Salted_ A Manifesto on the World's Most Essential Mineral, With Recipes - Mark Bitterman [25]
Most research papers that are cited in support of salt reduction do not actually show a measurable improvement in health outcomes as a result of lowering salt intake. Instead, they focus on statistical models extrapolated from many sets of scientific data to determine the probability of reduced cases of high blood pressure that would result from widespread dramatic reduction in salt intake. For example, there is some scientific consensus on data to support the idea that limiting sodium intake to 1,500 milligrams per day could lower the systolic blood pressure in hypertensives by 4 to 5 mm/Hg, and by 2 mm/Hg in people with normal blood pressure. But consider that “optimal normal” systolic blood pressure is 120 mm/Hg. Moderate hypertension starts at 20 mm/Hg above normal and severe hypertension starts at 60mm/Hg above normal. If a person with blood pressure of 160 mm/Hg were to cut salt consumption by two-thirds, from 4,500 milligrams per day to 1,500 milligrams, she could hope to see her systolic blood pressure drop to 150 or 155 mm/Hg. In other words, even the most successful campaign against salt imaginable would not lower the blood pressure of patients with high blood pressure down to a normal range. (And the impact that a sweeping reduction in sodium intake might have on our intake of other minerals like potassium, magnesium, and calcium has not been studied.) There are vast pools of data that suggest even the modest improvement above might not actually come to pass. The Intersalt study, which evaluated 10,079 men and women age 20 to 59 sampled from 52 populations around the world, found no correlation between average salt intake levels and average blood pressures. In fact, those who consumed the most (Tianjin China, 14 grams a day) had a median blood pressure of 119/70 mmHg, while those who consumed the least (an African-American community in Chicago, 6 grams a day) had a similar median blood pressure of 119/76 mmHg.
The entire argument may be beside the point. So long as the salt debate centers on sodium, it will fail to describe the importance of salt in our lives. In 1850, if you wanted to eat chicken you would raise one on grains and whatever bugs and seeds the bird could forage in your yard. You would cook it, and then sprinkle a few precious grains of handmade, mineral-rich sea salt on top. In 2000, you ordered a bag of fried nuggets made with a corn-fed chicken injected with refined sodium chloride solution to make it plumper, battered with a host of ingredients you can’t even pronounce, and then sprinkled with more refined sodium chloride on top. Our food has evolved into something strange and abstract, and it has become inundated with sodium chloride to help make it economical and palatable.
The easy way to gain clarity on the subject of salt and health is to focus on eating food intelligently. To paraphrase the writer Michael Pollan, buy only the foods your grandma would recognize. Or, in the case of salt, your great-grandma. Throw away the frozen poultry nuggets and, as far as I’m concerned, throw away the artificially refined koshering, table, and sea salts while you’re at it.
THE YIN AND YANG OF SALT
While scientists advancing Western medicine scramble to come to terms with the role of salt in nutrition, the far more ancient medical practices of the East offer a different understanding. Balance is the key, as represented in the concept of yin yang. Yin and yang cannot be separated, and indeed are continually