Salt: friend or foe?

Just recently, a long-time patient of mine brought me a copy of an article on salt and asked me to read it. The article, entitled “Health advice takes a pinch of salt” was from a publication named The Costco Connection that I had never heard of or seen before.

My patient told me that reading the article felt to him like listening to me talk, and he was sure that I would enjoy it as well. As it turns out I did. I found the article well-written and well-referenced, and it reminded me of a similar article I had read just a few months earlier in the New York Times.

The point of the article was that salt is widely believed among medical professionals and the public at large to cause high blood pressure, which then leads to heart attacks, stroke, and other cardiovascular ailments.

However, the link between salt consumption and high blood pressure has never been proved conclusively. The belief that there is such a link stems more from medical bias than scientific evidence. It is true that an observational study published in 1972 showed that among populations that used little added salt in their food high blood pressure was rare. One minor detail that was overlooked was that these same populations also did not eat sugar or processed food – two far more likely culprits in my opinion, than salt.

Further research failed to identify any links between salt consumption and high blood pressure or heart disease. A 2011 study published in the American Journal of Hypertension that looked at more than 6,000 people found no association between salt consumption and high blood pressure or heart disease. In fact, according to this particular study people who ate the least salt actually had the highest – not the lowest – incidence of heart disease.

Large population studies that attempt to link a single factor – like salt – with heart disease can have unpredictable outcomes because of so many other factors that could influence the results, in this case for example exercise, sugar, junk food, and so on. On the other hand if salt had a major impact on blood pressure, as it is held, this would show up every time regardless of other circumstances.

From my professional experience as a healthcare provider, having seen many people with high blood pressure give up salt, I cannot say that anyone was able to stop taking their blood pressure medications and enjoy normal blood pressure after going off salt. However, many people I know did achieve normal blood pressure with no medications after losing weight, starting an exercise program, changing their diets, and sometimes taking magnesium and/or certain herbal supplements.

Another large study known as Intersalt originally published in 1988 and reviewed in the July 8, 2011 issue of Scientific American in an article entitled “It’s time to end the war on salt”, looked at data collected at 52 international research centers. It too found no relationship between salt consumption and blood pressure.

Salt, as it turns out, is an essential nutrient for humans. In fact, the US FDA has a Recommended Daily Allowance (RDA) for salt. The RDA is defined as a minimum daily intake of an essential nutrient that will prevent symptoms of deficiency. What – you may ask – are the symptoms of salt deficiency? If you think cramps and tight muscles you are definitely on the right track, but to that I would also add weakened immune system and susceptibility to disease.

It is also my belief that foods and nutrients are always more beneficial when consumed in their most natural forms. Salt from the ocean and other natural sources is not pure sodium, but contains up to 30% magnesium and other minerals. These minerals play important roles in human health and magnesium, for example, is known to help normalize blood pressure, among the many other benefits it provides.

In contrast to this, what is sold as table salt is heavily refined to contain nothing other than pure sodium chloride. Like with oils, grains and other foods, it is the heavily refined and processed ones that are unhealthy. I don’t see why highly refined and processed salt would be any different from any junk food, whether it raises blood pressure or not.

For many years now I have been using and recommending only Celtic sea salt, a natural salt from northern France produced according to an age-old tradition that preserves all the minerals found in the ocean. People who try it tell me that it tastes delicious. According to studies funded by the French government not only it does not raise blood pressure, it helps lower elevated blood pressure.

If you are interested in trying Celtic Sea salt you can find it at natural food stores such as Whole Foods Market. It is also available at my office or online from my website. The New York Times article I referred to above can be found here:

2 Responses to “Salt: friend or foe?”

  1. Hello Dr. Volpe,

    Thank you so much for your helpful and informative blog! I am so glad to see you vindicating salt – it was a major factor for me in lowering blood pressure which had slowly risen over the years.

    I wanted to ask you a question about something you wrote in an earlier article ( In that article, you state that “inflammation needs calcium to sustain itself.” I am very curious where you draw that statement from, and couldn’t find it in the references you cited.

    It’s not that I don’t believe what you say, I simply would like to learn more about the relationship between calcium and inflammation, and searching in pubmed on the topic is not proving very helpful. So any references you can share would be much appreciated!


  2. I don’t remember writing that piece or where my references had come from. In any case there is no question that calcium plays a role in the inflammatory process, though that is not like saying that we can cause inflammation by taking a calcium supplement. PubMed may not be the best place to search for this but if you simply google it you will find a lot of quality references. Arturo Volpe