A sodium-balanced diet is well worth its salt, say experts

The much-maligned condiment may not be as bad as it’s made out to be

Perfectly spicing the fish. Rzeszow, Poland. Getty Images
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For thousands of years, salt – originally sourced from the mineral remains of lakes and seas, and more recently chemically composed from sodium and chloride – has been a main fixture in our diets. The Romans coined the word "salary" from the Latin word "sal", for salt, because a soldier's salary was the amount he was allotted to buy the seasoning. In an ode to salt written in 1912, psychoanalyst Ernest Jones explored the human obsession with salt – apparently, Plato described it as "dear to the Gods", and Homer called it "divine".

Once an expensive commodity owing to its preservative properties, useful before refrigeration, a good sprinkle of the white stuff was well sought after. But with rising levels of diabetes and heart disease, should salt even be relevant to our diets any more? According to recent findings from the Salt Institute, the answer, surprisingly, is a resounding yes. The institute in Naples, which is helping to develop the Dietary Guidelines for 2020-2025, is countering the widespread belief that sodium is detrimental to health, with a recent report stating that we're actually consuming less salt than is good for us.

The importance of salt in your body

"[We are] constantly losing salt through bodily functions," says Mark Kurlansky in his book Salt: A World History. The salt we consume is responsible for transporting nutrients and oxygen around the body, transmitting nerve impulses and moving muscles. So it's vital to our functioning, and because we can't produce it ourselves, we must consume it.

"The 2015-2020 Dietary Guidelines recommend that Americans consume fewer than 2,300 milligrams of sodium per day – and at-risk populations less than 1,500mg," says Jorge Amselle, director of communications at the Salt Institute. The organisation is countering these recommendations with evidence that indicates "there is a healthy 'range' of salt consumption that results in a lower risk". This range is between 2,800mg and 5,000mg of sodium a day – higher than previous recommendations of 2,300mg a day and the world average consumption of 3,600mg a day.

One study found that low-­sodium and high-sodium intakes are associated with increased mortality. Those who lose more salt (mostly through sweat) need to replace it. Could it be that the most health-conscious among us, those exercising and taking care to follow often-misplaced warnings about sodium in their diets, are actually putting themselves at risk? Dubai resident Emma Schlegel may have just the right approach. “If I feel tired and exhausted, adding extra salt to food usually perks me right up,” she says. “Lots of people forget that sodium is essential, especially in this climate where we sweat a lot, or if you’re a fitness junkie.”

The power of salt

James DiNicolantonio, pharmacist, cardiovascular research scientist and author of The Salt Fix, is a firm believer in salt's powerful properties. "I had patients coming to me years ago in the pharmacy with symptoms such as dizziness, muscle cramps and spasms," he says of his initial interest in sodium. "They were tested for low sodium levels in the blood, and many were found to be dehydrated. All their symptoms went away once the doctor told them to start adding salt back into their diet and/or reducing diuretics that they had been put on for high blood pressure."

The list of risks linked with low-sodium intake that DiNicolantonio warns of is extensive – dizziness, fatigue, sleep disturbances, muscle spasms and cramps, arrhythmia (abnormal heart rhythm), insulin resistance, increases in blood pressure and heart rate, worsening of kidney function and acute kidney failure, increases in uric acid, potential cognitive decline, worsening gait and falls (leading to) fractures.

If that weren’t enough, “low-­sodium diets can lead to negative magnesium and calcium balance, most likely through increased magnesium and calcium being pulled from bone and lost in sweat to preserve the loss of sodium,” DiNicolantonio says.

Is some salt better than others?

Then there’s the question of which types of salts are good for us. “All food-grade salt is the same, and there is no health difference. However, many individuals – especially expectant mothers – suffer from iodine deficiency,” says Amselle, suggesting that humble table salt fortified with iodine might be considered healthier for this reason. Research has found that iodine is crucial to brain development in the early gestation period.

Vegan food writer Jai Breitnauer swears by black salt. "It's an essential ingredient for a lot of vegan dishes because its sulphury taste mimics an egg flavour." Meanwhile, Suzane de Jesus, who lives in Dubai, brings flower salt [a variety harvested naturally from the sea, which forms as a delicate crust on the surface of the water as it evaporates] back from her native Portugal. "I use only Baesurisal flower salt because it adds a delicate flavour to food, which means the food will require little seasoning. It's known as the 'caviar of salt' for its costly, hand-cultivated production methods," she says.

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"I prefer Redmond Real salt," DiNicolantonio says. "It is cheaper and contains good amounts of natural iodine and calcium." For others, Himalayan sea salt or pink salt is the holy grail, touted for its health benefits owing to its rich mineral properties, which are often stripped away in traditional table salts. What it has in minerals, though, it lacks in iodine, and there is no evidence that it's actually beneficial to our health. The remedy may well be found in a happy medium.

When it comes down to how to ensure we’re consuming the right amount of these salts, though, the answer isn’t straightforward. The Salt Institute may have settled on a range – which works out to up to a teaspoon per day – but Amselle advises individuals to consult their doctor. According to DiNicolantonio, the amount of sodium a person needs depends on many factors. These include background medication and exercise: if you’re taking any diuretic medication, it could make you lose more salt through urine, while we lose about 1,200mg of sodium per hour of exercise. Even caffeine intake could dictate how much sodium we should be consuming. “Four cups of coffee causes about 1,200mg of sodium loss through urine,” he says.

Perhaps the solution is not to consume more salt, but rather to be better informed about it. How much sodium is in that loaf of bread or jar of pasta sauce you’re using, compared with what you’re losing through exercise and excretion daily? Seeking these answers might just be worth its salt.