The Salty Truth
Understanding the pros and cons of salt intake.
Salt. It’s in our oceans, our tears, and even in our bread. For something so ubiquitous, it’s oddly polarizing. Is salt good? Bad? Or is it just there to make your fries irresistible? Salt comes loaded with questions. One thing’s for sure: when I eat too much salt and weigh myself, it makes me irritable. I can gain 4 pounds in one day over a bowl of soup. Is this hurting my health or just my ego?
We’re told to follow guidelines—from the FDA, WHO, and other organizations—but do these recommendations really work for everyone?
One thing’s for sure: We consume a lot of salt in America. In 2023, individuals consumed, on average, 362 pounds of salt. Let’s take a fresh look at salt, unraveling the truth about these guidelines. Doing so empowers you to take control of your salt intake in a way that fits into how you want to live your life.
And will being intentional about your salt intake even prevent you from becoming a victim of a heart attack caused by high sodium? Let’s find out.
What Is Salt, Really?
Salt, or sodium chloride, is a mineral critical for life. Sodium is the key player here—it regulates fluid balance, supports nerve transmission, and enables muscle function.
But here’s the catch: sodium is only 40% of salt’s weight. That teaspoon of table salt you sprinkle contains 6 grams but only 2.4 grams (2,400 mg) of sodium. It’s sodium, not salt, which the guidelines are based on—a distinction that’s caused endless confusion.
Guidelines vs. Reality: A Mismatch
We’re told to limit sodium to 2,300 mg per day (about 1 teaspoon of salt), yet these guidelines rarely account for:
🥡 Your diet. If you eat whole foods—meat, fish, and vegetables—you might not need added salt at all. But if your diet includes processed foods, you’re likely consuming more sodium than you realize.
🧗 Your activity level. Highly active people lose more sodium through sweat and need more salt to maintain hydration and electrolyte balance.
🧑🏼🦰 Your life stage. Infants, children, pregnant women, and older adults all have different sodium needs, but the guidelines lump most adults into a single category.
🍥 Cultural and personal preferences. Taste matters! Food traditions and flavor preferences vary widely. What works for one culture or family might feel bland and unsatisfying for another.
The result? Generic recommendations that may work for some but leave others guessing or feeling guilty for deviating.
That’s why I wrote this article — we need a more personalized understanding of salt and its impact on us as individuals.
What You Need to Know About Salt
Rather than obsessing over sodium guidelines, let’s focus on types of salts – the yummy kind, not sodium. There are so many kinds!
Table salt (e.g., Morton): This is heavily processed and refined, often containing anti-caking agents to keep it from clumping. It’s typically iodized, meaning iodine has been added to support thyroid health. While practical for precision cooking and baking, the refining process strips it of other trace minerals, making it purely sodium chloride.
Sea Salt: Harvested through the evaporation of seawater, sea salt retains trace minerals like magnesium and calcium, which can subtly enhance flavor. However, these minerals are present in minuscule amounts, offering little nutritional advantage. Sea salt processing tends to be less intensive but raises concerns about contamination with microplastics from polluted waters.
Himalayan Pink Salt: Mined from ancient salt deposits in Pakistan, this salt’s pink hue comes from iron oxide. Like sea salt, it contains trace minerals but not enough to provide significant health benefits. Its “natural” branding is more about marketing than science.
Kosher Salt: Contrary to its name, kosher salt isn’t inherently blessed or religiously significant. It’s named for its use in koshering meat, a process that removes blood. Its coarse texture makes it easy to handle and ideal for seasoning food, though it’s nutritionally similar to table salt.
Specialty Salts: Smoked salts, black salts, and other gourmet varieties add unique flavors and colors but have no substantial nutritional differences. Their value lies in enhancing the culinary experience.
While these salts may taste slightly different, the nutritional differences are negligible. The choice comes down to taste, texture, and context.
The Physiology of Salt: What Happens to it in Your Body?
When you consume a salty meal, the sodium doesn’t just stay on your taste buds—it enters your system and sets off a chain reaction. As the salt travels down your esophagus and into your stomach, it begins dissolving and is absorbed into your bloodstream through the walls of your intestines.
Sodium, a master regulator of fluid balance, pulls water from surrounding tissues into your blood vessels, increasing the overall volume of blood. This sudden surge in blood volume forces your heart to pump harder, raising your blood pressure.
To compensate, your kidneys jump into action, working to filter and excrete the excess sodium, but this process is slow and passive, leaving your body in a state of temporary imbalance. The extra sodium and water in your bloodstream also find their way into the spaces between your cells, increasing interstitial fluid and causing puffiness—those bloated fingers and swollen ankles you might notice after a heavy meal.
To dilute the salt, you drink more water, which temporarily exacerbates the fluid retention. And if you’re sedentary, sitting at your desk or on the couch, your circulation slows further, delaying the recalibration process. Your heart and kidneys are left working overtime to manage a problem that could take hours—or even a day—to fully resolve, all for the fleeting satisfaction of an over-salted meal.
Does Salt Cause High Blood Pressure?
Salt’s relationship with blood pressure isn’t straightforward—it depends on individual factors and sensitivities. Does salt cause high blood pressure, or are some people more prone to high blood pressure, which salt exacerbates? It depends. However, excess sodium increases blood volume by pulling more water into the bloodstream, which we know raises pressure against arterial walls. Over time, this can strain the heart and lead to hypertension – it comes down to a matter of physics and fluid dynamics. However, not everyone is equally salt-sensitive:
About one-third of people with high blood pressure are sensitive to salt, meaning their bodies retain more sodium and water, exacerbating hypertension.
Genetics, age, weight, and activity level all influence how the body processes sodium. Some people excrete excess sodium more efficiently, experiencing little to no impact on blood pressure.
A diet rich in potassium can counteract sodium’s effects, helping relax blood vessels and maintain healthy pressure levels.
Research supports reducing sodium for those with high blood pressure or risk factors, but the universal application of low-sodium guidelines remains debated.
Salt, the Bacteria Killer
I think salt’s ability to kill bacteria is its superpower.
It’s well-documented that salt has been used for eons to preserve food. By drawing water out of microbial cells through osmosis, salt creates an environment where bacteria struggle to survive. Could this same principle apply to the body? Yes.
Saltwater gargles can soothe sore throats by reducing bacterial populations and swelling. Salt solutions, like saline, clean wounds and reduce bacterial load externally.
I’ve often wondered if ingesting salty soups may provide antibacterial components, raise sodium in the blood, and do the same there, but there is no evidence that this is true. If it were, though, it would also be true that high salt would kill good bacteria – so that wouldn’t be helpful, would it? However, it does provide comfort during illness through heat, salt, and possibly hydration. But the body craves what it needs, and I still think this may be another reason we crave soups when we’re sick – it needs the salt for some reason.
Personalizing Salt: Think Beyond the Guidelines and Ask Yourself Some Questions
If you’re unsure if you should decrease your salt intake, here are some questions to get you to think it through.
Do you have high blood pressure or a family history of hypertension? If so, cutting back on salt might be a simple way to protect your heart.
Are you active or live in a hot climate where you sweat heavily? If so, adding extra salt to your meals could be essential to replenishing lost electrolytes.
How much salt in your diet comes from processed or restaurant foods? If you eat out a lot, you may want to cut back.
Are you someone who reaches for the salt shaker before even tasting your food? This might be an automatic behavior worth reevaluating.
Have you noticed signs like puffiness, bloating, or frequent thirst? These could indicate that your sodium balance is off.
Do you like sodium and don’t want to give it up? If so, consider balancing sodium with potassium-rich foods like bananas, spinach, or avocado.
How do you feel after a particularly salty meal? Do you feel energized or sluggish? Reflecting on these subtle signals can help you better understand your relationship with salt and adjust accordingly.
Salt isn’t inherently good or bad—it’s about finding the right balance for your unique needs and lifestyle. Think about a moderation-first lifestyle—too much of anything is too much, which is also true for salt.
"Moderation in all things, including moderation."
– Oscar Wilde
Now, pass the shaker…or don’t. It’s up to you!
In good health,
Dr. Alice
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