by Julian Dollente, RN and edited by Christopher M. Cirino, DO MPH

Humans evolved in an environment rich in sodium. However, too much or too little sodium in our system can kill us. The body maintains a healthy balance of water and sodium, which is responsible for the functioning of muscles and nerves as well as preserving the body’s fluid balance. Although it only requires about 500mg of sodium daily, the average American consumes several-fold higher (3400mg).

Chips, pizza, popcorn, burritos, and tacos—these popular foods have something in common—they all contain lots of salt. Salt is a simple but widely used condiment in our daily diet. Many of us may find a salty taste satisfying, but salt offers more than add saltiness. It can enhance the sweetness and neutralize some foods’ unpleasant metallic flavor, which helps improve taste and the overall balance of flavor. Herbs and spices can also enhance flavor, but adding salt is the more accessible and cheaper way to make food taste good.    

For years, health organizations have been warning us about the dangers of salt. They claim that too much salt can cause health problems such as high blood pressure and heart disease. However, even decades of research have failed to provide concluding evidence to validate it. Conversely, there has been contradictory evidence that somehow supports both sides of the salt spectrum.

This article takes a detailed look at salt and its effect on the human body because there is way more to salt than meets the eye.

Difference Between Salt and Sodium

Why are salt and sodium often use interchangeably? Is there a difference between the two? Yes, there is.

Salt, or sodium chloride, is composed of about 40% sodium and 60% chloride. It is by far the most significant dietary source of sodium—the mineral associated with blood pressure problems. In other words, salt is the compound you eat, while sodium is the mineral you gain from eating salt. 

In food preparation, salt is often added to foods to improve the flavor. Historically, it has been used to preserve food because it prevents the growth of bacteria that cause food to spoil.

Most of the salt you eat comes from two sources: evaporating seawater or mining from deep within the earth. There is a variety of salt available, including plain table salt, Himalayan pink salt, and sea salt.  

While we need sodium in our diet to help regulate body fluids, too much of it isn’t great, especially for our health. 

Role of Sodium in the Human Body

Water comprises about 60% of an adult body’s weight. The water settles into various spaces, called fluid compartments. 

The three main compartments include:

• Fluid within cells
• Fluid in the area around cells
• Blood

The body functions in a normal state by maintaining a balance of fluid levels in each compartment. The water levels balance the minerals (macrominerals) such as electrolytes. Sodium transit into the system occurs mainly in the small intestines. Sodium enters the bloodstream via transporters on the intestinal membrane or via ion transfer (Na+/H+). Water follows the movement of this ion. 

Within the kidneys, a hormone known as anti-diuretic hormone (ADH) controls the reabsorption of sodium and water. Ultimately water depends on the sodium concentration, a concept known as the osmolar gradient.

In the body, most of the sodium remains in the blood and the fluid around cells. Electrolytes, particularly sodium, helps the body keep fluids in a normal balance. Sodium also plays a crucial role in regulating nerve transmission and muscle function and maintaining acid-base and water balance.

Sodium Intake and Overall Health

How does your body usually handle salt? The answer to this question is simple and direct. When sodium levels become too high, your brain will tell you to drink more water by making you thirsty. The more water you drink, the more you urinate—through which the body expels excess salt. Likewise, when sodium level becomes too low, your kidneys retain sodium in the blood leading to less urine production. 

We get sodium mainly through food and drink and then lose it in our sweat and urine. A healthy kidney consistently maintains the sodium level by controlling the amount excreted in the urine. Remember that these mechanisms are regulated by hormone production, mainly aldosterone and glucocorticoids. Interestingly, a high sodium intake correlated with obesity and higher blood pressure, suggesting a link to metabolic syndrome.

The article reviews the effects of sodium levels in the blood in the subscription section. Subscribe to gain access to this additional information.

Dietary Salt: Guidelines for Sodium Intake

Most of the salt in the modern diet comes from restaurants, food chains, or processed canned foods. And this comes way before we even put salt on our food. In the US, an estimation of about 75% of the salt comes from processed food. Salt naturally found in foods, added during cooking, or used at the table constitutes only about 25% of our sodium intake. 

The average American has a daily salt consumption of about 3,400 mg of sodium. Interestingly, a single teaspoon of table salt contains about 2,325 mg of sodium, more than the recommended sodium limit of 2,300 mg per day.

With several health problems attributed to an imbalance of sodium levels in your body, knowing how much salt is in your diet would be instrumental in achieving homeostasis of your body fluids.

4 Health Risks of Excess Salt Intake

Now that you know how salt can affect our overall well-being, here’s a look at how a high-salt diet may hurt you:

Increases Water Retention

The overuse of salt will make it difficult for your kidney to filter excess sodium from your bloodstream. Sodium levels will eventually rise, and your body will compensate by retaining extra water in an attempt to dilute the sodium in your blood. This build-up of trapped fluids will lead to water retention and bloating. 

Damages Cardiovascular Health

As stated above, salt leads to build-up in water. Excess water in your body (water retention) puts added pressure on your heart and blood vessels, causing your blood pressure to go up (hypertension). High blood pressure is a significant risk factor for stroke and heart attack.

Sodium and potassium are indirectly proportional, which means having a high-salt diet accompanied by a low-potassium diet presents a greater risk of having heart disease. Potassium helps in the excretion of sodium in your body. Therefore, a high-potassium diet may help relax your blood vessel leading to a decrease in blood pressure. Untreated hypertension may also lead to chronic kidney disease (CKD).

Higher Risk of Osteoporosis

The more salt is in your diet, the more calcium is lost through urination. Regrettably, if you don’t have enough calcium in your diet, the body’s response is to replace the lost calcium from your bones, increasing the risk for bone problems like osteoporosis. 

May Increase Risk for Stomach Cancer

Some evidence suggests that a high-salt diet may increase the risk of stomach cancer. Salt purportedly increases the growth of Helicobacter pylori, a bacteria associated with a higher risk of stomach cancer.

These studies only show an association between too much salt intake and stomach cancer, and more research is needed. 

Salt and Cognitive Impairment

As salt leads to vascular changes, it may be responsible for changes in the brain associated with Alzheimer’s dementia. One study showed that mice fed a salt-rich diet had a build-up of tau protein. This is one of the findings in Alzheimer’s pathology. The mechanism appears to be related to nitric oxide deficit and decreased perfusion in the brain.

Conclusion: Optimal Sodium Intake

Salt is an essential part of the diet because its components are crucial to normal body functioning. Like in many things, too much or too little is never good. It would be best if you did not take your salt intake to extremes. Your doctors will often suggest eating less salt and lowering sodium intake to avoid acquiring cardiovascular-related diseases. And while it is a good idea to be mindful of the amount of salt in your diet, you don’t have to avoid it entirely. A balanced diet of high and low salt is ideal in maintaining equilibrium. 

If your doctor advised you to reduce your salt intake, here are some tips for following a low-salt diet:

Eat more fresh fruits and Vegetables. Skip processed foods such as canned goods, bagged items, and frozen foods, and spend more time in the produce section when buying your grocery.

Read Labels. Do not buy processed items or canned goods that have more than 200 mg of sodium per serving. Keep in mind that a product labeled “no salt” may still contain sodium from other ingredients. Another nice thing about a natural food diet is that you don’t have to refer to any labels.

Cook without salt. Experiment with different herbs and spices for flavoring. There are many salt substitutes that you can use, such as garlic, chili powder, oregano, thyme, rosemary, and any other seasoning in your cupboard. Also, limit adding much salt to your food at the table.

Prepare your food. Foods in the restaurant contain higher amounts of sodium to keep the food fresh. Cooking your food lets you control how much sodium is necessary for you. If possible, you can check a restaurant’s nutritional menu online to find a low sodium selection before deciding where to eat out. 

Be mindful of natural sources of sodium. If you watch your salt intake, be sure to regulate your meat, bread, dairy products, and shellfish, as all these foods contain sodium.

Here are some of the food choices that you need to know. The foods alternatives provided below are only as they relate to sodium levels. Remember that the more natural the food is, the less sodium and carbohydrates!