I’m done worrying about what this person or that person says about salt these days.  The health and nutrition minders have split into two groups:

* Salt is poison and we should eat almost none (although, oopsie!, the sodium in salt is actually an essential nutrient)

* Salt is not a big deal

When it comes to nutrients, such as sodium, there is always the possibility that while some is good, a lot is bad.  This goes for water.  It’s hard to drink excess water, but sometimes a person does that and ends up in serious trouble (brain swelling, coma).  Fat soluble vitamins are another classic example: too much vitamin A or vitamin D can cause serious problems.  Extremely high doses of vitamin C can cause kidney stones.  Iron overload causes a host of medical problems and is sometimes hard to distinguish from other problems, making diagnosis difficult.  The list goes on.  Suffice it to say you can get too much of a good thing.

Now we have the latest salt rant from Dr. James DiNicolantonio, an associate editor for the a British Medical Journal’s Open Heart and a cardiovascular researcher, who not only says salt is fine, but eating too little will “.. make you fat and ruin your sex life.”   Surprise!  He’s written a book about this very topic — The Salt Fix — wherein he explains how:

* too little salt leads to insulin resistance and increased fat storage

* a low salt diet reduces sex drive, contributes to erectile dysfunction, and decreases fertility.

* low salt intake adversely impacts trauma recovery

He observes, correctly, that like other mammals, humans have been seeking out salt since time began.  He also notes that Koreans, for example, have a relatively high sodium intake — 4 grams/day — but have low rates of hypertension and coronary diseases.  At which point he makes the classic mistake of assuming that association equals causation, or in this case non-causation.  Koreans may eat a lot of sodium, but they also have a very unique diet, with lots of fermented foods and lots of vegetables.  Don’t tell me sodium is the only significant nutritional factor.  He makes the same mistake the anti-salt crowd makes: looking only at salt intake, rather than to the whole diet as a factor in heart disease.

His article does have an interesting discussion about the history of anti-salt research, much of which was done with rats bred to be sodium-sensitive (normally rats are not sodium-sensitive).  Surprise again!  If you feed sodium-sensitive rats a lot of salt, they develop health problems.  Translating those results to humans is problematic, but apparently that’s the intellectual leap researchers made.  He talks about the assumption behind the belief that excess salt in the body causes high blood pressure: the simplistic idea that sodium accumulates in blood, causing more water to pour into blood vessels to dilute the sodium, leading to higher blood pressure.  If that’s truly how some scientists think, it’s almost laughable (in any case, it’s recently been refuted).   Then there’s a rather exaggerated explanation for how low salt diets lead to insulin resistance which leads to obesity.  Not sure that train of thought holds up.  There is an unstated assumption that people actually are following the punitive 1.5 gram/day sodium limit imposed suggested by the American Heart Association, which I doubt.  And certainly eating a drastically low sodium diet could lead to adverse effects, but such a diet is likely to have other nutritional issues that can cause problems.

Dr.