We seem to have a special connection to salt. This humble seasoning, technically sodium chloride, so ubiquitous in our kitchens, has held a premier position in human society since prehistoric times.
From piping hot french fries to the rim of a margarita glass, from expensive fleur de sel on a chef’s signature rib dish to the shaker on our family dining table, salt is everywhere.
We connect to salt in a primal, elemental way. Not only would the flavor of many foods suffer without it, we would die without the sodium it contains.
But now the warnings to eat less salt are getting louder. Earlier this summer, the American Medical Association pushed the issue of salt onto centerstage. The group called for salt to be stripped of its “generally recognized as safe” status and categorized as a food additive, allowing the Food and Drug Administration more power to limit salt in processed foods.
Salt is not a new health threat. For decades, doctors have been calling for Americans to cut back their intake. Yet our love of the crystalline substance grows unabated. Indeed, most of us consume twice the recommended daily amount of sodium — 2,300 milligrams, or about a teaspoon of salt — and our intake appears to be inching up.
New designer sea salts are one of today’s most sought-after seasonings.
But now salt may be poised to be the next “trans fat.”
“We simply need to help people help themselves,” said Dr. James Rohack, a cardiologist and member of the AMA’s Board of Trustees, who believes new warning labels will help steer us away from major “salt loads” hidden in the foods we eat.
The AMA is calling for the food industry to slash sodium levels in half over the next decade, citing “overwhelming evidence” that excessive sodium intake is tied to hypertension, heart disease and stroke.
But why do Americans have a hard time giving up their favorite seasoning?
Dr. Gary Beauchamp has been trying to find out for the last 20 years. He is director and president of the Monell Chemical Senses Center in Philadelphia, a non-profit research institute that focuses on the science of taste and smell. His studies have explored how we detect salty tastes and the factors that influence how much we like salt.
Some biological programming may be a factor but so is our environment. We learn to like a salty taste because that’s what we’re exposed to, Beauchamp said. But his studies have shown that you can retrain your palate to like less salt.
“If you are able to cut your intake of sodium in half, you will eventually find lower levels acceptable,” he said.
Unarguably, the body needs some salt. Both the sodium and chloride in salt are essential nutrients. The minerals help regulate the body’s fluids and keep our muscles moving, including the heart.
Sodium and chloride are classified as electrolytes (along with potassium and a few other nutrients). That means they actually conduct electricity in the body, transmitting signals to muscles and nerves. Sports drinks contain electrolytes because these hard-working nutrients are lost in sweat.
Most table salt contains another nutrient: iodine. Salt was first fortified with iodine in the 1920s to help wipe out widespread iodine deficiencies, which can lead to the thyroid disease goiter. The use of iodized salt has virtually eliminated goiter in this country.
In food processing it serves as a preservative, regulates fermentation and enhances color, texture and “mouth feel” in foods. It also helps counter bitter tastes.
‘Salt wars’ old and new
For thousands of years humans have had a special attachment to salt, according to Mark Kurlansky, who chronicled this “obsession” in his eloquently written book, “Salt: A World History.”
“Salt has played a central role throughout civilization, in every culture and every religion,” Kurlansky said in a recent interview.
In modern times, salt is at the center of one of the longest battles in medicine.
No one disagrees that salt can affect blood pressure. The dispute is to what degree — and whether other factors may play a more powerful role. Perhaps the biggest divide is over a blanket recommendation for the population in general to reduce sodium.
Dr. Michael Alderman, a professor at Albert Einstein College of Medicine in New York and president of the International Society of Hypertension, is one of the most vocal critics against a dietary restriction of salt.
“Why in the world should everyone eat the same amount of salt?” asked Alderman, who thinks the AMA’s new call-to-action is a “reckless recommendation” and wants to see more research to demonstrate the health benefits of reducing sodium intake.
“We don’t know if it’s going to extend your life or improve its quality,” he said.
Alderman has conducted studies suggesting that low-sodium diets may increase the risk of heart attacks in some people. He contends that only “salt-sensitive” individuals should be concerned about sodium intake and believes there are better tools for controlling blood pressure than reducing salt.
Dr. Jeremiah Stamler, emeritus professor of preventive medicine at Northwestern University Medical School in Chicago and one of the country’s preeminent cardiovascular epidemiologists, thinks the salt controversy should be over.
“The salt debate is no longer valid from a scientific point of view,” said Stamler, who believes Alderman’s research is “flawed” and “scientifically inadequate.” Stamler is fully supportive of the AMA’s efforts to get some of the salt out of packaged foods and restaurant meals.
“The problem cannot be solved easily at the individual level,” he said. “We need the cooperation of the food industry. In the era of modern refrigeration, salt is an unnecessary food additive.”
HOW TO REDUCE SALT CONSUMPTION
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Hiding the shaker will barely make a dent because only a fraction of the salt we eat is added at the table. Most of the sodium in our diet comes from processed foods and restaurant meals. Here are ways to cut back:
• Eat fewer processed foods that come in boxes or cans.
• Buy fresh poultry, fish and lean meats instead of canned, cured, smoked or processed types.
• Do not add salt during cooking. Instead, sprinkle on a few grains of coarse sea salt or kosher salt at the table as a “finishing” salt. You’ll likely be satisfied with less.
• Use primarily fresh vegetables or choose plain frozen more often than canned.
• Rinse canned vegetables, beans and meats to remove some of the sodium added in processing.
• Make your own salad dressing and marinades with vinegar, fresh-squeezed citrus juices, oil and herbs. Bottled versions are spiked with salt.
• Make your own stock and gravy instead of using bouillon cubes or granules.
• When eating out, order foods that have been grilled, baked, steamed or poached instead of fried, battered, smothered or gratineed. Visit the Web sites of fast-food and national chains to find the nutritional values of their dishes.
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