Food Politics

Just curious. Of the people you treat, what improved health outcomes do you observe when you put people on low-salt diets?

In our medical practice, the effect of excess salt in the diet is individual, but well worth evaluating.
Frequently, with salt restriction, we see reduced swelling of the feet and hands, improved control of high blood pressure, reduced amount of medication required to control the blood pressure. Improved blood pressure control may translate into reduced risks for heart attack, stroke, and congestive heart failure. For our patients with congestive heart failure, reduced salt intake means improved symptom profile with less medication required. A generalized benefit we see in patients who start reading labels to control salt intake is an improved general awareness of the ingredients and nutrients in their food choices.

Dr. Nestle-
I have taken a Macrobiotic http://en.wikipedia.org/wiki/Macrobiotic cooking class and know a lot of people who also enjoy eating beautiful, nutrient packed minimally processed food. Though the food is not very salty, I keep hearing that special sea salt (like Celtic sea salt) http://en.wikipedia.org/wiki/Sea_salt
is much better for the body and can be used much more liberally than “table salt,” iodized or not. What is your view of this?

I know many nutritionists recommend Kosher salt, but unless one is a big, big seafood eater, one should stick with iodized salt to prevent hypothyroidism as well as goiter.

And just to let people know, salt is not the only “culprit” to hypertension. Hypertension is really a symptom rather than a risk factor for heart attacks. People with hypertension are often prescribed drugs too quickly to mask out these symptoms when hypertension maybe a BIG indication for some other issues down the road, such as a kidney failure or neuron damage. If the kidney is damaged, the kidney will release renin to increase the blood pressure. If the brain is not getting enough oxygen, the brain will increase the blood pressure.

You know, I was just wondering about sea salt. We enjoy it, but I wasn’t sure about covering iodine sources, since we don’t eat much at all in the way of processed ore prepared food. Thanks for the great information–we’ll stick with the iodized version of sea salt!

You know, I was just wondering about sea salt. We enjoy it, but I wasn’t sure about covering iodine sources, since we don’t eat much at all in the way of processed or prepared food. Thanks for the great information–we’ll stick with the iodized version of sea salt!

Is table salt really our only decent source of iodine? How much table salt should we be eating? For all other purposes, I’ve been trying to use sea salt, sea vegetables or tamari.

The way to avoid the salt is to make your own food. I don’t buy any food that is pre-made. If I want a chicken sandwich, I buy chicken breast and cook it. I do not buy chicken patties. I hate the taste of salt, maybe because my sister used it by the handful while cooking when we were younger so I eventually stopped using it all together. If you are cooking for someone(s), put the salt shaker on the table and let your guests season their food to their taste.
But sea salt is actaully good for you unlike the iodized variety.

Of course, it’s absolutely true restaurant food is high in salt. I am a professional cook and food writer, and I cook for a couple of high-end markets here in San Francisco.

I’ve often found myself wondering about the levels of salt we use in food, although I’m just as guilty as anyone in using so much of the stuff (I’m snacking on salted, roasted cashews as I write this). Knowing what I know about salt, and agreeing with your statements in today’s column, one might wonder why that’s the case.

As you pointed out, it’s flavor. When I make meatballs, for example, I use salt in the mixture (along with bread crumbs which contain salt, parmesan which is salty, and I’ll often salt the onions I use as I first sauté them, to help draw out moisture). Once the meatballs are mixed and then formed and ready to be put in the oven, I’ll sprinkle some more salt and pepper over them. Excessive? Perhaps even more so as I read what I’m writing.

Salt makes things taste good, and more to the point, it makes good things taste better. Most people enjoy strong, robust flavors. I suspect another problem is with the people who cook the food: most professional cooks I know have salty palettes from the constant barrage of flavors we encounter each day and from having to taste things critically. Salty food stands out.

It’s a tough call: we could stop salting our food so heavily but it seems a very real possibility our customers would reject the food. When was the last time you heard someone praise a restaurant because their order wasn’t salty enough? We could use our encounter with our customers as an opportunity to educate them, but I suspect not many people eat out to be educated. They might eat out to experience new flavors, to sample a dish they’ve heard about, but I doubt many people dine out for the chance to be enlightened on the perils of excessive sodium by their chefs.

I’d be curious to hear what your readers have to say.

Readers: weigh in! He is making an important point. Thanks for writing.