How Sodium Intake Affects Blood Pressure

So the next question is actually a deep dive, and it's a topic that has been hotly debated. There's a lot of interest. There's a contrarian approach, as with anything. There's conspiracy theories and on and on. And the topic is about sodium. How much sodium can you take in and still be healthy? What's the— how much salt can the average person consume? You know, do you really need to use electrolytes? Is genetics involved? There's a lot to unpack here. And I would say, I'll give you a high-level summary, and then we're going to really kind of dive into this because, again, there's a lot of influencers that have talked about it, that still talk about it, and you'll find a lot of people that don't think salt's a problem. And so I personally, after like my team And I have dug into this.

I think that excess salt is definitely bad for health. Most people, the sodium that is found naturally in foods, not unprocessed, so unprocessed whole foods, is sufficient for your sodium intake. I don't know that people necessarily need to supplement with electrolytes. By and large. Now, there are exceptions, but generally speaking, people are getting a lot of sodium. So, you know, that's kind of my take. There's a lot of factors that regulate people's sensitivity to salt. So there's genetics, being female, older, overweight, having a low potassium intake, that's really important, low potassium, people that have high blood pressure or impaired kidney function. There's a lot of factors to consider, okay? It's not a one-size-fits-all.

Increasing sodium loss from things like sauna, exercise, extreme endurance exercise, these all do counteract what is a, I would say, normally high dietary salt intake. However, people, I think, overestimate the amount of sodium that's lost in sweat. That can then lead to them sort of doing excessive electrolyte supplementation, especially if they're unaware of how sensitive they are to sodium. So I think that's also something to keep in mind. Like, people think they're just losing tremendous amounts of sodium from their sweat, and really, you lose sodium from sweat, but you're not losing probably as much as you think you are.

People that are keeping their processed food intake to a minimum, while doing a lot of intense exercise or sauna and have no specific risk factors, I think electrolyte supplements with a small amount of sodium is reasonable. Do you need 1,000 milligrams of it? Probably not. Probably not. Like maybe you take half of an LMNT. So with that said, you know, people might think they're avoiding processed foods, but if you eat out or if you order food from a grocery store that is prepared. All these prepared foods, even if they seem healthy-ish, they're pretty high sodium, generally speaking. I've yet to find a prepared food that's not high sodium.

So keep in mind that even if you think you're eating unprocessed foods, but you're eating like you're eating out a lot, the other people preparing food for you, you can't know your sodium intake because you're not the one putting the salt into it, and it's very likely that it's high. Okay, so hypertension is a real concern. About 30% of the population is— 30% of hypertension is attributed to high dietary sodium, and that's a lot. So keep that in mind. There's evidence that dietary sodium consumption can have a larger impact on blood pressure than is identified— than has actually been identified. I mean, there's been a lot of analysis done that have estimated a 30% reduction in sodium could save 40 million lives within 25 years. There's a lot of that stuff. Sodium sources.

So only a small amount of dietary sodium comes from unprocessed natural foods. So you're getting about less than— 700 milligrams a day of salt if you're eating a more like paleo type of diet where you're vegetables and you're eating fruits and you're eating meats and fish and you're preparing them yourself. So I would say that about 700 milligrams or so or less are coming from— of salt is coming from that type of diet. If you're actually eating a Paleolithic vegetarian type of diet, the salt goes Yeah. Even lower, it's like 200 milligrams. Now, a lot of people that eat vegetarian unfortunately do not avoid processed foods. They actually do eat a lot of— there's a lot of processed vegan vegetarian foods that people do eat.

And so I don't necessarily want to say that vegetarians are more prone to, you know, needing more salt, but if they are following a more whole foods diet and they're vegetarian, they probably are because there's not a lot of salt naturally just in vegetables and fruits. So there was an NHANES examination survey that was done in 2017-2018, found that more than 50% of the US population got its dietary sodium from pizza, breads, cured meats, soups, tacos, burritos, snacks. Cheese, burgers, mixed cheese dishes, cookies, cakes, sausages, turkey, lunch meats. So those are the major sources of sodium in our diet.

There's been a whole lot of randomized controlled trials, and I'll save you the pain of going through them all in detail, that have really shown that reducing dietary sodium intake decreases blood pressure in both people With and without hypertension. It does it in children, does it in adults, does it in all ethnic groups. It's undeniable that reducing sodium intake reduces blood pressure. That's just not debatable. That said, there is a lot of nuance that can be found. So you can find what are called J-shaped and U-shaped relationships with sodium intake and all-cause mortality or cardiovascular events, cardiovascular mortality, which it's basically like you don't want to have too low sodium, you don't want to have too high sodium. That's what the U-shaped curve generally means.

Okay, so let's talk a little bit about salt sensitivity. So about 1/3 of otherwise healthy individuals and about greater than 50% of those with hypertension, the effect of salt intake on blood pressure elevation appears to be exaggerated. So people are categorized as either salt-sensitive, and salt sensitivity of blood pressure is considered an independent risk factor for cardiovascular disease and death. Salt sensitivity appears to be determined by genetic factors. It's determined by race and ethnicity. It's determined by age. It's also more prevalent in women. Body mass index plays a role as well as diet. So there are some genetics, and in fact, if you do our genetic report, we do cover some of the salt-sensitive genes. Some people are extremely sensitive.

In other words, if they are homozygous for a certain SNP that regulates sodium intake, and they decrease their sodium intake, they will dramatically— have dramatic reductions in blood pressure, whereas other people without that SNP might just have minor reductions, if any. So there is a genetic component in terms of salt sensitivity. African Americans seem to be really salt-sensitive. And there's a lot of different sodium transporter polymorphisms that have been described to be more common in African individuals. And so, again, we do cover these sodium transporters polymorphisms in our genetic report. So if you have done any sort of DNA testing, make sure you run it through our report to see if you have those SNPs. Physical activity obviously plays a role.

As we mentioned, you are excreting sodium in sweat. And so physical activity can, you know, and there's other— physical activity just improves blood pressure for other reasons that are completely independent of sodium itself. But if we're just talking about the sodium, obviously, being physically active is going to make you have a lower— you'll be less salt sensitive because you're excreting more salt. So it's not like reducing— reducing salt intake from your diet will have less of an effect for you because you're already sort of reducing some of that salt by excreting it through sweat on a daily basis.