How bad is sodium for you, really?

It seems every nutrition website out there lists “bad” foods with large amounts of sodium right up there with foods with high levels of saturated or trans fat. Yet, Alton Brown states that as long as one has two functioning kidneys and drinks plenty of water, sodium is really a non-issue. So, are high levels of sodium really all that bad for you?

When Alton Brown gets a medical degree I may start paying attention to what he says. Until then, I’d rather put my trust in the American Medical Association.

Do you have a cite for that? I’ve never heard Alton say anything that irresponsible. Maybe it’s a little out of context or someone else said it?

The results of a recent study that looked at reducing salt intake in the US population are interesting: http://americanheart.mediaroom.com/index.php?s=43&item=689

I remember Alton saying pretty much that. There might have been additional qualifications about being generally healthy as in not on a low sodium diet by order of your doctor.

It’s always interesing to note in studies like these that say “would possibly save 200K or 150K lives per year.” It’s not like they’re not going to die. A more meaningful figure would be how much longer a person might expect to live with a sodium reduction. I don’t see that very likely, though.

Although they may be respected, how trustworthy are they?

Here’s a sorta cite:

I know people here have this book, though I don’t.

Alton Brown says it in “I’m Just Here for the Food,” pages 18-19 (version 2 but I think I remember it being in the first one too). He says:

But anyway, what exactly does large sodium amounts due to the human body? The AMA site states the average American eats two to three times the recommended amount of sodium daily. If this were true about fat or calories, wouldn’t the American population be in even worse shape than say our Japanese counterparts that indeed eat more salt and live longer?

I’d be curious to hear Qadgop’s take on this. From my understanding, if you don’t have a problem with hypertension, what Alton says is correct. But I am not a physician.

Huh, I just looked on the bookshelf and it turns out I have this one. Someone probably gave it to me for Christmas and I forgot all about it. I’m guessing he cherry-picked one study and made that claim about the guys in white lab coats finding salt okay in pretty much any amounts.

Nope. If you’re “salt sensitive”, you’re at risk for having health problems by consuming too much sodium:

http://www.healthandage.com/public/health-center/36/article/1130/Some-are-more-sensitive-to-salt-than-others.html

It’s from an old article, but more recent Google hits suggest eating too much salt if you’re salt sensitive is still found to be a health risk.

How does one determine salt sensitivity other than by contracting health problems related to sodium intake?

Call me a skeptic about the ill effects of sodium in those with normal renal function, but then I’m skeptical about everything, so follow your own physician’s advice.
From http://www.springerlink.com/content/pk170016663v398g/ , for example:

“The best available data derives from six prospective cohort studies. In sum, the scant available observational data do not rule out the possibility of benefit for some and increased risk for others. Considerable experience - most recently the hormone replacement study - underscores the hazards of extrapolating clinical recommendations from observational data alone. In the absence of any evidence from randomized trials of morbidity and mortality outcomes, and in the face of inconsistent observational studies, a universal recommendation for sodium restriction is unwarranted and inconsistent with the principles of evidence-based medicine.”

Now, if your kidneys and really, the rest of your physiology (for example, you don’t have congestive heart fairlure or something else screwing with your renin-angiotensin axis) aren’t normal, then all bets are off.

And from the other side of the fence: http://jama.ama-assn.org/cgi/content/full/301/17/1759

“To estimate the proportion of the adult population for whom the lower sodium recommendation is applicable, CDC analyzed data from the National Health and Nutrition Examination Survey (NHANES) for the period 1999-2006. The results indicated that, in 2005-2006, the lower sodium recommendation was applicable to 69.2% of U.S. adults. Consumers and health-care providers should be aware of the lower sodium recommendation, and health-care providers should inform their patients of the evidence linking greater sodium intake to higher blood pressure.”

Currently there’s no test for salt sensitivity, other than recognizing symptoms such as an unusual amount of water retention after salt binging, but that’s not a rock solid way to determine if you’re salt sensitive (and probably not a good idea). The safe bet is trying to stay within the recommended guidelines for sodium consumption.

Couldn’t resist getting my licks in from one more totally unbiased source:

http://www.saltsense.co.uk/documents/paper1.pdf

“Reducing salt intake has no significant health
benefits for the average healthy people. For
some sectors of the population it may even be
dangerous to switch to a low salt diet.”

And one for the road: http://www.aafp.org/afp/20040115/fpin.html

*"Reducing sodium intake does lead to a slightly lower average blood pressure. However, no evidence from controlled trials proves that reducing sodium intake decreases morbidity or mortality, or proves that modest sodium restriction is harmful…

Another recent Cochrane review of trials lasting at least six months showed that patients randomized to dietary advice to reduce sodium intake did not have lower cardiovascular morbidity or mortality than control patients (see accompanying table). However, the total number of cardiovascular events in the trials was small (e.g., only 17 deaths occurred). The only significant benefit from sodium restriction was that patients who had discontinued antihypertensive medications were more likely than control patients to avoid restarting medications.

I* (the author, not the Pedant) counsel my patients with hypertension to reduce their daily sodium intake to around
2 g to help reduce and control their blood pressure, and I offer them the hope of being able to discontinue antihypertensive medications as a result."

I have a vague recollection from my medical residency days that blacks are more prone to having issues with handling salt than whites, but that was back in the day when people thought there were different races, and I haven’t really kept up with what the current spin is.