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Are You Sensitive to Salt?

Nina Ghamrawi, MS, RD, CDE
June 4, 2024
June 4, 2024

In the realm of health, few debates are as contentious as the one surrounding salt. For those trying to manage blood pressure  or weight, you may have tried to cut the salt and sodium. But if your blood pressure didn’t budge, then what? You may start to ask: are you truly sensitive to salt?

In reality, research suggests that only around 25-50% of individuals with hypertension may be salt-sensitive. That means that about 1/3 of us can keep shaking that salt shaker! In this article, we unravel the complexities, challenge common assumptions, and explore the nuanced relationship between salt, hypertension, and shedding those extra pounds.

The Research

One study published in the American Journal of Hypertension, called "Salt Sensitivity: A Review with a Focus on Non-Hispanic Blacks and Hispanics" discusses that salt sensitivity prevalence rates vary among different ethnic groups, with higher rates observed in non-Hispanic African-Americans and Hispanics compared to non-Hispanic Caucasians. The study emphasizes the importance of understanding salt sensitivity in diverse populations for effective hypertension management strategies.

Another study published in Hypertension titled "Salt Sensitivity of Blood Pressure: A Scientific Statement From the American Heart Association" (2016) by David A. Calhoun et al. provides an overview of salt sensitivity prevalence estimates and highlights the need for further research to better understand individual variability in salt sensitivity.

How To Test For Salt Sensitivity

If you aren’t sure if you are sensitive to salt, you can easily find out with a 2-week experiment involving food and regular blood pressure monitoring. Blood pressure responds to changes in salt intake if you are truly sensitive to it, and can provide valuable insights into salt sensitivity. So here’s the method:

Week 1:

  1. Start by establishing your blood pressure baseline with a normal, unrestricted diet. Take two measurements one after another, with just about 1-2 minutes apart. Repeat this process three times a day for 3-7 days.
  2. While you are monitoring, keep a close track of all the meals, snacks, and even drinks that you consume. Consult with your dietitian to help you estimate your typical sodium intake, as well as other factors that may be influencing your blood pressure.

Next, set up an eating plan with your Dietitian to reduce sodium intake down to 2000mg/day or less. Make sure that when you begin the plan, eat similar foods as in week 1, really try to not make too many changes in food quality, including fruit and vegetable intake. Even be sure to not change exercise, caffeine, and fluid intake habits, as all of these can influence blood pressure outcomes and skew the true results.

Week 2:

  1. Once you start this plan, check your blood pressure baseline again for another 3-7 days.
  2. Compare the difference in blood pressure average between week 1 and week 2.

Your dietitian will be able to clearly compare diet compared with blood pressure results, and help you detect if there is any clear difference. Some clinicians inverse the method, suggesting to eat a regular diet in week 1, then add salt in week 2, with intensive monitoring both times. Both methodologies work to detect sensitivity, but the second may be used when a person already has a very low sodium diet, or consumes a lot of sodium food products that they can’t systematically remove salt without big changes in the meal. In the end, the sodium restriction either lowers your blood pressure, or it doesn’t. Your dietitian will then be help you and your provider plan next steps to help lower your blood pressure for life.

Key Points to Remember about Salt Sensitivities:

Salt Sensitivity Is a Spectrum:

  1. Salt sensitivity refers to how an individual's blood pressure responds to changes in salt intake. While some people have huge rises in blood pressure with higher salt consumption (salt-sensitive), others may not show such drastic changes (salt-resistant).
  2. Not everyone responds to salt in the same way. In fact, some people may have consistently low blood pressure because their diet doesn’t contain enough salt!
  3. Instead, talk to your dietitian to understand where you generally fall on the salt sensitivity spectrum, and just how much (if any) sodium you need to cut. Personalized dietary recommendations are key!

The Weight Loss Conundrum:

  1. The relationship between salt intake and weight loss is complex. While reducing salt intake may lead to temporary weight loss due to water retention reduction, the long-term effects on body composition and metabolism are less clear.
  2. For your weight, instead of thinking about salt, focus on general calorie intake, macronutrient balance, and physical activity.

Navigating Dietary Choices:

  1. Understanding salt sensitivity doesn't mean completely cutting out salt. Instead, make more informed choices about what and how much you eat. Salt hides in many unexpected places, and these hidden sources add up. Read labels.
  2. Get whole, minimally processed foods and flavor meals with herbs, spices, and citrus to improve taste without too much salt. Basically - eat REAL foods… I promise, you’ll get more benefits than just sodium reduction.
  3. If you are salt sensitive, read up on the DASH diet, and also ways to flavor your foods without salt.

Takeaways

As we understand salt, sodium, and their effects on the body, it becomes clear that we must also understand the details. Usually when people try to reduce sodium intake, they realize that it's easier to achieve when they simply reduce processed, refined, and packaged foods. However, when you eat more natural foods, you’re not only getting more vitamins and minerals - you’re also effectively cutting out the refined oils, added sugars, preservatives, food dyes, emulsifiers and other stuff that impact the gut and contribute to inflammation, tiredness, and mood. So challenge conventional wisdom and adopt a balanced approach that considers individual health needs. Are you truly sensitive to salt, or is it time to rethink the narrative? Talk to your Dietitian, check your blood pressure, and let's explore the answers together and pave the way for a healthier, informed journey.

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