This is a pretty long post, sorry. There’s a lot of information to cover on this very touchy subject. I’m going to break it up over two days. Today, we will cover just the explanation of why this war against salt is flawed, what salt (therefore sodium) does, and why it is important. Tomorrow, we will apply this to us specifically as ketogenic people.
Ever heard the expression “he\she is the salt of the earth?” It’s a complement, right? It means “good, dependable, solid, reliable.” Did you know in ancient times, a pound of salt had the same trade value as a pound of gold? For centuries, salt was the most stable monetary measure on the earth. People used it to season foods, heal wounds, and most importantly, keep foods from spoiling. We still do use salt for meats. Look at pemmican, jerky, cured hams, BACON, corned beef, deli meats, fermented foods like sauerkraut and kimchi, fish sauce, soy sauce, BBQ sauce, etc. Gold? Nah. It looks pretty but as far as putting it on my steak? I’ll pass.
Unfortunately times have changed, a little pinch here, a little there, salt is now the devil. Even more than dietary fat, this one food item has taken more of an unfair, bad science, misunderstanding hit than any other compound I can think of…and that is dangerous. Dangerous? NO NO NO Hobbit, salt is BAD!! The government and health organizations have been telling us that for years! BAD BAD BAD!! SALT WILL KILL ME!! Salt will drive my blood pressure numbers to look like qualifying times for the Indy 500!!! The doctors all tell us that!
The same doctors who tell us to eat whole grains, take statins, and that T2 diabetics should have diet rich in fruits… See where I’m going with this?
You’ve been mislead. Lied to. Given bad information. Remember that post a last week about doing research, studies, and how they can be flawed\skewed? Yup. All the fear we have over salt – specifically the sodium in salt – is wrong.
First, let’s break salt down. Salt, in it’s purest form is known as sodium chloride, 40% sodium, 60% chloride by weight. Right. 1 tsp of salt is not 1 tsp of sodium, in more precise measurements (and how they tell us we need to have it or not have it for intake) is 1 tsp of salt is 6 grams (6000mg), of that 2.3g (2300mg) is sodium. That number also happens to be the “recommended maximum” for sodium intake for people on the Standard Western Diet. According to the flawed medical wisdom, if we have more than 1 tsp a day of salt, we are going to die a lot faster, and we really should have about 1/2 tsp of salt (1500mg sodium). Oh, and that includes the salt and sodium already in the foods we eat. Even eating “clean” and “unprocessed foods” we are still getting sodium in our diet without ever touching the salt shaker.
Sodium is a critical chemical for life. I’ll get into why in a second. I just want you to concentrate on that one statement and hold this in your head as we continue with our conversation – sodium is critical for life. As a matter of fact, get up, go grab a snack. I want you to mull this over and really retain this crucial fact. Get a stalk of celery and shake some salt on it. Get a pickle (nice and salty). Get a few slices of pepperoni or roast beef. Grab a couple of almonds salted in sea salt. Ok, go get a snack, I’ll wait right here for you to come back.
Nah, I’m gonna get a snack too, Hobbits love snacks :).
I’m back. You back? Remember what I told you to remember? If you want to live, you need sodium. Period. Good, let’s move forward. The best way to debate an issue is to first look at the opposition and poke as many real, truthful holes in the position as possible. Let’s start with where this war on sodium started. I mean, there has to be study after study, exhaustive research on this, right?
The first time this was brought up was in the late 1800s in an OPINION paper. No hard science. The opinion was that since Paleo man didn’t have access to salt in quantities, it had to be bad for us. Yup. That was the focus. No one even questioned it. Ummm, Paleo man had a life expectancy of about 30 years, and I’m pretty sure that Dr. Gronk didn’t have a sphygmomanometer (that’s the cuff-thing they use to measure blood pressure). This was followed up in the late 60s by another opinion piece. The author determined that salt was bad for us because life expectancy increased in the modern era. They determined that since we no longer were using salt as a primary preservative, the lower cases of heart disease and longer lifespan was due primarily to lower sodium. Not one spot in that paper does things like, oh I don’t know, penicillin, access to health care, safer work environments, etc. come into the picture. The first real study was done om the 1970s and this is when the war started in earnest. Lewis Dahl did a study using lab rats that showed salt (and therefore sodium) created hypertension (high blood pressure), backed up with social data showing that cultures that have higher sodium dietary levels also have higher number of hypertensive individuals, with native Eskimos being the lowest intake and lowest BP numbers, while Japan had highest of both. Slam dunk, right? I mean this is HARD science! He gave a living thing more sodium and BANG! Hypertension!!
He did give them more sodium, the equivalent of 500g if that was a human. Look at that number again. Now, look at how much sodium is in 1 tsp of salt that I pointed out earlier. 2.3g. He gave those poor rats the equivalent of 217 teaspoons of salt. Yup, see what I mean about agendas and flawed science??? So what about the cultural proof? That has to matter, right? Nope. It looked only at sodium intake and high blood pressure. There’s a drastic difference between the lifestyle of someone in Japan and an Eskimo. Besides a greatly different diet, there’s stress, socio-economic differences, climate, sleep patterns, the fact that Japan has had several atomic tragedies, Alaska? None. We can toss this study right out. Unfortunately, the medical, food, and pharm industries didn’t.
So, have there been any studies that refute the above? I mean really, I can’t make such accusations without backing it up. Yup, there has. You might be familiar with the name Gary Taubes. He wrote an opinion piece citing several studies done showing that the public attention to sodium was a complete odds with the findings of the scientific community… but no one was listening. What about since then? A 10 year study of Boston Marathon runners who dropped out due to dehydration showed that the issue wasn’t the amount of fluid intake, it was the lack of sodium mixed with high glucose loading that lead to dehydration. As we know being keto, glucose (sugar) stores 4 parts water to 1 part glucose. That storage coupled with low sodium (the chemical that is responsible for water balance – I’ll get into what sodium actually does in the next segment) meant that water in the body wasn’t going to where it was needed. A 2011 study by the AMA showed that the lowest risk of death from coronary heart failure is an intake of between 4-6g of sodium a day. YES. more than double the recommended “too high” amount! Following that up the next year, a 2012 study by the American Journal of Hypertension (one would assume that they kinda get the science of high blood pressure, just sayin’) found that people on a low-salt diet had HIGHER cholesterol and triglycerides, not LOWER. Studies in 2011 and 2010 showed that low sodium creates an IMMEDIATE ONSET OF INSULIN RESISTANCE.
Read that again. Twice. Eh, one more time just so you get the full impact of this. Your low salt diet, mixed with high sugar diet (which we already know) caused your IR. Why are we even still having this discussion? Easy. Follow the dollars. No one is going to make money off telling you to eat more salt, less sugar. We already know this. My friends, you’ve been lied to again in the name of profits at the expense of your life.
So we now know that sodium is important, but why? “Hobbit, I have too much salt, I retain water! I look like the Michelin Man!” Of course you do. Balance. Remember, the body is going to do what it needs to do, regardless of what you want or think you want. Sodium is responsible for water retention. Water is the nectar of life. Just like we talked about with dropping calories too low, the body doesn’t trust us until we give it reason to. If your sodium intake is all over the map (not consistent) then it’s going to hold on to water just in case. Now, if you remember middle school science, the rule of sodium (remember those salt water tests with a potato?) and water is: water will go from area of highest concentration to lowest with the assistance of sodium… until equilibrium (balance, grasshoppah) is reached. So, if you are retaining water at a high rate, your balance is off. The body is going to hold onto that stuff until if finds a balance. Period. This is ok, though, because once a few days have passed and balance is reached, excess sodium and water goes the same path as excess protein… yup, you pee it out:). A point to remember, you will lose about 2.5g of sodium a day on a normal basis, this has to be replenished. If you’ve ever been around livestock, you probably know about “salt licks.” If you are in the salt belt in the US, a lot of road kill happens not because they are pretending to be chickens and get to the other side, but because they are on the edge of the road, licking the salt up that was put down over the winter to keep the roads from icing up. Yup, animals are inherently smarter than we are :).
The purpose of sodium covers several key needs of the body. Sodium is essential for maintaining volume of extracellular fluid. That means fluids outside of our cells. Plasma. That’s blood. Kinda important. Blood volume is determined by the amount of water and sodium ingested, excreted by the kidneys into the urine, and lost through the gastrointestinal tract, lungs and skin. The amounts of water and sodium ingested and lost are highly variable. To maintain blood volume within a normal range, the kidneys regulate the amount of water and sodium lost into the urine. For example, if excessive water and sodium are ingested, the kidneys normally respond by excreting more water and sodium into the urine. Right. The body is self-regulating. WOW. Who woulda thunk??? Why is blood volume important? In scientific terms (thank you Ben McDonald for the great graphic):
“Changes in blood volume affect arterial pressure by changing cardiac output. An increase in blood volume increases central venous pressure. This increases right atrial pressure, right ventricular end-diastolic pressure and volume. This increase in ventricular preload increases ventricular stroke volume by the Frank-Starling mechanism. An increase in right ventricular stroke volume increases pulmonary venous blood flow to the left ventricular, thereby increasing left ventricular preload and stroke volume. An increase in stroke volume then increases cardiac output and arterial blood pressure.” Richard E. Klabunde, PhD
Yeh. Ok. Hobbit, what does that mean in non-geek speak? The more blood volume you have, the higher your blood pressure and flow is in your arteries per “pump” of your heart. This isn’t the same as “blood pressure” that we measure in numbers at the doctors – that is more the response of your arteries to blood pressure AND viscosity – how thick the blood is. Proper sodium and water balance means the blood your blood isn’t as “thick” and flows easier, therefore less pressure is required to move the blood. Blood viscosity and blood pressure have an inverse relationship – the better the viscosity, the lower your blood pressure. Think pumping thick grease vs water. Less cardiac strain. Right. Your heart. If your blood pressure is too high and too thick, your arteries push back as they strain against the pressure. If you have more blood volume which results in more blood flow per beat of your heart to pump it to where it needs to go, and that blood flows easier because it isn’t all thick from lack of water volume (and is able to carry more nutrients and get waste out quicker), your heart doesn’t have to work as hard. A heart that can lop along at a comfortable pace is a happy pace. Less strain on your heart and arteries, which is really what the concern of “high blood pressure” is all about.
Sodium also prevents a couple of neurological things from happening, like disruption of neuro transmitters, our nerves and brain cells communicate with electrical pulses. Again going back to middle school science, we know that salt water is an excellent conductor of electricity, therefore, proper salt balance prevents random pain and loss of mental clarity because the neuro system can work properly. Yes, that is one of the reasons why being low on electrolytes causes headaches, muscle cramps, and light-headedness. EUREKA!!
Moving lower in the body, the kidneys need sodium. The kidneys will tell some kinda important glands like the pituitary gland to tell the adrenals what levels of adrenaline and aldosterone (a hormone that regulates electrolyte balance) to secrete. What happens when you are low on electrolytes and sodium in general besides the cramps and brain fog? Your heart races. This is because the kidneys send a signal that there is a crisis, which we know again from the talk of the lizard brain, this means the body is going to react. It releases adrenaline, which speeds up your heart rate because it suspects that soon – if it hasn’t already happened – the water and plasma level in your blood is going to drop. That means the oxygen holding level is going to decrease (water is 2 parts hydrogen, one part oxygen just in case you forgot), which means less oxygen for the brain. To make up for that, the heart gets adrenaline and kicks in the turbo to make sure the brain doesn’t kick the bucket. Unfortunately, that means more stress on the body. That is bad. Oh, and sodium also helps maintain pH balance. One last thing, sodium is an excellent chemical for heat regulation, high performance racing car engines use sodium-filed valves (those are things that open and close in an engine to let air\gas in and out, they are also directly in contact with the little explosions that make our cars run) because it transfers heat extremely quickly and efficiently. Chicken soup for a fever, anyone? Bueller? Bueller? Oh, wait, that wasn’t the last thing. Sodium has another very critical role – it balances out potassium. Yes, this is why your Nu Salt and No Salt are a potassium chloride\sodium chloride blend. They are ying\yang.
You know what no one talks about when it comes to salt intake? Chloride. Yeh, higher concentration element in salt, yet, we hear very little about it. Let’s make this very clear – chloride is as important as sodium, potassium, etc. In chemistry speak, sodium and potassium are positive ions – they have a positive electrical charge – and chloride is a negative ion – negative charge. Like magnets, this is what bonds sodium\potassium to chloride so we have a component we can eat. Chloride is the most common negative charged ion in our blood – 70% of the negative ions are chloride. No, not negative as in “damn, I hate my job” :D. As the principle negatively charged ion in the body, chloride serves as one of the main electrolytes of the body. Chloride, in addition to potassium and sodium, assist in the conduction of electrical impulses when dissolved in bodily water. Yup, that whole neuron thing again. In addition to its functions as an electrolyte, chloride combines with hydrogen in the stomach to make hydrochloric acid, the digestive enzyme that is responsible for the break down of proteins, absorption of other metallic minerals, and activation of intrinsic factor, which in turn absorbs vitamin B12. A constant exchange of chloride and bicarbonate between red blood cells and the plasma helps to regulate the pH balance and transport of carbon dioxide. Again, back to middle school, we know that carbon dioxide is what we breath out, if we don’t breath it out, we die. This is also bad :).
Ok, so the science lesson for today is over. Tomorrow, we talk about what all this means to us as ketogenic people, what we need to do to keep all our electrolytes in balance, and what those electrolytes – sodium and others – can do for us.