Dr. Mark Hyman breaks down the truth about salt intake
Katie Couric: Let’s start with the basics. We all know what salt is — but can you break it down for us further? What are the different types of salt?
Dr. Mark Hyman: When we think of salt, we are most commonly thinking about the salt we use on our food, which is primarily comprised of sodium chloride (NaCl). In reality, there are many types of salts. Today, we’re just going to talk about the salt we eat.
Salt is an extremely important part of history. It’s prominent in the Bible. It’s the root of the word “salary” and the origin of the saying that something is “not worth its weight in salt.” Once, it was a rare, highly prized substance. Today it’s everywhere, and it comes in different forms. My personal favorite is Himalayan pink salt. Aside from differences in taste and texture, table salt is typically heavily processed — which eliminates naturally occurring beneficial minerals. Sea salt has been shown to contain higher amounts of trace minerals than refined table salt, such as calcium, potassium, magnesium, zinc, and iron.
You might have also noticed that most table salt is iodized. This was a result of the iodine-poor diets that were causing goiters in the 1920s. But if you’re eating a diet that consists of real, whole foods, you don’t need iodized salt and you can get your iodine from foods like fish and seaweed. Also, most iodized salt contains additives and hidden sugars. Yuck! My advice when it comes to salt is stick to sea salt and avoid refined salt.
What effect does salt have on our bodies?
Salt, like fat, is quite complicated. It’s not like sugar. Sugar is sugar is sugar — and with a few exceptions, all sugars have the same effects on our bodies. But when it comes to salt, the type of salt we eat matters, and salt has different effects depending on the person.
Salt, or sodium, as we all know, has been linked to hypertension, the precursor of death due to heart disease and stroke, but only in a subset of people who are genetically salt-sensitive. Sodium is important for overall health, but our sodium levels needs to be in proportion to our levels of other important minerals — mainly potassium. When the ratio of sodium to potassium in our bodies is high (more sodium than potassium), high blood pressure follows. So, we need optimal amounts of both to stay healthy. The best source of potassium is whole, unprocessed, plant-based foods like cooked spinach, broccoli, squash, avocados, papayas, and bananas.
If you’re diagnosed with high blood pressure and hypertension, you’ll be instructed to eliminate sodium from your diet as much as possible. But this isn’t always great advice. In fact, patients with heart failure who ate a salt-restricted diet were 85 percent more likely to die or be hospitalized than patients who didn’t limit their salt intake. There are some people with high blood pressure who are salt-sensitive. But even then, the research doesn’t show much benefit to restricting salt.
Instead of focusing completely on salt reduction to reduce blood pressure and risk of strokes and heart attacks, I recommend addressing sugar and processed food intake first. We also need to look at overall inflammation, which is the root of most chronic diseases including heart disease. Eating a diet high in processed junk foods, eating out every single day, and over consuming refined sugars can contribute to inflammation. Just reducing salt is not the solution. We have to look at the whole picture. In fact, salt is needed to hydrate your cells and is an important part of staying properly hydrated — which is why I often use electrolytes added to my water.
It’s so common to add salt to dishes — both at home or when eating out. So… for someone who doesn’t have any immediate health issues to consider, how much salt is too much salt to add?
It’s not the salt that we add to foods at home that’s the problem; it’s the salt that food corporations add to their processed foods to make it edible. We should all avoid refined table salt and processed foods with high amounts of sodium. When you’re cooking at home with a little bit of sea salt, this shouldn’t be a problem.
If you’re dealing with high blood pressure or have a higher risk of heart attack or stroke, focus on reducing systemic inflammation. This is not just a salt issue. This means reducing and removing refined sugars and processed carbohydrates and eating a diet that is plant rich with some healthy fats and proteins.
Putting my patients on a low starch and sugar diet with good fats often significantly reduces their blood pressure. Try to cook at home as much as possible with a little bit of sea salt. Work with a practitioner to keep track of your markers to see how dietary changes are impacting your health.
Is there something else we could add for flavor instead of salt?
I love using spices, herbs and seasonings when I cook. Learn to use these ingredients and you can upgrade your meals! Some, like turmeric and ginger, are anti-inflammatory. Others, like oregano, are antibacterial and antifungal. And many are loaded with phytonutrients, which help our bodies naturally detoxify from everyday toxins.
I recommend keeping a range of pantry ingredients, including seasonings and spices, on hand: turmeric, cayenne pepper, thyme, rosemary, chili powder, cumin, sage, oregano, onion powder, cinnamon, coriander, cilantro, paprika, and parsley. Because you only use a little of these, they tend to last a long time, so you get a lot of value from them. Buy organic when you can and read all of the labels to ensure the products don’t contain hidden sugar, gluten or other problematic additives.
If you use all these amazing, potent spices and herbs you really won’t need to add much salt to make your meals taste great. Eating food that is good for you is not about feeling deprived. If you choose the right foods and the right recipes, you can reap the benefits of a healthy lifestyle without feeling deprived.
As an expert, what is your personal approach to salt?
I prefer Himalayan pink salt, as well as kosher and sea salt in moderation. We can safely add these to our food, as long as our diet is also rich in potassium. Also, if you add salt to your dishes after you’ve finished cooking them, flavor-wise you’ll get more bang for your buck.
Now, none of this means you can eat as much salty food as you want. You absolutely can be harmed by too much sodium. Although we have an unfairly negative view of salt as bad, emerging science has dis-proven the “salt is bad for you” mantra. The highly refined salt that food manufacturers add to processed and packaged foods is killing us. Again, it is not the salt you add to your food, but the salt added by food corporations.
I try to stay away from processed table salt and processed foods with bad fats, excess salt, and sugar. I cook at home as much as possible or choose restaurants that use sea salt and fresh ingredients. Again, we can’t just focus on one ingredient, we have to look our overall dietary habits. When we choose fresh, whole, real food, we are making the best choice for our health.
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