Heart-health experts tell us if salt is compatible with a heart-healthy diet.
Reviewed by Dietitian Maria Laura Haddad-Garcia
Salt is a beloved flavor enhancer in most dishes we consume daily. Yet, most people connect ingesting too much salt with an increased risk of hypertension, commonly known as high blood pressure, and it’s crucial to understand the link between these two. Before we jump into this, let’s clear up any confusion on salt versus sodium: the salt shaker on the average dinner table is made of two minerals: sodium and chloride. Every teaspoon of salt contains 2,360 milligrams of sodium, per the USDA.
“Sodium intake is one of the few risk factors for hypertension that we can actually control, whereas age, sex, race, and genetics are considered to be non-modifiable risk factors. It is of utmost importance that we are conscious of the things we can control that may have a huge impact on our health,” says Ricardo de la Villa Pagan, M.D., a cardiologist at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida.
According to the Centers for Disease Control and Prevention, 120 million American adults (nearly half of the adult population) have hypertension and 1.28 billion worldwide, per the World Health Organization. High blood pressure rates are alarming because having the disease increases your risk for the main causes of death—stroke and heart disease.
So, can salt be a part of a blood-pressure-friendly diet? In this article, heart health experts weigh in.
What’s the Link Between Salt and Blood Pressure?
Low to moderate salt diets like the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet hail in the heart health world to help improve blood pressure outcomes. “There is a direct relationship between increased salt intake and elevated blood pressure that should not be overlooked,” says De la Villa Pagan.
Aseem Desai, M.D., FHRS, a cardiologist with Providence Mission Hospital, explains salt's unsavory effect on the body. “Salt has what’s called an osmotic effect on water that is stored in the body’s tissues and organs. That means if the blood concentration of salt exceeds that of tissue, water will move into the bloodstream and increase the circulating blood volume,” says Desai.
If you’ve ever felt flushed, excessively thirsty or swollen after a salty meal, these could be telltale signs you’ve eaten too much salt. “Excessive dietary sodium causes the release of a hormone called anti-diuretic hormone or vasopressin that leads to water reabsorption and retention by the kidneys, increasing blood volume,” says Tariq Hafiz, M.D., FACC, ABIM, a cardiologist and the Medical Director at Pritikin Longevity Center. When too high for too long, blood pressure can wreak havoc on health. “Elevated blood pressure over time has been associated with the development of coronary heart disease, heart failure, stroke and chronic kidney disease,” says De la Villa Pagan.
While excessive salt can raise blood pressure, it’s not the only culprit. “Hypertension can be the result of one or more factors, including genetics, other conditions like kidney disease or diabetes, age, smoking, lack of physical activity or a poor-quality diet,” says April Wiles, M.A., RDN, LND and owner of The Gen X Dietitian.
Can You Eat Salt If You Have High Blood Pressure?
Before you toss out your seasoning salt, know that having high blood pressure isn’t a prescription for a life without flavor. “Many individuals who come to see me in my private practice think they have to avoid salt completely, which is far from the truth. Limiting it is important, but complete elimination is unnecessary and potentially harmful,” says Michelle Routhenstein, M.S. RD CDE CDN, the Cardiology Dietitian at Entirely Nourished. With or without high blood pressure, your body can’t function normally without salt because it contains sodium. Sodium is the mineral and electrolyte responsible for your body’s ability to balance fluids and maintain healthy muscle and nerve function.
The key to eating salt with high blood pressure is to keep a close eye on your intake to lower it and ultimately improve your heart function. According to the American Heart Association (AHA), if American adults limit sodium intake to 1,500 milligrams daily, it’s possible to see a 25% drop in high blood pressure prevalence. “Multiple studies have shown that avoiding excessive salt intake helps to lower blood pressure and generally leads to a healthier diet, which helps with weight loss, both of which lower cardiovascular risk. Lowering salt intake can help decrease your risk of stroke and death from a cardiovascular event,” says Gerald Orlando II, D.O., a primary care physician at Inspira Health Medical Group.
How to Consume Salt for Lower Blood Pressure
Enjoying an eating plan with less salt could enhance your quality of life, lower your blood pressure and preserve heart health. The AHA recommends that individuals with hypertension have no more than 2,300 mg of sodium per day, and 1,500 mg is ideal. “This may sound like a lot, but just one teaspoon of salt contains 2,300 mg of sodium. Worldwide, the average daily sodium intake ranges from 3,500-5,500 mg,” says Wiles. Here are a few tips to curb your salt intake in favor of better blood pressure.
1. Focus on Foods Rich in Potassium, Magnesium and Calcium
A helpful tip is to concentrate more on the foods you can add instead of what you should remove. “Try to focus on adding more potassium to the meal to help negate the effects of sodium. This can include adding avocado to a lox sandwich or a side salad with black beans to a pizza meal,” says Routhenstein. “Also consider foods that are not only rich in potassium, but other essential nutrients like magnesium and calcium, in yogurt, leafy greens, white beans, and sardines.”
2. Know Where Salt Hangs Out
Surprisingly, some sneaky foods containing high sodium levels, including salad dressing, may not taste very salty. “Many people think that the salt is mostly coming from the salt shaker, but it can easily add up in foods that don't necessarily appear salty like instant pudding mix packs, baking soda and low sodium soy sauce, “ says Routhenstein.
3. Embrace Herbs and Spices
“Look for recipes that leave out salt and allow you to season differently. Vegetables can be delicious with garlic, dill, rosemary, oregano and thyme. Cayenne pepper, curry, basil and chives go well with beef. Additionally, try cilantro, dill, sage or parsley with poultry or marjoram, oregano or lemon verbena paired with pork. Endless combinations of herbs and spices bring out the flavor of your favorite foods without added salt,” says Wiles.
4. DIY Your Favorite Dine Out Meals at Home
Copycat recipes are a great way to enjoy your favorite restaurant dishes while lessening the salt load on your foods. “This gives you more control over the amount of salt used in cooking. You may find that you can reduce the amount of salt in many recipes by half or more,” says Wiles.
5. Spread Out Your Salt Intake
“Try to split your sodium allotment throughout the day instead of consuming it all at once. For instance, if you have three meals and one snack, try to aim for 400 milligrams of sodium at each meal and 300 milligrams per snack,” says Routhenstein.
Frequently Asked Questions
How quickly can salt increase your blood pressure?
There’s no hard, fast rule on how quickly salt increases your blood pressure because everyone’s body will respond to salt differently. “Your blood pressure may increase within 30 minutes of consuming excess salt,” says Routhenstein. Yet, this increase is not permanent. Chronic excessive salt intake, along with other risk factors, are what lead to hypertension.
Does cutting out salt reduce your blood pressure?
Your body needs sodium to function optimally, so avoiding it altogether could also be harmful. Reducing blood pressure by lowering salt intake is possible, but some may also need medication. “The good news is that the benefits of lowering salt intake also happen pretty rapidly,” says Orlando.
How much salt can you eat if you have high blood pressure?
De la Villa Pagan notes that, according to the AHA, the upper limit of sodium intake should be 2,300 mg/day or less. This equals approximately two-thirds of a teaspoon of table salt. Yet, the AHA recommended 1,500mg/day as ideal.
The Bottom Line
If you have high blood pressure, it doesn’t mean you need to give up salt. Yet, balancing your intake is vital for managing your condition and overall health and well-being. While you support your heart health with high-nutrient foods, including whole grains, vegetables, fruit and legumes, cook with herbs and spices to boost the flavor of your meals. Maintain a blood-pressure-friendly diet by adding a few low-sodium and heart-healthy recipes to your meal plans. Always consult your health care provider for help managing high blood pressure.
Read the original article on Eating Well.