The #1 thing to avoid if you have high blood pressure, according to dietitians

 Really, you don't read research, do you?

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

The #1 thing to avoid if you have high blood pressure, according to dietitians

If you have hypertension, a health care professional may have recommended lifestyle changes to bring down your levels. Don’t overlook this very important one.

Reviewed by Dietitian Emily Lachtrupp, M.S., RD

Key Points

• Limit sodium intake to 1,500 milligrams daily by cooking at home and reading food labels.
• Boost potassium intake with fruits, vegetables and dairy to help lower blood pressure.
• The DASH or Mediterranean diet supports heart health and reduces hypertension.

If you know you have high blood pressure, you’re already a step ahead. Although high blood pressure (hypertension) affects nearly half of American adults, it doesn’t cause symptoms at first—so many people don't even know they have it. Your blood pressure is the force of blood pushing through your arteries. Normal blood pressure is below 120/80 mm Hg. The top number, systolic blood pressure, measures pressure when the heart beats. The bottom number, diastolic blood pressure, is the pressure when the heart is at rest between beats.

High blood pressure can lead to several health complications, such as stroke, heart attack, kidney disease, vision loss and more. “If you are diagnosed with high blood pressure, lifestyle modification is key. Assess your diet, weight and exercise habits,” says Maria Elena Fraga, RD, CDCES. Read on to learn more about what high blood pressure means, the biggest thing to avoid doing if you have it and proven strategies you can take to improve it. 

Don't Underestimate the Impact of Nutrition

The No. 1 thing to avoid if you have hypertension is underestimating the impact your nutrition habits can have on your blood pressure. Knowing that you can make a big difference in your blood pressure by changing some aspects of your diet is positive and empowering news.

Actionable habits for lowering blood pressure include limiting sodium, eating fruits and vegetables that are rich in potassium, cooking more at home and following blood-pressure-lowering eating plans. “Getting a handle on your blood pressure requires behavior and lifestyle changes, which can take time, effort, consistency and patience,” says Sarah Currie, M.S., RD. With that said, here are the impactful changes you can start making to your diet.

Related video: Two powerful foods that naturally reduce blood pressure according to doctors (Talking With Docs)Cut Back on Sodium

Over time, eating a high-sodium diet can narrow blood vessels and increase blood pressure. “You’d be surprised how many food items contain hidden sources of sodium,” says Fraga. Packaged foods are often packed with sodium, and some of the top culprits are canned soups, frozen meals and deli meat, adds Currie.

The American Heart Association suggests that cutting out 1,000 milligrams per day of sodium can have a beneficial impact on blood pressure. For people with high blood pressure, the AHA recommends consuming no more than 1,500 milligrams of sodium per day.

To reduce your sodium intake, try replacing a portion of salt in your recipes with garlic, fresh herbs and spices. Read package labels and restaurant menus before buying or ordering to help make lower-sodium choices. When you’re reading labels, look at the Daily Value percentage for sodium and aim for lower-sodium foods when possible. Foods with a sodium DV of 5% or less per serving are considered a low-sodium foods, while those with 20% DV or more of sodium per serving are considered high-sodium and should be limited.

Eat Potassium-Rich Foods

Potassium counteracts sodium by helping your body excrete it through your urine. (In short, you pee it out.) The mineral also helps relax blood vessel walls, which lowers blood pressure. The AHA recommends consuming 3,500 to 5,000 milligrams of potassium daily to prevent or treat high blood pressure.

Boost your potassium intake by eating more fruits and vegetables. Aim to eat 4½ cups of fruits and vegetables every day. Foods rich in potassium include:

• Lentils
• Prunes
• Bananas
• Kidney beans
• Orange juice
• Cantaloupe
• Squash
• Apricots
• Soybeans
• Raisins
• Potatoes
• Spinach
• Chicken breast
• Low-fat dairy products

Cook More Meals at Home

Restaurant meals are often high in sodium, which can make it difficult to stay within the recommended limits. One study found that the average sodium content in a fast-food meal was about 1,300 milligrams—nearly all of the recommended sodium limit for someone with high blood pressure In addition, another study found that foods considered ultra-processed have 150% more sodium than those considered not ultra-processed. Cooking at home gives you control over all the ingredients. Whole foods, like fruits, vegetables, dried legumes, unsalted nuts and seeds and fresh sources of protein contain little to no sodium. When cooking you can flavor foods with fresh and dried herbs and spices, including basil, oregano, cumin, rosemary, turmeric and more.

This doesn’t mean you can’t eat out—it just takes a little planning. If the restaurant provides nutrition information, check it ahead of time to plan out a meal that’s lower in sodium. Avoid or limit fried foods, which tend to be higher in sodium, says Currie, and ask for sauces and dressings on the side. Opt for baked, broiled, grilled or steamed proteins paired with green and other colorful vegetables. 

Consider the DASH or Mediterranean Style of Eating  

The DASH (Dietary Approaches to Stop Hypertension) diet was created to intentionally treat high blood pressure. This eating style focuses on eating fruits, vegetables, legumes, whole grains, low-fat or fat-free dairy, lean protein and limited saturated fats, red meat, added sugar and sodium. The DASH diet is rich in important nutrients that help lower blood pressure, including potassium, calcium, magnesium, fiber and protein.

The Mediterranean diet is very similar to the DASH eating plan, as it’s full of fresh fruits and vegetables, fiber-rich beans and whole grains, nuts and seeds. This eating plan also recommends limiting foods that contain higher amounts of saturated fat, such as red meat. One food that’s famously associated with the Mediterranean diet is extra-virgin olive oil, which is rich in polyphenols that can protect the heart.

Strategies to Improve Blood Pressure 

Improving the quality of your diet is one effective way to manage hypertension. Other lifestyle factors that help bring down blood pressure include:

• Get regular physical activity
• Avoid smoking.
• Practice stress management.
• Reach a healthy weight, if weight loss is recommended.
• Get enough sleep. Aim for seven to nine hours of sleep each night.

If lifestyle factors are not enough to keep your blood pressure in a healthy range, you may need medication. Reach out to a health care provider for guidance.

Our Expert Take

High blood pressure is a common condition affecting many Americans, yet, you can take steps to improve your numbers and prevent hypertension. One of the biggest mistakes people make is not realizing how important nutrition is for managing blood pressure and maintaining a healthy heart.

Small, consistent steps—like reading labels to cut down on sodium, cooking at home more often and eating plenty of fruits and vegetables—can make a big difference. For personalized support and guidance, ask a health care provider about working with a registered dietitian who can create an individualized eating plan and set goals that work for you.

Read the original article on EatingWell

How a simple salt swap could reduce Aussies’ stroke risk

 Will your incompetent? doctor and hospital know enough to get the dietician to update diet protocols on this?

Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING?

Of course your competent? doctor told you about the salt controversary years ago, right?

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

How a simple salt swap could reduce Aussies’ stroke risk

Aussies have been urged to shake things up in the kitchen and at the dinner table by making a simple swap that could reduce their risk of high blood pressure (hypertension); the leading cause of preventable death in Australia.

A new paper by Australia’s National Hypertension Taskforce recommends substituting regular salt, which is high in sodium, with potassium-enriched salt, saying the switch can significantly reduce high blood pressure and the risk of stroke and heart attacks, particularly for people already living with hypertension.

National Hypertension Taskforce member and Stroke Foundation Chief Executive Officer, Dr Lisa Murphy, says this small change can make a big difference.

“Your traditional Sunday roast or summer barbecue will still taste the same but will be better for your health. Research shows us that high sodium consumption is linked to hypertension so replacing sodium with potassium, an important mineral found in fruit and vegetables, is a simple but effective way to reduce your risk. And to make life easier, you can find potassium-enriched salt at your local supermarket.”

A recent global modelling study on the health effects of switching from regular salt to potassium-enriched salt by The George Institute of Global Health found replacing regular salt with potassium-enriched salt in Australia alone could prevent approximately 500 stroke deaths and 2,000 stroke events each year.

“This recommendation aligns with the latest international guidance from the World Health Organization, the European Society of Cardiology, and the American Heart Association, and has the potential to save thousands of Australian lives,” Dr Murphy said.

High blood pressure affects around one in three Australian adults and remains the leading cause of preventable death and disability nationwide. Excess sodium and insufficient potassium intake are key dietary drivers. Despite the strong evidence supporting the benefits of potassium-enriched salt, it is inconsistently recommended by clinicians and rarely used by patients.

“This is due mostly to clinicians and patients being unaware of the availability, effectiveness and acceptability of potassium-enriched salt and we want to change that,” Dr murphy said.

It is hoped the taskforce’s position, published in the National Journal of Hypertension, paves the way for the recommendations to be adopted more widely and marks an important step forward in the national effort to prevent and control hypertension.

The National Hypertension Taskforce was founded by the Australian Cardiovascular Alliance (ACvA) and Hypertension Australia, with significant support from Stroke Foundation and Heart Foundation as cofounding members. The Taskforce aims to increase the number of Australians with their blood pressure both treated and controlled effectively from 32% to 70% by 2030.

Study Reveals How High Salt Diet May Lead to Brain Inflammation

 

Of course your competent? doctor told you about the salt controversary years ago, right?

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

Study Reveals How High Salt Diet May Lead to Brain Inflammation

Salt: A New Path to Heart Resilience

 Of course your competent? doctor told you about the salt controversary years ago, right?

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

Salt: A New Path to Heart Resilience

Your body’s sodium levels are linked to your risk of heart problems, but salt intake isn’t the best way to manage them.

Salt has been villainized for decades—it gets blamed for high blood pressure, heart disease, and stroke. But what if the story is more complicated?

Sodium plays a crucial role in the human body. It helps conduct nerve impulses, contract your muscles, and maintain fluid balance in your cells. Without it, our bodies just don’t work.

But too much sodium can, in fact, lead to cardiovascular problems. A new study sheds some light on how much sodium is too much and finds that even normal amounts of sodium can be a risk factor.

Plus, the research offers some insight into a surprisingly simple way to keep sodium levels in check.

The Surprising Science of Sodium, Hydration, and Heart Health

The study, published in the European Journal of Preventive Cardiology, looked at over 400,000 individuals across a 20-year timespan. The researchers looked at two different markers of sodium in the body: serum sodium and tonicity.

• Serum sodium is a measure of how much sodium you have in your blood.
• Tonicity is a measure of how water moves in and out of your cells. 
• Both simple blood tests give doctors an idea of the fluid and electrolyte balance in your body.

Looking at over 20 years of medical data, researchers found that both serum sodium and tonicity can be used to predict hypertension and heart failure. As these measures go up, so does your risk of cardiovascular disease.

One of the most surprising findings was that sodium levels within the normal range could be linked to increased risk. The normal range of serum sodium is 135–146 mmol/L—but your risk starts going up at 140 mmol/L.

So, even if you’re in the normal range, you may have an increased risk of cardiovascular disease.

So, what can health-conscious people do to keep their risk low? You might guess “eat less salt.” And that’s not exactly wrong, but there’s a surprising habit that will help you even more: drinking enough water.

Hydration Is More Effective in Managing Serum Sodium Than Salt Intake

Serum sodium and tonicity can be affected by sodium intake, but the authors point out that proper hydration is an even better way to keep your sodium levels in check. Here’s a line directly from the study:

“differences in fluid intake have a greater effect on serum sodium concentration than differences in salt intake, suggesting that hydration status is likely the main contributor to serum sodium concentrations.”

The takeaway here is clear: if you want to keep the sodium in your blood in check—and reduce your chances of high blood pressure and subsequent heart failure—you should be drinking enough water.

In general, though, he says, high serum sodium is an indicator of dehydration. And the solution to dehydration is usually to drink more water.

Underhydration is linked to accelerated aging and premature mortality from other causes.

How to Hydrate for a Healthy Heart

Drinking enough water can help you fend off hypertension and heart failure. Because it also contributes to cognitive sharpness, a positive mood, and metabolic health, it’s basically an all-in-one healthy aging strategy.

So how much should you drink? We have a guide to hydration that will help you figure it out, but you can get started with some basic recommendations.

“In the absence of cardiac or kidney diseases, high serum sodium levels indicate dehydration, which can be easily corrected by drinking more water (at least 1.5 L/day),” says Crea. That’s just over six cups.

If you’re active or in a hot environment, drink more. Sipping throughout the day, even when you’re not thirsty, can keep your body’s fluid stores topped up.

Crea also points out that as we age, our thirst signals get a bit weaker, so you may want to drink a bit more than you feel like you need.

Dr. Jonathan Rabinowitz, professor at Bar-Ilan University and first author of the study mentioned above, recommends a simple test for hydration: “I think the simplest thing people can do is to check their urine color,” he says, adding that it should be “pale yellow.”

His advice is simple: “If it’s darker, drink more.”

It’s Still Worth Thinking About Sodium Intake

This study makes it clear that hydration is crucial for maintaining electrolyte balance for heart health—and the experts we talked to agree. But that doesn’t mean you should stop think about your salt intake.

The study points out that if your sodium levels are high, you should probably combine better hydration with monitoring your salt intake.

And the foods highest in sodium are things you should be having in moderation anyway. Research shows that pizza, white bread, processed meat, and savory snacks are significant contributors to sodium intake in the United States. These kinds of foods may also have preservatives, trans fats, and other things you won’t find in lists of research-backed foods for longevity.

As long as you emphasize minimally processed foods with a focus on vegetables, whole grains, and lean meats, your sodium intake shouldn’t be much of a problem. Especially if you’re drinking enough water.

How to Test Your Sodium Levels

If you’re worried about the sodium level in your blood, you can ask a doctor to test it. Serum sodium is included in the basic metabolic panel (BMP), which is something you should have done every few years.

There’s no specific test for serum tonicity—the authors used a formula to calculate it using serum sodium and glucose (if you’re curious, the formula is 2[Na + (mmol/L)] + glucose (mg/dL)/18). Serum sodium is easier to use, so you probably don’t need to worry about this—but, if you’re curious, you can ask your doctor to calculate it or use your test results.

Getting your sodium levels tested and keeping your salt intake in check definitely isn’t a bad idea. But your body is really good at regulating its electrolyte balance—as long as you’re drinking enough water.

So keep sipping, and know that every glass of water you drink is a step toward a healthier future.

The information provided in this article is for educational and informational purposes only and is not intended as health or medical advice. Do not use this information to diagnose or treat any health condition. Always consult a qualified healthcare provider regarding any questions you may have about a medical condition or health objectives. Read our disclaimers.

Salt Substitutes Cut Risk for Stroke Recurrence, Death

 

Lots more information here which your competent? doctor has already given you, right?

Has your competent? doctor instructed the dietician to ensure that all hospital meals fall within the limit? NO? So, you don't have a functioning stroke doctor, do you? 

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home.  So, this China study may not have much relevance in your country.

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

Salt Substitutes Cut Risk for Stroke Recurrence, Death

Marcia Frellick

February 05, 2025

0153

Add to Email Alerts

Switching to a salt substitute from regular sodium chloride significantly reduced the risks for stroke recurrence and death, offering patients a practical, low-cost therapeutic option, according to new data released today from a prespecified subgroup analysis of data from the Salt Substitute and Stroke Study(SSaSS) trial.

The open-label, cluster-randomized clinical trial was conducted in 600 northern villages in China. The subgroup analysis consisted of patients who self-reported a hospital diagnosis of stroke. 

In the trial, which assessed 15,249 patients with stroke, the use of a salt substitute cut the risk for recurrent stroke by 14% (relative risk [RR], 0.86; 95% CI, 0.77-0.95, P = .005). 

Reductions in the risk for hemorrhagic stroke were larger (relative reduction, 30%; P = .002). Risk for death was reduced by 12% (95% CI, 4%-18%; P = .003), with larger effects on stroke-related death (relative reduction, 21%; P = .01) over a mean follow-up period of 61.2 months.

The risk reductions were consistent across subgroups and sensitivity analyses, and the increased risk for hyperkalemia was not significant (RR, 1.01; 95% CI, 0.74-1.38; P = .96).

No Increased Risk for Hyperkalemia

In the sensitivity analyses, participants with repeated recurrent strokes during the follow-up period were excluded, imbalances in baseline characteristics were adjusted, and "possible" and "probable” and “definite" were added to the definition of primary outcome events.

Of the 20,995 people enrolled in the trial, only patients with a history of stroke were assessed in the prespecified subgroup analysis of 7703 in the salt-substitute group and 7546 in the regular-salt group. Mean age was 64 years, and 54% of participants were male. The salt substitute consisted of 75% sodium chloride and 25% potassium chloride by mass.

Concerns about hyperkalemia in the trial have been raised often, Daniel W. Jones, MD, from the Department of Medicine at the University of Mississippi Medical Center, Jackson, and colleagues point out in an accompanying editorial. They note that this subgroup analysis used common manifestations to evaluate the presence of hyperkalemia, including hospitalization and death related to arrythmia; neither increased in the salt-substitute group.

Caution in Some Groups

Concerns about the use of salt substitutes by patients with stage 3 or 4 chronic kidney disease and patients taking a potassium-sparing diuretic are "based on strong evidence," the editorialists add.

"The debate about the importance of increased potassium or reduced sodium as the primary driver of the benefit of the potassium-based salt substitute will continue but should not delay use of this strategy," they add, "as it is proven to be effective and safe for most people."

This analysis and other studies may prove to be the tipping point for the move toward mandatory sodium limits on food, and "should convince clinicians to increase attention to a low-sodium diet" that includes "a potassium-based salt substitute in most patients," Jones and colleagues note.

BP-Reducing Effects Well Established

Salt substitutes replace a portion of sodium chloride with potassium chloride and combine the blood pressure-lowering effects of reduced dietary sodium with increased dietary potassium.

"Previous studies have clearly demonstrated that sodium reduction and potassium supplementation not only reduce [blood pressure] independently but also have synergistic effects," note the study authors, led by Xiong Ding, MPH, with the School of Public Health at Wuhan University, China.

Among the trial limitations is its open-label design and the fact that concealing the intervention was not feasible. "However, outcomes were ascertained through standardized methods for all participants and verified by an independent end point adjudication committee blinded to trial-group assignment," Ding and colleagues explain.

The findings provide the evidence to "shape public health strategies worldwide, especially among populations who rely on home cooking with salt," they conclude, adding that salt substitutes "could significantly improve secondary prevention of stroke and cardiovascular health on a global scale."

A question commonly asked is what it would take to move from recommendations to reduce sodium intake to governmental requirements, Jones and colleagues write. And the common response is "a clinical trial demonstrating that a reduction in dietary sodium caused a reduction in cardiovascular events." 

"The SSaSS study, including this secondary analysis, provides that," the editorialists conclude.

Study authors Liping Huang, Yanfeng Wu, and Bruce Neal, report receiving grants from the National Health and Medical Research Council of Australia during the conduct of the study.

Americans eat too much sodium. 8 salt substitutes to help you cut back — and protect your heart health.

 Lots more information here which your competent? doctor has already given you, right?

Has your competent? doctor instructed the dietician to ensure that all hospital meals fall within this limit? NO? So, you don't have a functioning stroke doctor, do you? 

You'll want your competent? doctor to explain all these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home. 

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial January 2018

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease December 2014

Why Everything We Know About Salt May Be Wrong May 2017 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

Americans eat too much sodium. 8 salt substitutes to help you cut back — and protect your heart health.

Katie Drakeford

Tue, February 11, 2025 at 5:00 AM EST

7 min read

The average American consumes about 3,400 milligrams of sodium per day — well above the recommended limit of 2,300 mg daily. (Getty Images)

Generate Key Takeaways

Americans have a salt problem, consuming much more than the body needs for nerve and muscle function and maintaining a proper balance of fluids. According to the Food and Drug Administration, Americans eat on average 3,400 mg of sodium each day. The Dietary Guidelines for Americans recommends limiting sodium intake to less than 2,300 mg per day, which is about one teaspoon of table salt. The World Health Organization (WHO) recommends slightly less, at just 2,000 mg daily. That’s because too much sodium can lead to a variety of health problems, including heart disease, hypertension, stroke, vision loss and osteoporosis.

The WHO recently published guidelines on using lower-sodium salt substitutes to help reach this goal for disease prevention, stating the global effort to reduce sodium intake demands urgent action.

Cardiac and pulmonary wellness dietitian Sheri Gaw tells Yahoo LIfe that “salt alternatives are especially helpful for people who are at risk for heart disease, stroke or kidney disease.” But given the average American intake of 3,400 mg of sodium, “anyone can benefit from salt alternatives,” she says.

Health benefits of lowering sodium intake

Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention and New York City Health Commissioner, commented online on the WHO’s executive summary to raise awareness about this public health concern. The WHO paper states that 1.9 million people die each year from heart attack or stroke directly linked to excessive sodium consumption. According to one of his recent posts on Threads, Frieden says that switching to a salt alternative could prevent nearly 7 million deaths worldwide by 2030.

Adding to that is a new study, published in JAMA Cardiology and involving more than 15,000 patients, that found switching to salt substitutes led to a 14% reduction in the risk of recurrent stroke and a 12% lower risk of death.

“Reducing salt can help lower high blood pressure, reduce your risk of heart disease and potentially prevent kidney problems,” dietitian Samantha DeVito tells Yahoo Life. “When we eat too much sodium, the body holds onto extra water, which puts more strain on the heart and blood vessels. By lowering your salt intake, you're giving your heart a little break.” Consuming less sodium can also help reduce the risk of stroke and even improve bone health over time, “as high sodium levels can lead to calcium loss, which is bad for bones,” she says.

Toning down the saltiness of your food may have benefits beyond your physical health. “When you cut back on salt, you start to appreciate the natural flavors of food more, which can lead to a healthier relationship with eating,” DeVito notes.

People with heart disease, hypertension, kidney disease or fluid retention may benefit the most from salt reduction by switching to salt alternatives. However, since many Americans are guilty of overindulging in salt, it’s not a bad idea for most people to cut back. Dietitian Terry Brown says that “even ‘healthy’ people can benefit from a lower salt diet and the use of salt alternatives for overall chronic disease prevention.”

Here are 8 salt alternatives worth trying:

Traditional salt substitutes

Traditional salt substitutes swap out all or some of the sodium chloride for potassium chloride, which tastes almost identical to salt for most people.

Since low potassium levels can also lead to hypertension, getting a little boost in the form of a salt substitute is a win-win. The WHO recommends increasing potassium intake from food sources (like salt substitutes) to reduce blood pressure. This makes traditional salt substitutes like LoSalt, Nu-Salt or Morton Lite Salt an easy switch for those looking to reduce their sodium intake. Most salt substitute products are used in a 1 to 1 ratio with salt.

However, it’s important to keep in mind that these salt alternatives are not ideal for people with chronic kidney disease, as it may cause increased potassium levels in the blood, which is harder to regulate for those with the condition.

Citrus

Citrus, such as lemon or lime juice and zest, is another popular pick to amp up a dish’s flavor without adding any sodium.

“Lemon juice and zest offer an acidic kick that can mimic the taste of salt,” Gaw says. “I like the versatility of lemon juice as it can be used to flavor fish, meats, cooked vegetables, whole grains, salad dressings, soups, sauces and desserts.”

If you don’t typically have fresh citrus on hand, consider stocking up on crystallized citrus products from the TruCitrus line. They are budget-friendly and pantry stable so you don’t have to worry about spoilage.

Vinegar

Swapping salt for a small splash of flavorful vinegar when finishing a dish can wake up your taste buds and cancel out any bitterness in the same way salt does. DeVito says vinegar can enhance the taste of many dishes. “They bring acidity and brightness, helping balance flavors without salt,” she says.

DeVito recommends choosing a quality vinegar product and using it sparingly. A little goes a long way here.

Onion

Adding a bit of onion to your dish boosts flavor and adds a touch of sweetness. Dietitian Angie Konegi recommends shredding fresh onion, which releases more flavor and natural sugars, giving you a stronger onion flavor with enhanced sweetness when cooked.

If you don’t have fresh onion on hand, onion powder and dried onion work well too.

Smoked paprika

Smoked paprika is a great salt alternative that packs flavor and a little heat. “Smoked paprika is one of my favorite salt alternatives that provides a rich, smoky taste with a touch of spice,” says Gaw. “Instead of using salt or high-sodium seasoning packets, I like to use smoked paprika in taco meat, chili, stews or homemade hummus.”

The spice provides a gentle warmth to dishes so don’t be afraid to add a generous amount — start with a tablespoon or so — to take your dish to the next level.

Nutritional yeast

Nutritional yeast is a deactivated form of yeast, which is traditionally used for brewing beer and baking bread, but it’s often fortified with vitamins and lends a cheesy, umami flavor to a variety of dishes.

“Nutritional yeast is a great flavor enhancer that offers a cheesy-like taste with very little sodium and fat, unlike cheese,” Gaw says, adding that it contains beneficial nutrients and vitamins such as protein, fiber, folate, B12 and iron.

Sprinkle a small amount into soups and sauces or use it as a Parmesan-like garnish on top of dishes such as pasta or popcorn to add an extra boost of flavor.

Garlic powder

Garlic powder adds a subtly savory, sweet and slightly bitter flavor to foods. Dietitian Juliana Crimi often recommends garlic powder as it “adds bold flavor without the need for extra sodium.”

Search for a high-quality variety that uses just the garlic cloves instead of the paper and stems if your budget allows. It has more depth than inexpensive products, allowing you to use less, and it has a much longer shelf life than fresh garlic.

Other herbs and spices

When flavoring dishes without salt, it’s smart to experiment with the different herbs and spices in your fridge or pantry to find out what you like.

“Things like garlic, onion powder, basil, thyme, oregano and rosemary can add a ton of flavor,” DeVito says. “Fresh herbs, like cilantro or parsley, are great too. They’re packed with antioxidants and nutrients, and they don’t come with the health risks of too much salt.”

Adapting to a lower-sodium diet can take time, but eventually your tastes will adjust to lower amounts of salt. Konegni says it can take about two or three months for your taste buds to get used to using less salt.

Crimi adds: “By experimenting with different seasonings, you’ll be less likely to miss the salt while still enjoying delicious, flavorful meals.”

Katie Drakeford is a registered dietitian and freelance nutrition writer based in Oklahoma City, Okla.

Cognitive Decline Linked To Seasoning That 90% Overconsume

 Has your competent? doctor instructed the dietician to ensure that all hospital meals fall within this limit? NO? So you don't have a functioning stroke doctor, do you? 

But this:

 

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

And this:

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home. 

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT!

 

 The latest here:

Cognitive Decline Linked To Seasoning That 90% Overconsume

90% use too much of an everyday substance that can cause inflammation of blood vessels in the brain, which is linked to dementia.

A high-salt diet is linked to cognitive decline and possibly dementia, research finds.

Salt causes the delicate lining of the brain’s blood vessels to inflame, because of signals sent from the gut.

Fully 90 percent of Americans consume above the recommended dietary maximum of 2,300 mg per day.

Dr Costantino Iadecola, study co-author, said:

“We discovered that mice fed a high-salt diet developed dementia even when blood pressure did not rise.

This was surprising since, in humans, the deleterious effects of salt on cognition were attributed to hypertension.”

The effect was quickly reversed by lowering salt intake.

The conclusions come from a study in which mice were fed a high-salt diet that is equivalent to a high-salt diet in humans.

Subsequently, the mice had much worse cognitive function.Their brains showed 28 percent less activity in the cortex and 25 percent less in the hippocampus.

They had problems getting around a maze and did not show the usual interest in new objects placed in their cage.

They also had poorer blood flow in their brains and the integrity of the blood vessels there was worse.

However, these changes were reversed once the mice were returned to a normal diet.

The scientists found that these changes had nothing to do with higher blood pressure.

Worse cognitive functioning in the mice was seen even when the mice had normal blood pressure.

They were the result of signals sent from the gut to the brain.

These activated an immune response in the brain which increased levels of interleukin-17.

This eventually resulted in the inflammation of the delicate lining of the brain’s blood vessels.

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

 Ask your doctor about salt intake for hypertension and don't accept research from China on it.

• salt (39 posts to June 2011)

• salt restriction (3 posts to December 2015)

Review finds no proven clinical benefit to strict salt restriction for patients with heart failure

For decades, it's been thought that people with heart failure should drastically reduce their dietary salt intake, but some studies have suggested that salt restriction could be harmful for these patients. A recent review in the European Journal of Clinical Investigation that assessed all relevant studies published between 2000 and 2023 has concluded that there is no proven clinical benefit to this strategy for patients with heart failure.

Most relevant randomized trials were small, and a single large, randomized clinical trial was stopped early due to futility. Although moderate to strict salt restriction was linked with better quality of life and functional status, it did not affect mortality and hospitalization rates among patients with heart failure.

Doctors often resist making changes to age-old tenets that have no true scientific basis; however, when new good evidence surfaces, we should make an effort to embrace it."

Paolo Raggi MD, PhD, author of the University of Alberta

Source:

Wiley

Journal reference:

Raggi, P., (2024) Salt versus no salt restriction in heart failure a review. European Journal of Clinical Investigation. doi.org/10.1111/eci.14265.

Salt substitution reduces mortality, cardiovascular events, studies suggest

Ask your doctor to clarify if this substitute would help for the amount of salt you are using at home.

In many high income countries, approximately 75% of salt in the diet comes from processed foods and meals prepared outside the home. Taiwan might be considered high income but China is not.

 But this:

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. June 2011 

Researchers reveal surprising findings on how salt affects blood flow in the brain

November 2021 

You'll want your competent? doctor to explain these and give you an EXACT PROTOCOL ON SALT! Noting how much salt your brain needs to function properly! If your doctor doesn't know that, how much else doesn't s/he know? And you're being treated for a brain injury by them?

 

The latest here:

Salt substitution reduces mortality, cardiovascular events, studies suggest

Key takeaways:

• Salt substitutes reduced all-cause and cardiovascular mortality, as well as cardiovascular events, in eight trials.
• However, the results might be more generalizable to older populations that follow Asian diets.

Salt substitution may reduce the risk for all-cause and cardiovascular mortality, and it may also reduce the risk for major cardiovascular events, according to a systematic review and meta-analysis of randomized controlled trials.

However, the associations were based on low- or even very low-certainty evidence, and the effect may be stronger in certain populations, researchers said.

Salt substitutes reduced all-cause and cardiovascular mortality, as well as cardiovascular events, in eight trials. Image: Adobe Stock

“We had heard of salt substitutes as a promising method of reducing cardiovascular events and deaths but noticed that previous studies focused on shorter term follow-up, and we were aware that new [randomized controlled trials (RCT)] had been conducted since the last systematic review,” Hannah Greenwood, BPsychSc, a research assistant at Bond University in Australia, told Healio. “We conducted this study as we wanted to examine long-term studies only — that is, follow-up of at least 6 months — and ensure that the evidence was updated with the latest available data.”

In the systematic review and meta-analysis, published in the Annals of Internal Medicine, Greenwood and colleagues assessed 16 RCTs published through Aug. 23, 2023, in which participants (n = 35,251) used regular table salt or salt substitutions for at least 6 months.

The study’s primary outcomes were all-cause and cardiovascular mortality, major cardiovascular events (MACE) — like myocardial infarction or revascularization — and serious adverse events.

Among the RCTs, eight studied the primary outcomes. Of these, seven were conducted in China or Taiwan, three were conducted in residential facilities and seven included populations with an average age of 62 years.

According to the results, salt substitutes may reduce the risk for all-cause mortality (rate ratio [RR] = 0.88; 95% CI, 0.82-0.93) and cardiovascular mortality (RR = 0.83; 95% CI, 0.73-0.95), although both associations were based on low-certainty evidence. The researchers found that salt substitution resulted in an absolute reduction in all-cause mortality of five in 1,000 (95% CI, –3 to –7) and an absolute reduction in CVD mortality of three in 1,000 (95% CI, –1 to –5).

They also found very low-certainty evidence that salt substitution may result in a slight reduction in MACE (RR = 0.85, 95% CI, 0.71-1), and that its use did not increase serious adverse events (RR = 1.04; 95% CI, 0.87-1.25). The absolute reduction in MACE was eight in 1,000 (95% CI, 0 to –15), with one in 1,000 more serious adverse events (95% CI, 4 to –2).

Because most of the evidence was from older populations with an increased risk for CVD that followed an Asian diet, “generalizability to a population with a Western diet and/or with average cardiovascular risk is very limited,” Greenwood and colleagues noted.

According to Greenwood, primary care physicians “should consider suggesting salt substitutes to their patients looking to reduce their cardiovascular risk, especially if they are older or have existing cardiovascular risk factors, like hypertension.”

However, individual circumstances should be considered, as salt substitutes may not be suitable for all patients, "especially those with kidney disease,” she said.

Greenwood added that sodium intake is just one driver of CVD, “so salt substitutes should not be seen as a holy grail that will eliminate CVD.”

“Rather, salt substitutes are another tool to help manage cardiovascular risk, alongside medications and other nondrug approaches, including diet change, smoking cessation and exercise,” she said.

In a related editorial, J. Jaime Miranda, MD, MSc, PhD, FFPH, a professor and head of the Sydney School of Public Health at the University of Sydney, Australia, and colleagues explained that elevated BP is a major global health burden.

Thus, “we must turn our attention to effective evidence-based alternatives, such as the use of potassium-enriched salts,” they wrote. “Potassium-enriched salts are safe, can be incorporated into daily habits, and reduce sodium levels in processed foods.”

They concluded that implementing potassium-enriched salts into diets “holds promise to improve BP control and foster healthier societies on a global scale.”

References:

• Greenwood H, et al. Ann Intern Med. 2024;doi:10.7326/M23-2626
• Miranda J, et al. Ann Intern Med. 2024;doi:10.7326/M24-0860.

Sources/Disclosures

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Source:

Greenwood H, et al. Ann Intern Med. 2024;doi:10.7326/M23-2626.