Dietary Salt Recommendations Don't Line Up with Recent Evidence
HTML-код
- Опубликовано: 2 окт 2024
- Salty foods are delicious, but for decades we've been told that sodium in our diets is a bad thing. Recent studies suggest that while limiting salt intake is probably a good idea for people with high blood pressure, it probably isn't helpful for people who don't have blood pressure issues. In fact, an extremely low salt diet may even be more harmful than a more standard intake.
John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics
/ aaronecarroll
/ crashcoursestan
/ johngreen
/ olsenvideo
And the housekeeping:
1) You can support Healthcare Triage on Patreon: vid.io/xqXr Every little bit helps make the show better!
2) Check out our Facebook page: goo.gl/LnOq5z
3) We still have merchandise available at www.hctmerch.com
You used a ">" (greater than) instead of "
Looks like all of them are >
+
Robert Podruzny Andrew Bary I love how we can identify nerdfighters now! lol
+
+
Ok but can I have chloride with my sodium? Plain sodium is really painful to eat.
no
+
Table salt is mineral compound of sodium and chloride.
(That's the joke)
Joke aside, I belive they mean sodium Íon, Na+, and I'm guessing metalic sodium would not be able to supply that.
(And then there's the part when sodium reacts violently in water, but I supposed that was the OP joke)
This is gonna make some people really salty...
Na
If u have high bloody pressure, don't play LOL.
like the American Heart Association, lol
FYI, to me, >2.0g means more than 2.0 grams.
that bothered me too
This seems highly unlikely to me, can you point me to a place where this convention is outlined?
Also, the spaces between numbers and units of quantities are missing, so there is at least one more consistent mistake in the text thingies.
I don't know what "uni" you went to, but you may want to ask for your money back.
Maybe it was the Marriage Apothecary programme of CGNU Online E-Niversity. :)
Aaron Rankin Ok, so according to you, if Parameter is *larger* than 2, I should write "Parameter is 2", correct?
But what if I replace Parameter with Param? is it "Param is 2"?
What if Pm? "Pm is 2"?
At what point do I reverse the comparison?
Or do you suppose the word "is" is what governs comparisons? So are "Pm is 2" equivalent?
If it's a rule that applies to academic *world*, then what about other languages that don't have an analogue of "is"?
Grammatically correct Russian phrase is "Параметр
3:12 You said "less than" three times, but it's written always as ">"
Yeah, the guy lost all credibility with being completely oblivious to something so simple.
@@vitaminb4869 No, it's not that easy to lose credibility.
Your "less than" symbols are actually greater than symbols (3:10).
People in the normal blood pressure group will clearly have less risk of a coronary event given they don't have one of the major risk factors: high blood pressure. So my question is, will someone with a normal blood pressure consuming >7g Na per day eventually become hypertensive thereby putting them in the higher risk group? The other thing to take into consideration is the overall eating pattern: what sort of diet is >7g Na per day associated with?
Good summary and interpretation. The ">" should be replaced by "
+
I think you accidentally used greater than sign, instead of the less than sign at 3:19.
fyi there's a typo on some of the slides > is a greater than sign, not less than
wait. you mean we're supposed to eat all things in moderation?
that's just crazy talk!
According to FDA/AHA, 2-2.3g is moderate, but according to the study 4g-5g is what should be considered moderate. In fact, consuming 2-2.3g of salt daily might be harmful to your health. So this episode is suggesting that those organizations should change that.
+
+!!!!
+
@@LZKS Salting food to taste seems like the best strategy.
I have a nervous system disorder called PoTS, and it means that I have to be on a high-sodium diet. I even take a salt supplement up to five times per day that has 1270 mg of Sodium Chloride per dose. So that's 6,350mg of sodium chloride. Every day.
Plus extra in my diet with packaged lunch meats and pickles as snacks, as well as beef jerky, and added electrolyte mixtures in my water.
ALL THE SALT IS MIIINNEEE.
I went to the athletic training clinic in college with leg cramps and the AT told me to put salt on my dinner for the next week. After spending my childhood being yelled at for eating too much salty food, this was something of a surprise. Somehow campus food had caused my salt intake to go from low (yes, the same intake that I was being yelled at about) to almost nonexistent. Gotta keep those electrolytes in balance.
When I've been on excavations in the summer, working in the sun, we've always been reminded to bring salty snacks. When you're sweating, low salt is noticeable and can be dangerous!
You have to increase potassium and magnesium in the correct ratio or you will have a problem
Try Himalayan salt
I like it when people tell everyone that they cant eat salt because the have high blood pressure but they continue to eat and drink all kinds of sugar, drink alcohol, dont do anything for exercise and even smoke...good one.
I have the opposite problem, low blood pressure. Doctors always tell me just to eat more salt, so I try and it works but not for very long. I have to keep snacking on salty things all day long. It seems like there should be a healthier way to treat it, even a cup of coffee at breakfast and after work keeps it up and steady much better. Not to mention high salt foods are often high in other stuff that I don't want, junk food and the like.
I'd love to know how the AHA came up with the number 1.5. Was it science, or just guesswork?
Educated guesswork. Well, poorly educated guess work, if the study is correct.
Out of curiosity, how does someone consume 7000 mg of sodium a day outside of the most processed foods and massive caloric overconsumption? I think the salt isn't the most important issue in that situation.
since i am not that familiar with english terms: does "less than 3 grams of sodium" mean that if i would measure my dailys salt intake i would have to multiply that number by something like 0,4 since half of it is chloride wich weighs more per mol? Or is "soldium" just shorthand for all kinds of salts combined that are used in food products?
...damn i feel stupid now
I wondered the same thing, thanks for formulating the question.
The use of sodium in this terminology generally is used as a short hand for NaCl. These would be dry measurements of how much NaCl is in the product, while ignoring other salts like KCl.
That's an excellent point: why do we make a recommendation for sodium and then use the entire weight of table salt to follow it, when it's only half sodium?
Good point. Sodium has a mass of 23g/mol. Chlorine has a mass of 35g/mol. NaCl is 58g/mol, so there are .39655g of Sodium in 1 gram of NaCl, significant figures rounds to .40, or 40% Sodium by weight.
So multiply salt by 0.4, but the Sodium in nutrition facts is already calculated or measured another way.
I checked your math, and was somewhat disappointed to find it correct.
Any news/recent research on recommended sodium intake for people with low blood pressure? I have low BP and have been told to increase my sodium intake, but with so much focus (mainly media focus) on negative effects of sodium, I'm never sure how much is too much.
Related question: is it bad to switch to salt at home that does not have iodine or do most people get enough iodine from other sources? Thanks for the video.
Hi. @3:10 of this video, the text states">" (greater than), but you've read less-than for FDA, WHO and AHA. There's a small error. Which one is the correct one?
Thank you.
You're doing very important work, educating us about healthcare findings like this. Thank you for your service!
I love how Bayesian analysis lines up so well with common medical scenarios. It's about a million times easier to use than when analyzing physical systems for background signals, and I'm rather jealous.
With confusion over salt vs sodium and < vs >, I wanted to take a look at the video's sources. With no such links in the description, I can't see what the reality is.
Have their been any studies done on people who are hypotensive in regards to salt intake?
+
+
SlimThrull my doctor once recommended that I eat more salt as I have naturally low blood pressure. I don't know if there is any particular evidence though. Try PubMed?
I would also like to know. Due to a med condition my doctor has me take 4+ grams of salt supplements and my blood pressure is still borderline low even after 2 years.
There's no such thing as "hypotensive" people.
I'd love to see if there have been any new updates since then as I know people are still pushing salt reduction hard.
Please close caption for wider access
Hi! Can you please caption your videos? Love the information!
Would have been good to say why the disagree with the findings. Good video.
Says "less than", uses "greater than" symbols. Is that how it should be notated? maybe i don't know medical stuff. 3:08 if you're wondering what I'm talking about.
I noticed this too.
+
Math stuff. That I learned in grade 2.
Teagan P yea me too. I was just so confused by it that I couldn't tell what was real anymore.
Hi. Nice video but i got a little confused when you used ">" to mean "less than." Thanks
Does the AHA's criticism of this analysis hold any weight? Based on the structure of it presented within the video it seemed pretty scientifically rigorous, so what's the AHA's issue with it? Is it an example of resistance to change, or a criticism worth hearing?
Mostly resistance to change as is their MO. They took a long time to come around on cholesterol too. As well as the harms that some cancer screenings give. Like it or not, they're a political organization, though not in the way most people would commonly use the term. They don't like to be told they're wrong and will drag their feet in admitting it.
Confirmation bias.
> means greater than
I feel like half to the time I watch these videos the answer is always "there is no evidence"
Very interesting. Some friends of mine recently looked at me like I had 3 eyes because I encouraged them to add a pinch of salt to their food. I told them small amounts were fine and they don't have high blood pressure anyway but they thought I was barmy. Seems like they may be putting themselves at greater risk of disease by avoiding salt altogether!
I can feel less guilty about indulging in a little salt now...
not sure if you're already aware, but the less than sign is backwards when showing the recommendations for consumption of salt. For example, >2.3g rather than
question on my mind which may make a good episode... How does one get the RDA of potassium... from what I have found food sources would cause caloric surpluses... suplimentation is dagerous... episodes have been made detailing electrolyte drinks are not needed for the average person. why is potasium rea set at such imposibly high levels are there hidden sources other that fuits, vegitables, and mineral splimentation? why are there not the same warning labels on salt substitutes using potassium chloride as thier are on the mineral supliments in the vitamin eilse of a retailer. We worry about sodium levels why not potsium... they seem more important to health and seem far more dangerous in excess and deficency?
Hans Schroeder I’ve wondered about this too! Even if you only ate bananas or sweet potatoes (both very high in potassium) all day and nothing more, you would be over your recommended calorie intake before you reached the rda of potassium.
@@arasaeissarah weird
But don't people get hypertension through excess salt intake?
1:32 Are you sure you're talking about Sodium alone, or salt. Table salt is only about 40% sodium, so 7g of sodium is like 18g of salt.
Yeah, that could be confusing, but rest assured the study was based on sodium, not table salt (that would be ridiculous).
I'm not that sure, Woo Cheol Shin, they probably expressed the sodium amount in sodium chloride equivalent.
I suspect the grams mentioned in the video were grams of sodium chloride. All of them.
Could you please cover "hypotension" too?
This came out after EVO for a reason.
Cellular sodium pumps, neural excitation, creatine elimination, liver and spleen fat fluidity, viscosity of plasma, all regulated or sustained by sodium. Bicarbonate and sodium chloride are the main 2 forms of sodium we need. Most of other form of sodium are toxic or non beneficial, including the shit coming out of Carghill plants. Trihydrates sodium acetate is shit, let me tell you.
So sodium prevents/cures fatty liver?
People who consume less salt are not at risk due to low levels, but because they replace their pizza with ice cream. Less salt, same or eorse outcome. Pizza was better health wise than ice cream since it had some vegetables and tomato sauce while ice cream is nothing, but fat and sugar.
*worse
No. It's because we use a lot of Na (soduim) and Cl (chlorine) for essential nerve functions, and that's what table salt is (NaCl.) Nothing happens in your body without that stuff. If you have too little in your system, your nerves can't tell your heart and blood vessels and everything else to run as effectively.
Eristitia
Then how come i don't have any issues? I know plenty of vegans and cultures that eat low sodium with no problems.
You realise that many leafy green vegetables eaten by vegans such as kale and spinach are extremely high in sodium. There is absolutely no controversy that if you don't keep your sodium levels up to healthy levels, you will die. You will get a bunch of other symptoms first but you will still die. The average person will die after a couple days to a week of no sodium intake.
Also, define how much sodium is "low".
Seems like a reasonable hipotesis but expressed with an unreasonable level of certain.
I grew up in a house where salt was never added to anything under the seemingly outdated knowledge that salt is bad for your health. Today it seems as though every doctor and other assorted healthcare professional out there goes back and forth on every piece of knowledge presented to them to fit their own personal bias’s. I used to take a spoon and eat butter out of the tub when I was little and always got yelled at and told that it is bad for you and when I would question my parents on the matter, they always related butter’s unhealthiness back to its salt content. Today I refuse to add salt to anything because I find that the tiniest hint of salt too salty. I was shocked to learn that the amount of salt you eat needs to be carefully balanced and that consuming too little amounts of salt can have just as negative effects on your health as consuming too much salt. While I don’t think this will change my taste preferences on salt and the saltiness of food, I do find it intriguing that your salt consumption numbers need to be so precise in order to avoid the back lash associated with not consuming enough of it.
3:10 and following, you confused the < and > signs.
seriously u have used sodium in half and salt in latter half of ur video.. which is it?
Satyaki Mukherjee Sodium Chloride is the scientific term for table salt.
Blows my mind how conventional wisdom isn't always correct.
Ok, you are talking about sodium, NOT salt? Am I right that salt is only around 38% sodium? Sorry, not a native speaker and this is confusing :/
sodium chloride. so salt.
I think they were sloppy in the video, in this regard.
not rly, at least in the US (where Aaron is), Salt is called sodium in dietary guidelines and on product labels.
Can you correct this? At 3:20 you are saying greater than >, not less than
But who did the housekeeping?!?
I really HATE meta-analyses. They combine data from different studies, which have different pre-conditions, and therefore different starting conditions, and try to draw conclusions by mixing the groups. To me, this is asking for it, statistically speaking. Nothing like combining unrelated groups to get spurious results.
These data and their statistics smell of confounding factors. Potassium, water intake, eating your fruits and veggies? ect.ect.
Two comments:
1) isn't a 23% of relative risk quite insignificant for a correlational study?
2) I honestly have no idea how much salt/sodium I get in a day. The problem is the amount of salt that is already in the food.
It seems like we focus so much on sodium, when there's also potassium to consider here.
Shouldn't we be seeing some studies that looks into Na/K ratios than just Na?
here I believe the recommendation is eating between 3 and 6 grams of salt per day.
And had such a deja vu with this info
That's only if you have hypertension. Eating 7 or more grams doesn't seem to have a negative effect if you're a healthy adult
+alaman321 I was talking about what is recomnended here by the government.
It is different then what the FDA sais because I live in the Netherlands.
I said nothing about the article mentioned except that our recommendations are closer to it then those in the USA.
Ohhh I understand what you're saying. My mistake
+alaman321 Aah. that van happen. Sometimes I don't interpret something right too.
Have a nice, Hot, sunny day☺
Unfortunately I live in Australia so we're in the middle of winter haha! Not so hot or sunny. Hopefully you have some better weather than us!
I can't stop thinking about why organization recommendation labels has a greater than (>) symbol instead of less than a spoken. :D
I’m hypertensive because I produce too much aldosterone. People like me are about 10% of all hypertensive people. So I have to reduce my sodium to 1.5g per day. No one else needs to worry about it.
But use natural salt, not just the industrial waste they sell us as salt, and you’ll get some juicy trace elements too. Good stuff.
Consume >2g
It should be
I used to add salt to my freshwater aquarium and the fish were healthier, so these results are not surprising. Salt helps fish deal with stress, and it probably does for people too.
what type of salt and how much salt in how much water ?
@@incorectulpolitic I used regular uniodized rock salt. I don't remember the ratios. It was basically a pinch per gallon.
I wonder how water intake affects this result?
Water dilutes salt, and increases urine output, presumably disposing of some of the excess salt - at least as a guess. But has this been studied in any way?
Salt consumption is relative to if you are in ketosis and your diet and you can just drink more water to balance it out
You said a couple of times that not eating salt might actually be bad for you... can I see some studies to this effect? Thanks! :)
So instead of limiting salt i think we should just stop buiyng the regular table salt and go for rock salts that don't have plastic because salt in variyng ammounts is not bad for you but plastics definently are.
Did you mean 5000 mg or 5 gm sodium or salt because RDI is under 2400 mg. Salt is 40% sodium And 60% chloride. So in 5 g salt , 2400 mg is sodium which is RDI.
3:10 >2.3g means greater or more than 2.3g, not less than. +Healthcare Triage I expected better. I remember it because the smaller part of the symbol goes next to the smaller number.
what about this? nutritionfacts.org/video/sodium-skeptics-try-to-shake-up-the-salt-debate/ says the finding about too little salt being harmful is just a confounder caused by sick people not eating much (and thus not eating as much salt, either) or being told to eat less salt because they're not well in the first place.
Could you do an episode on gatorade? A friend of mine who gets very little exercise and has a diet consisting mostly of pizza, chili, chocolate and soda thinks that he needs gatorade to hydrate himself because his brother who has some medical training told him so. My gut tells me gatorade is more harmful than helpful here, I don't know why water wouldn't be a better hydration source.
Would love to hear your thoughts.
lots of things can hydrate you faster than water, but gaterade is frigging poison, and he isn't an athlete he doesn't need to be hydrated fast, he just needs to be hydrated, so water is better. I think a video debunking ridiculous claims soft drink companies make would be great
It's either you or him trolling, that can't be true. It almost sounds like in that movie.
Do you have a link to the review article so we can read it? I'm having trouble finding it.
So does Dr Fuhrman, and he's not a scammer. Believe what you want.
"Less than" is NOT ">" Sorry guys, it is an appalling typo.
Oooh, he missed the opportunity to say, we should take those recommendation with a grain of salt
Got your less-thans and greater-thans mixed up . . .
Homeostasis (h/t Hank Green, CC A&P)
I'll second that by raising a beer and a packet of potato chips to you!
Interesting. thank you as always.
If there was a "tipping point" in our body chemistry (or some people) wouldn't that produce the results you saw.
Yes, but its going to vary from person to person. No one can give anyone person the amount of sodium they should intake. The best we can do is this "If you get between X and Y units of sodium, you'll probably be fine."
Can you do one on how it affects your kidney?
Hmmmm....good to know about the salt intake
Can anyone link to the previous video mentioned at 3:03?
youtube com/watch?v=34S27FGwYr8
Less than or more than? Graphics and narrative contradict one another.
is sleeping on the floor better ? ?
I'm hypotensive and my sis has a heart condition.
She's prescribed salt tablets.
I throw salt on everything.
I laugh at all the low sodium suggestions.
(except where recommended by a licensed professional to treat an existing condition. I.e my late opa and his heart)
REDO YOUR CIRCUMCISION VIDEO. NO BS. NO BIAS.
Hello Healthcare Triage team! I was wondering if you could do an episode on glutamate. Glutamate is - to my understanding - what gives the taste to some spice (like the taste of soy sauce), but I've recently seen a lot of "Glutamate free" spices in my store. What is this about? Is Glutamate supposedly harmful? Is there such a thing as a glutamate allergy? Or is this just a trend invented by the spice/sauce manufacturers to make money?
As I understand it, some people have glutamate sensitivity. For people without this sensitivity, there is no known harm to glutamate in typical quantities. For the sensitive, anything more than a small amount can lead to feeling bloated and other relatively minor health impacts.
... I am not a doctor, nutritionist or scientist, so I could be wrong.
the inequality symbols at 3:15 are reversed from what you say.
Steve Reidling Then listen to what he says :)
How are you doing Aaron?
Is this the third of the Green brothers?
If these aren't randomized controlled trials, then couldn't the reason those who ate less than 3000g of sodium a day have worse outcomes, because those who are at higher risk for heart disease would be more strict with their diet?
It seems obvious that those who are at higher risk will go on to have higher cardiac incidents, so maybe low sodium diets do work, they just aren't an absolute fix.
I meant 3000mg
So shoot for a little over 3 grams
I came here after a single paragraph on a healthline article told me that over 7 grams is dangerous, but under 3 grams is as well, and that 4-5 grams is the healthiest range. This was all after saying the FDA recommends between 1.5 and 2.3 grams earlier in the article. SO MUCH CONFLICTING DATA!
I've also NEVER had high blood pressure despite being extremely overweight at a point in my life despite eating a lot of extremely salty food for a lot of my life. *throws arms in the air in confusion*
What you have to consider is what gave those with high blood pressure the problem in the first place? It's the salt. It's decades of consuming a high salt diet. A five year study is meaningless. Those societies who traditionally consume low salt levels have low blood pressure from their youth into their own age. On the other hand societies that eat levels of five grams and above have rising blood pressure with age. And of course they suffer the physical problems that come with high blood pressure.
I love your stuff and find research like this fascinating, my question is this though: how does salt consumption (high, middle, and low) affect people with renal failure?
Thanks for bringing this to the mainstream. I know a few people (living in a country where air conditioning is not common) are suffering from episodes of hyponatremia in summer all the while... still cutting on salt!
What is the best practice for salt intake with meds like spironalactone which lower blood pressure. I take spiro for pcos and have serious salt cravings and when I don't eat more salt than I used to my blood pressure drops and I get very dizzy and faint
SALTINESS INTENSIFIES!!!!
This leaves people with hypertension in a weird position. Also, wouldn't this indicate that it has to do with sodium, but that the link might not be linear in nature? i.e. it could have something to do with comparative potassium levels.
How does the increased salt intake in normal BP people affect their kidney function? It might not lead to death but does it increase the chance of their kidneys failing?
Nice video, excellent conclusions, but pleeeeease a the link to the references.
The titles of the studies are shown in the video at the very bottom. Hope this helps.
Isn't the rda 1 gram? You mean food can be delicious again? YEESSS!!
RDA is 2,300mg for normal, healthy people and 1,500 for those at risk for hypertension (which includes all african-americans).
Nice. How do you keep people down? Tell them not to consume what they need to succeed.
+Eristitia whut.