing our sodium intake, and worried that if such a seemingly essential part of our diet were cut out, it “might have unintended harmful consequences.”

What Our Bodies Are Designed To Eat

We must realize, however, that this big decrease in salt consumption that so many Americans avoid would not really be a change at all, but a return to what our bodies are biologically designed to eat. Before the 20th century and the advent of mass-produced, processed foods, salt was not nearly such a large and inimical part of our diet. Whole, unprocessed foods are naturally very low in sodium. An apple has just 3 mg of sodium; a russet potato just 19.

Yes, the absence or dramatically reduced amount of salt in our diets can be challenging at first, but soon the taste buds, dulled by years of over consumption of salt, will start to come alive again. Guests at the Pritikin Longevity Center in Florida have been amazed when, after just a few days on a new diet low in sodium, they were able to, for the very first time, taste the natural sweetness of corn or the nuttiness of whole grain breads and pastas.

90% of the Sodium We Eat Is NOT From Our Salt Shakers

Although we must look to ourselves first as both the reason for and solution to our current dependence on salt, the food manufacturers and restaurant corporations who have been loading their products full of sodium, largely on the sly, must also shoulder some of the guilt. The natural reaction for many Americans who want to cut down on salt is to take the salt shaker off their kitchen tables. This is a good start but sadly does little to decrease our sodium intake. The vast majority of the salt we consume every day, about 80%, comes from the processed foods we buy in supermarkets and order at restaurants. Another 10% of so (all we really need) comes naturally from the plants and animals we eat.

To make matters worse, the companies producing this food even highlight the “healthiness” of their food – the fact that their products are low in fat or cholesterol or have no MSG. Meanwhile, they are still chock-full of sodium chloride, or salt. Swanson is now running commercials nationwide touting their MSG-free chicken broth. But just one cup of this broth is packed with 860 mg of sodium. Even the “low sodium” version is ridiculously high in sodium:  570 mg per cup. Restaurant menus promote “healthy” entrees that may be vegetarian or light on fatty cheeses or sauces but still contain an entire day’s worth of sodium, and often more.

Food researchers at the nonprofit Center for Science in the Public Interest recently published the nutrition facts for “healthy” dishes at large chain Mexican restaurants, but check out the sodium levels:  the guacamole at one restaurant chain had 1,170 mg of sodium; the Pico shrimp tacos, 1,650 mg; the chicken salsa fresca, 2,410mg; and the grilled vegetable fajitas, a whopping 3,240 mg.⁴ Healthy? We don’t think so.

Drug Treatment

With salt lurking in unhealthy quantities on every pantry shelf and behind every restaurant door, it may seem impossible to cut our sodium intake, and many of us might naturally try to find a quick fix for the resulting high blood pressure. However, like food labels that seem too good to be true, we must also be wary of drug companies who want us to believe that our high blood pressure can be easily cured through prescription medications.

A 2005 study published by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure showed that hypertensives on drug treatment were, on average, only 19% less likely to die from hypertension-related complications like heart attack or stroke than those given placebos.⁵ Not that impressive once you realize that hypertension increases your risk of heart disease and stroke at least 300%.

Furthermore, in this study, the drugs were shown to promote weight gain and increase a patient’s risk of Type 2 diabetes by 40%. Having Type 2 diabetes greatly increases the risk of heart disease. So ironically, these drugs, intended to improve cardiovascular health, may very likely be increasing a patient’s risk of heart attack by promoting weight gain, increasing diabetes, and/or adversely impacting blood lipids like cholesterol and triglyceride levels.

Far more effective for most hypertensives is focusing first and foremost on the root cause of the disease, which is excess salt consumption and a typical modern diet full of refined carbs and fatty animal products.

Can We Stop Worrying About MSG and Focus on the Real Problem, Which Is Salt?

Just as disturbing as the astronomically high percentage of Americans who will suffer from hypertension as a result of their excess intake of salt is the extremely limited amount of publicity that this epidemic is receiving. Food companies and the media are largely silent about the dangers posed by the thousands of milligrams of added salt jammed into the food we eat on a daily basis. They instead focus on phantom dangers such as the flavor additive MSG, which Pritikin nutritionists have for years pointed out has few, if any, of the supposedly life-threatening side effects it has been purported to have.

MSG, a flavor enhancer often used in Asian-style dishes, was said to cause a variety of health problems such as shortness of breath, asthma, and numbness in limbs. However, extensive research on MSG conducted over the past few decades has shown that a connection between MSG and these health issues does not exist.^6,7,8,9,10

In fact, MSG is derived from the most common amino acid in the human body, glutamate, which occurs in all natural foods. Furthermore, the sodium in MSG has been proven to be much less dangerous than sodium in salt (sodium + chloride). If food manufacturers used MSG instead of salt to season foods, we could cut sodium levels in soups, salad dressings, sauces, and other chronically high-sodium products by 75%, and largely prevent the development of hypertension.

Despite these science-based facts, MSG is still demonized in the media and needlessly excised from a few processed food products while dangerously high levels of salt continue to be slipped into food. Why?  It all boils down to money. MSG may be far safer than salt, but it’s more expensive than salt. The food industry’s profits would tumble if they had to replace the salt in their food with MSG, so it’s to their economic advantage to feed fears about even small amounts of MSG.

Bottom Line: The Clear Connection Between Salt and High Blood Pressure

Our nation’s deadly love affair with salt must end now. For substantive change to occur, food manufacturers and other organizations must stop ignoring the guidelines set forth by the National Center for Disease Control and Prevention and, instead, follow in the footsteps of groups such as the New York City Health Department, which this week announced initiatives to reduce the amount of salt in packaged and restaurant foods by 25% over the next five years.

And right now, each of us can take steps to improve our own individual health and lower blood pressure in the safest and most effective way, and without the need for drugs, via a low-sodium eating plan like Pritikin.

For more than 30 years, the Pritikin Longevity Center has advocated a diet that limits sodium consumption to no more than 1,500 mg a day. The Pritikin Eating Plan, based on naturally low-in-sodium whole foods like fruits, vegetables, beans, and whole grains, may at first be tougher to follow than a pill regimen, but the results are infinitely more substantial and long-lasting. Research on more than 1,000 medication-taking hypertensives found that nearly 60% left the Pritikin Center completely free of these drugs, and their blood pressures in normal ranges.¹¹ Virtually all of the remaining 40% left with their drug dosages substantially reduced.

The first step towards a healthier you is not a pill but a “lifestyle prescription.”  The side effects of this prescription are all good – no, they’re great! They include a thinner you, a much healthier you, a happier you.

• ¹Vasan, Ramachandran S, et al.Residual Lifetime Risk for Developing Hypertension in Middle-aged Women and Men: The Framingham Heart Study.  JAMA, 2002; 287: 1004.
• ²alar, Kartika, and Roland Sturm. Potential Societal Savings From Reduced Sodium Consumption in the U.S. Adult Population. American J of Health Promotion, 2009;  24, (1).
• ³Bibbins-Domingo K, et al. Population reductions in coronary heart disease associated with modest increases in salt intake: projections from the CHD policy model. AHA 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention; March 10-14, 2009; Palm Harbor, Florida. Abstract P51. Also available at: http://americanheart.mediaroom.com/index.php?s=43&item=689.
• ⁴Nutrition Action, March 2009.
• ⁵Kostis, John B, et al. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. American J of Cardiology, 2005; 95: 29.
• ⁶Geha RS, Beiser A, et al. Review of alleged reactions to monosodium glutamate and outcome of a multicenter double-blind placebo controlled study. J Nutr 2000;130(Suppl):1058S-62S.
• ⁷Stevenson DD. Monosodium glutamate and asthma. J Nutr 2000;130(suppl):1067S-73S.
• ⁸Go G, Nakamura FH, et al. Long-term health effects of monosodium glutamate. Hawaii Med J. 1973;32:13-7.
• ⁹Heywood R, Worden AN. Glutamate toxicity in laboratory animals. In Glutamic Acid: Advances in Biochemistry and Physiology. Edited by LJ Filer, Jr, et al. p. 363. Raven Press, New York.
• ¹⁰

Simon RA. Additive-induced urticaria: experience with monosodium glutamate. J Nutr 2000;130(Suppl):1063S-66S.

• ¹¹Roberts, Christian K. and R. James Barnard.Effects of exercise and diet on chronic disease. J Applied Physiology, 2005; 98: 3.

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