Salt…. Too Much, Just Right, or Not Enough

Salt in its simplest form is sodium and chloride, which are both electrolytes and essential nutrients our bodies need to function optimally. Salt is one of the most common ways we consume sodium in our diets and has come under scrutiny as many people may be consuming too much in our diets. Sodium has so many roles in our bodies to help it function normally. It helps maintain fluid balance and blood pressure so our hearts can pump blood throughout our bodies with ease. It also aids in our ability for our muscles to contract and move us around the world. Naturally, our body has strategies for maintaining the right amount of sodium, and our kidneys are one of the main organs that regulate the amount of sodium we have at any given time. We lose sodium daily from sweating and through our urine; thus, we must continually consume it from our diet to ensure our bodies stay in balance.

Simply put, sodium is essential. But how much do we need to live a well-balanced life? Well, that depends ….

How much salt should a healthy person who is moderately active consume?

The 2020-2025 Dietary Guidelines for Americans recommend that adults in the United States consume less than 2,300 milligrams (mg) of sodium each day. This equals approximately 1 teaspoon of salt from all our food and beverages per day.

Where does salt come from in my diet? 

Very little sodium occurs naturally in foods and is commonly added to make foods shelf-stable and add flavor. For example, it has been estimated that 75-80% of Americans’ salt intake comes from processed foods where salt has been added during food processing or manufacturing. In addition, salt added in home cooking from whole food ingredients or salting your food at the table contributes very little to our diets. The easiest way to no longer worry about your salt intake is to consume a diet low in processed foods and rich in fruit, vegetables, whole grains, and legumes.

What are the consequences of too much salt in our diets?

Over time too much salt consumed regularly in our diets puts additional strain on our kidneys to filter out more salt, leading to increased urination and other water losses in our bodies. This can reduce our blood volume, making it harder for our hearts to pump blood throughout our bodies, increasing blood pressure, and forcing our hearts to work harder. Over time this extra pressure on our heart and strain on our kidneys can lead to high blood pressure and eventually hypertension. Chronic hypertension damages the heart, blood vessels, and kidneys, increasing the risk of heart disease and stroke.

Gastric Cancer

Gastric cancer is the fifth most common cancer worldwide. The American Institute of Cancer Research (AICR) has found links to high consumption of foods preserved by salting with increased incidences of gastric cancer. Salt-preserved foods include meat, fish, and vegetables, including pickled vegetables and salted or dried fish, as traditionally prepared in East Asia.

What are the consequences of too little salt in our diets?

There are several instances where a person could have too little salt in their body. One way is from severe and prolonged vomiting or diarrhea, excessive use of certain drugs (see list below), and too severe restriction in the diet. However, this is uncommon as the kidneys will naturally work to retain more salt in our bodies. Salt follows water, and so when a person is experiencing an excessive amount of water loss or an overload of water above sodium levels, a condition known as hyponatremia can occur. Hyponatremia can be a severe medical condition, and you should work with your medical team to manage it. 

Chemotherapies that can lower sodium level

• Cisplatin
• Cyclophosphamide (Cytoxan)
• Ifosfamide
• Melphalan
• Vinblastine
• Vincristine (Oncovin)
• High dose Imatinib

Other Medications that can lower sodium level

• Diuretics
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Opiate derivatives
• Serotonin-reuptake inhibitors (SSRIs)
• Ibuprofen (Advil, Motrin), Naproxen sodium (Aleve)

Tips for maintaining the right amount of salt in your diet

• Consume mostly plants most of the time
• Fill your plate with whole grains and legumes regularly and vegetables and fruit.
• Consume smaller portions of salty foods such as soy sauce, salted pickles, fish, salty cheeses, and olives
• Limit consumption of highly or ultra-processed foods
• Limit consumption of Energy drinks and sports drinks if you are not exercising more than 60 minutes per day and experiencing a high sweat loss
• Cook more meals at home

Which type of salt should I choose?

There are many different types of salt to buy: table salt, kosher salt, and sea salt.

• Table salt is a highly refined salt enriched with iodine, usually laced with chemical additives to stop it from clumping in damp conditions.
• Kosher salt is a flaky, coarse-grained salt that is less refined than table salt and additive-free.
• Sea salt comes from evaporated seawater and contains trace minerals, which may enhance its nutritional properties and taste. There are many different types of sea salt, from fine white to coarse grey, and all are worth a try. But even with a natural product from the sea, salt is still salt and should be used sparingly.

We recommend using kosher salt or acceptable sea salt for cooking and the more expensive grey sea salts as a condiment. Always correct the seasoning of your dishes toward the end of cooking. You can always add salt, but you can’t take it out once it’s there. A pinch of salt added to vegetables as you sauté them will bring out their juices and flavor. Salt is added to some marinades for animal proteins because it can help trap moisture and taste during the cooking process.