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Why can we eat salty food, but can't stomach salty water?

Why can we eat salty food, but can't stomach salty water?


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I know that too much sodium is bad for our health. However, it struck me as odd that we like to add salt to pasta sauce or other foods we eat, yet trying to drink salt water can bring on the gag reflex.

Is this because sea water is many times more salty than the salt we would add to our food? Or is there another reason?


Seawater is many times more salty than the "pinch" of salt that is often recommended to add to cooked dishes.

According to the USGS

the concentration of salt in seawater (salinity) is about 35 parts per thousand. In other words, about 35 of 1,000 (3.5%) of the weight of seawater comes from the dissolved salts

To translate that to a typical glass of water: seawater is equivalent to adding a bit more than an entire tablespoon (17.5 mL) of salt to a 16oz (~500 mL) glass!

By the way, 1 tablespoon of salt is about 7100 mg. To put that into perspective, you'd have to consume almost two entire 8-cut pizzas (using Domino's as a reference) or more than 7 McDonald BigMac cheeseburgers to consume that same amount of salt.

In fact, consuming 7,100 mg of salt would more than triple the recommended amount for daily intake. According to the FDA:

Americans eat on average about 3,400 mg of sodium per day. However, the Dietary Guidelines for Americans recommends limiting sodium intake to less than 2,300 mg per day-that's equal to about 1 teaspoon of salt!


7 Reasons You’re Craving Salty Foods

If you suddenly find yourself grabbing for potato chips and other salty foods, there could be something going on in your body besides simply wanting something savory to snack on. Salt cravings can arise for many different reasons, from dehydration to stress and PMS.  

“In general, salt is an addictive flavor, and we are engineered as humans to crave it as it is necessary for survival,” says Amy Shapiro, a registered dietitian who works in her own New York City-based private practice and is also the nutritionist for Daily Harvest, a nutritious frozen-meal delivery service. “So when we don’t have enough, our body will push out real symptoms in order for us to seek it out.”

Here are the details on some of the most common culprits behind salt cravings:


Salt and Water

Once absorbed into the body, sodium’s major function involves regulating blood volume. Sodium attracts water. When blood volume is too low, sodium rushes into the bloodstream, which in turn causes water to rush into the bloodstream. As a result, blood volume increases. But when too much sodium accumulates in the bloodstream, too much water also accumulates -- resulting in excess fluid volume. This often leads to high blood pressure and an increased workload on the heart.


Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Comments

This mentioned salty fries and Chinese food having a lot a sodium. Another thing that came to mind is frozen “healthy” dinners. So many people grab those seeing they are low in calories and the fact that they say “healthy” or “weight loss” on the box. However, those meals are incredibly high in sodium. I try to get in the habit of checking the labels for this reason.

Read an article by a dietician and health expert MD who states that,” eating sea salt is not harmful, but is beneficial to make your bones stronger, it very least raises your blood pressure!

There are zero credible data to support such a claim. This illustrates the confusion and misinformation that exists in this space. Be cautious when hearing things like this.


What causes salt cravings?

Anyone who has ever eaten a large serving of chips, popcorn, or french fries knows that salt cravings can be hard to resist.

Although most people in the United States consume far too much salt in their diets, salt cravings are still a common problem.

Some people believe that a food craving is a sign that the body is deficient in something, but this is usually not the case. Most cravings are tied to unhealthful foods that offer little to no nutrition.

Salt cravings are common and are usually the result of factors such as boredom or stress. Occasionally, a salt craving can be tied to a medical condition or a sodium deficiency.

In this article, we look at seven causes for salt cravings, including lack of sleep, excessive sweating, and some underlying medical conditions.

Share on Pinterest Salt cravings may be the result of stress.

When stress levels rise, many people crave their favorite foods for comfort. Foods that people commonly crave are often high in fat, sugar, or salt — also known as sodium.

The “comfort food” habit can decrease a person’s overall health. An article in the Journal of Health Psychology found a significant association between levels of chronic stress, food cravings, and higher body mass index (BMI).

Another study found a link between stress and higher levels of the hormone ghrelin, which increases hunger. The results of the study suggest that ghrelin may increase food cravings and lead to weight gain.

People who do not get enough sleep may crave snacks with high “satisfaction levels” such as salty, crunchy foods.

A study in the journal Sleep found that people who were sleep-deprived were less able to resist cravings for their favorite unhealthy foods. This resulted in weight gain.

Because lack of sleep may also be linked to other health problems, people who are consistently having inadequate rest may wish to discuss this with their doctors.

Sleep disorders, stress, and busy schedules are often to blame, but a health professional can offer a clear diagnosis and potential treatment plan.

Eating due to boredom is an emotional eating behavior, similar to stress eating.

To determine whether a salt craving is due to boredom or hunger, it is helpful to look for the body’s hunger cues.

True hunger occurs when a person’s body is in need of food. If a person has not eaten for several hours, they may have true hunger.

Other signs of hunger include:

  • noisy stomach grumbling
  • wanting to eat almost any food, not a specific one
  • a desire to eat that gets stronger over time

These signs indicate that it may be time to eat a meal or snack. Salty, high-fat foods are rarely a nutritious choice, however.

Instead, a person should look for something with crunch and flavor, such as raw fruits or vegetables. These choices can keep the salt intake to a minimum while calming the desire for crunchy, satisfying foods.

Sweat contains salt, so when a person sweats, their sodium levels decrease.

For most people, light sweating is nothing to worry about. Sodium levels do not drop significantly with day to day sweating, and typically, only water is needed to replace fluids after a workout.

Endurance athletes or those who work in very hot environments may need to consume more salt, however, to replace what is lost through excessive or prolonged sweating.

When a person loses too much sodium, their body may begin to crave salt. One study found that people who work in hot conditions for 10 hours can lose up to 15 grams of salt, although this number may vary widely from person to person.

Electrolyte-enhanced drinks or sports drinks may be recommended for people who exercise excessively or who spend long hours in a hot environment. These drinks contain sodium and other electrolytes to replace what is lost through sweat.

A woman may experience a variety of physical and emotional changes in the days leading up to her menstrual period. These changes are known as premenstrual syndrome (PMS).

Food cravings, including a craving for salty foods, are a common symptom. These cravings may be related to hormonal fluctuations.

Women who experience PMS-related cravings may wish to try:

  • Calcium and vitamin B-6: A 2016 study found that women who took 500 micrograms (mg) of calcium and 40 mg of vitamin B-6 had fewer PMS symptoms than those who took vitamin B-6 alone. Calcium and vitamin B-6 tablets are available to buy in health stores, pharmacies, and online.
  • Acupuncture and herbs: A review of studies found that women who received acupuncture and herbal medicine had a 50 percent reduction in PMS symptoms.
  • Vitex (chasteberry): This herb may improve some PMS symptoms. It should not be taken by women who are taking hormones, birth control pills, or who have a hormone-sensitive medical condition. Vitex is available to buy in health stores, pharmacies, and online.
  • Oral contraceptives (birth control pills): Birth control pills appear to improve PMS symptoms, according to a recent study in 2016. However, birth control pills can have side effects and risks that should be discussed with a doctor.

Addison’s disease, or adrenal insufficiency, occurs when the adrenal glands do not make enough hormones.

These hormones control the body’s response to stress and regulate blood pressure. As a result, Addison’s disease can cause very low blood pressure and sudden cravings for salt.

Besides salt cravings, people with Addison’s disease may experience:

  • weakness
  • long-term fatigue
  • low appetite or unplanned weight loss
  • stomach pain
  • nausea, vomiting, or diarrhea
  • dizziness or fainting due to low blood pressure
  • low blood sugar, called hypoglycemia or irritability
  • irregular or absent menstrual periods

Addison’s disease may be caused by:

  • an autoimmune disorder and AIDS
  • certain bacterial or fungal infections
  • pituitary gland problems
  • stopping long-term steroid medications

Addison’s disease requires medical care to replace the hormones that the adrenal glands are not making.

In severe cases, a person may go into adrenal crisis. This happens when levels of cortisol in the body drop to dangerous levels. Adrenal crisis is a medical emergency.

Bartter syndrome is a genetic condition that is present at birth. People with Bartter syndrome cannot reabsorb sodium in their kidneys. As a result, they lose too much sodium in their urine, which leads to a loss of potassium and calcium as well.

Due to low levels of sodium, people with Bartter syndrome may crave salt. They may also experience:

  • slow weight gain, seen in children
  • the need to urinate often
  • low blood pressure
  • muscle cramps and weakness

This syndrome is usually diagnosed in infancy or childhood through urine and blood tests. It can be managed with potassium, salt, and magnesium supplements.

Cystic fibrosis (CF) is a hereditary disease that affects the lungs and digestive system. The condition can be life-threatening, and those affected tend to have a shorter-than-normal life span.

CF causes the body to use too much salt, leading to a lack of salt and water outside of the cells. This causes the production of thicker-than-normal mucus that can clog the lungs and obstruct the pancreas.

Due to the balance of salt in the body being disturbed, people with CF may crave salt. Other symptoms include:

  • constipation
  • the need to urinate often
  • kidney stones
  • low blood pressure
  • muscle cramps and weakness

CF is usually diagnosed in infancy or childhood through urine and blood tests. It can be managed with potassium, salt, and magnesium supplements.

Very often, salt cravings are simply food cravings due to stress, fatigue, boredom, or PMS. However, ongoing salt cravings can be an indication of certain medical conditions.

If an obvious cause for salt cravings cannot be found, or risk factors for kidney or adrenal problems are possible, then a person should talk to their doctor.


Causes of Dehydration

In addition to simply not drinking enough water to replace normal body water losses, other causes of dehydration include diarrhea, particularly if you experience excessive diarrhea in a short amount of time, and vomiting. If you experience concurrent diarrhea and vomiting, your risk of dehydration increases. A fever increases your likelihood for developing dehydration. The higher the fever is, the greater your risk for dehydration. Excessive sweating from situations in which you overexert yourself or become overheated--especially if you do not compensate for fluid and electrolyte loss--leads to dehydration. Additionally, dehydration is a potential manifestation of any condition causing you to urinate more than usual. These conditions include the use of diuretic medications, excessive alcohol consumption and uncontrolled diabetes.


Why Can't You Drink Saltwater?

A few days ago, Lockheed Martin, of the military-industrial complex, announced that its scientists had come up with a super-thin, super-strong saltwater filter .

Exciting stuff! And no, this filter isn't for some kind of avant-garde Nordic Food Lab coffeemaker (though that could be cool): it's for turning seawater into freshwater. Which, if you've been reading any of the doomsday reports on our future, might be useful once we start running out of drinkable water and everything goes all Mad Max.

Right now, there are two main ways of desalinating water: evaporation and "reverse osmosis," a long way of saying "shoving saltwater through a filter." Evaporation works like youɽ expect--you just heat the saltwater up and capture the freshwater that floats away. But because of the huge amount of energy it takes to boil all that water, it's pretty much only used by countries in the Middle East where there's more crude oil to burn than there is water to drink. Reverse osmosis is more power-friendly, but the filters that they use at most plants today are so bulky that you need a hugely powerful pump to force the saltwater all the way through to the freshwater side.

But this new filter is only one atom thick. Really! It's made of a web of carbon atoms joined together like a chain-link fence--the holes between the atoms are big enough to let water through, but stop the heftier salt molecules from passing. Plus, it's strong enough ("a thousand times stronger than steel," said one scientist) that you can use just one sheet of this filter to separate the salt. Which means that you could turn saltwater into fresh with something as simple as a bike pump.

All this salty talk is making us thirsty! Thirsty and thinking: Why do we even need to take the salt out of the water? If it's so bad for us, why do sports drinks add it in? And why do we keep eating it in everything, if it's actually bad for us?

Well, first we need to learn some very basic physics. If two bodies of water are separated by a water-permeable membrane (like the filter in a desalination plant or the cell walls in our body), they'll naturally flow toward evening out the concentrations of chemicals on both sides of the membrane. When that chemical is salt, one of two things can happen. If there's too high a concentration of salt coming in, the cells force out extra water to maintain balance, basically wringing themselves out. They stop functioning, you stop functioning. This is called death.

Likewise, if the concentration of salt is too low, the cells suck up a bunch of water and start exploding. This, too, can kill you, though you likely won't actually explode. This is also why sports drinks have salt in them--to keep that balance between your cells and the liquid around them in check--and why hospitals use saline solution for IV drips. Since your blood is a little salty (around 9 grams of salt per liter), pouring freshwater straight into your veins would make the blood cells absorb the freshwater and burst (seawater, by comparison, generally has around 35 grams of salt per liter, which is why it's so bad to drink instead of normal water).

Our bodies do need salt to survive, of course, but only a tiny amount. The CDC says that you only actually need 180 milligrams per day (unless you're sweating up a storm), which is about half of one one of those tiny fast-food salt packets. The recommended maximum in the U.S. is five times that, and most people end up eating even more in the course of an average day. Unless you're sick, starving, or dehydrated, running out of salt is probably not going to become a major health issue anytime soon.

In fact, too much salt is definitely bad for us. Test after test has shown that eating a lot of salt increases your risk of heart attack and stroke, and that cutting down lowers the risk. But that hasn't stopped people from eating way more salt than they need to survive, and not just in the salt-happy States. A massive international study in the ➀s found that people across the world all eat roughly the same amount of salt (i.e., way more than they need), whether they know it's bad for them or not.

Which means that, no matter where you are, or where you're from, salt, and more salt than you need to live, tastes good. As the free-market enthusiasts at food companies like to point out , we Americans like food with tons of salt in it, and keep on buying it, day after day, with no apparent upper limit on how much we'll eat.

And any home cook knows that most food ends up tasting kind of lame without salt, but there is a balance to be struck. Packaged foods, like bread, soups, and cookies, tend to have more salt than we would ever bake or mix into them ourselves, so cooking at home is a good way to start. And once you're doing that, try salting just to the point where it brings out the flavor in the other ingredients, but doesn't actually taste salty. Compare two pieces of meat, or bites of salad, with different amounts of salt, and see if you can hit that perfect point of intensifying the flavor of the food without overwhelming it.

Or, if you're really committed do desalinating your life, you can train your tongue (again, according to science ) to be more sensitive to salt by gradually lowering the amount you include in your food. But be warned: it'll take a while, and until then, the journey will be bitter and bland.


Blech! Brain Science Explains Why You're Not Thirsty For Salt Water

Just a 10 percent shift in the salt concentration of your blood would make you very sick. To keep that from happening, the body has developed a finely tuned physiological circuit that includes information about that and a beverage's saltiness, to know when to signal thirst. Nodar Chernishev/Getty Images hide caption

Just a 10 percent shift in the salt concentration of your blood would make you very sick. To keep that from happening, the body has developed a finely tuned physiological circuit that includes information about that and a beverage's saltiness, to know when to signal thirst.

Nodar Chernishev/Getty Images

When you're thirsty, a swig of fresh water brings instant relief. But gulp down some salty sea water and you'll still feel parched.

That's because your brain is trying to keep the concentration of salt in your body within a very narrow range, says Zachary Knight, an associate professor in physiology at the University of California, San Francisco and an investigator with the Howard Hughes Medical Institute.

"If you experience, for example, a 10 percent change, you would be very sick," he says. "A 20 percent change and you could die."

Shots - Health News

Off Your Mental Game? You Could Be Mildly Dehydrated

Knight and a team of researchers wanted to know how the brain keeps that from happening. They report the results of their search in an article published Wednesday in the journal Nature.

"There has to be a mechanism for the brain to track how salty the solutions that you drink are and use that to fine-tune thirst," Knight says. "But the mechanism was unknown."

So Knight's team began studying brain cells known as thirst neurons.

First, the team piped fresh water directly into the stomachs of some thirsty mice.

"Within a minute or two, infusing water into the stomach rapidly turns off these thirst neurons in the brain," says Chris Zimmerman, a graduate student in Knight's lab who conducted the experiment. "And not only that," Zimmerman says, "if we give [the mouse] access to water it doesn't drink at all."

The Salt

Still Thirsty? It's Up To Your Brain, Not Your Body

Next the team repeated the experiment, using salty water. And this time, the thirst neurons stayed on and the animals kept searching for fresh water that would reduce the concentration of salt in their bodies.

More study revealed how the system works. Cells in the gut are constantly measuring saltiness and communicating that information to thirst neurons in the brain.

"What's really exciting about this is not only that we've discovered this new signal from the gut to the brain, but also that we've found that it has a really specific role in controlling our behavior," Zimmerman says.

A second study in Nature looks at a different system that also affects salt intake.

"We wanted to know how sodium appetite is regulated by the brain," says Yuki Oka, an assistant professor of biology at Caltech and an author of the study.

The first thing Oka's team did was use a technique called optogenetics to switch on the sodium appetite neurons.

The effect on mice was immediate. "They pick up a piece of rock salt and then start eating it," Oka says.

When the team switched off the sodium appetite neurons, the animals stopped eating salt.

Your Health

Athletes Run Risk of Overhydrating

But how does this system work when there's no scientist flipping the switch?

Previous research has shown that part of the answer involves cells that measure salt concentrations in the bloodstream.

But Oka's team figured that likely wasn't the whole answer, because animals need only a tiny amount of sodium in their diet. So they need to stop eating salt long before concentrations in blood start rising.

The scientists thought there must be a second "off switch" somewhere — one that could be flipped sooner.

They found it in the animals' taste buds.

"When you put sodium-salt on top of the tongue, and then, when you taste it, that's sufficient to suppress sodium appetite neurons," Oka says. That's how we know to stop eating salt before we've consumed a harmful dose.

And sports drinks, the UCSF scientists explain, contain a much lower concentration of sodium than is found in our bodies that's why the drinks don't trigger the brain's "stop eating salt" response.

Correction March 28, 2019

A previous version of this Web story incorrectly stated that sports drinks contain the same concentration of sodium that is found in our bodies in fact, sports drinks contain a lower concentration.


Salt and Sodium

Salt, also known as sodium chloride, is about 40% sodium and 60% chloride. It flavors food and is used as a binder and stabilizer. It is also a food preservative, as bacteria can’t thrive in the presence of a high amount of salt. The human body requires a small amount of sodium to conduct nerve impulses, contract and relax muscles, and maintain the proper balance of water and minerals. It is estimated that we need about 500 mg of sodium daily for these vital functions. But too much sodium in the diet can lead to high blood pressure, heart disease, and stroke. It can also cause calcium losses, some of which may be pulled from bone. Most Americans consume at least 1.5 teaspoons of salt per day, or about 3400 mg of sodium, which contains far more than our bodies need.

Recommended Amounts

The U.S. Dietary Reference Intakes state that there is not enough evidence to establish a Recommended Dietary Allowance or a toxic level for sodium (aside from chronic disease risk). Because of this, a Tolerable Upper intake Level (UL) has not been established a UL is the maximum daily intake unlikely to cause harmful effects on health.

Guidelines for Adequate Intakes (AI) of sodium were established based on the lowest levels of sodium intake used in randomized controlled trials that did not show a deficiency but that also allowed for an adequate intake of nutritious foods naturally containing sodium. For men and women 14 years of age and older and pregnant women, the AI is 1,500 milligrams a day.

A Chronic Disease Risk Reduction (CDRR) Intake has also been established, based on the evidence of benefit of a reduced sodium intake on the risk of cardiovascular disease and high blood pressure. Reducing sodium intakes below the CDRR is expected to lower the risk of chronic disease in the general healthy population. The CDRR lists 2,300 milligrams a day as the maximum amount to consume for chronic disease reduction for men and women 14 years of age and older and pregnant women. Most people in the U.S. consume more sodium than the AI or CDRR guidelines. [1]

Sodium and Health

In most people, the kidneys have trouble keeping up with excess sodium in the blood. As sodium accumulates, the body holds onto water to dilute the sodium. This increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. Increased blood volume means more work for the heart and more pressure on blood vessels. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, and stroke. It can also lead to heart failure. There is some evidence that too much salt can damage the heart, aorta, and kidneys without increasing blood pressure, and that it may be bad for bones, too. Learn more about the health risks and disease related to salt and sodium:

After conducting a review on sodium research, the Institute of Medicine concluded that reducing sodium intake lowers blood pressure, but evidence of a decreased risk of cardiovascular diseases (CVD) is inconclusive. [2] It is clear, however, that high blood pressure is a leading cause of CVD. It accounts for two-thirds of all strokes and half of heart disease. [3] In China, high blood pressure is the leading cause of preventable death, responsible for more than one million deaths a year. [4]

There may be a genetic component to salt intake, as people respond differently to lower sodium intakes. [2] Those who are “salt-sensitive” experience the greatest blood pressure reductions after following a reduced sodium diet. Those who are “salt-resistant” do not experience these changes even with significant increases in sodium intake. Studies have found that women more than men, people older than 50 years, African-Americans, and those with a higher starting blood pressure respond the greatest to reduced sodium intake. [5,6] However, there is not enough evidence to make strong conclusions about specific groups who may be salt-resistant the overall evidence supports a benefit of limiting sodium intake for everyone, even though the optimal target amount is not clear.

Observational and clinical research has found that higher sodium intakes are associated with cardiovascular diseases and related deaths. The following are key studies:

  • Intersalt: Researchers measured the amount of sodium excreted over a 24-hour period (a good stand-in for salt intake) among more than 10,000 adults from 32 countries. The average was nearly 4,000 mg of sodium a day. Yet the range was huge, from 200 mg a day among the Yanomamo people of Brazil to 10,300 mg in northern Japan. [7] Populations with higher salt consumption had higher average blood pressures and greater increases of blood pressures with age. Four groups of people—the four countries with salt intakes less than 1,300 mg per day—had low average blood pressures and little or no upward trend of blood pressure with age.
    • The authors conducted a re-review and update on the Intersalt data. [8] They found: 1) a stronger association than their prior study with higher sodium intakes and higher blood pressure, and 2) a stronger association with higher sodium intakes and higher blood pressure in middle age participants as compared with younger adults.
    • After an average of 10-15 years, the TOHP participants in the sodium-reduction groups were 25% less likely to have had a heart attack or stroke, to have needed a procedure to open or bypass a cholesterol-clogged coronary artery, or to have died of cardiovascular disease.
    • The higher the ratio of potassium to sodium in a participant’s diet, the lower the chances were of developing cardiovascular trouble. This suggests that a strategy that includes both increasing potassium and lowering sodium may be the most effective way to fight high blood pressure.
    • In the first study, 459 participants were randomly assigned to either 1) a standard American diet high in red meat and sugars, and low in fiber, 2) a similar diet that was richer in fruits and vegetables, or 3) the “DASH diet,” which emphasized fruits, vegetables and low-fat dairy foods, and limited red meat, saturated fats, and sweets. After eight weeks, the fruits and vegetables diet and DASH diet reduced systolic (the top number of a blood pressure reading) and diastolic (the bottom number of a blood pressure reading) blood pressure, with the DASH diet producing a stronger effect.
    • The second study found that lowering sodium in either the DASH or standard American diet had an even stronger impact on reducing blood pressure. The DASH study contributed much of the scientific basis for the Dietary Guidelines for Americans 2010, which recommends reducing daily sodium to less than a teaspoon.

    Chronic kidney disease (CKD) shares risk factors with cardiovascular disease, with high blood pressure being a major risk factor for both. Salt sensitivity is reported to be more prevalent in patients with CKD due to a reduced ability to excrete sodium, which may lead to increased blood pressure. [14]

    Although there is evidence that links high sodium intake with high blood pressure, there is not adequate evidence that a low sodium restriction protects against or causes better outcomes of CKD than a moderate sodium restriction. One systematic review of patients diagnosed with CKD found that high sodium intakes of greater than 4,600 mg a day were associated with progression of CKD, but low sodium intakes less than 2,300 mg a day had no significant effect when compared with moderate sodium intakes of 2,300-4,600 mg a day. [14]

    Guidelines generally advise a moderate rather than low sodium restriction to prevent the development and progression of CKD. A daily sodium intake of less than 4,000 mg is recommended for overall management of CKD, and less than 3,000 mg daily for CKD with symptoms of fluid retention or proteinuria, a condition in which excess protein is excreted in the urine. [15]

    The amount of calcium that your body loses via urination increases with the amount of salt you eat. If calcium is in short supply in the blood, it can leach out of bones. So a diet high in sodium could have an additional unwanted effect—the bone-thinning disease known as osteoporosis. [3] A study in post-menopausal women showed that the loss of hip bone density over two years was related to the 24-hour urinary sodium excretion at the start of the study, and that the connection with bone loss was as strong as that for calcium intake. [16] Other studies have shown that reducing salt intake causes a positive calcium balance, suggesting that reducing salt intake could slow the loss of calcium from bone that occurs with aging.

    Research shows that a higher intake of salt, sodium, or salty foods is linked to an increase in stomach cancer. The World Cancer Research Fund and American Institute for Cancer Research concluded that salt, as well as salted and salty foods, are a “probable cause of stomach cancer.” [17]

    Food Sources

    Sodium isn’t generally a nutrient that you need to look for it finds you. Almost any unprocessed food like fruits, vegetables, whole grains, nuts, meats, and dairy foods is low in sodium. Most of the salt in our diets comes from commercially prepared foods, not from salt added to cooking at home or even from salt added at the table before eating. [1,18]

    According to The Centers for Disease Control and Prevention, the top 10 sources of sodium in our diets include: breads/rolls pizza sandwiches cold cuts/cured meats soups burritos, tacos savory snacks (chips, popcorn, pretzels, crackers) chicken cheese eggs, omelets.

    Are “natural” salts healthier than table salt?

    The most widely used, table salt, is extracted from underground salt deposits. It is heavily processed to remove impurities, which may also remove trace minerals. It is then ground very fine. Iodine, a trace mineral, was added to salt in 1924 to prevent goiter and hypothyroidism, medical conditions caused by iodine deficiency. Table salt also often contains an anticaking agent such as calcium silicate to prevent clumps from forming.

    Kosher salt is a coarsely grained salt named for its use in traditional Kosher food preparation. Kosher salt does not typically contain iodine but may have an anti-caking agent.

    Sea salt is produced by evaporating ocean or sea water. It is also composed mostly of sodium chloride, but sometimes contains small amounts of minerals like potassium, zinc, and iron depending on where it was harvested. Because it is not highly refined and ground like table salt, it may appear coarser and darker with an uneven color, indicating the remaining impurities and nutrients. Unfortunately, some of these impurities can contain metals found in the ocean, like lead. The coarseness and granule size will vary by brand.

    Himalayan pink salt is harvested from mines in Pakistan. Its pink hue comes from small amounts of iron oxide. Similar to sea salt, it is less processed and refined and therefore the crystals appear larger and contain small amounts of minerals including iron, calcium, potassium, and magnesium.

    Larger, coarser salt granules do not dissolve as easily or evenly in cooking, but offer a burst of flavor. They are best used sprinkled onto meats and vegetables before cooking or immediately after. They should not be used in baking recipes. Keep in mind that measurements of different salts are not always interchangeable in recipes. Generally, sea salt and table salt can be interchanged if the granule size is similar. However, table salt tends to have more concentrated, saltier flavor than kosher salt, so the substitution is one teaspoon of table salt for about 1.5 to 2 teaspoons of kosher salt depending on the brand.

    Signs of Deficiency and Toxicity

    Deficiency

    A deficiency of sodium in the U.S. is rare because it is so commonly added to a wide variety of foods and occurs naturally in some foods. Hyponatremia is the term used to describe abnormally low amounts of sodium in the blood. This occurs mainly in older adults, particularly those living in long-term care facilities or hospitals who take medications or have health conditions that deplete the body of sodium, leading to hyponatremia. Excess vomiting, diarrhea, and sweating can also cause hyponatremia if salt is lost in these fluids that are expelled from the body. Sometimes too much fluid abnormally collecting in the body can lead to hyponatremia, which might stem from diseases such as heart failure or liver cirrhosis. In rare cases, simply drinking too much fluid can lead to hyponatremia if the kidneys can’t excrete the excess water. Symptoms of hyponatremia can include: nausea, vomiting, headaches, altered mental state/confusion, lethargy, seizures, coma.

    Toxicity

    Too much sodium in the blood is called hypernatremia. This acute condition can happen in older adults who are mentally and physically impaired who do not eat or drink enough, or who are sick with a high fever, vomiting, or infection that causes severe dehydration. Excessive sweating or diuretic medications that deplete the body of water are other causes. When sodium accumulates in the blood, water is transferred out of cells and into the blood to dilute it. This fluid shift and a build-up of fluid in the brain can cause seizures, coma, or even death. Extra fluid collecting in the lungs can cause difficulty breathing. Other symptoms of hypernatremia can include: nausea, vomiting, weakness, loss of appetite, intense thirst, confusion, kidney damage.

    The interplay of sodium and potassium

    A study in the Archives of Internal Medicine found that:

    • People who ate high-sodium, low-potassium diets had a higher risk of dying from a heart attack or any cause. In this study, people with the highest sodium intakes had a 20% higher risk of death from any cause than people with the lowest sodium intakes. People with the highest potassium intakes had a 20% lower risk of dying than people with the lowest intakes. But what may be even more important for health is the relationship of sodium to potassium in the diet. People with the highest ratio of sodium to potassium in their diets had double the risk of dying of a heart attack than people with the lowest ratio, and they had a 50% higher risk of death from any cause. [21]
    • People can make a key dietary change to help lower their risk: Eat more fresh vegetables and fruits, which are naturally high in potassium and low in sodium, but eat less bread, cheese, processed meat, and other processed foods that are high in sodium and low in potassium.

    Related

    1. Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US) 2019 Mar.
    2. Stallings VA, Harrison M, Oria M. Committee to Review the Dietary Reference Intakes for Sodium and Potassium Food and Nutrition Board Health and Medicine Division National Academies of Sciences, Engineering, and Medicine.
    3. He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. Journal of human hypertension. 2009 Jun23(6):363.
    4. He J, Gu D, Chen J, Wu X, Kelly TN, Huang JF, Chen JC, Chen CS, Bazzano LA, Reynolds K, Whelton PK. Premature deaths attributable to blood pressure in China: a prospective cohort study. The Lancet. 2009 Nov 21374(9703):1765-72.
    5. Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013 Apr 4346:f1326.
    6. He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013 Apr 4346:f1325.
    7. Intersalt Cooperation Research Group. Intersalt Cooperation Research Group Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24-hour urinary sodium and potassium. BMJ. 1988297:319-28.
    8. Elliott P, Stamler J, Nichols R, Dyer AR, Stamler R, Kesteloot H, Marmot M. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. BMJ. 1996 May 18312(7041):1249-53.
    9. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, Appel LJ, Whelton PK. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007 Apr 26334(7599):885.
    10. Cook NR, Obarzanek E, Cutler JA, Buring JE, Rexrode KM, Kumanyika SK, Appel LJ, Whelton PK. Joint effects of sodium and potassium intake on subsequent cardiovascular disease: the Trials of Hypertension Prevention follow-up study. Archives of internal medicine. 2009 Jan 12169(1):32-40.
    11. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014 Mar 4129(9):981-9. *Disclosures: Dr. Appel is an investigator on a grant from the McCormick Foundation.
    12. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH. A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine. 1997 Apr 17336(16):1117-24.
    13. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine. 2001 Jan 4344(1):3-10.
    14. Smyth A, O’donnell MJ, Yusuf S, Clase CM, Teo KK, Canavan M, Reddan DN, Mann JF. Sodium intake and renal outcomes: a systematic review. American journal of hypertension. 2014 Oct 127(10):1277-84.
    15. Kalantar-Zadeh K, Fouque D. Nutritional management of chronic kidney disease. New England Journal of Medicine. 2017 Nov 2377(18):1765-76.
    16. Devine A, Criddle RA, Dick IM, Kerr DA, Prince RL. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. The American journal of clinical nutrition. 1995 Oct 162(4):740-5.
    17. World Cancer Research Fund, American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. London 2007.
    18. Centers for Disease Control and Prevention. Sodium and Food Sources. https://www.cdc.gov/salt/food.htm Accessed 3/18/2019
    19. Brown IJ, Tzoulaki I, Candeias V, Elliott P. Salt intakes around the world: implications for public health. International journal of epidemiology. 2009 Apr 738(3):791-813.
    20. Dietary Guidelines for Americans Scientific Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services. 2010.
    21. Yang Q, Liu T, Kuklina EV, Flanders WD, Hong Y, Gillespie C, Chang MH, Gwinn M, Dowling N, Khoury MJ, Hu FB. Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Archives of internal medicine. 2011 Jul 11171(13):1183-91.

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    The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.


    How to Lower Sodium Levels

    Despite your best intentions, eating less salt can be a struggle. Most foods nowadays are heavily processed and contain large amounts of sodium to enhance their flavor and increase their shelf life. That’s why health experts recommend checking food labels and avoiding any products containing more than 200 milligrams of sodium per serving.

    Most foods contain sodium. One large egg, for instance, provides about 11 milligrams of sodium. Chicken breast contains up to 75 milligrams of sodium per serving. Therefore, it's not really necessary to add salt to your meals. Canned foods, frozen dinners, smoked or cured meats, potato chips, salted nuts and junk food are the worst offenders. For example, smoked salmon delivers over 666 milligrams of sodium per serving.

    Eat whole, natural foods to lower your sodium levels. When cooking, use herbs and spices instead of salt. Choose fresh or frozen meat and vegetables instead of processed varieties. Drink plenty of water and unsweetened tea to flush out excess sodium. These small changes can go a long way toward better health.



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