Defeat Diabetes

Why salt isn’t bad for you

3 mins read

By Dr Penny Figtree

A recent media blitz reminded us all that salt is dangerous stuff

Someone clever at The Grattan Institute has done the maths. If we all cut back on salt, we could collectively live an extra 36,000 years and prevent 6,000 hospital visits a year PLUS save billions of health care dollars! Apparently, salt is wreaking havoc by causing high blood pressure, strokes and death. 

But is salt really the problem?

The real health crisis culprit

Whenever I buy my petrol, forced to wade through acres of chocolate bars, lollies and soft drinks to find the cash register hidden behind a mountain of Mars bars, I am reminded that the glaringly obvious problem in our society is not the salt: it’s the sugar.

Sugar, in all its guises, is the root cause of many metabolic diseases. I see the results of reducing dietary sugars and starches through a low carb approach while working as a GP. By encouraging my patients to try a low carbohydrate diet, I have a lovely time stopping a lot of blood pressure medications. STOPPING, not STARTING. And I rarely limit salt. Instead, I suggest more salt.

Carbohydrates and blood pressure

A huge body of research supports limiting carbohydrates to reduce blood pressure and the need for medication (Unwin et al., 2019).  That’s why my mind boggles when I read these headlines about limiting salt. It just completely misses the mark. 

So why the confusion?

There is a small group of people who do have something called “salt-sensitive hypertension”. This is when an individual’s kidneys can’t process salt properly, causing their blood pressure to increase. Most of us, however, can handle plenty of salt, if only we limited the carbohydrates. 

The problem with eating a lot of carbohydrates is they increase a hormone called insulin, which instructs the kidneys to hold onto salt and water. So, your blood pressure rises with the body holding on to more salt and water. This also contributes to puffy legs and hands. 

The world ‘experts’ have not figured this out yet. So they tell us all to limit the salt to try and reduce blood pressure. But we low carb practitioners know that blood pressure drops once you limit the sugars and starches, even if you add extra salt.

Carbs and blood pressure: a case study

I vividly remember a lady with chronic kidney disease and swollen feet. After 1 week on a very low carbohydrate diet, her feet were not swollen, and we had to stop 2 fluid tablets because her blood pressure was so low. She was very happy to be able to wear her nice shoes again and clean between her toes. I also had to ask her to drink a salty Oxo cube daily because she felt lightheaded!

Low salt vs high salt diets

Some studies even indicate that low salt is harmful (Lelli et al., 2018, Ellison and Welling, 2021). It seems the sweet spot for sodium intake is about 3-5 g a day (1-2 teaspoons of salt). However, lower and higher salt intakes are associated with increased mortality, particularly in the elderly. So this is a U-shaped relationship; very low and very high salt intakes are potentially harmful ( Mancia et al., 2017).

Our government guidelines suggest limiting sodium to less than 2 g or 1 teaspoon of salt daily. Maybe that is not such good advice!

So unless you have salt-sensitive hypertension, I advise you to focus on the sugars and the starches (white foods like rice crackers, biscuits, pasta and bread). Cut them out. Cook your delicious meats and above-ground vegetables, but don’t forget to add lots of salt to that low carb meal! Check your blood pressure and do not go low salt unless you have salt-sensitive hypertension. 

Enjoy low carb, real food with salt.

 

About the author:

Dr Penny Figtree, low carb keto GP Port Macquarie

"It is so much fun as a doctor to stop medications rather than starting them!"

Dr Penny Figtree is a GP based in Port Macquarie, NSW. She has been practising low carb medicine for 2 years and describes this as the most rewarding part of her 18-year career. 


For more info and to contact Dr Figtree, visit www.drpennyfigtree.com/

References

Ellison, D.H. and Welling, P. (2021) ‘Insights into Salt Handling and Blood Pressure’, New England Journal of Medicine. Edited by J.R. Ingelfinger, 385(21), pp. 1981–1993. Available at: https://doi.org/10.1056/NEJMra2030212.

Lelli, D. et al. (2018) ‘Association Between Sodium Excretion and Cardiovascular Disease and Mortality in the Elderly: A Cohort Study’, Journal of the American Medical Directors Association, 19(3), pp. 229–234. Available at: https://doi.org/10.1016/j.jamda.2017.09.004.

Mancia, G. et al. (2017) ‘The technical report on sodium intake and cardiovascular disease in low- and middle-income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association’, European Heart Journal, 38(10), pp. 712–719. Available at: https://doi.org/10.1093/eurheartj/ehw549.

Salt: is lower always better? (no date) The Nutrition Coalition. Available at: https://www.nutritioncoalition.us/salt-is-lower-always-better (Accessed: 24 November 2023).

Shaking the habit: experts call for mandatory maximum salt limits in Australian food | Health | The Guardian (no date). Available at: https://www.theguardian.com/australia-news/2023/oct/30/australia-salt-intake-grattan-institute-recommends-mandatory-daily-limits-sneaky-salt-report (Accessed: 24 November 2023).

Unwin, D.J. et al. (2019) ‘Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care’, International Journal of Environmental Research and Public Health, 16(15), p. 2680. Available at: https://doi.org/10.3390/ijerph16152680.

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