The negative health effects of too much salt

According to Canadian food writer Naomi Duguid, salt is "as familiar as water and the air we breathe" and "just as essential to us." However, Wilson also notes that "it's impossible to deny that eating less salt really would improve the health of millions of people[.]"

Currently, the average American consumes a teaspoon and a half of salt a day, higher than the World Health Organization's (WHO) recommended limit of five grams or one teaspoon. Much of this salt comes from processed foods, such as deli meat.

Processed meats, which include sliced ham, bacon, and sausage, are often loaded with sodium during the curing, smoking, or preservation process, with one study finding that processed meats have around 400% more sodium than unprocessed meat.

This excess sodium can increase blood pressure, which then increases the risk of heart attack and stroke. In a 2010 review of research published in Circulation, scientists found that each serving of processed meat a day is associated with a 42% higher risk of heart disease and a 19% higher risk of diabetes. These findings have also been supported by more recent research.

The benefits of reducing your salt intake

According to Wilson, hypertension now contributes to more deaths every year than tobacco, suggesting that efforts to lower salt intake are necessary to reduce this potential mortality risk.

"We know that reducing salt works," said Sonia Pombo, a public health nutritionist and the lead campaigner for the U.K charity Action on Salt.

For example, British food companies voluntarily reduced the salt in their products without announcing the change to consumers between 2003 and 2011. Over that time, the reduction in salt was associated with a 42% decrease in deaths from strokes.

"The reason it worked so well is that in the U.K., as in the U.S., the vast majority of the sodium people consume comes in the form of processed food or food consumed away from home," Wilson wrote. "Much of this salt is so well hidden that we are not even aware we're consuming it."

However, it's also important to reduce the salt intake in your home cooking. In the 1950s, Japan had some of the highest stroke mortality rates in the world and similarly high salt consumptions, mostly from traditional cooking ingredients such as miso and soy sauce.

Then, the Japanese government began a campaign to reduce people's salt intake. By the 1960s, the campaign had successfully reduced Japan's average salt intake from 18 grams a day to 12.1 grams a day. Meanwhile, deaths from strokes dropped by 80%, and both children and adults saw a decrease in blood pressure.

Reducing salt intake even further could also lead to greater reductions in health risks. According to the New England Journal of Medicine, 1.65 million deaths could be averted worldwide every year if salt consumption was reduced to WHO's five-gram limit.

How to counteract your salt intake

"Eating less sodium would make most people healthier," Wilson writes. But "the trick is finding ways to reduce your intake without sacrificing deliciousness." Two potential ways to do this include:  

1. Adding more potassium to your diet

"The ratio between potassium and sodium in our diets plays a crucial role in regulating blood pressure," Wilson writes.

According to a 2018 study of more than 400 Americans, eating a diet rich in foods that are high in potassium, such as fruits, vegetables, and low-fat dairy, helped lower blood pressure, even if the diet itself was relatively high in sodium.

Some potassium-rich foods include sweet potatoes, spinach, black beans, yogurt, and bananas. There is also a salt from Madagascar called siratany that is much higher in potassium than regular salt. People in Madagascar consider it a "healthy salt" for individuals with high blood pressure.  

2. Working to develop a less salty palate

According to Wilson, the late food writer Laurie Colwin found that after she went on a salt-free diet for health reasons, she began to appreciate the flavors of food more readily without salt.

To get your palate used to less salty tastes, Wilson recommends replacing some of the required salt in a recipe with a bit of lemon or vinegar. "I never thought I would say this, but sometimes food tastes brighter and fresher with less salt rather than more," she writes. (Wilson, Wall Street Journal, 6/22)

The  American Heart Association (AHA)  rated  10 types of popular diets based on how well they align with AHA's dietary guidance, with the Dietary Approaches to Stop Hypertension (DASH) diet receiving a perfect score.