“My motto is: Live every day to the fullest - in moderation.” Lindsay Lohan

During the trans-Saharan gold trade from the seventh to the eleventh century, the Mediterranean countries were sending caravans of camels to trade salt for gold, sometimes ounce for ounce. Salt was as precious as gold. Over the last few decades, however, we have been taught that salt is bad for our health, like fat or eggs or the sun or other things. We hear that salt causes hypertension, contributes to potassium deficiency, and makes us retain fluids. There are so many misconceptions and confusing information about salt that many respond by going to extremes and eliminate salt completely. We live in a society that loves extremes; extreme dieting, extreme cleansing, extreme sports, but how does it serve us when it comes to salt?

To avoid confusion, all guidelines talk about sodium intake, not salt intake (1 gram of sodium is equal to 2,5 grams of salt which is about 0,5 teaspoon). The European guideline and the United States Food and Drug Administration recommend 2.3 grams of sodium a day. The World Health Organisation say we should be eating 2.0 grams. The American Heart Association goes even further and suggests that we have no more than 1.5 grams. 

To paint the picture, an average adult in the UK consumes about 3.2g of sodium (8.1grams of salt or more than 1,5 teaspoons) a day, and most Americans have about 3,4 grams a day. 

What does research say about sodium intake?
A recently published study in The New England Journal of Medicine enroled more than 100,000 people from 18 countries and found that people who consumed more sodium than the current guidelines recommend, had significantly higher blood pressure than those who followed the recommendation. 

Another study has confirmed this finding concluding that people who consumed high levels of sodium, more than 7 grams of sodium a day had a significantly higher rate of heart attacks, heart failures, strokes and even death than people who consumed 3-6 grams a day.

The conclusion is rather straightforward. Those who eat twice as much (or more) sodium as most guidelines recommend are at high risk. The studies didn’t say that salt was bad for our health or salt caused high blood pressure, heart attacks or death. They said that overdosing salt was unhealthy. The trouble is that we tend to respond to this sort of health news with an immediate fear, particularly when the data is complicated or difficult to understand. 

Experts agree that reducing excessive sodium consumption is necessary but caution that little evidence exists to recommend a very low salt diet. 

It would be interesting to see if a diet with a low sodium intake, between 1.5 and 2.3 grams a day has a health benefit. 

A new study did just that. In addition to looking at excessive sodium intake, it compared the health outcomes of people who had very low sodium diets. The results were shocking. It turned out that people who ate less than 3 grams of sodium a day had a significantly higher risk of cardiovascular events and death than those who consumed 3-6 grams of sodium a day. Moreover, the risk was still higher even when compared with people who had more than 7 grams a day!

This study wasn’t the only one to prove that a very low salt intake was harmful. Another research following more than 3,650 people over almost a decade confirmed that excessive salt consumption was associated with high blood pressure and that a low-sodium diet was associated with higher mortality from cardiovascular events. 

The results led to a conclusion that too little salt in our diet is as detrimental to our health as excessive amounts of salt or actually, even worse. 

Drifting from one extreme to the other is harmful regardless of whether it comes to fat, eggs, meat or the sun. In health, more than in any other area of life an imperfect moderation is better than a perfect extreme. 

Before anti-hypertensive drugs were available, doctors successfully controlled high blood pressure with diet under 2.0 grams of salt a day using a rule of thumb: no added salt allowed.