Should YOU cut back on SALT??

[@Randzhabar]

Highest quality non-partisan videos on nutrition I’ve seen on YT, thanks as always

[@samuraibat1916]

He's the goat

[@HPLeft]

I am a 68-year-old man who switched from regular sodium to Losalt (a UK-manufactured product with 170mg of Sodium to 450 mg of Potassium chloride per 1/4 teaspoon) a couple of years ago. I am currently also on a low dose of calcium channel blocker. My blood pressure is now consistently in the high 110s or low-middle 120s (after previously experiencing blood pressure in the 140s to 160s). I also rigorously avoid any packaged food where potassium is not at least greater, if not double-to-triple, sodium. I am extremely happy with my results.

[@RiDankulous]

That’s great, but I don’t like that potassium salt. It’s not a huge deal for me though my blood pressure is near normal but still it’s smart to control salt intake carefully.

[@anathardayaldar]

I think the key phrase here is "rigorously avoid any packaged food..." Most consumers are not aware what packaged food is doing to them.

[@tomgoff7887]

Yes, bread is also high in sodium.

[@RiDankulous]

@@tomgoff7887 True, and i believe most store breads should be called ultra-processed junk food. They masquerade as being healthy. I cook my own bread, and I do use salt sometimes but if I make bread flatter on a cookie tray (still using yeast though and rising), I find that a crunchy crust is tasty enough where I don't need the salt. This is whole wheat bread with yeast (2 ingredients). I only do it since I went whole food-plant based for health.

[@rthib1960]

I appreciate your channel more and more as time goes on. Some nutrition channels start with valid, solid info, then as time goes on veer into personal opinion and then blossom into full-fledged Gurus! You have stayed true to your original stated purpose, and you info is extremely valuable. THANK YOU SO MUCH! Ron from NH

[@MrPopestar]

For about 30 years I suffered from ectopic heart beats. I finally found the cause - not enough salt in my diet. As someone who never adds any salt to my cooking or food and someone who is fairly active and drinks lots of water, I think my system was lacking in salts. I now add some sea salt to my cooking and I have had a massive reduction in ectopic heart episodes.. So yes anecdotal, but I didn't have enough salt in my system..

[@MochaZilla]

It may be anecdotal but its based on facts. You need salt and if you exercise and do not eat much processed foods, you must add the salt to your food. I also rarely eat processed foods and i always add Celtic or Redmond salt to my water and foods. The more sweating I do, the more salt i add. I also add potassium chloride to my water as well.

[@pdblouin]

On a population scale, I worry anecdotes like these do more harm than good, since the vast majority would benefit from a reduction in sodium intake. People like you are a rounding error. But I'm aware this channel attracts health-focused viewers, so if someone honestly eats zero processed food, I don't doubt that they could benefit from added sodium.

[@MrPopestar]

@@pdblouin I don't disagree - but surely people don't take anything in the comments as something they should be doing! I point out its anecdotal and in no way should be taken as 'fact'. I suppose my point of the comment was that I took the no salt thing too far and it was detrimental to me for a long time and anyone else who is suffering from ectopic heart beats might want to review their salt intake. That is all. As you say - most western people would benefit from salt reduction.

[@harvinderubhi5540]

​@@pdblouinbe aware we have different thresholds so there will be outliers around the mean from population studies. Our bodies are our personal labs.

[@Teneab]

​@@pdblouinPerfectly said, I was feeling the need to reply to the comment, but your reply perfectly summarizes my thoughts.

[@hannstv]

Really like and respect this channel. A lot of good info explained in a very clear manner.

[@AndyMorrisArt]

Another great video. Years ago I had BP around 135/85 and I had absolutely no idea how much sodium I was getting because i just ate whatever which included a lot of fast food which certainly tasted salty quite often. So I don't know what my sodium intake had been possibly over 4 grams a day. All I know is that I started reading packages and cooking most meals at home and targeted 1500 mg of sodium a day, plus I started walking ~ 4 mornings a week 30-60 minutes at a pace of 3.8 mph. I lost weight fast about 10 pounds and my BP dropped to 122/70 which the doctor said was good, so since then I try to get about 1500 mg of sodium daily. I see YT Videos talking about people need more salt but they're usually put out by "doctors" promoting Carnivore or Meatcentric super high protein diets that are scared to death of Lectins & Phytates so I ignore them, but I do understand that our bodies need sodium. I've heard that the minimum daily need is around 500 mg so I figure if I'm between 1000 and 1800mg I'm probably in a good zone, but of course I don't really know for sure.

[@RiDankulous]

It is a very big drop. I don’t think most people would get that big with drop but I’m glad you’re healthy.

[@TipoQueTocaelPiano]

Your diastolic blood pressure dropped 15 points and your systolic only 13? That's interesting.

[@Firebuck]

Thanks for the quick course in statistical power. Now that I understand it better, I can see how important it is for evaluating what a study can (and cannot!) tell us.

[@MochaZilla]

The eay i like to think of it is "studies provide insight, but rarely provide hard evidence applicable to everyday life because we dont live in labs or controlled environments." Sure they provide useful information, but as a natural health enthusiastsl, I have to rely more on hundreds and thousands of years of medicine practices as well.

[@avoycendeether8869]

I'm glad I hung on until the end. I'm going to take your advice & pick up a home BP monitor. Didn't realize how affordable they are.

[@itaygev1377]

Gil i came to your channel through physionic, and i've got to say i'm not dissapointed by one bit. heavily researched content, intresting and diverse subjects, and lastly the videos are just straight to the point without scrumbling too much. i'm subscribed and waiting for more intresting content as in the meanwhile, i watch more of your old videos.

[@shahid-irshad]

Audio podcast please. I’ve been requesting this for a long time now. I know this can be time-consuming for you maybe but this will help your regular followers a lot like me who can listen while driving or cooking thanks

[@ZsuzsaKarolySmith]

There’s an app called Musi - it plays YT videos with your screen turned off - without ads too - and you can set playlists on it.

[@ffxiiangel]

The balancing act of my sodium, potassium, magnesium intake was a challenge for me about two years ago. I feel like I’ve finally gotten it figured out now and it’s made a world of a difference on how my body feels. I had hypertension and it’s gone back to normal.

[@MochaZilla]

Usually hypertension is caused by either excessive sodium OR deficiency in potassium. Many people are potassium deficient so it can be alleviated by many through either eating nore fruits and veggies or consumption of potassium chloride.

[@Lennybird91]

There is all this talk about sodium and rarely anything about potassium. The two literally work hand-in-hand opposite to each other. Science and medicine needs to start not just advocating for lower sodium but increased potassium and more importantly, the ratio.

[@4124V4TA-SNPCA-x]

​@@Lennybird91 The mineral wheel, a.k.a. “Mulder’s Wheel” after it's inventor, an agronomist named Mulder, was first developed in the mid Twentieth Century. It is well known and used ever since. Not only used but revived and expanded upon. Similar wheels for vitamins, toxic and non toxic metals and all kinds of things do exists. I think it is well known and used by anyone who even a little bit care about it. And you cannot force knowledge into the head of those who aren't interested. Just like you cannot force musical theories into those who doesn't care at all about music.

[@mirandamom1346]

How can mortality be the only important outcome? Quality of life matters to me, and I’d much rather not have to deal with the sequelae of a stroke or heart attack!

[@espenstoro]

As a lifter who drinks between 4 and 5 liters of water daily without even trying, I'm bumping my salt a fair bit nowadays. Especially since I'm in a calorie deficit, I get less salt due to less food, so I put it in water before training. I'm not running to the bathroom twice an hour anymore, I stay hydrated, and performance is so much better. BP seems to be fine as of now.

[@TyRaff]

Similar here, if I don't add salt, I urinate way more.

[@heatherh.946]

This is still the best source of information regarding diet and health on the internet. Thank you!

[@ruthhorowitz7625]

From my experience cardio reduces BP way more than reducing salt intake.

[@Vodka007]

cardio also makes you sweat and clear salts out of the body

[@ruthhorowitz7625]

@@Vodka007 all exercise does, but only running lowers my BP

[@brucejensen3081]

Increasing BP in short bursts seems to lower it overall. Maybe has an effect of lowering chronic stress, which seems to be a big factor in elevated BP.

[@paulmaxwell8851]

That's because only 1 in 4 adults has a sodium sensitivity. They can really benefit from reducing their salt intake. Of course, we don't know who is who.

[@bobbyadkins6983]

It all depends on how much you are already eating. Some need to cut back and some need more.

[@jeffm5099]

The vast majority of people are already consuming way too much sodium in their diet through processed foods.

[@bobbyadkins6983]

@@jeffm5099 No doubt, but some still need more.

[@someguy2135]

One more source of iodine in the diet is seaweed like Nori snacks. A much healthier snack then most of the alternatives.

[@pearljam_1]

I don’t know if I would consider those snacks 😂

[@MatthewWhelptonIceland]

With the current interest in the gut microbiome, you will often see recommendations to eat more kimchi and fermented vegetables but these are higher in sodium. Can you do a video reviewing the health benefits/challenges of eating more fermented vegetables?

[@TangoMasterclassCom]

Interesting video! You explain so good how guidelines (nutrition, movement) are based on what could be "achievable" for the general population, and I think this way we always live half a century in the past, because people don't easily change their habits, and we can never progress when we test lifestyle and keep it at what is achievable for the people that already created all these habits. A status quo and only very slow progress. I have always been very interested in healthy lifestyle, so I always looked at the nutrition guidelines and tried to follow those. Personally I would love to get guidelines that say "this is the general recommendation, and this is what people can strive for". For many years I have eaten cheese and dairy as an ethical vegetarian (I know, contradiction in terminae, because vegetarianism can not be ethical), because the general guidelines included cheese and dairy, until I finally learnt 7 years ago, that I did not NEED to eat these foods to stay healthy. Quite the opposite, I noticed my health got so much better (less saturated fat, and less inflammation) not eating these foods.

[@kenwin5845]

I always have a low blood sodium, often just below normal. My potassium is usually on the upper end or slightly over. I never salt food, and eat a high fibre diet. I still have high blood pressure. Diet has had no impact on BP, but the rest of my health is very good. I am moderately active.

[@TyRaff]

Can we get a video on sodium consumption irrespective of blood pressure?

[@Parker_Miller_M.S.]

In sports nutrition there are contexts where we do advise/recommend more sodium to replace that which has been lost and enhance hydration. 1) if someone is a very salty sweater, 2) if its hot and humid producing lots of sweat, and 3) even if one is not sweating a ton, adding sodium as part of a flavored hydration method helps increase drinking frequency if plain water is too bland and reduces water intake. This can be very helpful if it's cool temperature wise and dry air. Based on the meta-analyses of RCTs using lower sodium or non sodium salt substitutes, and dietary pattern data along with general nutrition guidelines, i do suggest to my clinets to be advised about their sodium intake and to aim for the target of 2300mg/day on average.

[@RiDankulous]

I learned to another great term from you doctor and it’s called gustatory habituation. Even my voice to text recognizes it.😂 I think people underestimate the power of slowly reducing salt. It is night and day difference compared to just cutting down abruptly. Thanks for your interesting information

[@johnfontana7256]

It’s a no- brainer!, if you eat processed food ,sit on a couch all day, and never break sweat,you need to cut back!

[@JasS19362]

I salt my food pretty generously and I generally avoid UPF and realised through tracking that it’s almost impossible to over-consume salt if you’re not eating pre packed foods

[@hjglass]

Hi Gil. I’ve been following and enjoying your content for a couple of years and am now studying to become an RD. Want to start off by saying thank you so much for your work - I find the way you communicate science really inspiring and I often share your channel with friends and family who come to me with nutrition questions. This is a bit of a tangential topic request, but since it’s related to sodium I thought I’d put it in this chat. I was wondering if you could do a deep dive on the science behind all the electrolyte drinks/powders we see nowadays and their claims that they improve hydration. It seems like a LOT of sodium for the average person who probably is already getting too much and as far as I can tell its recommended use case would be very particular - athletes who are sweating a lot, maybe lactating moms, or people who’ve recently had GI distress that caused vomiting/diarrhea. And in the latter case, I would think that it would actually be more beneficial for it to contain some glucose to improve water absorption and thus rehydration in the gut via sodium-glucose cotransporters. However many of these drinks market themselves as sugar-free, which seems to be counterproductive to their purpose. Would love to hear your thoughts. Thank you!!

[@salvarunatortuga5396]

Is MSG considered a salt substitute? And if so how does it compare to salt in terms of blood pressure, mortality, etc?

[@ThatFuckinGame]

It's probably the same since sodium the biggest factor. Wich MSG has.

[@judyjohnson9610]

It's a flavor enhancer. I would certainly restrict its use, like salt it is high in sodium.

[@dan-qe1tb]

I've been on antihypertensive drugs since 2006, and I think people need to understand that high blood pressure, is a complex, multifactorial health condition, with a genetic component, and not just "something that happens when we eat too many salty foods". The following also sound right at first: "cholesterol is something that happens when we eat too many burgers and deep fried foods", and, "diabetes is something that happens when we eat too many sweets". Those are overly simplistic. I get ten hours a week of exercise and my body fat has become very low. That's still not enough for me to get the lower number below 80 all the time. The numbers do line up with what Gil had presented in a recent video (the table that had the multiple actions you could take, and what the related reduction in your bp would typically be). But, I've been exercising for a very long time and haven't gotten any younger. Some people do need the boost from the medications. It's possible that the hydrochlorthiazide I was taking until recently, was making me pass too much potassium. It was low off the scale last summer, one time, even though I eat lots of potassium containing foods and supplemented slightly too since it had been over 100 degrees when I was exercising. The doctor had pointed out that potassium on the low side of normal means my kidneys are working well. I got potassium chloride, but I use it little, and cook from scratch. I have my sodium and potassium levels tested several times a year as part of the standard metabolic panel. How do people know if they need to take supplements or not, or how much, if they don't get this done?

[@etmax1]

I've found that when particularly in summer I have to occasionally (maybe once every 1-3 weeks) drink a glass of water with about a table spoon of salt lest I get cramps. The salt doesn't affect my blood pressure much at all, in fact if I look at the readings over that time, say a week either side of the salt drink, I see no correlation between the salt and BP. I am on BP meds though, which may have an impact.

[@fd_skate]

I put extra salt on most cooked meals, but I eat very little salty snacks. I hope it evens out! 😇

[@painterishere]

thank you for another great video! Could use of a sea salt rich with minerals make any difference? Hopefully there will be another video about on that subject. Cheers

[@LVArturs]

Unlikely, sea salt is still over 90% plain old NaCl. Same with Himalayan.

[@Parker_Miller_M.S.]

Just marketing hype, there's no unique benefits to "sea" salt or Himalayan

[@MochaZilla]

​@@Parker_Miller_M.S.false, there is benefits to having small amounts of naturally occurring minerals in yoyr salt. Also, many sea salts and table salts have unhealthy byproducts, like aluminum and sugar added as well as silicone dioxide as an anti caking agent. So the best salt you can get is pur, unaltered salt without the poison added.

[@MochaZilla]

​@@LVArtursyou're forgetting all the unhealthy additives in processed salt. These are unnecessary ingredients and unhealthy, so the more pure salts like Redmond real salt or Celtic sea salt are the best you can get.

[@AndyMorrisArt]

"Rich" generally confers a lot of something, whereas Sea Salts and pretty coloured salts have only trace amounts of minerals not significant amounts. Sea Weeds can have high levels of some minerals such as iodine, in fact such high levels that they could deliver too much so you need to read the package and adjust a serving size to deliver the dosage you are seeking.

[@MightyDrunken]

I've found that I almost never use salt even when cooking, everything is so salty already. A pot noodle might have 2g, ready meals and prepared soups, so much salt. Even curry powder often has salt. Chinese sauces have tons of salt. I think I need to change my diet because of this.

[@alinamazurkiewicz4407]

Thank you! I didn't even know about salt substitiues! Very good idea! Nice to see it might work.

[@ponycarfan]

I stopped eating all processed foods, which eliminated almost all salt from my diet. I have to purposefully ADD salt to my diet. Since eliminating processed food, my blood pressure is lower, even though I salt everything I eat.

[@cheese7119]

YEEEESSS THANK YOUUU I waited for this exact episode :D

[@shaystern2453]

YES

[@littlevoice_11]

What are your thoughts on electrolyte supplements? Effectively sodium potassium and magnesium as a drink for the general public - marketed at those who exercise, are on a low carb diet and also health conscious individuals

[@OTatime]

I have used Morton Lite Salt in my weight loss journey. I also use it to make my own electrolyte beverage - it has all of the necessary elements found in commercial electrolyte drinks and powders. I’ve lost 90 pounds and kept it off for three years. Accordingly, my blood pressure has dropped from borderline hypertensive range down to consistently in the 116/65 ballpark.

[@ithacacomments4811]

better salt is Himalayan Pink Salt....84 trace minerals.

[@bellenesatan]

​@@ithacacomments481184 trace minerals including healthy treats like aluminum, lead, cadmium, and all sorts of fun things!

[@bellenesatan]

​@@ithacacomments4811 Listed below is a list of minerals and elements Himalayan Rock Salt contains. Per 100g: Hydrogen 0.30 g/kg Lithium 0.40 g/kg Beryllium

[@OTatime]

@@ithacacomments4811 Nope. Not in the consistent proportions needed to be a reliable electrolyte source.

[@jeffrey1312]

Math guy here. Another important statistical issue is Confidence Interval and Alpha Value, commonly called P value. In statistics you can have a high confidence something is within a wide interval or a low confidence something is in a narrow interval. I'll read these papers, but the ones I've seen in the past were really quite weak to the point I felt like it was dishonest.

[@imthinkingthoughts]

effect size is also critical for interpretation

[@kinpatu]

Another issue with using all cause mortality is that it ignores all cause morbidity, which is arguably just as important.

[@JeffC-fq1be]

That would be a problem - not an "issue."

[@4124V4TA-SNPCA-x]

But Single study like this cannot do everything at once.

[@keppela1]

Surprising the salt substitute had such a big effect as it doesn't change the amount of salt people are getting from processed food (i.e. the primary source of sodium in most people's diets).

[@jimatsydney]

Any gardener knows potassium is in every vegetable. The problem I have with this is that potassium chloride is not found in food and is an artificial chemical. JUST EAT MORE VEGGIES INCLUDING SEAWEED.

[@ericwarmath1091]

Four triggers for blood pressure: exercise, magnesium, potassium and Thaimine. A lot of people don't get enough of any.

[@vegangreatlife]

Thanks for this as I find myself trying to get that right balance of Na:K. I’d love to see studies on people eating plant-based as they will naturally be consuming higher K to Na in their diet if consuming lots of fruits, veg, beans and grains without using a lot of high sodium packaged foods. Would avoiding salt be as beneficial as many in that community are doing? I’ve also seen studies indicating that miso which is fermented may not effect the body like straight up salt. I’m curious bc I always tended towards LBP, yet getting too much of either relative to the other has an impact.

[@demonfedor3748]

When I followed keto diet I lost a ton of weight and also ate a lot of potassium which caused my systolic blood pressure to drop close to 100. I felt sluggish and weak. I now moderate my potassium intake. And try to follow a more plant focused diet.

[@aleksander4711]

Right after MI being on lowering blood preassure meds I tried to cut on salt . I started experiencing extreme feeling of weakness, and chronic pain in upper arms and legs. There was no relevant decrease of electrolytes in blood levels.

[@ClassyBadAssy1]

Potassium is very challenging to obtain in our diets on a daily basis, so does using the salt substitute increase K levels for optimal BPs?

[@MochaZilla]

100% yes it does, and i have been adding KCl to my water for about 5 years now. It is a suoer cheap and effective method for increasing potassium. Bulk Supplements sells pure potassium chloride powder for very little. And 1/8 tsp is 500 mg potassium, so it will last you a long time.

[@AndyMorrisArt]

I was wondering that as well.

[@ZsuzsaKarolySmith]

Bananas have loads of potassium!

[@ukispargitus970]

What about when curtting salt is the main source for iodine so important for Thyroid? Iodized salt has been often suggested to keep that organ in order against the development of thyroid nodules. Who drinks enough milk? Or fish and seafood? *Essentially we are saying that cutting regular salt, means cutting iodine and increasing health risks with Thyroid.*

[@gordonv.cormack3216]

I'm less salt sensitive since I lost weight, lowered my overall BP, and increased my exercise. I still use pure potassium chloride for cooking and table salt, but I notice when I do eat lots of sodium (typically through occasional consumption of cheese, processed meats, or snacks) it doesn't seem to have any noticeable effect on my BP. Not sure why bother replacing half the sodium in table salt when you can replace all of it with potassium. Also, the potassium substitutes sold in Canada are iodized, just like table salt.

[@TyRaff]

There is a blood pressure study from the 70s performed in Scotland who's results showed a tighter correlation for potassium and BP than it did for sodium. I can't think of any studies offhand, but I'd be interested in sodium consumption vs sodium-chloride consumption, ie. Foods with certain preservatives vs added salt.

[@wxdave5448]

As always, it’s never that simple. Population level studies VERY often fail to deal with uniqueness we humans have. Anecdotally, my mid-80’s parents have both been told by cardiologists to *increase* their salt intake as have I since a young age, despite some hypertension. The electrolyte need for salts in our systems out weighs the hypertension issues (even if some medication may be needed to control it using other methods).

[@ZsuzsaKarolySmith]

Sodium can come in the form of fruit and veg, not necessarily just table salt. Celery in particular is quite high in sodium.

[@michaelhoile1369]

Another great video 📹 👏

[@stan8926]

Lack of salt (like you prepare all your food and do not put salt) can reduce stomach acid and cause acid reflux. I went on WFPB Salt free diet and my BP went form 140/90 to 105/70. After 4 years I started adding salt and my BP still drops below 100/70 often. For me the main was diet and then salt does not affect the BP much.

[@AndrewPawley11]

Excellent.

[@ChessMasterNate]

Some mention of salt actually being required could have been appropriate. Also, the iodine in dairy varies dramatically. If there is little in the soil that grew the hay or whatever the cows are eating, there will be little in the milk. The Northwest US and the Appalachians are especially low, in the US, but there are many places where the soil is low in iodine. I think the most reliable way to get iodine is to supplement it with a drop or two of Lugol's Formula (that is not a brand). It is great in eggs, where I think it makes the eggs actually taste better. In water, it is a lot worse. I remember the story of a woman who was told not to give her mother any salt, and the mother died because she could not get enough sodium. She begged and begged. My mom just had a heart attack, and low sodium may have been a factor. My mom was with my sister in Yuma, AZ. to get some dental work across the boarder. It was hot weather, and she had to walk back and forth across the boarder and to the dentist for 3 days. I feed her normally where she lives with me in San Diego. I make everything from scratch. I do add salt but modest amounts. I use lemon pepper on the salmon we eat one to two times a week, and I put it in the scrambled eggs we have 2 days a week. I always have celery on hand if she wants some. She also has snacks that she insists on, that I don't make. There are some fig bars, some likely nutritious brown bread, and some Belvita blueberry cracker things. She also eats kefir cheese. I assume these things have salt. After she went to the hospital, they measured her sodium as very low. I don't know the exact number. Okay the crackers have salt, the fig bars only very little and the kifer does not have any. I never could get her to see a doctor about anything. She is 88, and was not on any meds. I tried to do my best with supplements, but I am driving blind with no labs. I just try to feed her very healthy and I could get her to walk at the lake sometimes. I try to get her blood pressure time to time. But she hates the cuff and panics that the circulation is being cut off. I tell her "Of course, it is cut off, but just for a minute." But it does not work. So, yeah the readings are high, but I have no way of telling if that is from her psychological state or actual high blood pressure. A big reason I started studying nutrition in earnest was to feed my mom the best possible diet she would tolerate. And as I could not see her labs as there were none, I went by my labs, as I was eating roughly the same things. I made modification after modification and went from 16 things out of normal in my labs to 5, maybe less as I am due for more labs. My resting HR is 49, BP is 117/71. I am really disappointed, I could not get her more healthy. Hopefully, her recovery will go well. She had to have two heart surgeries. I also hope I have no difficulty getting her to take a high blood pressure medication they are sure to prescribe. They did say the rest of her labs look good, but I don't know if that is just a lowered bar from being 88, or actually good, regardless of age. My mom sometimes got my sister to buy things I would not buy because I did not think they were healthy, and there were healthy alternatives. And I, too, would occasionally break down and buy something she wanted on her birthday or Mother's Day. My brother made her a profoundly unhealthy meal on Mother's Day. That also may have been a factor. I literally cannot eat his cooking. I have been eating too good too long, that it makes me sick. I skipped the char grilled fatty lamb chops, the bowl of melted butter for the artichokes and such. I just ate my artichoke dry, and as there was little else to eat, I ate his butter drenched rice pilaf and butter drenched zucchini and other vegetables. And I am not exaggerating. He literally had a bowl of melted butter for everyone at the table. I did not eat very much. I anticipated crap food, so I ate something before I came. His cooking is a massive point of pride, and everyone but me congratulates him on the food. He says life is too short not to enjoy it. I try to tell him that your tastes change as you eat healthier, and you do enjoy the healthier food, but he just won't listen. He says he eats brussel sprouts, because he knows I can't stand them, as a sort of challenge to my claims of eating a healthy diet. He complains about aches and pains. I say I had them, lots of them, I could barely walk, it felt like my bones were grinding against each other, if I got on my knees they would bruise badly, and that is very true, but all these problems are all completely gone. I can sit on the floor for an hour fiddling with DIY stuff and I get up and nothing. No ache, whatsoever. I can easily bend down and touch my toes with no pain. Every morning when I feed the cats, one cat always stays two steps below me, but I can still bend down and pet him without bending my knees, though I have to grab the railing to keep from tipping over. I hike at the lake, and can climb one cliff that has got to be close to 60 degrees, usually just with my legs, I am 55, and 270 lb (I have lost 60 lb, all of it fat. I do have a lot of muscle and genuinely have large bones, but I still need to lose more fat. I am trying to do it slowly, so there is no rebound). 5 days a week, I eat 2 serving bowls of mixed non-starchy vegetables, a handful of raw hulled sunflower seeds, about 15 raw filberts, 10 almonds, 5 half walnuts, and 4 string cheese sticks for breakfast. Just before my morning hike, I have an apple and some dried apricots. Lunch is more variable, and I have no dinner...generally. I prepare everything in ways to minimize Advanced Glycation End-products, and avoid a dozen or so foods that are higher in lead. I also have a number of supplements I have carefully researched that I take. There is iodine in the drinking water, as I use revers osmosis and have filled a 260 gallon tote with the filtered water and need it to stay clear of bacteria. Iodine seems like the best way. I was just putting 1 drop of Lugal's Formula iodine in the scrambled eggs the 2 days of the week we have eggs, but with iodine in the water I don't think it is necessary anymore, and I don't want to go too high. I think for the elderly that are prone to high blood pressure, trying to manage it with adjustments to sodium and potassium can easily be inadequate, and probably should not be tried at the extremes. Better one medication now than 8 later.

[@James-hn6fe]

Some say thst sodium damages the endothelial. Blood pressure is not the only issue.

[@j.lahtinen7525]

Would be interesting to see if the hyperkalemia, in the people who got it, could be countered simply by having them eat a little bit of liquorice - since eating too much liquorice can cause hypokalemia. And if it would work, what would be the appropriate dosage of liquorice?

[@veronicaheaney3464]

My doctor recommended that I reduce my Na intake because my BP was going up, though it wasn’t out of range. Figured it would probably be ok since Lo-salt simply reduces Na but increases K which is also needed. However, substituting Lo-salt for my usual salt resulted in elevated K levels in my blood. BP was pretty much the same. Personally, I think my BP elevation at my doctor’s office is my simply being there, not at home where it is rarely elevated.

[@hystrionic]

I'd like to see a follow up where they compared regular salt to an intermediate potassium salt that was more balanced (more Na, less k). less risk of hypokalemia but maybe still benefits?

[@chayabudhabi]

Please can you review Esselstyn (diet) and Ornish (diet, exercise etc) claim of reversing heart disease?

[@brucejensen3081]

Think I will take this with a grain of salt. Not that I am salty about this, but this whole low salt thing has led to many with low sodium levels, and those that need to reduce sodium, don't care

[@jeffm5099]

Very few people have low sodium levels. Have you bothered to look on a package of anything how much sodium is contained? It's insane how much sodium people are consuming now days.

[@Anonymous-nn4sk]

I would like to know the effect of salt reduction on stomach acid production and indigestion.

[@harryturnbull4781]

Massive question mark here - did these participants take blood pressure tablets or suspend them for the trial?

[@MrMohshehab]

when replacing saturated fats with poly/monounsaturated ones, is the reduction in apoB caused by the avoidance of saturated fats or the addition of unsaturated fats ? how do unsaturated fats work exactly to reduced ldl ?

[@heathensein6582]

Never ask questions. People here don't like it and perceive these far-fetched interpretations as facts

[@m_m991]

​@@heathensein6582according to you

[@baarbacoa]

Based on my observations,, the reality is that most human beings would rather die or suffer physically than change their dietary or exercise habits.

[@loganmedia1142]

Exercise requires suffering physically and mentally. Eating food someone doesn't really like is not great either.

[@baarbacoa]

@@loganmedia1142 You can get used to eating right. It doesn't take that long.

[@ZsuzsaKarolySmith]

In my experience, all it takes is a health scare! It’s not that hard to change habits, especially when see results early on. But you do need to change your mindset first - and most of us need a short sharp shock to do that - and hopefully at a stage in our lives when it’s not too late!

[@JD-tn5tb]

What about celtic sea salt or pink himalean salt? Do they contribute to heart attacks and strokes? I've heard from some sources that they are actually good for you. Years ago, I heard that it was good to drink celtic sea salt and water to clean the body out.

[@CptApplestrudl]

So what's a recommended daily intake? I've looked at a few sources I could find quickly and it seems like at least ~2g is totally fine and even up to 5 or 6g can still be healthy. 10-12g/per day or higher is likely too much.

[@ElCid_86]

Iodized salt vs sea salt make a difference?

[@phyx1s]

Advertice to everyone to buy a bloodpressue machine assumes that people know hoe to execute bloodpressue measurement accurate en reproducable. Specially if you want to see small changes made by swapping sodium to postassium. These changes are smaller than the errors one can make if not measured correctly.

[@KarlKrassnitzer-mm8wb]

The salt substitution trial shows phanomenal outcome. At my oppinion the salt reduction study seems creepy. I personally do not ad salt to my food, eat no processed food for many years. Train a lot endurance and sweat a lot and feel good without salt or electrolytes. My minerals are coming from plain food. Maybe a strict salt restriction shows the same or better outcome than salt restriction with potasium. Especially for salt sensitive people.

[@johngerbeb]

Ask and I recieve! Thanks for the topic. Kinda sad that the study allowed participants to add salt if they wanted. Compliance to low salt is pretty tough because manufacturers put it in everything. The Dr. Gregers out there seem to make it work on "lower is better period" but they are definitely full bore and make their life about it. Hard to tell if their panel of doctors is lefit or the same religious types like that are angry at carnivores. Would it be worth the squeeze?

[@dan8964]

Salt enhance taste, therefore increase calories intake. I wonder if there's a study of amount of salt intake vs calorie intake

[@AZ89231]

Missing the interaction bt macronutrients and minerals ie refined carbohydrate intake and sodium. The higher the refined carbohydrate intake, the more impact reduction in sodium has on blood pressure control. The lower the refined carbohydrate intake, the more negligible sodium intake becomes, approaching a general requirement to increase sodium intake if refined carbohydrates (or total carbohydrates) approach zero intake

[@patriciaadams3010]

Hmmm. Extremely informative, as usual, but not totally what I wanted to hear. I am on a low dose BP med that does jack up my blood potassium level. I am afraid to use a salt substitute for that reason, but I don't think I'd be able to stick with a low-sodium diet. Ugh, what to do? And what level of hyperkalemia should be concerning?

[@edl653]

Almost forgot. One way to lower one's serum salt is to drink a couple more glasses of water per day. Of course, you can't add more salt to food. So on top of any liquids you already drink, add more water.

[@RemotHuman]

6:25 why not just do a study that measures everything, and then future studies can find correlations from all the data you gathered. I guess it would have to be a correlational study only, sine you can't do every intervention without running out of statistically significant number of people for each group... or can you.

[@xenasloan6859]

Am I alone in my thinking here? The substitute was not a placebo but a natural antagonist-type/remedy to elvated Na+. In other words, the unequivocal need for both sodium and potassium is known science; what seems to be ignored is the restorative effect on regaining the balance between the two without demonising either - homeostasis perhaps(? )

[@lv1985aa]

I always add 400mg potassium chloride powder to any high sodium meals just to even out the ratio a little more

[@RealJonzuk]

im having at most 900mg of sodium a day from 2 protein shakes but if i have one its like 500-600mg of sodium i use the NuSalt, really good stuff fresh lemon juice can also help you cut back on sodium if you put it in your dishes

[@MochaZilla]

That level of sodium is detrimental to your health. Meaning, you are consuming far too little sodium.

[@SuperAngelic5]

Some of the salt substitutes taste nasty. Does anyone have a suggestion for a salt substitute?

[@MochaZilla]

Dont substitute salt. You need salt for life. Redmond real salt or Celtic sea salt are the best options.

[@AndyMorrisArt]

I've just learned to appreciate less salty food, but I've been playing the low salt game for nearly 30 years now. A lot of times if I buy prepared foods which is very rare, it will almost be too salty for me to eat. Same with sweets.

[@gregorygreene1940]

I use NuSalt. I find it's very close to regular salt. Sprinkling salt on food is not the problem for me though. It's all the built in salt that adds up during the day. Had to get rid of a lot of stuff that has tons of sodium in it.

[@SuperAngelic5]

@@MochaZilla thanks

[@genericusername5909]

Is the decrease in cv events in line with rates of undiscovered sodium sensitivity?

[@Utomneian]

idk, i see conflicting information about sodium all the time. i'm sure that not going to wild with salt helps health, but i can only handle reducing one major bad thing or another, and i decided to try going low to mid carb for a while, with some occasions where i break the diet for my own sanity. if i had the willpower and willingness to never have cake, brownies, ice cream, or cookies again, i would be keto or something, lol... but yeah, i feel like i have been able to lower my BP just as much with low carb, as low sodium diet, and it's easier to avoid carbs than sodium, at least for me. i don't "add salt" but i can handle giving up carbs most days, because not only do carbs affect BP, but they make you fat, give you fatty liver disease, and diabetic if you go hard on them all the time. all reducing sodium promises is slightly lower BP and maybe less cardiac events? so yeah, i am definitely over the AMA "recommended" amount of sodium per day, but after conducting experiments on myself, off my meds for a few days, i find myself between 119/67 and 135/89 at the highest (though i measured within an hour of exercising and eating lunch, so i don't know if that really counts?). compared to where i was a year ago, 135/89 doesn't even phase me, i saw 140/90 to 160/100 easily if i had a "fun filled weekend" involving alcohol, carbs, and especially sweets which are the demons of carbs. since i've been taking a break from alcohol, reduced carbs to the point of depression (i really love potatoes and rice, this makes me miss them so much) but also minimized sweets (like a square of dark chocolate a day max). as hard as this simple diet change has been to commit to, it does seem to be helping well enough without worrying about fat and sodium, though i don't really intake that much fat either way. if i could afford steak even once a week, i would have it, but tenderloin is like $17 a pound where i live, so i mostly just eat chicken, plain yogurt, and pistachios for my protein and fat intake.

[@reasonsformoving]

Not sure if you did a video yet on this but what about someone who has a good apo-b profile - 60 - but has high cholesterol?

[@demonfedor3748]

Yes,there was a discussion about it. The takeaway is when in doubt follow the apoB. ApoB particles are the very thing that gets stuck in arterial walls, cholesterol is just along for the ride.

[@Julottt]

I think the people who had benefit from lowering their salt intake were eating more than 1500-2000 mg of sodium daily. A comparison with a no added/hidden salt diet would be much more interesting.

[@samdaniels2]

Should salt intake change if you’re taller and do more exercise?

[@stacielivinthedream8510]

I believe so if you work out as you sweat more while working out. I use more sea salt because of this even though I'm only 5'5".

[@coalhater392]

If you don't run marathons on the daily then no around the 1500 mg is good enough.

[@MochaZilla]

100% yes, bigger body, more mass, more water needed, and more minerals (and protein, etc). And if yoy exercise even more sodium necessary.

[@aaronbr2001]

I’d like to know this too. I’ve heard you can sweat up to 2000mg per hour and I work out more than an hour a day. I have read that high salt increases risk of stomach cancer though.

[@stacielivinthedream8510]

@aaronbr2001 they are talking about table salt, but sea salt is healthy! I heard we sweat out a 1/2 tsp for every hour worked out or something like that. I'd goggle it to be sure. This is mainly for bikers and runners who sweat a lot.

[@kempetai2099]

Dr Carvalho, whats the ideal saturated fat intake, either the minimum you need to survive or the optimal amount in grams, where theres no siginficant damage after taking additional grams. Please make a video or reply, all ive seen is 6% of total caloric intake but im not sure if theres a better more optimal target. Thanks!

[@4124V4TA-SNPCA-x]

I don't think that can be easily answered in a comment. For multiple reasons. Substitution is key and healthy sources of good unsaturated fats also contain saturated fats. Your overall diet and lifestyle and health history also plays a part in it. But I'm not an expert, by far. Just my 2 cents.

[@imthinkingthoughts]

I don't think there is an optimum, as its not necessarily dose-dependent. We cant determine an optimum dosage from epidemiology. If you go to gills youtube channel you can search for saturated fat and see his video on it

[@imthinkingthoughts]

Also, the type of sat fat might matter, eg plant based vs animal based. Just try to eat as plant-based as possible, reduce animal intake, fish are good in moderation but not necessary, and don't try too hard to 'optimise' your diet or you might find yourself falling into fad diets, restrictive diets, marketing ploys, orthorexia etc which will all likely be more detrimental than any optimisation of sat fat intake. Ask me how I know.... Wishing you happiness and health!

[@davedewsnap288]

So adding salt subs on top of say, DASH, should further reduce BP?

[@CraigHocker]

Something new here? I started using 50/50 Na/K salt blend from store. I avoid things like salted butter, add the 50/50 to taste. And of course avoid most of the time high processed food.

[@James-hn6fe]

You would have to drop your sodium imtake to as few as 200 mg a day to gain a benefit. Cutting it 50% will not help you.

[@jgreen9361]

7:34 Getting people to modify what they do not want to modify is really hard. An elderly couple on a generally healthy diet decided to cut back on salt and sugar. The outcome could have been predicted. The lady with a sweet tooth was found to be low in sodium, but continued to put on weight from the cake and biscuit addiction. The man with the savoury biased palette, successfully cut down on sugar, salt levels are fine. Blindingly obvious conclusion, if you are eating healthy complex carbs you don’t need sugar at all. But, you do need some salt.

[@yasim9435]

Yes but people in the group exercising regularity/athletes (beyond nursing home living) do loose a lot if liquid which reduces BP. So exercise might have even bigger effect on the BP outcome. Also people in this group often have to supplement diet with electrolytes minerals that may include salt which complicates interpretation

[@0xszander0]

This is what I was about to say. Yes it's interesting but what about younger people that workout regularly?

[@anathardayaldar]

I tried the potassium salt. Tasted too wierd for me.

[@DarthNoshitam]

Everyone thinks that a little bit of potassium supplementation will cause hyperkalemia. Hyperkalemia requires a LOT of potassium!

[@lynnmunson564]

Unless you have chronic kidney disease and/ or are on certain medications. Then one MIGHT develop hyperkalemia (or not). An older population is more likely to have kidney problems.

[@MochaZilla]

You'd have to be consume 10,000 mg+ of potassium to start seeing any issues. ​@@lynnmunson564

[@4124V4TA-SNPCA-x]

I think NaCl intake, like most things diet and nutrition related, are Way oversimplified. And official salt/sodium guidelines make no sense AFAIK. Low salt intake can be more harmful than more in many cases. It is very multi factorial and like all things it cannot be studied alone in a vacuum. All other mineral intake (see the Mineral Wheel a.k.a. Mulder's Wheel etc.), age, level of exercise, hydration, genetics and health history all must be taken into account. Therefore optimal intake depends on an individual basis. While the majority of US, EU, SE-Asian and other major populations will see a health improvement on the population level, many individuals will suffer the consequences. On a healthy, home made whole food diet, especially on WFPB saluting good is recommended, for example. Many diseases also make them mandatory. On hot summers several elderly people in nursing homes due to their low salt intake. And there are other things but my comment is quite long already as it is. I applaud your recommendation of careful individual experimentation as it is cheap and easy and pays off both in the short and long term. I'm not an expert, mind you. Also lowering ultraprocessed food, avoiding soft beverages and size bought juices, having enough exercise and sleep are all more important factors. Of course sodium intake counts, just like Na/Ka balance. The sodium-potassium pump (Na+/K+-ATPase) and other enzymes and the functions they play a role must be also taken into account. Your remark of several MDs not understanding the most basic of statistical terms are frightening but insightful. Thanks, Dr Carvalho.

[@kenhaze5230]

I cut back on raspberry bushes the other day while trimming them, but I'm more careful now.

[@--Snowy--]

😅Who let the Salt out?!! 😱

[@ggjr61]

If I lower salt my sodium drops. Last test my sodium was back up but my potassium had dropped.🙄

[@mikecain6947]

Where can you buy a blood pressure cuff for twenty bucks?

[@pynn1000]

Online blood pressure cuffs are about €20 in Europe so should be similar to US$.

[@mikecain6947]

@@pynn1000 TY

[@ZsuzsaKarolySmith]

Amazon - but I would spend a bit more on a good one. Omron is a trusted brand. Mine was £30 in the UK.

[@robdodd4591]

I don't know why but in the UK we have no iodine in our salt. For some reason its all deionized, Unless I've got that wrong?

[@pearljam_1]

it’s added in, not removed. I guess people back in the day weren’t getting enough iodine so they started adding it in.

[@robdodd4591]

Ahh thanks Pearljam

[@TyRaff]

​@robdodd4591 in the US, we had an epidemic of goiters caused by lack of iodine consumption. Adding it to table salt is arguably the most effective public health intervention ever in the US.

[@edl653]

Salt causes dehydration as water is drawn out of cells. Dehydration of cells, cause the production of Fructose. The production of Fructose, particular of in the liver creates Uric Acid. Elevated Uric Acid directly impacts high blood pressure. - Best to avoid adding salt to food purposely and "eventually one gets used to the taste difference, but it takes time." - It is helpful for older folks, but the younger one limits salt intake the less damage their body will suffer from elevated blood pressure and the body's fructose production which results in increased fat production and storage.

[@andersstengaardjensen2208]

TLDR - what's the bottom line here?