"Is Salt Restriction Always Healthy? Is it the Best Treatment for Hypertension?"

Sodium appears to be the only essential nutrient that actually causes craving. Sodium deprivation alters the taste response. Ever read in a recipe the phrase "Salt to taste"? We all have. Sodium is the only necessary nutrient for which this instruction makes any sense. We need at least 500 milligrams of sodium daily for life. Too little sodium is perhaps more of a problem than too much in most healthy people. Note the word "healthy" and emphasize it. Societies on the largely processed food diet are getting plenty of sodium, in fact some people believe too much sodium, but they also are getting very low intakes of both potassium and magnesium. The story of salt and hypertension is complicated, but when we consider our quite low dietary intakes of both magnesium and potassium, the puzzle nears solution. Sodium and potassium must be in balance, or at least in a ratio that is not too high on the sodium side, and magnesium must be adequate for blood pressure to be normal and healthy. All three minerals are thus important for maintaining acceptable blood pressure. To add to the complication, calcium in a healthy ratio with magnesium is also important in some cases. For a person with adequate amounts of tissue magnesium and potassium, almost no amount of salt is too much, and these people are amongst the healthiest in the society. But, even if dietary sodium and potassium are in balance, a low magnesium level can lay the groudwork for development of metabolic symdome X -- and, with it, hypertension. If magnesium status is normal and cellular magnesium balances well with cellular calcium, low potassium intake coupled with high salt intake can cause essential hypertension that is not associated with metabolic symdome X. Adapted from: "The Magnesium Factor" by Dr. Mildred S. Seelig and Andrea Rosanoff, Ph.D.

The following links to research on this subject may be of interest to your situation:

McCarron, D. A. (1997). "Role of adequate dietary calcium intake in the prevention and management of salt-sensitive hypertension." Am J Clin Nutr 65(2 Suppl): 712S-716S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9022571

Morris, C. D. (1997). "Effect of dietary sodium restriction on overall nutrient intake." Am J Clin Nutr 65(2 Suppl): 687S-691S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9022566

Note: This article might be especially interesting to those who exercise regularly and/or who produce a lot of sweat.

Nishimuta, M., N. Kodama, et al. (2005). "Positive correlation between dietary intake of sodium and balances of calcium and magnesium in young Japanese adults--low sodium intake is a risk factor for loss of calcium and magnesium." J Nutr Sci Vitaminol (Tokyo) 51(4): 265-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16261999

Alderman, M. H. and B. Lamport (1990). "Moderate sodium restriction. Do the benefits justify the hazards?" Am J Hypertens 3(6 Pt 1): 499-504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2114882

Alderman, M. H., S. Madhavan, et al. (1995). "Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men." Hypertension 25(6): 1144-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7768554

Burnell, G. M. and T. A. Foster (1972). "Psychosis with low sodium syndrome." Am J Psychiatry 128(10): 1313-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5013752

Contreras, R. J. and M. Frank (1979). "Sodium deprivation alters neural responses to gustatory stimuli." J Gen Physiol 73(5): 569-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=458420

Egan, B. M. and K. T. Stepniakowski (1997). "Adverse effects of short-term, very-low-salt diets in subjects with risk-factor clustering." Am J Clin Nutr 65(2 Suppl): 671S-677S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9022563

Esslinger, K. A. and P. J. Jones (1998). "Dietary sodium intake and mortality." Nutr Rev 56(10): 311-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9810812

Graudal, N. A., A. M. Galloe, et al. (1998). "Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis." Jama 279(17): 1383-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9582047

Hanneman, R. L. (1993). The Politics of Sodium Restriction in the United States. Seventh Symposium on Salt.

Luft, F. C. and M. H. Weinberger (1997). "Heterogeneous responses to changes in dietary salt intake: the salt-sensitivity paradigm." Am J Clin Nutr 65(2 Suppl): 612S-617S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9022556

Miller, M., J. E. Morley, et al. (1995). "Hyponatremia in a nursing home population." J Am Geriatr Soc 43(12): 1410-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7490395

Pentimone, F., L. del Corso Daniela Moruzzo, et al. (1991). "[Sodium and diseases in the aged]." Clin Ter 138(5-6): 199-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1836167

Swales, J. D. (1980). "Dietary salt and hypertension." Lancet 1(8179): 1177-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6103995