Diabetes Self-Management Blog

It has long been conventional wisdom that Americans eat too much salt. Consuming too much sodium in the diet has been linked to hypertension (high blood pressure), which is of particular consequence to people with diabetes because they are already at higher risk for the condition. Hypertension is often called “the silent killer” because of the damage it can cause long before symptoms are present. According to the American Heart Association, possible consequences of hypertension include heart and artery damage (leaving people more susceptible to a stroke or heart attack), kidney damage, and vision loss — outcomes that are also recognized as diabetic complications and linked to sustained elevated blood glucose levels.

But a recent column in The New York Times suggests that the salt situation is less clear-cut than one might think. Some medical experts estimate that reducing salt in processed and restaurant foods could save as many as 150,000 lives each year, while others warn that these estimates are based on questionable data and that such a salt-reduction effort could have unintended negative consequences. One researcher profiled in the article conducted a study that found salt consumption to be remarkably consistent across 33 different countries, leading him to theorize that people automatically and unconsciously adjust their intake of salt based on how much of it their body needs. Given that people can and do add salt to their food (including, according to reports, New York City mayor Michael Bloomberg, a prominent advocate of salt restrictions) — and that people could conceivably eat more food to maintain a consistent salt intake if their food were less salty — the effect of regulating salt in food could be neutral or even negative, if this theory is valid. Critics have pointed out that this researcher, David A. McCarron of the University of California, Davis, is a paid consultant for a group that advocates on behalf of the salt industry.

On the other side of the salt argument is the Center for Science in the Public Interest (CSPI), a nonprofit nutrition advocacy group. Its director has testified before Congress that the government could save $9 billion a year in medical costs if salt were reduced by 25% in packaged items and restaurant food. The group issued a lengthy report on the dangers of salt in 2005. In it, CSPI concedes that the best method of measuring dietary salt intake — urine analysis — has not been used in most studies connecting salt consumption to medical outcomes. Instead, many studies have relied on self-reporting of dietary habits, which tends to be less accurate. Nevertheless, CSPI has called on the US Food and Drug Administration (FDA) to regulate salt as a food additive, which would end food manufacturers’ near-complete control over the salt content of their products.

Have you tried reducing the amount of salt or sodium in your diet? Did you succeed, and if so, did you experience lower blood pressure or any other positive or negative effects? Do you think the FDA should have the power to regulate salt as a food additive? Should lawmakers and regulators wait until a randomized clinical trial of a low-salt diet has been conducted (which would be lengthy and expensive) before mandating salt reductions in food, as some skeptical scientists are urging? Or should salt be reduced as a precaution, in the wake of substantial but not definitive evidence? Who should decide? Leave a comment below!

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Comments
  1. I have tried diligently to reduce the sodium in my diet. As a result my kidney damage has not progressed (its not possible to reverse it). Unless you cook everything from scratch it is very difficult and time consuming to cook low sodium meals as most canned soups and other items are very high in sodium. Occasional items such as no salt added tomatoes are available in the grocery stores where I live.

    There is enough evidence to limit salt in all prepared foods. I feel the FDA should have the power to regulate sodium in our canned, frozen and boxed food and in restaurants. If not totally, it should be a requirement that at least there should be soups available in all geographical areas with very low sodium content.

    Posted by Marje Stone |
  2. I have reduced my salt consumption at every chance. I read the labels and find that some processed products have sodium levels that approach or exceed the FDA recommended maximum.
    Diet companies have high sodium levels in their diets. My experience with one is that the total sodium level in the foods you have to buy exceed the FDA recommended maximum.
    Eat high sodium added snack foods? Add salt? I think not.
    I have found that after avoiding salt for over ten years, that salt tends to have an unpleasant and metallic taste.
    My bloodwork comes out just fine, so there must not be anything unreasonable in the side effect department.
    Instead of just dumping salts into food to make it taste good, why don’t processors just include small packets of salt you can add yourself? If you just have to have the salt taste - there it is. Otherwise, just dump it and forget it. It wouldn’t cost manufacturers any more to add packets than it does to add a marketing coupon. They could even put advertising on it at no additional cost.
    Reducing sodium should be good business, but I think most manufacturers are afraid to find out how to be first in line. If you stay with the mainstream, you can’t go wrong.

    Posted by Fred |
  3. Salt in processed food, both canned & frozen should be regulated. After all, you can always add salt, but it is not possible to remove it!

    Posted by Jane R Cecil |
  4. I am glad that most canned vegetables, tomato sauce, and other items now can be purchased with “no salt” added. These are great to use in homemade soups. When spices and seasonings are added, the lack of a lot of salt is not even noticed. Crackers can now be purchased without salt so manufacturers are beginning to realize that many people need no salt added items and many people do not like much salt in their food. Low sodium (which is often not much lower) items should be more available. Using the salt shaker to always add salt to a food item is really a habit; often the “shakers” don’t even taste food to see if they really need to add salt. We are a people who use too much salt and too much SUGAR in our diets. Who knows how much we could reduce the cost of medical care in the U.S. if we cut way back on both of these?!! Think of the health problems we could either eliminate or cut way back on (especially DIABETES, HIGH BLOOD PRESSURE and HEART PROBLEMS). We must eat healthier and smarter.

    Posted by Sondra Heaton |
  5. I had a heart attack and congestive heart failure in January. Now I learn that my kidneys are failing quickly too. All this while I was taking medications for BP, Diabetes, and Gout. #1 thing I was told to do was eliminate salt from my diet.

    Posted by Mac McCallum |
  6. My husband is a salt freak. Asking him to give up or reduce salt would be like asking him to give up or reduce breathing. For myself, I couldn’t care less about salt. However, about a year plus ago I switched to sea salt versus the well known commercial brands of salt one can purchase at the market. Interestingly enough, with the switch to sea salt, my husband’s “swollen” feet/ankles have returned to normal (unswollen) looking feet/ankles. I guess/figure this is a good sign for an insulin-dependent diabetic. Go figure!!!

    Virginia

    Posted by Virginia |
  7. I had always heard too much of anything is bad for you. But growing up and on into adulthood I used iodized salt like it was water. It was only after my doctor diagnosed me with hypothyroidism and started me on levothyroxin did my salt cravings stop. And I mean went away completely.. That was in 1998. I was also diagnosed with high cholesterol/tryglycerydes and pre diabetes. Six months ago he lowered my dose and after a month my salt cravings came back. He has now raised my dose back and slowly my cravings are stopping. Please note that I never have had high blood pressure with or without salt. There is only a small percentage of people that have salt related BP problems, but doctors have found it easier to tell everyone to reduce salt intake. So again too much of anything probably is bad for you.

    Posted by Janet |

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