503 Salt and Potassium

Stay Healthy Naturally May 20, 2020

In a recent newsletter Dr. Michael Murray (doctormurray.com) wrote about the importance of the potassium to sodium ratio in our diets. Our daily requirements of these two essential minerals are 2,300mg sodium and 4,700mg of potassium. A typical American diet contains 2,500 to 7,500 mg of sodium (up to 3X too high) and only 2,500 mg potassium (about half of what’s needed). I wrote about sodium back in 2013 #222 Salt - how much is too little?]

One way to counter this imbalance is in the salt we use. Most salts - including many of the fancy health food salts like Celtic gray salt or Himalayan pink salt - are mostly sodium with only a trace of potassium. A few salts are formulated to have equal or even higher potassium, and taste just fine. By the way, the pink color in Himalayan salt (and in potash mined in Saskatchewan) comes from iron oxide (rust) not the potassium.

Here is a table showing the amounts of these key minerals in a variety of salts.

Salt Sodium (mg/g) Potassium (mg/g)
Refined Table Salt 391 0.9
Redmond Real Salt 378 1.0
Celtic Gray Sea Salt 338 1.6
Himalayan Pink Salt 382 3.5
Ideal Protein Salt 192 254

The miniscule amounts of other minerals, including iodine [see #282 Iodized Salt], in the unrefined salts are not significant for your health. Salt mined from ancient deposits are more likely to be free of pollutants. True sea salts, like Celtic Gray salt, are made by evaporating ocean brine and may also contain micro-plastics.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner. Find this article on my website for links to sources and further reading.

413 Kidney Stones [27 March 2017]

Kidney stones is a painful condition when crystals, usually calcium oxalate but also uric acid and other types, form in the kidneys. Small stones pass through without problems but larger ones can lodge in the urinary tract and block the flow of urine causing severe pain.

About 1 in 10 Canadians experience kidney stones at some time. Men are much more likely than women to develop kidney stones.

There is much you can do to prevent the formation of kidney stones:
• Drink 2-3 litres of water throughout the day to keep urine pale yellow
• Avoid soda pop as the phosphoric acid promotes stone formation
• Limit consumption of sugar, especially fructose
• Limit protein to 1g / 2 lbs lean body weight
• Limit red meat which lowers your citrate level
• Avoid or limit high oxalate content foods: beets, rhubarb, spinach, Swiss chard, sweet potatoes
• Avoid excess sodium
• Take extra magnesium, at least 1:1 with calcium
• Eat calcium-rich foods but go easy on calcium supplements – calcium in foods binds oxalates in the intestine preventing their absorption
• Maintain a healthy weight – obesity is a risk factor for kidney stones
• Exercise reduces risk of kidney stones

Stones that are too large to pass comfortably on their own require medical attention. Sound waves can be used to break up larger stones or surgery may be required. Potassium citrate is sometimes given to alkalize the urine and dissolve calcium oxalate stones but has some unpleasant side effects. Recent research using hydroxycitrate, an extract from the tamarind fruit (Garcinia cambogia) is showing promise of being a more effective and safer alternative.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

222 Salt – how much is too little? [24 June 2013]

The Canadian Heart & Stroke Foundation’s DASH diet for lowering high blood pressure recommends no more than 2,300 mg of sodium per day. But some organizations like the American Heart Association are pushing for as little as 1,500 mg (half a teaspoon) per day. A recent report questions the benefits and safety of this lower amount.

The report, titled “Sodium Intake in Populations: Assessment of Evidence” by an expert group of the Institute of Medicine for the Centers for Disease Control and Prevention, was published in May 2013. The group looked at new evidence that had been published since the last report in 2005. The new data showed no health benefit in restricting sodium below 2,300 and indications of possible harm. The “possible harm” included increased rate of heart attacks and risk of death. It looks like the Canadians, with their more conservative recommendation, got it right this time.

Previous predictions on benefits of sodium reduction (like the prevention of 14,500 heart attacks each year in Canada that I quoted in my column #022 July 27, 2009) are based solely on salt’s effect on blood pressure. Actual studies of health outcomes found that groups with the lowest salt intake often had worse health outcomes, including higher death rates. Obviously salt plays many important roles other than affecting one’s blood pressure.

Over-restricting salt in seniors is especially dangerous because symptoms of hyponatraemia (low sodium levels) are commonly associated with aging – fatigue, confusion and poor balance – and can easily be overlooked.

Potassium in balance with sodium is more important than just sodium levels – see my columns #129 and #211 for more on potassium.

Hyperinsulinism (high insulin levels) is the underlying cause of metabolic syndrome which includes high blood pressure. See my column #084 Insulin and Blood Pressure (03 Oct 2010). The insulin causes the body to retain sodium and excrete potassium. Normalizing insulin not only prevents type 2 diabetes but also reverses high blood pressure with normal salt consumption.

Additional points not mentioned in the Eagle ad article:

Salt is a nutrient and is essential for life so can't be completely eliminated. There are however sources of sodium other than salt that are not essential (and likely harmful) so should be avoided: sodium benzoate, sodium nitrate, and MSG.

80% of sodium in the typical American diet comes from processed foods; 10% from natural foods; and only 10% added at the table. The best way to reduce sodium would appear to be to reduce processed foods.

Iodine is added to commercial table salt which is believed responsible for the lower rates of hypothyroidism in North America. There is some concern that reducing salt, or switching to the marginally more nutritious sea salts, could lead to more iodine deficiencies. Probably true but it need not be the case. There are other sources of iodine supplementation readily available, either as a liquid supplement or some form of kelp supplement.

To recap, the only benefit to reducing salt is to lower blood pressure. Levels below 2,300 mg have no blood pressure lowering effect. Levels lower than 2,300 can be detrimental to our health.

Sources:
IOM Report
New York Times article and opinion piece
Health Sciences Institute articles 1 and 2
Canadian Heart & Stroke Foundation – DASH diet

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

211 Potassium [8 April 2013]

Potassium is one of a special group of minerals called electrolytes which includes calcium, magnesium, sodium and phosphorous. Electrolytes occur in the blood in an ionic form, meaning they carry an electric charge and are not attached to anything. Electrolytes affect the acidity of the blood (pH), the amount of water in the blood (and therefore blood pressure), and muscle function (including the heart). Potassium is essential for bone growth, proper nerve transmission, heart and kidney function, and adrenal function.

The role of potassium in regulating blood pressure is often overlooked. Potassium deficiency is at least as important, and possibly more so, than excess sodium (see my column #129 Salt in Balance, 29 August 2011). Other signs of potassium deficiency include:
• water retention
• muscle weakness and cramps
• heart arrhythmia
• constipation

Our diets are often deficient in potassium. The Paleolithic diet was estimated to contain 11,000 mg potassium and 700 mg sodium. Compare that with our modern diet with 2,500 mg potassium and over 4,000 mg sodium. (Not that the Paleolithic diet ratio was necessarily ideal; the point here is that the ratio has flipped). The Health Canada “Adequate Intake” amount for potassium is 4,700 mg for adults.

Good dietary sources of potassium include vegetables like lima beans, squash, spinach, broccoli, sweet potatoes, avocados and asparagus, and fruits including papaya, prunes, cantaloupe and bananas. Don’t overdo the bananas, though, as they are high in sugar and have only half the potassium of the green vegetables. Unrefined sea salts with a pink color are another source of potassium. Potassium is also available as a supplement, usually in citrate form.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

Sources

Mercola: The Guilty Pleasure that Could Save you From Heart Disease, 5 March 2012

"Paleolithic Nutrition – A Consideration of Its Nature and Current Implications", New England Journal of Medicine, January 31, 1985: 312; 283-289, S. Boyd Eaton, M.D. and Melvin Konner, Ph.D.

129 Salt in Balance [29 August 2011]

I wrote about the health benefits of reducing salt in my July 27 2009 column #022. It now appears that reducing sodium is only half the equation – increasing potassium is just as important. The Centers for Disease Control and Prevention (CDCP) studied more than 12,000 adults for 15 years and found that those with the highest sodium and lowest potassium intakes had the highest risk of dying from cardiovascular disease. Those with the lowest risk had the lowest ratio of sodium to potassium intake, nearly equal amounts of each. Source: Archives of Internal Medicine July 11 discussed in a Los Angeles Times article by Jill Adams.

Sodium, of course, is an essential nutrient – we can’t live without it – and the emphasis on cutting salt is leading to more cases of sodium deficiency. This condition, called hyponatraemia, is more common in the elderly and is often misdiagnosed. A Rosetown octogenarian friend began having strange symptoms a few years ago and was diagnosed with hyponatraemia. His doctor prescribed potato chips (I can think of healthier sources of salt), and he quickly recovered.

Dr. David McCarron, a nutritionist and professor at U of California, recently wrote in the Financial Post that the recommendation to restrict salt for heart health is based solely on opinion – there is no reliable evidence supporting it. First, he writes, “…only a minority of individuals’ blood pressure is sensitive to salt.” Secondly, three different trials testing low-sodium diets on people with kidney and heart disease showed higher risk of hospitalizations, cardiovascular events, and death in the low-sodium group. McCarron called for large-scale controlled trials to test the current policy of sodium restriction for safety and effectiveness.

Meanwhile, what to do? Don’t overdo salt but don’t eliminate it completely either (if you still eat a lot of processed foods, you needn’t worry about a deficiency!). And make sure you are getting enough potassium – balance is the key to health.

This article is intended for educational purposes only; for medical advice consult your licensed health practitioner.

022 Reducing Sodium [27 July 2009]

Reducing sodium consumption is one of the easiest ways to reduce your risk of cardiovascular disease. Researchers estimate that cutting sodium consumption by 50% could prevent 14.500 cases of heart attack, stroke and congestive heart failure in Canada each year.

Health Canada recommends daily intake of 1,500 mg of sodium; the average Canadian eats more than 3,500. And it’s not the salt shaker on the kitchen table that’s the problem – 80% of our sodium intake comes from hidden salt in processed foods.

The Canadian Medical Association, the Canadian Stroke Network, and Blood Pressure Canada are urging Canadian food industries to cut sodium by at least 1/3 to as much as 2/3 by 2020. As a consumer you can add pressure on the food industry by the choices you make. And don’t wait 11 years to cut back on your sodium consumption.

Here are three strategies you can implement now to reduce sodium in your diet:

1. Eat more unprocessed foods. When you eat it raw or cook it yourself you can control the amount of salt. Replace the salt shaker on your table with a flavorful low-sodium vegetable seasoning.
2. In the grocery store, read labels and choose items with the lowest sodium content. This can vary as much as 10 times for the same food. Every purchase of a low sodium item sends a message to the food manufacturers who will respond with more low sodium selections.
3. In restaurants, soup is one of the main sodium culprits.  Choose a salad instead; and ask for oil & vinegar dressing (prepared dressings can be high in sodium). If you do try the soup and it tastes salty, tell your server you won’t eat it and why. If enough people send this message back to the cooks they will eventually cut back on the salt ladle.

Seniors may have the greatest challenge to cut back on salt. We [I’m 55 today – does that qualify?] were more likely raised with a liberal salt shaker, and as we age our taste buds don’t work as well. Adding more salt is one way to make food tastier; a better way is with healthy spices. I enjoy adding ginger and chili pepper to my soup and casseroles.

This article is intended for educational purposes only; for medical advice consult your licensed health practitioner.