I remember as a kid being told by my parents to go easy on the salt, red meat, avocados and whole eggs. But to make sure each day started out right – with a hearty 2 cups of Grape-Nuts drowned in a large amount of nonfat milk.
Don’t want all that saturated fat to clog the arteries. Can’t have too much protein because it will cause kidney failure. And God forbid you salt your food and end up with heart disease from hypertension.
My dad subscribed to a monthly newsletter called Bottom Line. This is where the majority of my parents medical and nutrition advice came from and whenever we would disagree on little things like protein consumption, red meat and salt intake they would always cite the Bottom Line as their source.
When I first started working with Dr. Mauro Di Pasquale in 1999 my parents were beside themselves. How could I askew carbohydrates and eat a high protein & fat diet. Increased salt intake was necessary on a Ketogenic diet since the majority of salt people take in is in the form of processed packaged foods. They would always go back to the Bottom Line as their source for everything. Even going as far to recommend I speak to one of their doctor friends about this crazy diet high in saturated fat!
Interestingly my performance went up, my blood panels improved, micronutrients improved from ditching gut irritants like wheat, rye and barley and my strength increased; still they would always harp back to the Bottom Line as their rock on which to offer advice on nutrition.
My dad has since passed away but recently I got into a discussion on salt intake with my mom after she read a review of salt reduction to optimize health in their favorite newsletter – Bottom Line.
Here are a few lines from an article written in Today’s Dietitian from Feb 2018. This is an example of the information discussed in Bottom Line. (Since BL is a paid subscription newsletter I am not able to link any information.)
“Under the latest clinical practice guideline on high blood pressure from the American College of Cardiology (ACC), the American Heart Association (AHA), and nine other organizations, more people than ever before are categorized as having hypertension or elevated blood pressure, and they’re advised to limit dietary sodium, ideally to no more than 1,500 mg per day.”
“Reducing sodium intake by 1,000 mg per day generally reduces systolic blood pressure by 5 to 6 mm Hg among people with hypertension, and by 2 to 3 mm Hg among normotensive individuals.1 The modest blood pressure reduction in people whose blood pressure is in the normal range is cited to support recommendations to lower sodium intake to help prevent hypertension.”
“In addition to a general assessment of overall diet quality, since the majority of Americans’ sodium consumption comes from processed foods…”
While making salt recommendations for Americans in Today’s Dietitian they let slip the real culprit – processed foods.
Could it be the increased consumption of processed foods by Americans, lack of sleep and exercise by the Average American is much more to blame for hypertension and heart disease then consuming salt in a diet consisting of real foods – meat, fowl, fish, seafood, eggs, vegetables, roots, tubers, bulbs, herbs, spices, animal fats, olives & olive oil, avocados, and coconut oil and full fat dairy?
According to the CDC, the average intake of sodium for American adults is ~3,300 mg of sodium a day, which is well above the standard recommendations the USDA at less than 2,300 mg of sodium per day. The American Heart Association (AHA) recommends less than 1,500 mg a day for general health and disease prevention.
But where did this attack on salt start?
Chris Kresser writes, “Conventional healthcare experts have been recommending salt restriction ever since the 1970s, when Lewis Dahl established “proof” that salt causes hypertension. In his research, he induced high blood pressure in rats by feeding them the human equivalent of over 500 grams of sodium a day – 50 times more than the average intake in the western world.”
Presently, there seems to be a lot of conflicting reports on the health of salt. Just last year in 2017, Huffington Post published an article titled, Too Much Salt? 5 Simple Ways To Slash The White Stuff From Your Diet. The author, Gina Roberts-Grey, tries to throw hand grenades from the opening line:
“We all know that consuming too much salt is bad for us — but mounting scientific evidence indicates it’s even worse than we thought.”
It seems as if any consumption of salt is the root cause for all sickness, illness, death and any bad luck you had gambling in Vegas after a 6 shots of tequila.
But has it always been this way?
As far back as 6000 BC, salt has been a vital and integral part of the world’s history with countless civilizations built on these two elements sodium (Na) and chlorine (Cl) bonded together.
Salt has long been considered one of the pillars of civilization, because it enabled food to be preserved, it was one of the earliest goods to be manufactured, and it was one of the first articles to be traded. Salt has been produced for centuries from one of three basic methods: by evaporation of seawater, by digging it out of the ground, or by extraction of crystallized salt as brine. Global annual production of salt is currently over 200 million tons.
Today, the legacy of salt touches every aspect of our lives with words like “salary” being derived from the word “salt.” Salt was highly valued and its production was legally restricted in ancient times, so it was historically used as a method of trade and currency.
In the movie Gladiator (2000) with Russell Crowe, the Numidian hunter who fights with Maximus was purchased from a salt mine in Carthage. Salt was such a precious commodity to the Romans they used it as money and forms of payment. The expression to be worth one’s salt, which means you’re competent and deserve what you’re earning, has roots in ancient Rome, where soldiers were sometimes paid in salt or given an allowance to purchase.
I remember being 6 years old and watching the movie Ghandi (1982) at the local drive in movie theater.
*If you were born in more recent times and not from Generation X or before, drive in movie theaters were parking lots with massive screens on one end. You would pull in your car, truck or van, park in a stall with a speaker. That speaker would and hang on the window of your vehicle so you could hear what was happening on the screen.
We had an old VW van and on Saturday nights my dad would make a bunch of popcorn, put it in brown bags and put sodas in an old metal cooler. We would throw pillows and blankets into the back to make forts at the drive in.
The famous scene where Ghandi marches to the sea to make salt always struck me as odd. We have salt in the spice cabinet and my parents told me to not use too much because it was not good for you. But here is this pivotal scene where Ghandi and his followers embark on the Salt March where they trek 240 miles to the coastal town of Dandi on the Arabian Sea. Gandhi and his supporters defy British policy by making salt from seawater. This was their major act of defiance resulting in the India’s independence from British rule.
Britain’s Salt Act of 1882 prohibited Indians from collecting or selling salt, a staple in their diet. Indian citizens were forced to buy the vital mineral from their British rulers, who, in addition to exercising a monopoly over the manufacture and sale of salt, also charged a heavy salt tax.
When I first came into the NFL, salt intake was closely monitored and salt gum was freely handed out during the hot days of training camp. We were told to salt our food. Then Gatorade got a strangle hold on the training room and salt gum was replaced with electrolyte packs to dump into water.
Little known fact, I played in the hottest game in NFL history in Dallas on September 3, 2000. The temperature was 163 degrees on the field and they told us to not lay down on the turf if we got hurt. The guy holding the first down marker collapsed and had to be carted off.
The water cups on our sideline were full of pickle juice. Science tells us during intense bouts of sweating the body loses both sodium and potassium and needs to maintain the electrolyte balance. The calcium chloride and vinegar present in pickle juice makes the sodium and potassium more readily absorbed by the body.
Did the pickle juice win the game?
Probably not, but it did prevent us from cramping and has ever since been known as the Pickle Juice where the Eagles beat the Cowgirls, 41-14
Personally, having done some form of a Ketogenic diet since 1999, I thought I was dialed on my salt intake – or so I thought.
I figured around 4 grams a day was ideal for a hard training athlete until Robb Wolf recommended I read the Salt Fix by Dr. James DiNicolantonio.
DiNicolantonio states in his controversial book, “Low-salt diets are putting the population at risk as there are literally millions of people who are at risk of salt deficiency, with over six million people in the US alone diagnosed with low sodium levels in the blood every year.”
“Moreover, if a high salt diet really put people’s health at risk then why are the highest salt-eating populations (Japan, South Korea, and France) living the longest with the lowest rates of coronary heart disease in the world?” he said.”
DiNicolantonio goes into great detail on how the body self-regulates sodium content. Sodium is a necessary element for proper blood volume, and the body is adept at regulating how much sodium it retains.
If a person or athlete happened to consume too much salt their kidneys will just excrete it in urine. However, too little salt and your body will engage several biological systems to retain it, including constricting blood vessels to compensate for lower blood volume resulting in an increased blood pressure.
Turns out a healthy pair of kidneys can process up to 10 times the amount of salt that the typical American consumes each day.
Stan Efferding has had great success with his Vertical Diet. I follow Stan on social media and interviewed him in 2012 for my lecture on Foods for Performance at the Ancestral Health Symposium (AHS) at Harvard.
In his Vertical Diet e-book Stan writes, “Salt all of your meals. This is a huge performance enhancer and metabolism booster and will help you recover faster from workouts and have more stamina and endurance.”
He goes on to echo Dr. DiNicolantonio’s recommendation of consuming salt from ancient deposits untouched by modern pollution. Stan recommends 8 grams of salt a day for athletes following his diet recommendations.
Robb Wolf and I have been friends since he gifted me a NorCal S&C shirt at the 2008 CrossFit Games. He has been the dominant force behind the Paleo movement and has extended his reach to the Ketogenic crowd. He forwarded me some solid work done by his friends at KetoGains.
They have some recommendations on sodium and salt intake while following a Ketogenic diet.
“Low-carb diets lower insulin levels, which makes the kidneys excrete excess sodium from the body. This can lead to a mild sodium deficiency. This is one of the main reasons people get lightheadedness, fatigue, headaches and even constipation on a low carb diet. Aim for 5000 to 7000 mg spread throughout the day, via broth, bouillon, pickle juice, colored salt, or even sodium pills.”
Recently, I spoke to Robb about my own salt intake and he recommended I start supplementing salt in a pre/post workout meals and measuring my total consumption with a target around 8-10 grams a day.
The results were interesting. Over the course of 5 days (starting my increased salt intake on Thursday morning) my resting heart rate fell from an average of 49-52 to 46-49 and my HRV score shot up about 30-50 points. For those of you that take your HRV score, this it the difference between being in the yellow for light day and green ready to smash the world.
Just some background, my training volume and frequency did not change. It has been hot here in Texas for the last two weeks. And my diet did not change in food quality or macros.
Here is my take on salt.
I have seen my own personal performance go up when I have increased my daily consumption of salt to 8-12 grams a day.
For the last 60 years the American people were sold a lie on the myth there was a direct correlation between heart disease and cholesterol. This started with Ansel Keys’ Seven Countries Study in 1959 and ended with a statement made a few years in a quiet press release by the USDA that there was no connection between heart disease and cholesterol. It has been known for years low blood serum cholesterol levels are related to poor androgen profile, depression and eminent death.
It came out in the last few years Ansel Keys was paid a sum of money by a sugar lobby to vilify saturated fat instead of sugar. To this day, doctors the world over are telling their patients to limit saturated fat to control cholesterol because they didn’t get the memo that information is outdated and incorrect.
After reading the Salt Fix, I believe the near non-existent salt recommendations by the USDA and AMA are incorrect and fall into the camp as saturated fat.
However, let me make this clear to anyone reading this, you should do your own research, soul searching and testing with salt intake.
For me personally, I have seen my blood pressure and resting heart go down and my HRV score go up dramatically.
I would recommend anyone wanting to increase their salt intake should start by measuring your current salt intake including foods and make changes based on these numbers. Reading the Salt Fix, the Vertical Diet and reaching out to the Power Athlete Nutrition Team and/or Ketogains would be good place to start.
You mean we’ve been fed another line of BS by the food industry? Gasp!
Thanks for the reading recommendations and the solid article, John. Very much appreciated.
Here’s a 1983 paper on how low-salt diets only work for a fraction of hypertensive patients:
My understanding is that in a normally functioning body, low salt levels are offset by high renin levels. If you don’t eat enough salt, then your kidneys secrete renin to keep your blood pressure at a high enough level. And persistently high renin levels are associated with their own cardiovascular risks. So eating a low salt diet could expose you to those risks, in addition to inhibiting your athletic performance.
Great article thanks as ever John. I have shared the link with a bunch of people!
As someone who measures their HRV daily, I’m really interested in how this affects HRV score. Other than the kidneys don’t have to work as hard, any idea why the score improves so much?
Also, what value do you put on HRV? I think I’ve heard you say on podcasts how you felt you could manipulate your HRV score based on doing activity recovery (or some other form of exercise, I can’t remember), so do you think it’s actualy a valid indicator of anything?
With measurements like HRV, if you have enough data points you can see trends over long periods of time. Those trends when you throw out the outliers have validity. I have years of HRV from JJ then using the Whoop and Oura for measurements since January, I have a pretty accurate environment to test things when I change one variable – like upping my salt intake.
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Thanks for the Article. And I agree with Scott C. above. BTW. The word Salary comes from the use and payment of salt for money.