Here's What's Shakin' With Salt
May 12, 2000 -- Do you crave pickles, splash on the soy sauce with reckless
abandon, sinfully savor each grain of salt on your pretzels? If you are like
most Americans, you are probably taking in more salt than current guidelines
recommend -- whether you know it, or want it.
'So what?' you think, 'Salt makes food taste good!' Besides -- you
rationalize to yourself -- I don't have high blood pressure; well, at least not
really high blood pressure. So, what's the big deal?
What you might not know is, that question has created a veritable
storm in a saltshaker, if you will, within the medical community.
The role of salt in high blood pressure and heart disease is not as clear as
it once seemed, and many experts disagree about the importance of salt intake
and current recommendations for salt consumption. It is clear that some groups
of patients need to carefully watch salt consumption, but whether the entire
population benefits from restriction is uncertain. In addition, newer research
has brought to light other factors in blood pressure control which may be even
more important than salt. Some researchers argue that salt restriction has been
overemphasized. But others feel that current recommendations are helpful, and
should be continued.
The latest battlefield for the great salt debate is the American Journal
of Clinical Nutrition, where two experts in the field argue for and against
keeping the current American Heart Association (AHA) recommendation of no more
than six grams of salt a day for an adult. Studies show Americans currently
average about nine grams of salt a day.
Norman Kaplan, MD, is in favor of keeping the current recommendations with
an eye towards lowering them in the future. Kaplan, a professor of internal
medicine at the University of Texas Southwestern Medical Center in Dallas,
writes that high blood pressure is a problem for about one in five Americans
(including more than half of the elderly) and the problem is probably
Kaplan says there is enough evidence from human and animal studies to show
that excess salt intake is "intimately" involved with high blood
pressure, even though a direct cause-and-effect cannot be proven. And that even
modest reductions in salt intake can lead to modest reductions in blood
pressure, leading to health benefits for individuals. These small individual
benefits translate into big benefits for society as a whole. Kaplan also argues
that a decrease in salt intake may also provide other benefits, including less
bone thinning, fewer kidney stones and less thickening of the heart muscle.
"The evidence supporting the need for a reduction in dietary sodium
intake is convincing and supports the appropriateness of the current U.S.
dietary guidelines. As noted, this guideline may not be set low enough to
prevent the development of hypertension ... If this goal can be reached,
perhaps even greater reductions will be feasible in the future," writes