Matthew Messer

Matthew Messer


"Our article briefly outlines 6 misconceptions about salt consumption."

First misconception: Salt is healthy, eat all you can!

In truth: Like all essential minerals, we need salt, but this does not mean that the more we eat the better. There is a healthy range, beyond which consuming more is definitely unhealthy. Too much salt can be bad for you! (1,2,3,4)

Second misconception: Salt from the Himalaya, Parajd, or the sea is much healthier than conventional table salt, and is a good source of other minerals and trace elements.

In truth: Most specialty salts contain 98-99% sodium chloride just like simple table salt, so they contain only trace amounts of other minerals and trace elements. Himalayan salt, for example, contains only ~2 mg calcium, 3 mg potassium, 1 mg magnesium and 0.03 mg iron per gram(5), which is almost zero - typically a single bite of natural food contains more of these minerals. Don't rely on salt to supplement minerals or trace elements!

Third misconception: Salt does not increase high blood pressure, and salt reduction is harmful.

In truth: In healthy individuals there is no significant effect, but for those with established hypertension, reducing salt intake has been shown to be beneficial. (6) However, it is important not to rely on salt reduction alone for similar problems, as many other lifestyle factors affect blood pressure.

Fourth misconception: Humans used to consume a lot more salt historically, so more must be healthier.

In truth: Anthropological evidence suggests that people in the Paleolithic Period consumed very little salt compared to people today (7), which is not surprising as salt was not mined at that time. This was written about by the founding father of the paleo diet, but similar trends still recommended higher and higher intakes. Perhaps the reason is that where salt was the only preservative in the old days, salt intake was relatively high - but how does that imply that it is healthy? It doesn't.

Fifth misconception: Salt reduction is crucial for a majority of people

In truth: Many people place too much importance on salt intake. Too much and too little salt can cause problems, (8) but there is a relatively wide healthy range. The vast majority of salt intake comes from modern ultra-processed foods and fast food, (9) of which high salt content is only one problem, so minimizing it is generally a good idea. If you cook your own food from natural ingredients and don't have high blood pressure, you can salt your food to taste.

Sixth misconception: Potassium salt is a harmful substance, used to purposefully poison us.

In truth: This is a completely unfounded theory. Potassium is an essential mineral, of which we need several grams a day and almost all our natural foods contain a lot of it. In another article, we wrote about a large-scale study in which a potassium salt containing 25% potassium chloride significantly reduced the risk of cardiovascular disease, amply illustrating the 'dangers' of potassium chloride. (10,11)

  1. He FJ, Tan M, Ma Y, MacGregor GA. Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Feb 18;75(6):632-647. doi: 10.1016/j.jacc.2019.11.055. PMID: 32057379.
  2. O'Donnell M, Mente A, Alderman MH, Brady AJB, Diaz R, Gupta R, López-Jaramillo P, Luft FC, Lüscher TF, Mancia G, Mann JFE, McCarron D, McKee M, Messerli FH, Moore LL, Narula J, Oparil S, Packer M, Prabhakaran D, Schutte A, Sliwa K, Staessen JA, Yancy C, Yusuf S. Salt and cardiovascular disease: insufficient evidence to recommend low sodium intake. Eur Heart J. 2020 Sep 14;41(35):3363-3373. doi: 10.1093/eurheartj/ehaa586. PMID: 33011774.
  3. Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, Sacks FM, Thorndike AN, Van Horn L, Wylie-Rosett J. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021 Dec 7;144(23):e472-e487. doi: 10.1161/CIR.0000000000001031. Epub 2021 Nov 2. PMID: 34724806.
  4. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016 Oct 11;68(15):1609-1617. doi: 10.1016/j.jacc.2016.07.745. PMID: 27712772; PMCID: PMC5098805.
  6. Graudal N, Hubeck-Graudal T, Jürgens G, Taylor RS. Dose-response relation between dietary sodium and blood pressure: a meta-regression analysis of 133 randomized controlled trials. Am J Clin Nutr. 2019 May 1;109(5):1273-1278. doi: 10.1093/ajcn/nqy384. PMID: 31051506.
  7. Eaton SB, Eaton SB 3rd, Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications. Eur J Clin Nutr. 1997 Apr;51(4):207-16. doi: 10.1038/sj.ejcn.1600389. PMID: 9104571.
  8. Graudal N, Jürgens G, Baslund B, Alderman MH. Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. Am J Hypertens. 2014 Sep;27(9):1129-37. doi: 10.1093/ajh/hpu028. Epub 2014 Mar 20. PMID: 24651634.
  9. Liem DG, Miremadi F, Keast RS. Reducing sodium in foods: the effect on flavor. Nutrients. 2011 Jun;3(6):694-711. doi: 10.3390/nu3060694. Epub 2011 Jun 20. PMID: 22254117; PMCID: PMC3257639.
  10. Neal B, Wu Y, Feng X, Zhang R, Zhang Y, Shi J, Zhang J, Tian M, Huang L, Li Z, Yu Y, Zhao Y, Zhou B, Sun J, Liu Y, Yin X, Hao Z, Yu J, Li KC, Zhang X, Duan P, Wang F, Ma B, Shi W, Di Tanna GL, Stepien S, Shan S, Pearson SA, Li N, Yan LL, Labarthe D, Elliott P. Effect of Salt Substitution on Cardiovascular Events and Death. N Engl J Med. 2021 Sep 16;385(12):1067-1077. doi: 10.1056/NEJMoa2105675. Epub 2021 Aug 29. PMID: 34459569.

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