Not as bad as you think for most people. This is another one of my hot buttons about which I have written before. Many people assume that salt is bad for everyone, though opinions on optimal amounts vary widely. For example, the European Heart Journal recently stated that there is little or no evidence supporting the extremely stringent guidelines of the American Heart Association.(1) The Europeans cap the recommendation at 5g/day (5,000 mg), while Americans recommend only 1.5g/day (1,500 mg).
Though safe sodium levels are hotly debated, a carefully run, long-term trial found that significant sodium reduction only lowers blood pressure two or three points. (2) Bouncing it back to the Europeans, a study in the British Medical Journal (3) found that sodium restriction led to a 25% decline in heart attacks and strokes. So restricting sodium certainly can help some people delay death from cardiovascular disease.
But in a very large study of nearly 7,000 American adults, there was no connection between sodium or potassium intake and elevated blood pressure. (4)
Well, if the medical community can’t even agree on safe sodium levels, then how are we to decide what is safe for ourselves? Here are my (I-am-not-your-physician) recommendations:
1. If you have been diagnosed with high blood pressure, ask your doctor and stay away from processed food as much as possible.
2. If you do not have an issue with high blood pressure, simply strive to eat food that does not come in a bag or box with a long list of ingredients.
3. If you have low blood pressure, adding salt to your diet may or may not help. But if you are one of those who are salt-sensitive, you may find some relief with a little extra salt in your diet.
(1) European Heart Journal, January 20, 2017
(2) Journal of Human Hypertension, January 2005
(3) British Medical Journal, April 28, 2007
(4) Journal of Clinical Hypertension, April 11, 2014