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Low-Salt Diets and Hypertension

In the realm of dietary discussions, salt often raises the spectre of hypertension. However, the sodium story transcends blood pressure, revealing its multifaceted role in physiological processes. Sodium, an indispensable mineral, necessitates dietary intake due to our inability to synthesize it endogenously. Beyond its impact on blood pressure, sodium orchestrates a symphony of functions in the body. This blog delves into the intricacies of sodium's significance, explores the perils of low-sodium diets, and elucidates how optimising mineral intake could revolutionise health outcomes.



Sodium is essential


We all know that when someone utters the word "salt," blood pressure concerns start floating in the air like storm clouds. But let's start by clearing the air on sodium, the real MVP of minerals! Sodium isn't just any mineral; it's an "essential" one, meaning our bodies can't produce it, so we've got to ingest it through our diets. So, why is sodium so darn important?


Picture this: sodium, the master conductor, orchestrating an intricate symphony of physiological processes in your body:

  • Blood Pressure Maestro: Sodium plays a starring role in regulating blood pressure, a crucial aspect of cardiovascular health.

  • Cellular Choreographer: It's responsible for moving thyroid hormones into cells and generating action potentials, the electrical impulses that make your nerves communicate.

  • Mineral Maven: Sodium doesn't play solo; it enhances the absorption of other vital minerals, amplifying your metabolic prowess.

  • Sleep Inducer: Ever heard of vasopressin? Sodium helps release it, ensuring you get a good night's rest.

  • Mineral Unifier: Sodium fosters a harmonious mineral balance, a symphony of health.


Researchers have unearthed a fascinating trend across diverse populations: when allowed unrestricted sodium intake, people tend to settle in around 3,000 to 4,000 milligrams per day, which translates to about 7.5g to 10g of salt. This golden range, observed worldwide, seems to be the sweet spot for optimal health.


My experience with sodium


Ever tried fasting and felt your heart doing the cha-cha? Enter Josh's recommendation: increase your sodium intake. I know, sounds counterintuitive, right? But that's when the tide changed for me. Migraines? Gone. Fasting hunger? Under control. Mental clarity? Off the charts. Turns out, this unassuming mineral can be a game-changer!


Low-sodium diets and blood pressure


Let's unravel the puzzle of low-sodium diets and their link to blood pressure. It all started in the 1960s with a scientist named Lewis Dahl. His study suggested that low-sodium diets were associated with lower blood pressure and subsequently a reduced cardiovascular burden. But subsequent research adds a twist to this tale.


The INTERSALT study, involving 52 diverse populations, questioned the universality of the low-sodium hypothesis. Shockingly, only 5 of the 55 populations that consumed <2.4g of sodium displayed lower systolic blood pressure. Cardiovascular risk is a dance between heart rate and blood pressure, making the low-salt narrative more complex.


The effects of low sodium diets


Busting myths time! LOW-sodium diets might not be all they're cracked up to be:

  • Stress Hormone Spike: Low-sodium equals a surge in stress hormones like adrenaline, noradrenaline and cortisol.

  • Aldosterone & Angiotensin II Play: These artery-stiffening hormones are upregulated on low-sodium diets.

  • Heart Rate: Heart rate, for the most part, is increased on a low-sodium diet.

  • Insulin Resistance Parallel: Surprisingly, low-sodium diets mimic insulin resistance triggered by high sugar intake.

  • Fasting & Sodium Woes: Fasting and ketogenic diets can disrupt sodium conservation, leading to imbalances.

  • Exercise & Sodium Drain: Both exercise and caffeine intake contribute to sodium loss.


What could be causing hypertension?


Potentially around 50% of these people could have their high blood pressure fixed by increasing your salt intake. Here are the potential 3 main players in the hypertension story:

  1. High Aldosterone levels lead to increased angiotensin II – artery stiffening hormone.

  2. High insulin resistance

  3. High cortisol levels.

Low-salt is just as bad for raising your insulin levels as high sugar.

Low-salt and fasting


If you start consuming a diet from wholefoods, you are going to probably be losing salt from your diet. Being on a keto diet or fasting means that your body cannot conserve salt during a fast, your insulin levels drop during a fast and remains low. Insulin helps us to RETAIN SODIUM. This is why you cannot conserve salt when fasting or when you are on a ketogenic diet as you do not have that rise in insulin after a meal that helps to retain electrolytes.

Other things that cause you to lose salt:

  • Caffeine: 4 cups = 1/2 a tea spoon of salt. Your kidneys cannot adapt to the caffeine and spill sodium.

  • Exercise: 1hr on of strenuous exercise can cause of loss of 1,200mg of sodium (3 grams of salt)



How much salt do youlose when fasting?

  • You lose 2g of sodium (5g of salt) a day for the first 7 days

  • You still lose around 1.5g (3.75g of salt) of sodium A DAY thereafter.


Therefore, most people require around 2g of sodium per day to prevent this loss in the urine every day. You may need to add this to your ‘normal sodium’ intake to prevent brain fog, dizzy spells, palpitations, hunger cravings, thirst etc.

Sodium through time

Historically, our diets contained 2 to 10 times more salt than today diet, due to nose to tail animal consumption (blood, organs), brackish water intake, and salt-preserved foods. And guess what? Populations with high salt intake, like in France, South Korea, and Japan, boast lower cardiovascular risks. Talk about turning the tables!

Sodium & blood sugar

Hold on to your hats: low-sodium diets can mimic high-sugar diets in terms of perturbing blood sugar levels. Yes, it's that intricate! This connection underscores sodium's role in regulating blood sugar and maintaining harmony in our bodies.

Low-sodium & addiction

There are centres in the brain for both sugar and salt along with tastes receptors on our palate. These pathways are also linked to reward as they both have a hedonic effect when consumed. The scary fact of consuming a low-salt diet in the presence of sugar, is that the addictive response is increased. You get a dopamine surge that tricks your body into a sense of euphoria and energy after consuming sugar! In animal studies, they have shown that a low-salt diet + cocaine leads to an increase in addictive response to the cocaine.

Kidneys and salt

Moderate amounts of salt should not increase blood pressure for a prolonged time as your kidneys process 150 times the daily recommended UK salt allowance each day! Within 75 minutes of ingesting salt, your body would have normalised the fluid balance and any osmotic changes. So, a sustained state of high blood pressure is not ancestrally consistent response to the ingestion of salt. Remember we evolved from the sea, and therefore your blood contains 3.2 grams of sodium per litre of blood - that is a total of around 40 grams of salt in your body!

SGLT2: The unveiled connection

Enter SGLT2, the unsung hero in our tale. This transport protein is a key player in glucose and sodium regulation in the kidneys. But here's the kicker: low sodium intake triggers the release of insulin, which, in turn, leads to sodium retention via SGLT2. Hyperinsulinemia, a precursor to diabetes, becomes a looming concern. Could this be the missing link?

The hydration hoax

Water, water everywhere, but not a drop to drink... without sodium! Too much water without an adequate balance of sodium can dilute your blood sodium levels and lead to sodium depletion. That's where your salt thermostat comes into play, keeping tabs on your sodium needs.

Naru Nutrition's mineral magic

So, what's the sweet spot for mineral intake, you ask? Here's a rundown:

  • Sodium: 3,000 to 4,000 mg daily

  • Potassium: 4,000 to 5,000 mg daily

  • Magnesium: 400 to 700 mg daily (split doses for better absorption)

  • Calcium: 1,300 mg daily


You've just embarked on a journey through the intricate landscape of sodium and its connection to your health. Low-sodium diets might not be the saviour they're touted to be, especially when it comes to blood pressure. The SGLT2 connection adds a whole new layer of complexity to the story. So, let's raise our shakers to finding that delicate balance and embracing sodium as a vital player in our health symphony!

Disclaimer


As you delve into this newfound knowledge, remember that these insights are not a substitute for personalised medical advice. Before making any significant changes to your diet, it's always wise to consult a healthcare professional. So, as you navigate the seas of sodium and minerals, consider this your compass, guiding you toward a healthier, more informed path. Stay curious and keep exploring the intricate tapestry of health and wellness!

References:

  • Sowers, James R., Adam Whaley-Connell, and Murray Epstein. "Narrative review: the emerging clinical implications of the role of aldosterone in the metabolic syndrome and resistant hypertension." Annals of internal medicine 150.11 (2009): 776-783.

  • Whaley-Connell, Adam, Megan S. Johnson, and James R. Sowers. "Aldosterone: role in the cardiometabolic syndrome and resistant hypertension." Progress in cardiovascular diseases 52.5 (2010): 401-409.

  • Horký, K. "[Aldosterone as an endogenous cardiovascular toxin and the options for its therapeutic management]." Vnitrni lekarstvi 57.12 (2011): 1012-1016.

  • Whipp, G. T., et al. "Regulation of aldosterone in the guinea-pig—effect of oestrus cycle, pregnancy and sodium status." Aust J Exp Biol Med Sci 54.1 (1976): 71-8.

  • Williams, Gordon H. et al. “Studies of the Control of Plasma Aldosterone Concentration in Normal Man: III. RESPONSE TO SODIUM CHLORIDE INFUSION.” Journal of Clinical Investigation 51.10 (1972): 2645–2652. Print.

  • Mrnka, L., et al. "Low-salt diet alters the phospholipid composition of rat colonocytes." Physiological research/Academia Scientiarum Bohemoslovaca 49.2 (1999): 197-205.

  • Catanozi, Sérgio, et al. "Dietary sodium chloride restriction enhances aortic wall lipid storage and raises plasma lipid concentration in LDL receptor knockout mice." Journal of lipid research 44.4 (2003): 727-732.

  • Alderman, Michael H., Hillel Cohen, and Shantha Madhavan. "Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I)." The Lancet 351.9105 (1998): 781-785.

  • Cohen, Hillel W., et al. "Sodium intake and mortality in the NHANES II follow-up study." The American journal of medicine 119.3 (2006): 275-e7.

  • DiNicolantonio, James J., et al. "Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis." Heart (2012): heartjnl-2012.

  • Sharma, Arya M., et al. "Effect of dietary salt restriction on urinary serotonin and 5-hydroxyindoleacetic acid excretion in man." Journal of hypertension 11.12 (1993): 1381-1386. GOUGEON, RÉJEANNE, et al.

  • "Effects of Sodium Supplementation during Energy Restriction on Plasma Norepinephrine Levels in Obese Women*." The Journal of Clinical Endocrinology & Metabolism 73.5 (1991): 975-981.

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