Thanks so much! Please subscribe to my Substack and perhaps listen to my podcast: Live Long and Well With Dr. Bobby on Apple/Spotify.... and please send suggestions for topics!
True that they keep lowering the bar. I do believe that the evidence for lowering BP targets is evidence supported. But, that does not mean the salt restriction is the answer-as I tried to explore
You raise good points. And, without doing an N of 1 trial in yourself, the 3 mm average could be 0 or 10 mm difference with salt restriction, probably based upon inherent salt sensitivity or lack thereof
My message isn't that folks shouldn't reduce salt. But, that it can be a more nuanced and evidence based decision and not shaming that you wish to continue salt. In your case, you are happy with the dietary evolution.
I appreciate the kind words. One size does not fit all and salt makes food more yummy. It is an important consideration and not just a knee-jerk everyone should lower their salt. I won't make many friends among nephrologists....
Agreed and done both. I do have moderate sleep apnea (despite being a very fit 69 y/ Ironman Triathlete...Used CPAP for many years and now wear a mandibular advancement device. Thanks for the observation.
I have been thinking about refined salt salt since I caught a line from a science show about elements returning to their natural form. Its been about 100 years since we started adding iodine to salt resulting in the most common salt in our products. I believe the thinking was it was helpul for goiter problems for people living in areas that lacked natural sources of iodine and was quite successful.
I have often wondered about the other side of the story. What happened to the people living in areas already rich in iodine (sea-side villages)? Does any one wonder or talk about this? Too much iodine - hypothyroidism, hyperthyroidism, other thyroid issues? Any geographical studies? Reduction of refined salts to those restaurants neighborhoods and foods?
I think we may be doing ourselves a disservice by focusing on singular elements and thinking we can remove one item or two and fix the mess we have created with what we are consuming — often by creating a pill that just causes a whole new set of problems.
Excellent article. Nicely highlights the concept of “responders” and “non-responders”, as well as the limitations of evidence based on population average effects when applied to individuals.
I still recommend salt restriction for hospitalized patients with acute heart failure and volume overload. But based on Sodium HF, I no longer bother with stable outpatients (but noting that patients should still eat healthy food and not daily KFC).
I deal with dietary salt by always using ‘light salt’ (Morton Lite Salt is a salt and potassium chloride blend) in my cooking and when salting my food. This decreases my sodium intake while increasing my potassium intake. I notice no taste or other issues with this product. I encourage my family and friends to use this product.
Great points. My goal was to move from the broad prohibition against salt to a more nuanced personalized medicine perspective.
it would be interesting to know whether your BP changes with and without the added sodium.
Thanks so much! Please subscribe to my Substack and perhaps listen to my podcast: Live Long and Well With Dr. Bobby on Apple/Spotify.... and please send suggestions for topics!
Very interesting. Did it affect your BP or just your HRV?
True that they keep lowering the bar. I do believe that the evidence for lowering BP targets is evidence supported. But, that does not mean the salt restriction is the answer-as I tried to explore
You raise good points. And, without doing an N of 1 trial in yourself, the 3 mm average could be 0 or 10 mm difference with salt restriction, probably based upon inherent salt sensitivity or lack thereof
My message isn't that folks shouldn't reduce salt. But, that it can be a more nuanced and evidence based decision and not shaming that you wish to continue salt. In your case, you are happy with the dietary evolution.
totally agree and salt has the added factor that it makes many foods taste better...
Really THIS is the issue. If you ever check on salt content (for example Panera even in their SALADS!) it's really crazy.
"More striking: over 70% of that sodium comes from packaged foods, restaurant meals, and processed products — not your salt shaker."
Great and that is backed by the Chinese study that I discussed in the article.
I appreciate the kind words. One size does not fit all and salt makes food more yummy. It is an important consideration and not just a knee-jerk everyone should lower their salt. I won't make many friends among nephrologists....
Agreed and done both. I do have moderate sleep apnea (despite being a very fit 69 y/ Ironman Triathlete...Used CPAP for many years and now wear a mandibular advancement device. Thanks for the observation.
Anyone with high blood pressure on the morning should haver a sleep study and ambulatory blood pressure monitoring.
I have been thinking about refined salt salt since I caught a line from a science show about elements returning to their natural form. Its been about 100 years since we started adding iodine to salt resulting in the most common salt in our products. I believe the thinking was it was helpul for goiter problems for people living in areas that lacked natural sources of iodine and was quite successful.
I have often wondered about the other side of the story. What happened to the people living in areas already rich in iodine (sea-side villages)? Does any one wonder or talk about this? Too much iodine - hypothyroidism, hyperthyroidism, other thyroid issues? Any geographical studies? Reduction of refined salts to those restaurants neighborhoods and foods?
I think we may be doing ourselves a disservice by focusing on singular elements and thinking we can remove one item or two and fix the mess we have created with what we are consuming — often by creating a pill that just causes a whole new set of problems.
Excellent article. Nicely highlights the concept of “responders” and “non-responders”, as well as the limitations of evidence based on population average effects when applied to individuals.
I still recommend salt restriction for hospitalized patients with acute heart failure and volume overload. But based on Sodium HF, I no longer bother with stable outpatients (but noting that patients should still eat healthy food and not daily KFC).
I deal with dietary salt by always using ‘light salt’ (Morton Lite Salt is a salt and potassium chloride blend) in my cooking and when salting my food. This decreases my sodium intake while increasing my potassium intake. I notice no taste or other issues with this product. I encourage my family and friends to use this product.