Around 1920, though, something happened, and an essential nutrient--honored from dim antiquity--would be subjected to a relentless and mindless attack, by scientists who should know better, and in most cases do. Indeed, the anti-salt hysteria set the pattern for today's sad mess that we call "science," where it's more about ego and maintaining the guild, than it is about the search for truth.
In 1925, Allen and Sherrill published a study claiming good results in treating hypertension with a low salt diet. To put it kindly, there was mixed success in duplicating their results, and by the 1930s, low salt was abandoned.
In the 1940s, along came Walter Kempner, who began treating malignant hypertension patients with a diet of white rice, fruit, fruit juices, and sugar. The original idea was to reduce the load on the kidneys, and given the extreme reduction in fats, protein, and salt, this was achieved. More than that, Kempner's diet shifted the sodium/potassium ratio such that patients registered an incredible 20 times as much potassium as sodium in their diet. This is fully six times as high as even the most ardent anti-salt proponents would recommend.
Kempner's patients--many of whom were obese--did lose weight, and did drop their blood pressure. Despite the glaring confounding factors of weight loss and dramatic potassium increase, Kempner insisted that all his good results were due solely to sodium reduction. Yet, his diet gained fame and plenty of adherents, including present day physicians who absurdly believe that a high-carb diet is the best way to treat type 2 diabetes.
As would be revealed in a lawsuit finally settled in 1998, Kempner whipped the bare buttocks of one of his patients for violating the diet, and was also said to have kept her as a sex slave. Nonetheless, Duke University would stand by their man: "Dr. Kempner was a giant who developed a whole approach to an understanding of nutrition that shaped the world's understanding of health," said John Burness, senior vice president for public affairs. "His positive impact on countless lives cannot be overestimated."
One of Kempner's true believers was Lewis Dahl, who "proved" the salt/hypertension link in 1962 by feeding rats massive amounts of salt--the human equivalent of more than a pound of salt per day. Not surprisingly, the rats did not thrive on this diet, and some became hypertensive. I wish I were making this up.
In 1988 came the Intersalt study, which--among other things--drastically overplayed low blood pressure/low dietary salt findings involving isolated aboriginal groups, especially the Yanomami Indians of Brazil. Note that this was within a context of data from 38 countries, with the findings that the per capita daily consumption of sodium in the majority of countries ranged between 2990-4830 milligrams of sodium (current guidelines are 1500-2300 mg--based on nothing at all). The Intersalt results also indicated--in its principal findings--that there was no clear pattern between the level of salt intake and blood pressure.
Yes, the Yanomami "confirm" salt/hypertension if you disregard--again--the glaring confounding factors such as vastly different lifestyles, levels of physical activity, caloric intakes, and environmental stresses, as well as other information strongly suggesting their genetic predisposition to low blood pressure. Still, this obvious outlier fueled the fires of salt restriction, and it continues to this day, despite compelling evidence that it is truly bad medicine.
Several recent studies link lowered salt intakes to a variety of health problems, including low-birth weights and cognitive impairment in children, along with increased rate of falls and fractures among the elderly. In assisted living facilities, where all residents are given low-salt diets, the rate of falls and fractures are three times as great as in the normal home environment. But wait, there's more.
Low salt diets have been implicated in insulin resistance, congestive heart failure, iodine deficiency diseases, and an increase in all-cause morbidity and mortality.
I'll leave you with this: The widely touted super-healthy Mediterranean diet averages 4200 mg of sodium per day. Consider that a standard hospital saline IV drip, which supplies an average of three liters of 0.9 percent sodium chloride per day is equivalent to more than 10,000 milligrams of sodium per day, and this doesn't include any dietary sodium. Yet, the patient's blood pressure is routinely checked every four to six hours, and does not change.
That's right. You can disprove this anti-salt nonsense any day in any hospital in the world. One more health meme that refuses to die, even though it might kill you.
Michael D. Shaw
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