As it turns out, in my own neck of the woods there is a small woo-factory. I came upon it when I saw an internet add extolling the virtues of salt, as long as it’s expensive salt. The author of the article turns out to be a doctor in my very metropolitan area. There is so much woo here that it may take a few posts to get through it all.
The article is called “Salt Your Way to Health” and is featured on the website for a company that just happens to sell, well, fancy salt. There is a bit of a cage match going on with my internal writer and internal scientist. To properly deconstruct and critique this article would create an unreadably long post. So please indulge me with a little patience as I toe the lines of readability and de-wooification.
Salt and Hypertension
Before firing up the de-wooificator I’m going to have to tell you a little bit about salt and hypertension. Sodium chloride (salt) is essential to human life. Salt is the primary extracellular electrolyte in the body, and we can’t live without it. Common American table salt also contains trace amounts of added iodine to prevent goiters. That being said, consuming too much salt has health consequences. First, in people with congestive heart failure, too much can make it difficult to breath, and even kill.
When it comes to hypertension, salt consumption has been studied extensively. Most of this information is available for free and is summarized in the JNC VII Report on hypertension, a summary of which can be found here. High blood pressure kills and disables millions of Americans every year, mostly via strokes and heart attacks. It has no symptoms, but is easily treated. It is one of the best-studied human medical problems. Lowering blood pressure has been shown to lower the risks of stroke, heart attack, and other hypertensive-related diseases.
Prevention is usually preferred when appropriate. If we identify patients with pre-hypertension, lifestyle modification can go a long way to preventing or delaying the need for medication. Excellent studies have shown that salt reduction, especially in combination with the DASH diet, can significantly lower blood pressure (N Engl J Med, Vol. 344, No. 1 ยท January 4, 2001). (The DASH diet is not specifically low-sodium, but emphasizes fresh fruits, low refined carbohydrates, etc.). Some people with hypertension are more sensitive to salt than others, and African Americans in general benefit more from salt reduction than other ethnic groups.
Weight loss also helps lower blood pressure significantly in people who are overweight. Eliminating certain medications, such as NSAIDS (motrin, naproxen, aleve, etc.) and decongestants can help lower blood pressure. Most of these preventative measures eventually fail, perhaps due to an aging cardiovascular system, an inability to lose weight and exercise, genetic predispositions, or other factors.
Unfortunately for the “holistic” folks out there, research has shown that most hypertensive patients will require at least two medications to sufficiently lower blood pressure. Thankfully, most of these medicines are relatively cheap and safe (for instance, hydrochlorothiazide and lisinopril, two very effective medications, are each available from Target and Wal-Mart for $4, or in a combined pill for $4.)
So, we know a lot about hypertension and its connection to salt consumption–it’s an important connection, more so for some patients than others.
So why would a doctor promote salt purchase and use?
