The less salt in our diets the better, right? Everyone knows that a high intake of salt is linked to elevated blood pressure and a higher risk for cardiovascular problems. But new research says that for some people, too little salt might be just as harmful.
The research team is from the Michael G. DeGroote School of Medicine at McMaster University in Canada. They analyzed data associated with more than 130,000 people from nearly 50 countries, and concluded there is just one group of people who should reduce their salt consumption: those with high blood pressure who also have a high salt intake.
In fact, their research showed that rates of heart attack, stroke and death were higher among people who took in too little salt (compared to those who took in an average amount). This was true regardless of the presence or absence of high blood pressure in the study’s subjects.
Lead study author Andrew Mente says, “While our data highlights the importance of reducing high salt intake in people with hypertension, it does not support reducing salt intake to low levels. Our findings are important because they show that lowering sodium is best targeted at those with hypertension who also consume high sodium diets.”
Even though it typically gets a bad rap, sodium – an electrolyte – helps maintain the balance of water in and around our cells, and is essential for proper muscle and nerve function. An abnormally low amount of sodium in the blood is called hyponatremia; it can result in too-low blood pressure levels, fatigue, weakness, headache, confusion, nausea and muscle cramps. Studies have also shown that low sodium intake is associated with a higher rate of premature death in those with Type 2 diabetes.
Hyponatremia is a common disorder among older people (age 65+), affecting about 10 percent of those living at home and about 20 percent of those living in long-term care facilities. Several recent medical papers found a direct relationship in older people between hyponatremia and unsteadiness, falls and bone fractures.
There are a number of medical conditions more common among older adults than the general population which also increase the risk of developing hyponatremia; they include certain cancers (including lung cancer), underactive thyroid or adrenal glands, and decreased function of the heart, liver or kidneys. Some medications also increase the risk, including diuretics (which can inhibit the movement of sodium in the body), some types of antidepressants, and the anti-seizure medication carbamazepine.
People with any of those conditions or on those medications could be harmed by a low salt diet.
The first approach to treating moderate hyponatremia is often identifying and resolving any underlying medical condition that may be causing it. Your doctor may also move you away from medications that could be affecting your sodium level, advise you to moderate the amount of water you drink, or increase the amount of salt in your diet. (The National Heart, Lung and Blood Association says that 500 grams of iodized salt is the minimum we should ingest each day.)
Severe cases warrant more aggressive treatment, such as an intravenous sodium solution to raise sodium levels in the blood, and medications that help to manage the symptoms of hyponatremia.
While hyponatremia can be effectively treated; the Mayo Clinic offers these prevention tips:
• Treat associated conditions. Getting treatment for conditions that contribute to hyponatremia can help prevent low blood sodium.
• Educate yourself. If you have a medical condition that increases your risk of hyponatremia or you take diuretic medications, be aware of the signs and symptoms of low blood sodium. Always talk with your doctor about the risks of a new medication.
• Drink water in moderation. Drinking water is vital for your health, so make sure you drink enough fluids. But don’t overdo it. Thirst and the color of your urine are usually the best indications of how much water you need. If you’re not thirsty and your urine is pale yellow, you are likely getting enough water.
In the interest of fair balance, getting too much sodium can indeed cause significant health problems. In keeping with the study’s findings, Besty Root – a registered, licensed dietician & certified diabetes educator in Vero Beach – emphasizes the danger of too much salt for those with elevated blood pressure, saying “high blood pressure is a killer. It increases the risk of stroke and heart attack. It’s not something to mess around with.” Those suffering from or at risk for hyponatremia need to be conscious of keeping their sodium levels up, but Root says, “Most [healthy] people get more than enough sodium without even trying.”
The government’s Dietary Guidelines for Americans recommends the consumption of less than 2,300 milligrams of sodium daily – the equivalent of 1 teaspoon of salt. According to the Centers for Disease Control and Prevention, about 90 percent of Americans consume more salt than the recommended daily limit, with the average daily intake being somewhere around 3,400 milligrams.
Root suggests anyone advised by their physician to reduce their sodium intake ask for guidance specific to their situation.