Thoughtfood 5: Duality And Your Salt Intake

by Alex Bernier,

How has salt shaped your life? 

In November 2011, I was two and a half months into a fully immersed paleo diet experiment where most forms of carbohydrates were strictly excluded from my eating habits – No bread, no rice, no sugar, all vegetables, no fun.  

At that point, the very sight of a low-carb meal was enough to trigger a profound anger within me. My taste buds had gone missing, I had the physical drive of a sloth, and my most productive thinking hours were between 10 pm and 4:30 am.

My brain chemistry was a total mess, and despite my greatest dieting efforts to keep myself afloat I sank into the worst bout of depression I had ever experienced. Getting out of bed every morning was a battle, and my performance at work was profoundly affected. 

This lasted until January 2012, when a mentor of mine reminded me how switching from my typical student eating habits to a strict high-protein, low-carbohydrate paleo-style diet had significantly decreased my total salt intake. I wasn't eating any processed food, and because of a programmed fear of the white magic I never salted my meals either.

My mentor advised me to salt liberally.

I was reluctant at first because of all the negative things I had heard about it throughout my life. But as it turns out, salt is essential for a wide array of physiological functions in my body, including stimulating my nervous system.  After unlearning what I thought I knew, I went to my local wellness store to pick-up some pink Himalayan salt, which contains 80 something more minerals than your typical white table salt. 

At that point, I had no motivation to do any physical activity. It is hard to say exactly what happened, but one I thing I observed after adding a bit of pink Himalayan sea salt to my first glass of water in the morning and significantly integrating it into my cooking for a little more than a week is that it gave me the strength I needed to get out of bed early in the morning while decreasing my overall anxiety levels.  

Salt may not have cured my depression, but it certainly gave me just enough energy to kick start the journey towards overcoming it.

With this newly found mojo I started working out again, and everything else eventually fell back into place. I was able to maintain a strict paleo diet – with very little sugar – for another year, hovering around a 90% strict, 10% cheat adherence guideline. It was insightful and empowering.   

To this day, I continue to use pink himalayan salt, and although my eating habits have evolved since then, the experience has forever shaped my perspective on salt. How could a nutritional public enemy supposed to hurt me turn out to be so helpful?

What does Science have to say about salt?

The Latest Buzz On Salt 

Salt has been under the white hot light for several decades now, and although public health organizations have shunned its consumption, the evidence concerning any potential benefits of such recommendations remains unclear. 

A few days ago, a fascinating study published in the International Journal of Epidemiology revealed a strong polarization of scientific reports between salt intake and health outcomes. Indeed, 269 reports – including primary studies on the matter, systemic reviews of these studies, and any other related publications – were identified by the team of researchers to then be classified as either supporting the salt hypothesis, contradicting it, or inconclusive.   
 
Basically, the paper is an analysis of all the analyses (systematic reviews) that have examined all of the available science on the matter -academic publishing inception, so to speak. Additionally, a network of academic citations amongst the various reports was established to see who cited who, and how often.

These results expose the flaws of the questionable science supporting the salt-health hypothesis. 

For instance, the researchers identified six potentially eligible studies that were not included in any of the systematic reviews analyzed. This means important data has been completely omitted from the review process, like never hearing the testimonials of six witnesses present at the crime scene in a trial. This skews of conclusions established by the systematic reviews. In court, such evidence would be tainted and dismissed.

Next, a substantial citation bias was observed on both sides, meaning published reports preferentially cited previous reports that reached similar conclusions. The study found researchers were 50% more likely to cite a report if it supported their hypothesis.

A network of 2165 citations found in the 269 reports was mapped as the following graph:  

Friends citing friends. Source:  International Journal of Epidemiology  , 2016, 1–10 doi: 10.1093/ije/dyv184

Friends citing friends. Source: International Journal of Epidemiology, 2016, 1–10 doi: 10.1093/ije/dyv184

It's easy to solidify your perspective with the opinions of those who think just like you. In academic publishing, just like the song, you get by with a little help from your friends.



Lastly, it was observed that the available literature in the field is dominated by a few reports and a few prolific authors, which paints a picture of scientific paternalism within the community itself. Are all the voices being heard?

It is important to mention that this research received no grant from any funding agency in the public, commercial or not-for-profit sectors. 

All in all, the report reflects the duality between opposing groups of scientists who differ in their interpretation of the data, making me question the validity behind generalized guidelines from public health organizations - If scientists can't even agree on the matter, is it really safe to continue advocating a population-wide salt reduction guideline? The implications of a mistake could be disastrous. 

The study can be found here: https://ije.oxfordjournals.org/content/early/2016/02/17/ije.dyv184.full.pdf