Get the Salt Out Read online

  FLUID RETENTION, WEIGHT GAIN, AND HEADACHES Excessive sodium causes fluid retention, which stresses the heart and circulatory system and results in edema—swelling of tissues. Edema can manifest itself in tissue puffiness or bloating all over the body or it can be localized in such areas as the ankles, fingers, pelvic, and abdominal areas. Women with hormonal problems seem to be particularly susceptible to developing fluid retention and often can become irritable or depressed when they retain water during their premenstrual cycles. Some women have been known to gain as much as fifteen pounds in “water weight” for a few days every month. Although water weight gain is not the same as fat gain, women who suffer from it temporarily have trouble fitting into their clothes and almost always can benefit from reducing their salt intake.

  Fluid retention probably also contributes to two other ailments associated with excessive salt use: headaches and migraines. Although it is unknown exactly how salt does its damage, Seymour Diamond, M.D., executive director of the Diamond Headache Clinic in Chicago, has found that patients often develop headaches a few hours after eating salty food. Although Dr. Diamond has focused on salt alone, other high-sodium food additives like monosodium glutamate (MSG), sodium sulfites, nitrites, and nitrates also can trigger headaches.

  STOMACH ULCERS AND STOMACH CANCER The stomach, which uses sodium to produce hydrochloric acid, seems to be particularly sensitive to unnatural, refined sources of sodium: excess salt contributes to the development of ulcers, and certain sodium additives can cause stomach cancer.

  Amnon Sonnenberg, M.D., of Harvard Medical School, has seen a strong correlation between the incidence of gastric ulcers and the consumption of common (refined) table salt. According to Dr. Sonnenberg, the rise and fall of ulcers directly parallels the rise and fall of salt intake.

  In addition, a high intake of salt-preserved, smoked, and cured foods is a known risk factor for stomach and esophageal cancer. The sodium nitrites and nitrates used in these foods can form nitrosamines in the stomach. These chemicals are some of the most potent cancer-causing agents known. The Japanese, who have the highest incidence of stomach ulcers and stomach cancers in the world, consume more salt-, nitrite-, and nitrate-treated foods than any other culture.

  The evidence clearly shows that too much dietary sodium is a culprit in many health problems. But how much is too much? The amount actually differs from one individual to the next. The next section will help you understand why and will show you how to determine the right amount of sodium for you.

  HOW MUCH SODIUM DO WE NEED?

  The answer to “How much sodium do we need?” really depends on who you are.

  Not only do your sodium needs vary depending on your genetic background, but they also change during different stages of your life, depending on such factors as how much you exercise, where you live, and what you eat.

  While many health professionals today would like us to believe that all individuals can thrive on an extremely strict low-sodium diet, the issue is not nearly so black and white. There is great variance in our sodium needs and even in our tolerance to unrefined salt. If we learn about the factors that influence our sodium needs, each of us will be able to determine our individual ideal sodium intake.

  GENETIC HERITAGE The genetic blueprint each of us has inherited plays a significant but greatly overlooked role in many aspects of nutrition and body chemistry. In no area is that more apparent than in our varying reactions to salt.

  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 ca
n 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:

  Age. People become more salt-and sodium-sensitive as they age. (Some experts believe that the development of both salt-sensitivity and hypertension in middle age would decrease dramatically if we consumed less sodium throughout our lifetimes.)

  Weight. Overweight individuals generally are more sensitive to salt than individuals who are of average weight.

  Disease. Individuals who have kidney damage or renal disease are less able to tolerate salt and excessive sodium than healthy individuals.

  Environment. Individuals who live in high elevations need more sodium than those who live in lower altitudes.

  Exercise and physical activity. Individuals who exercise frequently or work in physically strenuous jobs require more sodium than others. Endurance athletes, in particular, lose large quantities of sodium through perspiration and need to be especially careful to replenish sodium and other electrolytes.

  Illness or accident. During a bout with the flu or any type of illness that includes repeated vomiting or diarrhea, sodium can become depleted in the body and should be replaced. This same situation can occur in any type of accident where bleeding has occurred.

  Diet. Vegetarians, who consume much more potassium than sodium from plant foods, often need to add some naturally rich sodium sources or unrefined salt to their diet to better balance these two important electrolytes.

  Pregnancy. Pregnant women require more sodium to accommodate the sodium needs of the growing fetus. Care should be taken to eat additional nutrient-dense foods to meet the extra requirements for sodium and other nutrients. However, to prevent the development of pregnancy-induced hypertension (PIH), pregnant women need to avoid high-salt junk foods and be sure they are getting enough protein, calories, and calcium.

  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.

  SO WHAT DO WE EAT?

  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:

  Vegetables Fish

  Whole grains Shellfish

  Legumes Poultry

  Nuts Eggs

  Seeds Milk

  Fruits Lean meats

  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:

  ⅛ teaspoon natural salt = 250 milligrams sodium

  ¼ teaspoon natural salt = 500 milligrams sodium

  ½ teaspoon natural salt = 1,000 milligrams sodium

  ¾ teaspoon natural salt = 1,500 milligrams sodium

  1 teaspoon natural salt = 2,000 milligrams sodium

  A misconception about salt is the belief that we need to use salt that is iodized. (Iodine, as you may know, is an essential mineral that promotes the proper functioning of the thyroid gland.) Although table salt, which is stripped of all its minerals, has iodide added to it to ensure adequate intake, both unrefined sea salt and Real Salt contain trace amounts of naturally occurring iodine. If you use natural salt as recommended in this book and eat iodine-rich fish or seafood, or use seaweed-based salt substitutes at least a few times a week, you ca
n rest assured that your iodine intake will more than meet your needs. (See tips 54, 55, 60, and 61 for more information on iodine-containing salts and salt substitutes.)

  The taste for salt is one of four basic, instinctive tastes humans have, but the manner in which we satisfy that taste is a learned behavior. Unfortunately, most Americans have been conditioned to indulge their taste for salt with poor quality foods, especially nutrient-poor refined carbohydrates, that are only given some semblance of taste with killer doses of refined salt—something cookbook author Jeanne Jones calls “the great dietary whitewash.”

  Instead of continually spiking the foods you eat with more and more salt, use this book to stimulate other long-ignored tastes, to accentuate your sense of smell, and to satisfy your taste for salt naturally and intelligently. Doing so will show you how to enjoy real foods again and how to create meals that both your taste buds and your body can truly savor.

  Contrary to popular belief, getting the salt out of your diet isn’t as simple as passing up the use of the salt shaker.

  In fact, if you’re the average American, throwing away your salt shaker will hardly make a dent in your sodium intake because salt added at the table is minimal compared to the salt that is hidden in the processed foods we eat every day. Salt is added so insidiously and so routinely to foods by manufacturers that it’s difficult to escape it. From obviously salted snack foods like chips, pretzels, and roasted party nuts to basic staples like soups and breads, salt is in there. It’s even hidden in cereals like cornflakes and desserts like instant chocolate pudding.