A couple of issues ago, I made a passing comment about the AMA's recent public statement concerning salt, questioning both the validity of their pronouncement and their qualifications to make such a statement in the first place. What a furor it created!

Since then, I have been interviewed by several newspapers, magazines, and appeared on radio talk shows -- all to talk about salt. Who knew it was such a big deal? But since it is, it seems worthwhile to revisit the subject again in more detail.

The primary issue that got lost by the AMA is that not all sources of sodium and salt are the same. As far as the body is concerned, there is no connection between the chemically-cleansed sodium chloride table salt you buy in the supermarket (which is also added to virtually every processed food you buy) and the mineral rich organic unrefined sea salt available in health food stores. One can kill you; the other heals you. In fact, it's essential for life.

Of course, everyone can agree that just like anything else, salt or sodium should not be consumed in excess. (But then again, that's true of water and oxygen as well.) Which brings us back to why the AMA came out with a warning at all: Americans are consuming ever higher amounts of sodium, up to 6,000 milligrams a day, instead of the recommended 500 to 2,000 milligrams per day. These high amounts, in a form that is unfriendly to the human body and with no ancillary trace mineral benefits, are what lead to serious health problems. However, this is not necessarily the heart of the debate. The issue is that the AMA is against all forms of salt, a broad-brush condemnation designed more for media sound bites than to truly advance the cause of health.

This is a point echoed in a U.S. Food and Drug Administration article "A Pinch of Controversy Shakes Up Dietary Salt":

"Now modern technology has made salt readily available and at a price almost anyone can afford. As a result, many of us take salt and its merits for granted. But scientists keep salt in the news by debating its role in a healthful diet. At times, discussion and controversy threaten to obscure salt's importance and to confuse thoughtful consumers."

So let's examine the true nature of salt to gain an understanding of how different types of salt act in our bodies. And let's also examine some real health issues connected with salt; and finally, let's talk about how to choose and balance salt in your diet.

Brief History of Humans and Salt

"Worth its weight in gold" is an expression that served well for salt in ancient times. The history of salt is sprinkled with piracy, war, economics, religion, and health. In fact, the next time you contemplate your current salary, consider that the very word "salary" is derived from the Latin word sal because Romans often received their pay in salt. If this is hard to accept, consider that during the Age of Discovery, Africans and European explorers traded an ounce of salt for an ounce of gold -- even-steven. Around 110 BC, salt trade was so valued that salt piracy was punishable by death. And Mahatma Gandhi even used salt as major leverage against the British Empire in 1930 when he led thousands of people to the sea to collect their own salt in order to avoid the salt tax imposed by the British.

The Importance of Salt

One point everyone can agree on is that the body needs sodium chloride to function.

If we look at the big picture for a moment, we can recognize that:

• A human embryo develops in salty amniotic fluid.
• Our developed human bodies possess three distinct fluid systems - blood plasma, lymphatic fluid, and extracellular fluid -- all salty fluids.
• As a main component of the body's extra-cellular fluids, salt helps carry nutrients into the cells. It also helps regulate other body functions, such as blood pressure and fluid volume, and works on the lining of blood vessels to keep the pressure balance normal. The concentration of sodium ions in the blood is directly related to the regulation of safe body-fluid levels.
• 0.9% sodium chloride in water is isotonic with blood plasma. It is known medically as normal saline. It is the mainstay of fluid replacement therapy that is widely used in medicine in prevention or treatment of dehydration, or as an intravenous therapy to prevent hypovolemic shock due to blood loss.
• The propagation of nerve impulses by signal transduction is regulated by sodium ions. (Potassium, another metal closely related to sodium, is also a major component in the same body systems).
• Sodium is an energy carrier. It is also responsible for sending messages from the brain to muscles through the nervous system so that muscles move on command. When you want to move your arm or any muscle in the body, the brain sends a message to a sodium molecule that passes it to a potassium molecule and then back to a sodium molecule etc., etc., until it gets to its final destination and the muscle moves. This is known as the sodium-potassium ion exchange. Therefore, without sodium, you would never be able to move one muscle of your body.

Salt VS Sodium

Although the words salt and sodium are often used interchangeably when it comes to nutrition, they are not the same. Salt is sodium chloride (NaCl) and Sodium (Na) is, well, just sodium -- a soft metal occurring in isolation only on the periodic table of elements or in a lab.

While it is correct to say that our bodies need sodium, nature has not designed sodium as a solo player but offers it in a complex consisting of natural salt and essential trace minerals, as well as providing it in a variety of foods. Some foods naturally high in sodium/salt are fish, eggs, nuts, prawns, crabs, lobsters and seaweed (Note: all of these natural sources of salt are also natural sources of iodine.) Other naturally occurring sources of sodium (although not quite as high) are celery, carrots, cauliflower, pineapples, jackfruits, and even fresh cow's milk. And then, of course, there is pure, natural unrefined salt -- the salt once worth it's weight in gold and the focus of this newsletter.

So, with all these great natural sources of sodium, why do we have refined table salt?

Good question.

A Modern Misconception about Salt

Much like the story of refined flour it seems to come down to aesthetics and economics.

• Unrefined salt tends to be off-white or gray in color, whereas refined table salt is bright white. It's prettier.
• Unrefined table salt tends to clump in the presence of moisture and be unusable in shakers. As for table salt, what's the slogan for Morton® Salt? "When it rains, it pours."
• Since unrefined table salt tends to clump in the presence of moisture, grocers and suppliers have to eat the cost of salt that has to be pulled from shelves when it becomes unsellable. Not so with refined salt that doesn't clump. In other words, refined salt is more profitable.
• Refined table salt has added iodine to make up for the nutrients lost in refining.

As a point of comparison, here's the story of white flour.

• White flour is "prettier" than brown flour, aesthetically more appealing.
• White flour bakes lighter in texture because it has no bran.
• White flour doesn't spoil because all the beneficial oils have been removed, which means it lasts far longer on the grocer's shelf than whole wheat flour. Again, economically more profitable.
• White flour is "enriched" to put back a small amount of the nutrients lost in refining.
• And white flour products are now getting added fiber (sawdust in some cases) and essential fatty acids to improve their nutritional profile.

Salt and flour have suffered the same fate. The process of turning naturally occurring non-white salt into the white-powdery-easily poured table salt involves a distinct trade-off between health and aesthetics/profitability.

And there's one other financial reason for the dominance of refined salt in the market. Only 7% of salt goes for food; the other 93% goes to industry. Industry requires chemically pure sodium chloride for manufacture of explosives, chlorine gas, soda, fertilizers and plastics. In effect, table salt represents a "cheap" production overrun.

Two Salts

In today's market, we now have two distinct choices when it comes to salt: unrefined and refined. Unrefined salt (sea salt) is 97.5% sodium chloride (with up to 14% of that being moisture content in some brands) and 2.5% consisting of some 50+ other trace minerals. Refined salt is also 97.5% sodium chloride, but the other 2.5% no longer consists of trace minerals, but rather, chemical additives.

Unrefined salt is at heart sea salt, but can come from two sources: either freshly dried from the sea, as in Celtic Sea Salt, or mined from ancient inland ocean beds as in the Himalayan Salt and RealSalt brands. In either case, the salt is a naturally occurring complex of sodium chloride, major minerals such as calcium and magnesium, and a complete complement of essential trace minerals. This is the form of salt the body recognizes and is designed to use. (Note: a case can be made that mined salt is actually purer than fresh ocean water salt since the inland beds, unlike ocean water, have been sealed off from all pollution -- particularly manmade -- for millions of years.)

Note: much of the salt labeled "sea salt" is actually refined table salt unless the package is clearly labeled "unrefined." (This is also true for Kosher salt!)

Refined salt, on the other hand, is a manmade creation of the last century that contains anti-caking chemicals (with very important health consequences as we shall see in a minute) and added iodine. Iodine was added for people who lived inland and at one time did not benefit from natural iodine found in seafood. Truth be told, all refined table salt is actually sea salt at heart, either refined from the sea (brine sourced) or found in salt mines created by ancient seabed deposits known as halite. Refined salt is processed at high temperatures altering the molecular structure of the salt (not good) and removing the beneficial trace minerals. The human body doesn't like it.

Refined and unrefined salt act and react differently in our bodies.

Fundamental differences

Unrefined sea salt

• Natural salt is a prime condiment that stimulates salivation and helps to balance and replenish all of the body's electrolytes.
• The natural iodine in these salts protects against radiation, atomic fallout, and many other pollutants.
• Unrefined sea salt supplies all 92 vital trace minerals, thereby promoting optimum biological function and cellular maintenance:
  
  • Here is a partial list of the minerals found in unrefined salt and their function in human metabolism:
    
    • Sodium: Essential to digestion and metabolism, regulates body fluids, nerve and muscular functions.
    • Chlorine: Essential component of human body fluids.
    • Calcium: Needed for bone mineralization.
    • Magnesium: Dissipates sodium excess, forms and hardens bones, ensures mental development and sharpens intelligence, promotes assimilation of carbohydrates, assures metabolism of vitamin C and calcium, retards the aging process and dissolves kidney stones.
    • Sulfur: Controls energy transfer in tissue, bone and cartilage cells, essential for protein compounds.
    • Silicon: Needed in carbon metabolism and for skin and hair balance.
    • Iodine: Vital for energy production and mental development, ensures production of thyroid hormones, needed for strong auto-defense mechanism (lymphatic system).
    • Bromine: In magnesium bromide form, a nervous system regulator and restorer, vital for pituitary hormonal function.
    • Phosphorus: Essential for biochemical synthesis and nerve cell functions related to the brain, constituent of phosphoproteins, nucleoproteins and phospholipids.
    • Vanadium: Of greater value for tooth bone calcification than fluoride, tones cardiac and nervous systems, reduces cholesterol, regulates phospholipids in blood, and a catalyst for the oxidation of many biological substances.

Refined table salt

• Inorganic sodium chloride upsets your fluid balance and constantly overburdens your elimination systems, which can impair your health.
• When your body tries to isolate the overdose of refined salt you typically expose it to, water molecules must surround the sodium chloride molecules to break them up into sodium and chloride ions in order to help your body neutralize them. To accomplish this, water is taken from your cells, and you have to sacrifice the water stored in your cells in order to neutralize the unnatural sodium chloride.
  
  • This results in dehydrated cells that die prematurely.
• Refined table salt contains added iodine, which may indeed have helped eliminate the incidence of endemic goiter, but has conversely increased the incidence of hypothyroidism.
• Refined table salt lacks all trace minerals.
• Refined salt contains anticaking agents such as ferrocyanide, yellow prussiate of soda, tricalcium phosphate, alumine-calcium silicate, sodium aluminosilicate. All work by preventing the salt from mixing with water, both inside the box and inside the human body. This prevents the salt from doing one of its important functions in the organism: regulating hydration.

The problem of excess salt in the diet

Salt and Water

• Fish survive by excreting large amounts of salt through their gills. Humans excrete salt through their kidneys. But there is only so much salt that can be urinated away, and salt-sensitive individuals excrete less sodium than normal.
• Potassium neutralizes the negative effects of sodium. The more potassium you have in your diet, the more sodium you can have without any negative health consequences. Not surprisingly, natural sources of unrefined salt contain potassium; whereas refined salt does not.
• If the body can't reduce the salt, the next best way to hit the right level is to increase the amount of water. This causes the body's extremities to swell up.
• If you're not drinking enough water, the body finds the extra water it needs by robbing its own cells. In extreme cases, neurons shrink and begin to stretch; brain and spinal membranes may begin hemorrhaging. The brain shrinks. Too high a concentration of salt in the body can lead to irritability, muscle twitching, seizures, brain damage, coma, and sometimes death. Usually, though, the results aren't quite so drastic.
  
  • Dr. Myron Weinberger, an Indiana University medical school professor who authored the salt sensitivity study, says that given the "horrendous excess of salt that we end up with every day," some individuals can't get rid of it all, especially those born with subtle kidney problems that may go undiagnosed. Part of the problem is the chemical attraction between sodium and water.
• Hypertension
  
  • High levels of sodium in the diet combined with low water consumption leads to hypertension. "Every grain of salt that is retained in the body carries with it 20 times its weight in water which increases the (amount of) fluid in circulation," Weinberger said. "If you think of the blood vessels as piping, as you push more fluid in them, then the pressure goes up."

Conclusion:

Choosing and balancing salt in your diet.

Unfortunately, you can't rely on fruits and vegetables any more for your trace minerals: they just don't contain them. Even organic fruits and vegetables are largely deficient, unless the grower goes to the extra expense of remineralizing the soil. In the end, you have to supplement either with unrefined sea salt or with a trace mineral supplement. Of course, we can all agree on one thing: a healthy diet is a diet in moderation.

Unfortunately, refined salt addiction is perhaps as prevalent and subtly dangerous in modern society as drug addiction, poor diet, and a sedentary lifestyle. Excess refined salt increases appetite and decreases bone density. Hmmm!

The bottom line is unrefined natural sea salt is as essential to life as oxygen, water, vitamins, proteins and essential fats -- in conscious moderation of course. The health benefits of unrefined salt must not be overlooked based on an overgeneralization in salt guidelines.

In that light, I recommend:

• Use unrefined sea salt (RealSalt, Himalayan, Celtic, etc.) instead of refined table salt.
• Use it in moderation.
• Read labels and back way down on sodium in packaged foods.
• Minimize fast food consumption since most fast food is off the charts when it comes to sodium.
• Avoid salt-based household soft-water systems. They can significantly increase the sodium levels in your body.
• Hydrate sufficiently (but not to excess).
• Keep your kidneys functioning properly. Twice a year (more often if you have kidney problems) use a bottle of chanca piedra or a kidney flush formula.

Addendum 28 Sept 2011 [ed]

A study released in July of 2011 and published in the Archives of Internal Medicine strongly reinforces Jon Barron's position that the major problem with sodium intake is not with the sodium itself, but with the sodium/potassium ration in the body. Balancing out higher intakes of sodium with higher intakes of potassium is likely to negate any negative effects.1 And in fact, reducing your consumption of sodium too much may have negative health consequences.