Why Avoiding Salt May Be a Huge Health Mistake

all right guys so thank you so much for joining me I'm here with the one and only James Dean Nichol Antonio the author of the new book the salt sticks I am so ecstatic to have the opportunity to have a conversation with him because you know I have a few as I think most people do knowledge gaps where you know there are areas where I just haven't spent a lot of time doing my own research and one of those areas is sodium and salt intake and you are the de facto expert you've written this tremendous book so I'm really excited to get to have a conversation with you so for you know for one thanks for being here yeah thanks for having an axe of course so why don't you give me first for people that haven't heard of you or haven't heard of the book why don't you just tell me a little bit about your background yeah so I'm dr. James dinickel Antonio doctor of pharmacy and a cardiovascular research scientist at st. Luke's Mid America Heart Institute I published over 200 papers in the medical literature mostly on nutrition and how that relates to cardiovascular health so I originally started off publishing a lot on medications and then what ended up happening is I had a like a gym accident I actually tore my pectoralis tendon when I was bench pressing by myself and I no longer could eat whatever I wanted and just kind of workout and just you know burn the calories off and so what I ended up having to do was I had to really dig into nutrition to figure out how I could sort of maintain an optimal weight and physique without being able to just you know benchpress 300 pounds and burn off the sugars that I was consuming probably you know up until you know my mid-20s that was on a high carb diet and so what ended up happening is for sparking my interest in salt I was working as a community pharmacist and I was having a bunch of patients coming up to me with um dizziness and fatigue exercise intolerance really high heart rates especially when they're going from a seated to a standing position and they were all kind of placed on this low salt diet from their doctor because they had high blood pressure thinking it was the right thing to do um there were like just telling me all I want to do is to be able to taste my food again I just want to be able to salt my food but it's supposedly this dietary demon right and so I would kind of push back and I would tell them you know you should let your doctor know that you're having these dizzy spells and severe salt cravings and maybe just get your salt levels checked on you know your serum sodium in the blood and I had a couple patients come back really low and the doctor you know cut cut down the diuretic or completely eliminated their diuretic or and always told them to you know you know start adding salt back because you have really low sodium levels in the blood and so that sparked my interest I was like you know being an athlete I was the wrestler and I ran cross-country I always knew that you know I never my performance always suffered if I didn't make sure I was ingesting enough salt so the low sell guidelines for everybody never made much sense and that's really how I started publishing about salt over the last five years and then I spent about two and a half three years researching and writing the salt X Wow now is that is the impact that salt has on your physical performance something that's well known amongst athletes because I'm not an athlete that's not something that I am that's not a concept that I'm familiar with it used to be um pretty well known prior to the 1977 dietary goals before they demonize salt even the the British soccer team when they played Mexico for the World Cup in 1970 in Mexico like sweltering heat all their training sessions they were put on slow-release sodium tabs and during every game they all all players soccer players got salt tabs and it was like really well-known back he talked to anyone back in the 5060 70s it was really well-known in in the athletic performance that you you take a salt tablet and after we demonize salt you're right virtually no one that I've talked to now in the athletic world really understands the benefits of salt and that really was something very eye-opening in my research and really cool and the book probably one of the best takeaways in the book is how salt can improve athletic performance that's incredible so what happens when we eat salt I mean common common knowledge I think you know we have this idea that we consume salt it goes into our blood and that causes our blood to dilute the sodium it's in the blood and therefore blood pressure increases is that you know an overly simplified model of what happens yeah I mean basically just like with with dietary fat right how we oversimplified the LDL cholesterol leading to heart disease type of pathway we oversimplified it with salt we took one surrogate marker blood pressure and we fell at the feet of that and you're right it was a very simple hypothesis that if you consume more salt you are going to raise your sodium levels you're going to activate thirst you're going to drink more water to dilute those higher sodium levels so that's going to raise blood volume and lead to high blood pressure and basically we based this low salt guidelines and complete hypothesis and it's just what ends up happening is it's just not true at all well if we don't get enough salt so many other harms outweigh any type of potential benefit and in the book I kind of show that even if you get a reduction in blood pressure when you cut your salt intake you're just volume depleting yourself and raising your heart rate and it's kind of like people need to start thinking about low self diets like restricting their fluid intake all you're doing is like telling someone basically to only consume like one cup of water just because you lower their blood pressure by doing that doesn't mean that's a healthy you know advisable thing to do one of the case studies that you documented in your book was a woman who presented to you showing symptoms that to me because I'm very familiar I do a lot of research on diet and lifestyle and neuro degenerative disease it sounded like she was almost eliciting symptoms of like a dementia with a movement disorder she was having her gait changed and she was having cognitive difficulty and this was all from you know she was on an SSRI and antidepressant and that was really shocking to me because you know 1 in 10 Americans as I'm sure you know is now on some kind of antidepressant that number shoots up to one in four for women in their 40s and 50s and so the idea that SSRIs can promote sodium depletion and that those symptoms can then look like or mimic something that might be misinterpreted as dementia to me was really eye-opening how my god yeah what's really interesting is in order to bring vitamin C into the brain it has to travel a sodium and actually what ends up happening is if you have low sodium levels in the blood and you're eating a high carb diet because vitamin C can also be brought in by a glucose transporter but it'll compete with glucose and so when you have higher glucose levels you kind of now are relying on sodium to bring in vitamin C into the brain and so there's actually studies showing that if you induce low sodium levels and animals you can actually cause cognitive impairment and memory impairment like literally they can't follow through the maze as well if they have normal sodium levels and partly that's probably because there's that transporter that drives vitamin C into the brain and vitamin C is very important for cognition and sodium also brings vitamin C into the bone so there is you know so many important benefits of salt that so few people even realize sediment C is instrumental in the synthesis of neurotransmitters like serotonin dopamine acetylcholine so by limiting our sodium we could essentially be sort of handicapping that machinery 100% because in order to even absorb vitamin C as well in absorbant in the gastrointestinal tract sodium pulls vitamin C and biotin pulls a couple water soluble vitamins so it's definitely important that I kind of you know maintaining in your salt status is going to help obviously maintain your vitamin C status like we just discussed but it also helps maintain magnesium and calcium as well so it's it's kind of like maintaining that optimal balance so all the other minerals are in an optimal status as well but the Hat is so how do people really get a sense of their blood sodium levels I mean as far as I know sodium is a biomarker that's pretty you know it fluctuates data you can have a different sodium reading from one minute to the next is that is that correct yeah absolutely correct and so basically one of the by have a table of what are the signs of potential signs of salt deficiency and really it comes down to dehydration on the lap what you'll see on a lab work is if you're consuming like adequate amounts of water your blood urea nitrogen will be out and what does the doctor normally tell you when your bu n is elevated they just tell you you're dehydrated well most of the time it's probably actually salt deficiency it's not that you're not consuming enough water and part of the reason why someone might not consume enough water is because they're not consuming enough salt and salt helps activate our thirst as well so it is also important in that aspect but symptomatically what you'll see is it's very common of exercise intolerance and dizziness and increased heart rate muscle spasms muscle cramps when you're working out that's a very important sign of self efficiency literally overtraining syndrome is a salt depletion of the tissues because you're constantly sweating out salt and most athletes are never replacing back what they're losing and so you're they're also getting those kind of workout headaches and because salt helps blood circulation and so you can get massive headaches when you work out if you don't have enough salt in ya so not to call you off so with the BU n then be a better surrogate marker for your sodium levels and sodium in the same way that may be like your blood glucose levels are not really a good show of your average levels we rely more on like the hemoglobin a1c in that scenario I mean would you say to be UN is a marker that people should sort of look out for yeah no that's a great um that's a great comparison and I do agree that um you can be deficient in salt absolutely and have completely normal sodium levels in the blood because your body's fighting to maintain a normal sodium level what will actually happen is if you go on a low salt diet and you're consumed when I say a low salt diet I mean like less than one teaspoon of salt which is less than 2300 milligrams the body will start pulling sodium from your bone to maintain normal sodium levels so you can have completely normal sodium levels and be severely deficient pulling sodium from your bone but also magnesium and calcium so keeping a good amount of salt intake can help reduce magnesium and calcium being pulled from the bone and then spit out the urine so what are the sort of recommendations that you would make I mean obviously there's no you know I'm sure you'd agree there's no such thing as a one-size-fits-all optimal diet should we all be eating a lot more salt are there people that should eat more salt are there people that should I mean one thing that that you talked about is the fact that you know when we're on a low-carb diet it causes our kidneys to excrete more sodium so I mean should people on a lower carb diet be going out of their way to eat more salt or like what is the sort of takeaway prescription yeah no it's a great great question and really it comes down to an individual basis but I will say that ninety percent of American adults are consuming caffeine in some way or another and caffeine is a huge salt waster out the urine so we consume just four cups of coffee per day we can lose between a half a teaspoon to a full teaspoon of salt in just four hours in the urine and the half-life of caffeine is like 5.2 hours so in just four hours you can lose an entire teaspoon of salt so everybody's consuming caffeine and we're losing an entire teaspoon of salt why would we consume less than a teaspoon it makes absolutely no sense so if we're consuming caffeine if we're on low carb diets which also you know encourage sodium depletion if we're taking antidepressant drugs like SSRIs which encourage sodium depletion these are all things that might warrant eating more so salt yeah and and people exercising more and people exercising more are there people that should anymore so people I mean would you would you say that people that have developed type-2 diabetes people that have chronically high blood sugar chronically elevated insulin I mean should they be adding more salt to their diets as well yeah so that might be the population that actually needs to be adding more salt into the type 2 diabetics with high blood pressure because low salt diet can cause insulin resistance even work they can make you know your insulin resistance worse and elevate insulin levels more because that helps the kidneys retain more salt so that's just what what happens with the body but also when you cut your salt intake the vasodilating properties of insulin you also become resistant to that the arteries actually become resistant to the Vaser dilating properties of insulin so literally low salt diet can potentially cause hypertension and diabetes and there was actually a study I mentioned in my book in that very population type 2 diabetics with hypertension and they compared 3 grams of sodium to 6 grams of sodium and basically the 6 grams of sodium fixed their insulin resistance so the very you know people we think should be avoiding salt may actually need to be consuming salt and people that are told by their cardiologist or dude to restrict salt you'd say that's something that patients could give push back to their cardiologists yeah a hundred percent I mean honestly that's probably one of the worst patient population to restrict salt intake again for many reasons and so one of them is that low salt diet increased heart rate and obviously in someone who has coronary artery disease that's the last thing you want to do is elevate their heart rate and literally I've seen studies where the heart rate goes up more than 25% so can you imagine like someone's heart rate going from like 60 beats per minute to 80 beats per minute that's like an insane increase like 20 beats per minute every single minute yeah I mean I'm sure you're familiar with the The Lancet review published I think was May of 2016 where they found that people on very low sodium diets below average intake had increased risk of mortality yeah no I mean among other things is that it actually increased increases blood viscosity and it activates platelets low salt diet have been shown in hypertensive patients to actually activate platelets and increase blood viscosity and so when you add that in with an increase in heart rate increased blood viscosity and you activate all the stress hormones noradrenaline and adrenaline and you activate all the artery stiffening hormones angiotensin ii running in aldosterone that is a metabolic storm for causing a clot a heart attack a stroke whoa so I asked some of my facebook followers what questions they might have for you and Melissa wanted to know why am I always creating salt on a ketogenic diet yeah I mean this habit this literally happened to me for more than just the initiation period so what ends up happening one we cut our carbohydrate intake when we initiate a ketogenic diet is we go from having a chronically elevated level of insulin to a much lower amount of insulin so the kidneys have relied upon insulin to reabsorb salt so when you cut the carbs and drop the insulin the kidney starts spilling salt and what ends up happening is normally the first week most people need about 2 grams of sodium per day in it extra in order to prevent what's being depleted and about one gram of sodium extra for the second week but people with bad insulin resistance to start with their commutes have become so dependent on insulin that they could be spilling sodium for weeks on end and you really got to match that with symptoms and because I also in the big caffeine consumer I chronically craved salt felt dizzy during my ketogenic journey and I had to make sure that I increased my salt intake chronically so how do you do that you just sprinkle some salt in your water you throw more salt on your food like we got it actually looked like day to day for you yeah so day to day so what you'll basically if you were to kind of sit next to me or follow me for a day what I would do normally for breakfast I have two to three pastured eggs and so what I like to do is I'll put on ancient lakes magnesium flake salt the flake salts really good for my eggs and it's great the flake salt is honestly insanely high in magnesium it's a hundred and eighty milligrams of magnesium per 10 grams of salt I mean to give you a comparison Himalayan salt only has one point four milligrams of magnesium per ten gram so it's like astronomically different what's good what's the brand again I'm going to put the link down below when I post this video yeah it's it's ancient lakes magnesium infused so cool and they have two different salts so there's a magnesium infused salt which has 44 milligrams of magnesium per 10 grams of salt but it has good amounts of iodine and then there's their special flakes salt and that's like at the bottom of the magnesium brine like the last kind of brine that they create to make these flakes salts that are super saturated in magnesium just insane amounts of magnesium so I'll do that in the morning on my eggs and then normally what I'll end up doing is for lunch I'll probably consume like like a bowl at Chipotle like I'll just do some some vegetables beans with it corn some me cheese stuff like that and then for dinner normally what I'll do is I'll season some pork chops put a nice layer of salt so what a lot of people don't realize is salt is more than just flavor if you create a coating that and you sear meat you trap in all the juices and all the flavors so that's like a really good benefit and what I'll do is once I'm done cooking the pork chops I'll kind of elevate the plate a little bit and let all those salty juices create a nice broth and then I'll put like eight ounces of spinach in that salty broth and I'll eat those bitter greens that I never would have without the salt and so salt is your gateway to not only exercising more but eating healthy right it like my kids won't eat bitter greens or nuts or seeds without salt and so it's like we're so afraid of salt that we'd rather have our kids eat low sell processed food when it's like just give them real food and add the salt to taste and that's one of the major vehicles for salt in the American the standard American diet is in processed foods I mean when people talk about you know the notion that Americans are eating a lot of salt it's not in the form of these salt you know salt that we put on our food that we season our foods with it's in these ultra processed foods yeah no exactly people aren't consuming salts from you know ancient oceans with high minerals and you know that don't have dextrose added to them and don't have anti-caking agents added to them and our bleached white they're consuming and they're like you said eighty percent of you know the salt intake in Americans is from processed foods the top source of salt in the American diet is bread which is actually kind of an interesting and counterintuitive yeah and then they put like the salty deli meat like with the phosphates and nitrates on top of the bread right and it's just like this process salt bomb but you're not getting the good salt right so now yet this I was going to say now that we're rethinking and reframing the way we view salt that doesn't make those foods good for us suddenly correct those foods are still high and ultra refined refined carbohydrates very low in nutrient content but we're saying that the salt content in them is perhaps not the dietary demon that we once thought it was exactly so raychel from my facebook fan page asks and you kind of already talked about this but with all the different brand names and different types of salts such as sea salt gray pink or Himalayan salt which do you recommend as the healthiest option prices vary widely so yeah how do you you know what do you tell your average consumer who's a intimidated by all the options in the supermarket yeah no it's a great question if you go into like my kitchen cabinet what you're going to find is two salts one is Redmond real salt and the other is the ancient lakes magnesium infused salt or their flake salt that's pretty much all I use and the reason is is because they're one of the only salts from an ancient ocean and people like I was blown away like the nuances and of salt but basically if you get like Celtic sea salt or sea salt from a modern-day ocean you actually get the pollution in the salt so there's going to be microplastics potentially heavy metals and other contaminants when you actually get your salt from an ancient ocean I was for millions of years ago you're not going to have that issue and so literally salts from modern-day oceans have been tested with you know high pretty high levels of microplastics so it is a real it's a real documented measured thing and what I'll do if I'm working out more than an hour a day I'll probably use Redmond because you sweat out a lot of iodine and Redmond real salt has about 170 micrograms of iodine for 10 grams of salt and we sweat up to a hundred micrograms of iodine per hour of exercise um if I am going to be working out on an hour or less I'll probably use ancient lakes magnesium salt because it still has good amounts of iodine it's going to give me 10 grams of their salt has 121 micrograms of iodine so it'll kind of cover that one hour of exercise for my iodine loss but if I go above that then I'll probably grab rad mints great to know I actually also use Redmond real salt it's great and I have a salt lamp as well I don't know if this benefits me in any way other than just looking cool but so what other things should people know I mean what are their symptoms that people should look out for you know maybe they're not eating enough salt there's some you know subjective sensation but they might be able to recognize standing up from a seated position and feeling a bit sort of lightheaded is that normal or is that something that you know might indicate that you're not eating enough salt for example yeah so what happens when you go from a seated to a rising position and you're dizzy is you're just not getting good blood circulation to the rain and so adding salt can actually treat that extremely quickly and so I've got a few people with pots and it's very common there's there's over three million people in the US with it more common in females but pops is basically that postural orthostatic tachycardia syndrome where when you go from us seated to a standing position you get an over thirty feet per minute increase in heart rate and I've had people tell me that if they drink pickle juice right away it kind of like cuts that rapid heart rate out right away and so that's how quick sell can actually fix you know that type of symptom and people who have pots another symptom like we talked about is exercise intolerance overtraining syndrome where their joints are hurting and they're becoming slowly depleted and salt is another big symptom but just salt cravings your body has a built-in safety mechanism to try to prevent you from dying of salt efficiency and one of them is actually activating the reward system so when you so you get more cravings for salt and when you actually get salt in the diet you'll consume more of it the problem is is sugar can hijack that activated reward system when we're on low salt diets and so low salt diet can potentially lead to sugar and drug addiction because it activates the reward center in the brain and so people craving sugar may actually be a sign of salt deficiency because they're not only craving it more potentially because the brain's reward system is activated for it but they're more insulin resistant on the low salt diet and when you're more insulin resistant and you have elevated levels of insulin your body can't kind of grab those stored fat stores so it craves more dietary carbohydrates so what are some things that people should not be eating more of in their diets you mentioned sugar assuming sugars on the do not eat list the in the salt fix that accurate yeah no I mean that's the bad way crystal right there really the giveaway right salt good sugars bad but ya know like obviously industrially processed omega-6 vegetable oils are probably very bad for the health there's good studies I published a review paper and BMJ open heart how you know those those industrial seed oils that are high in omega-6 have been shown to potentially increased cornering our disease mortality cardiovascular events and all cause mortality compared to saturated fat so we can pretty much say with a pretty resounding yes that they're probably more harmful than saturated fat whether saturated fat is bad I honestly don't really believe so that I don't believe that saturated fat per se is bad I do think some people can over consume red meat but I do think women are under consuming red meat because the body is not very efficient at getting rid of iron stores if you're a man and the iron requirements for a man are more they're less than half that of a woman who hasn't gone through menopause yet so I think a lot of women are actually iron deficient and not eating enough red meat very interesting and you say that men likely eat too much meat the catch though I think if you are a man in your and you're consuming more than a pound and a half of meat you're probably slowly accumulating iron very interesting Wow these are all great great tips any other takeaways it's covered so much ground yeah no I think there's a bunch of disease states that can precipitate salt deficiency so I counsel patients with Crohn's disease and ulcerative colitis on a daily basis and they don't absorb salt very well and because can become depleted in salt extremely quickly and same with patients with celiac disease and even people with in flavius they don't absorb salt well and so there are so there's that group of population and there's millions of people who've had their colon removed or part of their ileum removed and they don't absorb salt while I have a few family members that have actually been placed on a low salt diet and wound up in the hospital with severe dehydration and low sodium levels in the blood and one of them didn't absorb salt well because they had their colon removed and literally your colon helps you absorb salt and there's also a bunch of disease states kidney damage to the kidneys where your kidneys can no longer retain your salty blood basically right like your your kidneys have to filter three and half pounds of salt every single day and they have to actively reabsorb all that salt and if they can't reabsorb it and it's spilling you can literally die of salt efficiency like within minutes um and sugar consuming a diet high in sugar for four years can actually damage the kidneys didn't lead you to become a salt waster Wow is there an upper tolerable limit on salt intake I mean is there you know we don't want people to or do you want people to watch this video and then go pound five tablespoons of salt yeah that's such a great question honestly I'm so glad you asked it because for the last 10,000 years we've consumed an extremely high salt diet because we didn't have refrigerators to preserve our food so we literally salted everything so in the 1600s in Sweden the average intake of salt per person was a hundred grams which is over ten times what we consume today in the 1500s in Europe they consumed 40 grams of salt and in the 1700 they consumed 70 grams of salt there was no real chronic disease back then right and so the kidneys can absolutely tolerate if you have normal kidneys at least 90 to 100 grams of salt per day and if you look at some of the longest living populations Japan South Korea they all eat a high salt diet so I mean we have good evidence that if you eat a high salt diet you potentially can live longer so I don't know of any good evidence that would ever say that someone would want to cut your salt intake Wow well thank you so much this has been enlightening I can't wait to share I can't wait to share this with the world spread the word where can people find out more about you and your work and if they want to follow you on social media what are your social media handles yeah people can follow me on twitter at dr. james doneck di ni si they can follow me on my Facebook so I have my personal page and I my professional page which is dr. James D nickle Antonio and I'm also on Instagram and people can check out my website the salt fix com where they can learn more about the book when where's the book available yeah the books available nationwide apartment ennoble people can order it online at Target and online at Walmart it's also available obviously on Amazon and things like that too awesome thank you so much for your time thanks for having me next

Channel: Max Lugavere

Views: 22,075

Rating: 4.9326601 out of 5

Keywords: is salt good for you, is salt bad for you, low salt diet, low salt recipes, low salt foods, low salt meals, low salt cooking, low salt diet recipes, low sodium diet, low sodium recipes, low sodium meals, low sodium symptoms, low carb flu, how to reduce blood pressure, keto flu, keto flu relief, the salt fix

Id: XyWPY4w7PDs

Length: 28min 45sec (1725 seconds)

Published: Wed Jul 19 2017