Dear Alice,

What happens if we have too little or no salt?

Dear Reader,

You might’ve heard that salt has a bad name, and at high levels, it can increase the risk of cardiovascular disease, impair kidney function, and cause headaches. However, cutting salt from your diet altogether is also not a super healthy idea, as your body actually requires some to function. Inside your body, salt dissociates into two minerals — sodium and chloride — which carry electrical charges, hence the name “electrolytes.” But, the needs for these electrolytes are small. The Recommended Dietary Allowance (RDA) for sodium in a healthy adult is 2,300 mg per day (about one teaspoon of table salt), and around 1,500 mg for those with high blood pressure or at risk for high blood pressure. Yet the average American adult consumes closer to 3,400 mg, with young- and middle-aged men consuming over 4,000 mg on average. Holy sodium, Batman! Although there’s no consensus on a minimum requirement, some research has indicated that it’s probably best to stick between 1,500 and 3,000 mg per day.

So, if salt isn’t totally a “bad guy”, then what are its merits? A small amount helps your body transmit nerve impulses, keeps your blood pressure from dropping too low, and coordinates contraction and relaxation of your muscles. But a little goes a long way, and healthy bodies are quite efficient at conserving sodium. The body is able to use a hormone called aldosterone to regulate the level of sodium in the blood, and the kidneys can be signaled to start conserving sodium if levels drop too low. Typically, acute cases of dangerously low sodium (called hyponatremia) are rare and would probably only be caused by excessive loss of fluids through vomiting, diarrhea, sweating, or by drinking a large amount of water without consuming anything else. A person with hyponatremia might feel fatigue, confusion, muscle weakness, or headache, and in rare cases, seizures or coma. If you’re an athlete who sweats a lot and are worried about hyponatremia, you might consider meeting up with your health care provider to check in about your sodium levels and how much sodium and water to consume during physical activity to strike a healthy balance.

Over the long-term, consuming very low amounts of sodium chronically may actually slightly increase the risk of cardiovascular disease. Researchers believe there is a “sweet spot” of sodium intake for optimal cardiovascular health, probably somewhere around the current recommendation of 2,300 mg, and closer to 1,500 mg for those at risk for hypertension, such as middle-aged and older adults as well as African Americans. But overall, more people have to worry about the cardiovascular effects of having too much sodium — not too little.

The name of the game here is balance. Eating processed or pre-packaged foods and eating out are to two of the biggest contributors of sodium to people’s diets, making up about 80 percent of most people’s daily sodium intake. Eating lots of fresh foods and cooking at home more often can be strategies to strike a healthier balance. If, for some reason, you think you’re consuming below the recommended amount, perhaps adding just a dash or two of table salt to your meals could help you be sure you’re getting enough of those necessary electrolytes. Remember, a little goes a long way, and two-thirds to one teaspoon per day is sufficient (this includes both what’s cooked into AND what’s added on top of your food). However, unless you’ve been making a concerted effort to avoid salt altogether, most people would more than likely be getting the recommended minimum in a healthy, balanced diet. For even more ideas on hitting that sweet spot (or rather, salty spot) of sodium intake, consider reading Managing high blood pressure through diet.

Here’s to finding your balance,

Alice!

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