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wellblog

Low Salt Intake = Early Death

4/25/2021

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The American College of Cardiology has long acknowledged that reduced sodium intake does NOT have a scientifically established benefit: https://www.acc.org/.../the-hazy-relationship-between...

Rather, low-salt recommendations are based on an inductive argument from several presupposed (and now refuted) assumptions. It may surprise the reader, but there has been no confirming evidence for the salt-cardiac risk hypothesis since 1944: https://www.amjmed.com/article/S0002-9343(17)30508-9/pdf. And even then, the strongest argument showed potential benefit for only 25% of those with already-existing hypertension.

In rigorous science, we find 7 salt knowns:

1.) life doesn’t exist without sodium
2.) sodium transport IS cellular function
3.) low salt is associated with early death
4.) low salt worsens diabetes**
5.) low salt worsens cholesterol***
6.) low salt worsens stress hormones***
7.) low salt precedes cognitive decline****

** https://pubmed.ncbi.nlm.nih.gov/21289228/
*** https://www.who.int/.../review.../salt-blood-factors/en/
**** https://cjasn.asnjournals.org/content/13/3/366

What we know:

4,000-6,000mg per day = no issue
Over 7,000 = possible risk for certain populations
Under 3,000 = HIGH RISK
* https://pubmed.ncbi.nlm.nih.gov/22110105/

Less than 3 grams of sodium per day is associated with increased risk of heart attack and stroke.

In 2010 I experienced a turning point wherein more and more clients of mine came from clinical backgrounds. In part, I attribute this to a single question I began more aggressively asking during initial meetings: “do you read your own journal?” It came to me one day when I met with an internal medicine doctor who mentioned something about the benefit of statins. I said, “but now we know there is no significant benefit.” She gave me one of those you-know-nothing looks, followed by a similarly-toned upbraiding. I was a little surprised, because there had just been a massive review in the Annals of Internal Medicine and JAMA on no established benefit from statins EVEN IN HIGH RISK POPULATIONS: https://jamanetwork.com/.../jamaintern.../fullarticle/416105. The only thing I could think to say was, “do you read your own journal?” I had a printed copy of the summary in my drawer, handed it to her, and saw the color drain out of her face.

In the summer of 2012 I spent time with a number of gracious clinicians who let me shadow their work for a day or more. One cardiologist curiously said, “you know, there has never been a peer-reviewed, published paper on ANY benefit for ANY dietary supplement, right?” I’ve seldom in my life been stricken silent by a bigger admission of ignorance. I was embarrassed for him. Since I was his guest, how exactly could I ask him if he has read his own journal? It's a damning question, obviously; and I got the sense his ego couldn't handle it. That year, the American Journal of Cardiology published a paper specifically showing that Vitamin D supplementation lowers risk of cardiovascular disease: https://pubmed.ncbi.nlm.nih.gov/22071212/. In fact, the Journal of Investigative Medicine confirmed these results the week he said this: https://pubmed.ncbi.nlm.nih.gov/22534630/. Likewise, omega 3 supplementation showed up in cardiology-related research that whole year. Not only recently, but for over a century there have been Nobel Prizes awarded for peer-reviewed findings on supplements. Vitamin C and Nitric Oxide have no evidence? We better alert the Nobel committee. Piles of NIH grants have been awarded in order to do precisely what this cardiologist said has never been done.

"Really?", I pressed him, doing my best to pretend I was learning something new from him. He doubled down, "oh yes; NEVER." The reader may not catch this right away. But aside from being totally incorrect and uninformed, that style of "argument" is a well-studied fallacy called argumentum ad ignorantiam (the argument from ignorance or appeal to ignorance). It comes up often in metaphysical debates. sometimes criticized as the god of the gaps or conversely as the evolution of the gaps or multiverse of the gaps with regard to cellular life, abiogenesis, pre-Planck time, and other pieces of prehistory which we can't directly observe, predict, test, or prove/disprove. More succinctly, it can be put into a concise sound byte: I've never seen or accepted evidence for X; therefore, there is no evidence for X; moreover, therefore, X is proven false. It can appear persuasive to those who've never studied formal logic; but it's an empty pseudo-reasoning. I certainly wasn't going to spend the effort showing him his basic mental faculties were faulty. Instead, since he doubled down on the literature claim, I placed the pressure inside his framework, "which peer-reviewed publication DISPROVED the benefit of which supplement?". Checkmate. His gurgling, bubbling stammer said it all. 

Opinions are nice and all. Even reading the literature is nice, although insufficient. We have to apply rigor in our analytical thinking as we drive down into known mechanisms. And in known biological and biochemical mechanism, there are no debates on the benefits of dietary salt or the risks from low-sodium intake. Good luck trying to have a heart beat or form a new memory in the absence of sodium. A heart beat IS sodium transport. A brain cell action potential IS sodium exchange.

Low Salt = Early Death
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  • Elev8 Wellness
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