Friday, July 22, 2011

Low Salt Diet Increases Cardiovascular Mortality

Read the full article with links and references here.

Another article here.

More data in the Salt Wars - Aug 14, 2014; http://www.medpagetoday.com/Cardiology/Hypertension/47203

Low Salt Diet Increases Cardiovascular Mortality by Jeffrey Dach MD

from Jeffrey Dach MD Bio-Identical Hormone Blog

Hypertension Low Salt Natural Sea Salt Jeffrey DachLow Salt Diet Found to Increase Mortality
by Jeffrey Dach MD

The Low Salt Diet Revisited

A recent study on the effect of a low salt diet made headlines, finding that a low salt diet increases mortality for patients with congestive heart failure.(1-6) The study concluded there was not enough evidence to advise a low-salt diet for the rest of us. They doubted a low salt diet would benefit the population.(6) In this article we will re-examine the low salt diet, clear away the confusion, and make recommendations about salt intake, hypertension, and health.

Above left image, harvesting sea salt courtesy of wikimedia commons. (Salt Farmers - Pak Thale.jpg)

Health Benefits of Salt
We know from many years of published studies that increasing salt intake increases blood volume and also blood pressure. Salt is essential for maintaining blood volume, blood pressure, and overall health. The salt content of blood is similar to ocean water. Both have sodium chloride, also known as salt.

Importance of Salt

One example of the importance of salt is the common practice of starting an intravenous solution of salt and water as the first line treatment for the trauma patient upon arrival to the hospital Emergency Room.

Low Salt Diet to Reduce Blood Pressure

One of the central dogmas of mainstream medicine is the "low salt diet" as a treatment for reducing blood pressure in the hypertensive patient. Indeed, popular wisdom says that the "low salt diet" is also healthy for the rest of us "normal" people who don't have hypertension.(25) Along with the rest of my medical school class, I was indoctrinated to believe this. Is this really true? Many studies have looked at this question. They show the "low salt diet" will in fact reduce blood pressure slightly. However, this effect is minimal, and is counteracted by compensatory mechanisms that release harmful substances into the bloodstream, hormones and chemical mediators that counteract the "low salt diet". The released chemical mediators include insulin, epinephrine, norepinephrine, renin, aldosterone, etc. These are harmful and damaging to the vascular system. (7-11)

Low Salt Diet Increases Cardiovascular Mortality

In addition, a number of studies have found that a "low salt diet" increases cardiovascular mortality. (5) A study published in the 1995 Hypertension found 4.3 times greater mortality in hypertensive men on a low salt diet.(12) They also found higher plasma renin in these men, a hormone produced by the body which causes salt and water retention by the kidney to compensate for the low salt diet.(12-15)
A 2011 JAMA provides the reasons for this increased mortality and says ... (16)

The underlying mechanisms explaining the inverse association between cardiovascular mortality and 24-hour urinary sodium excretion might be that a salt intake low enough to decrease blood pressure also increases sympathetic nerve activity, decreases insulin sensitivity, activates the renin-angiotensin system, and stimulates aldosterone secretion. (16)

A 1998 JAMA report found that a low salt diet increased plasma renin 3.6-fold and aldosterone by 3.2-fold, increases that were proportional to the degree of sodium restriction. (17) The authors also reported the "low salt diet" increased other harmful substances such as noradrenaline, cholesterol, and low-density lipoprotein cholesterol (LDL). (17) A 1999 report in American Journal of Hypertension found that "moderate salt restriction aggravates both systemic and vascular insulin resistance." (18)
The Difference Between Refined Salt and Natural Sea Salt

In his book, Salt Your Way to Health, Dr. David Brownstein points out the difference between Refined Salt, commonly used in all processed foods, and Natural Sea Salt.(21) White refined salt is processed so that all the trace minerals are removed, and instead has chemicals added (up to 2% of weight). The added chemicals are ferrocyanide, aluminum, ammonium citrate, etc and are used for anti-caking, free-flowing, and to prolong shelf life. The final result is a lifeless, unnatural salt product which tends to acidify the body also called refined salt. Natural Sea Salt, on the other hand, retains all the trace minerals naturally found in the ocean. In addition it alkalinizes the body and has many health benefits. Natural Sea Salt is made by evaporating ocean water, and then collecting or harvesting the salt.

Popular brands of natural sea salt include:

1) Celtic Sea Salt®, Light Grey, By The Grain & Salt Society, Coarse Ground, 1 lb

2) Roland Fine Sea Salt, 27.8-Pound Package (See all Sea Salt)

Case reports from Dr Brownstein's Natural Ocean Sea Salt Book

Case Number One- Food Allergies (from the Salt book) 61 year old female with numerous allergies. The patient switched from refined salt to natural sea salt, measured urine and saliva pH, which went up (alkaline) and noted allergies resolved.

Case Number Two-Male Hypertension on Meds, Jack 63 year old hypertensive on two BP meds, Dyazide and Lopressor causing fatigue and erectile dysfunction. He switched from a low salt diet to natural sea salt and two months later blood pressure was lower. Pt reduced BP meds to dyazide at half dose.

Case three, Barbara -Hypertension, 53 y/o went to primary care doctor for check up and was shocked to find her BP was 165/100. She had been on a low salt diet for years. Blood tests showed a low sodium level (137). She was then placed on natural sea salt, half tsp per day, and vitamin-mineral regimen, and eliminated refined foods.
Two months later her blood pressure was 110/70, and she felt better.

Case Four Sandra, similar story to Barbara.

Case Five, Seizure Disorder.
Jerry 12 years old with recurrent seizures on meds.Sodium was 138 on low salt diet. Switched to natural sea salt. Seizures decreased by 50%.

Case Six Migraines. Lisa 31 , three migraines per month, clinically dehydrated, low sodium 139. Instructed to take half tsp Celtic Sea Salt per day, and 2 liters of water per day. Migraine headaches disappeared.

Case Seven- Fibromyalgia . Judy 35 y/o , five years with fibromyalgia. BP drops upon standing. Adrenal Fatigue. RX adrenal hormones (DHEA, cortisol, pregnenolone, testosterone, progesterone ) , and natural sea salt., whole foods, plentiful water. Immediate improvement.

Clinical Uses of Natural Sea Salt

Adrenal Exhaustion:
Sea Salt is essential for treatment of adrenal fatigue.
Diabetes, Elevated Blood Sugar-
It is impossible to control blood sugar on a "low salt diet". These do well on sea salt.
Muscle Cramps -
often relieved by minerals in Sea Salt.
Osteoporosis Treatment
requires minerals found in Sea Salt
Low salt diet causes increased mortality. Use natural sea salt, with reduction in blood pressure noted in any cases.

How to Reduce Blood Pressure Naturally -Salt Substitutes
The low sodium, high potassium, high magnesium salt substitute (26)

A number of studies have looked at substituting table salt with a variant with reduced sodium, and increased potassium, and magnesium, which has shown to reduce blood pressure. (26) Magnesium alone is an excellent mineral supplement which may be effective for blood pressure control in hypertensive patients.(27)

Salt Substitute From Finland

Jonathan Wright's clinic offers a salt substitute which contains potassium, magnesium, and lysine which was found beneficial in a Finland.(28)(29)
WrightSalt is available through the Tahoma Clinic Dispensary (www.tahomadispensary.com 888-893-6878 ), or Ayush Herbs (800-925-1371),

L-Arginine and the ADMA Connection

In 1998 the Nobel Prize in Medicine was awarded to Furchgott and colleagues for the discovery of the role of Nitric Oxide in blood pressure regulation (among other things). (29-31) Recently, a new test has been devised called the ADMA from Metametrix Labs which is useful in hypertensive patients, showing the ability (or inability) to manufacture Nitric Oxide. If ADMA is found to be high, indicating low Nitric Oxide production, then increases can be achieved with a simple amino acid supplement called L-Arginine. (29-31) The increased Nitric Oxide brings down and controls blood pressure.(32) The references for the ADMA test can be found here.

No Iodine Added to Natural Sea Salt

Remember, Natural Sea Salt does not contain added iodine, so it is important to test for iodine levels, and supplement with iodine if found low. Iodine supplementation is our most important means for breast cancer prevention.

Credit and thanks goes to the book, Salt Your Way to Health, by David Brownstein MD for much of the information in this article.

Jeffrey Dach MD
7450 Griffin Suite 190
Davie Florida
954 792-4663