1. If you had a bumper sticker of your philosophy—a short message or mantra for the world regarding salt—what would it say?
Eat real food, and salt to taste!
2. When it comes to salt consumption, what is the big dilemma we are facing: Are Americans typically getting too much salt, too much “bad” salt from processed foods, or not enough “good” (mineral-filled) salt at all (or all of the above!)?
The biggest dilemma is that people are being forced to consciously restrict their salt intake and needless suffering is occurring because of this. Salt is an essential micronutrient. Our bodies not only control our salt intake but make adjustments for us. Another issue is that so many medications, disease states, and lifestyle choices cause us to need more salt, and if we would only listen to our internal salt hunger, we could start thriving again.
3. When people eat a lot of processed foods and fast foods, is the salt one of the main problems causing ill health, and if so, why?
The reason why salt is demonized is because it tracks with processed foods. Salt itself is not harmful; it’s all the other ingredients (refined sugar, artificial sweeteners, flour, flavoring agents, colorants, mercury, etc.) that are bad for our health. In fact, because our body drives us to consume around 8 to 10 grams of salt each day, if processed foods are lower in salt we will likely end up eating more of them to get the salt our body craves. In other words, the unintended consequences of low-salt versions of processed foods (other than an increase in food-borne illnesses) is an increase in the risk of insulin resistance, diabetes, obesity, and overall cardiometabolic disease.
4. What shady secrets about the processing behind “regular” table salt (and the salt used in processed foods) can you share to help wake us up to its negative effects?
I think first and foremost we are better off consuming regular table salt than no salt at all, especially iodized salt, which gives us three essential minerals (iodine, sodium, and chloride). Regular table salt is processed, it does contain anticaking agents, it is bleached white, it does lack the other minerals contained in unprocessed natural salt, and it is treated at high heat. That being said, there are certain natural salts that I recommend in my book, The Salt Fix, as well as a guide for how to dose yourself with salt prior to and during exercise to achieve optimal performance.
5. When people have been told to cut down on salt and they comply, but go too far, what can result and how does this present in a patient?
The most obvious symptoms of over-restricting salt intake are orthostatic hypotension, cold extremities, fatigue, decreased exercise performance, erectile dysfunction, sleep disturbances, and cognitive issues. The less obvious symptoms include an increase in the artery-stiffening hormones (e.g., renin, angiotensin II, aldosterone), an increase in heart rate–stimulating hormones (e.g., adrenaline and noradrenaline), an increase in the fat-storing hormone insulin, and a reduction in the insulin-sensitizing adipokine adiponectin. The latter two consequences can lead to an increase in fat accumulation. In other words, low-salt diets may promote obesity.
6. Is it possible to overdo “good salt” as we cook and eat a whole-foods diet daily, or does our palate tend to keep us safely in the balanced zone?
In the long run, your brain controls your overall salt intake, so you shouldn’t have to consciously think about how much salt you are adding to your food. Eat real food, salt to taste, and you should do just fine.
7. Once I have some better salt in my cabinet, can it serve me in other medicinal ways beyond just daily eating (i.e., it is a humble healer for various ailments?)?
Yes. In fact, in my book, The Salt Fix, I have over 40 pages dedicated to who needs more salt and how you can discover whether you are lacking in this essential mineral.
Dr. James J. DiNicolantonio, PharmD is a Cardiovascular Research Scientist at Saint Luke’s Mid America Heart Institute.
Dr. DiNicolantonio graduated from the University at Buffalo School of Pharmacy in 2010 with his Doctor of Pharmacy. He is a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute, Kansas City, Missouri. Dr. DiNicolantonio’s research interests focus on nutrition and cardiovascular health. He is the author or co-author of over 200 publications in the medical literature. Dr. DiNicolantonio also serves as the Associate Editor of British Medical Journal’s (BMJ) Open Heart, which is published in partnership with the British Cardiovascular Society.
To learn more about Dr. DiNicolantonio click on the below links: