Get the Salt Out (3 page)

Officially, about half of all people who have high blood pressure—and a quarter of people who have normal blood pressure—are considered “salt-sensitive,” but many of us are salt-sensitive to one degree or another. Very salt-sensitive individuals experience troublesome symptoms like water retention or an increase in blood pressure when they use even the slightest amount of salt. Less salt-sensitive people, probably the majority of us, can tolerate moderate amounts of sodium, while a few individuals can consume large amounts of sodium without experiencing health problems. These individuals appear to be salt-resistant. (Some, however, have argued that even in these
individuals, a long-term diet high in salt can “set the stage” for high blood pressure and other illnesses later on in life.)

Salt-sensitivity runs along family lines: if one or both parents are salt-sensitive, their children are much more likely to be salt-sensitive, too. But our salt-sensitivity—and our particular requirements for sodium—are also influenced by ancestors a bit further back in our history. As I explained in my book
Your Body Knows Best
(Pocket Books, 1996), scientific researchers have discovered that our nutrient needs are determined far more by where our ancestors originated than by where we live now.

This fact seems particularly evident in the case of blacks, who are more salt-sensitive than whites and have a higher incidence of hypertension. Most blacks or their ancestors originally lived in warm tropical climates where very-low-sodium, high-potassium fresh fruits, vegetables, and other plant foods were abundant, and their body chemistries adapted to these native foods and dietary conditions. Even though many blacks today have moved away from the lands of their distant ancestors, they continue to carry in their genes a sodium-sparing mechanism and greater need for potassium. This makes the high-sodium, low-potassium standard American diet (often called S.A.D.) particularly problematic and dangerous for African Americans. Statistics prove this. The American Heart Association reports that compared to whites, blacks have a greater rate of deaths from stroke, heart disease, and kidney failure, and high blood pressure is the number-one preventable cause of more than sixty-five thousand deaths annually among African Americans.

This is only one way genetic background affects our sodium requirements. Further research will likely uncover other similar correlations in the future.

STRESS
Another factor that can greatly affect our tolerance to salt is the amount of stress we experience and how we react to
it. When the human body experiences any type of stress—whether it is physical, emotional, or psychological—the body responds in the following ways:

STAGE 1: THE ALARM REACTION. During the beginning stage of stress (which is often called the “fight or flight syndrome”), the adrenal glands, the body’s “stress glands,” produce extra amounts of adrenal hormones to help the body mobilize its energy to meet the stress. Blood pressure rises, heartbeat increases, sugar is mobilized from the liver, and the adrenals overproduce aldosterone, a hormone that causes the kidneys to retain sodium in the body. People who are in this stage of stress may not even consume much sodium in their diet, but they
retain salt in their tissues
because of their stressed body chemistry. (Note: if the source of stress is removed, the adrenals return to their normal functioning and sodium levels also return to normal.)

STAGE 2: THE RESISTANCE STAGE. Gradually, if the stress continues over a long period of time, the body enters a stage of resistance in which it requires nutrients in excess of its normal needs. To meet its additional requirements, the body draws on vitamins and minerals from its tissue reserves.

STAGE 3: THE EXHAUSTION STAGE. If the stress continues for too long, the body eventually uses up its reserves of both energy and nutrients and falls into a state of exhaustion. During this stage, the body’s adrenal glands become burned out and no longer have the ability to produce aldosterone. Without enough aldosterone, the body loses sodium through the urine and actually becomes
deficient in sodium
—not because it consumes too little sodium but because it cannot hold on to the sodium it absorbs.

In my nutritional practice, I see many clients who have elevated blood and tissue sodium levels. These individuals are developing problems like high blood pressure, edema, or kidney
disease. Today, however, as a sign of our stressful times, I am seeing an increasing number—the majority of my clients, in fact—who have low sodium levels because of weakened adrenal glands. These individuals oftentimes are allergic, suffer from chronic fatigue, experience tremendous flatulence, have low blood pressure, and have cold hands and feet.

Individuals in this stage of stress can benefit from a temporary increase in sodium intake until their adrenal glands can be strengthened. On the other hand, individuals in the initial alarm stage of stress can be helped by reducing sources of unnecessary sodium in their diet until their body chemistry improves. (For more information on nutritional ways to strengthen adrenal glands and normalize body chemistry, see the sections Dealing with Stress and Nutrient Necessities sections in
chapter 10
.)

GET TESTED
One way to determine how much sodium you may need is by asking your doctor to perform a simple nutrient analysis blood test on you. If your sodium level falls between 137 and 144, you probably will do best with moderate levels of sodium in your diet (about 2,000 milligrams a day). If you have a sodium blood level above 144, you are retaining salt in your tissues and need to eliminate unnecessary sodium sources, especially sources like salt-contaminated water. (See
chapter 2
for more information on this common problem.) If you have a sodium level below 137, you have low sodium and may need to increase your sodium intake slightly.

OTHER FACTORS
Other factors can affect whether we need more or less sodium in our diets:

As this section has shown you, sodium needs vary widely from one individual to the next. Giving a blanket nutritional prescription for people who have so many various lifestyles and different genetic backgrounds is an invitation to trouble for our individual and collective health. The answer to our individual sodium requirements isn’t as simple as some experts would like us to believe. The truth is that some of us require more sodium and some of us require less, but all of us can benefit from getting refined salt out of our diets.

Getting the refined salt out of our diets and reducing our sodium intake to a more moderate level requires only one main strategy: to eat as naturally as possible.

It may sound simplistic, but it’s true:
natural foods are always lower in sodium than their processed and packaged counterparts.
What is the difference between processed and natural foods? Processed foods usually come packaged in boxes, plastic bags, and cans, and are designed to sit on grocery shelves for months. Healthful, natural foods, on the other hand, are as close to their natural state as possible. They include:

All of these foods have no refined salt and all of them, except for shellfish like lobster, shrimp, and crab, are low in sodium. Shellfish, however, can be included in a low-to moderate-sodium diet because they are sources of “good” sodium, which the body can easily use, as well as sources of other important minerals. Natural foods have other benefits, too: ounce for ounce, they contain considerably more of the essential nutrients humans require than processed foods do. They are particularly rich in potassium, a mineral that balances the action of sodium in the body, and many are good sources of magnesium and calcium as well. Potassium, magnesium, and calcium are all believed to counteract the effects of excess sodium in the diet and help prevent conditions like high blood pressure and heart disease.

Once you emphasize natural foods in your diet, refined salt no longer will be a problem. In fact, low-sodium eating will come about automatically All you have to do is combine natural foods in any way you see fit and—
voilà!
—both unhealthy forms of sodium and excessive sodium in general will go by the wayside.

The only other thing you will need to do is fine tune your diet to find the balance of protein, carbohydrates, and fats that’s right for you. Some of us seem to thrive on higher amounts of complex carbohydrates while others are actually better designed for more protein and high-quality fats. (If this concept seems strange to you, think about the Eskimos, who eat large amounts of meat and fatty fish and practically no produce but are quite healthy.) Most of us, however, do well with an almost equal balance in our diets: protein from both animal and vegetable sources; complex carbohydrates from fresh vegetables, fruits, whole grains, and legumes; and essential fats from nuts, seeds, and unrefined vegetable oils. Be sure to experiment with your
natural foods diet to determine the ideal amount of each of these three nutrients for you.

No matter which balance of nutrients suits you best, natural foods will cause your sodium intake to drop so dramatically that you can afford to use small amounts of salty seasonings such as natural cheese or reduced-sodium tamari soy sauce as condiments. You’ll even be able to add some “good” salt—either unrefined sea salt or a rock salt called Real Salt—at the table. (See the section Healthier Salts and Salternatives in
chapter 1
for more information on these products.) Although salting food at the table may seem contradictory to the theme of the book, statistics clearly show that it is not.
Ninety percent of the sodium Americans consume comes from processed and prepared foods;
only 5 percent comes from the use of the salt shaker after cooking. Research also shows that salt added after cooking tastes stronger than when it is added before or during cooking. This means that by adding salt at the table instead of during the preparation of food, you will be apt to use less. Therefore, if you drastically cut down on both processed foods and salt used in cooking, you can feel free to add a few dashes of natural salt to foods. It will help you meet your sodium requirements and will satisfy your taste for salt far more than the salt that is hidden in greater quantities in processed foods. A little bit of salt is all you need though, as the following chart will show you: