Salt and high blood pressure

I, for one, question if salt and high blood pressure necessarily go hand in hand. Because I know of people who eat fairly salty foods and yet have healthy blood pressure levels. They are not isolated individuals who might be exceptional cases. And yes, they have been scientifically studied.

These are followers of the macrobiotic diet. The diet is known to be on the salty side, with liberal use of salt, salty seasonings like miso and shoyu (soy sauce), and pickles like umeboshi, a salted plum.

In the early 1980s, as part of the Framingham Heart Study by Harvard researchers, which is one of the most comprehensive medical studies ever conducted on heart health, a group of macrobiotic practitioners in Boston, USA, were studied. And it was found that, despite their fairly salty diet, they had healthy blood pressure levels about 10 points below the US national average. Overall, they had excellent health.

Why do macrobiotic practitioners eat salty foods in the first place? And what makes them able to "defy" the supposedly strong relationship between salt and high blood pressure?

Well, firstly macrobiotics practitioners are not afraid of salt. They do not view salt as the "bad guy" that causes high blood pressure and other heart problems like hardening of the arteries and increased risks of stroke. Instead, they understand that salt makes a person strong!

Proper use of salt

• Always use natural sea salt, no refined table salt. Even for miso, shoyu and salted pickles, they insist on only products made with natural sea salt.
  
  
• Always cook salt together with food, ideally for at least 10 to 15 minutes. Never sprinkle salt onto food after cooking. Alternatively, salt is taken in the form of seasonings like miso and shoyu, which are produced through months and years of salt fermentation. The idea here is that, through cooking, fermentation or pickling, salt molecules are "chelated" or combined with food molecules. Salt is not eaten directly.

Might these two factors be key to the link, or rather the lack of a link, between salt and high blood pressure?

Hard to say. Going by scientific evidence, there is not a lot of it except for that 1980s study on macrobiotic practitioners. Practically all the studies that show a positive corelation between salt and high blood pressure were done with regular refined salt.

Scientists do not conduct separate studies on people who take natural sea salt because they simple assume that it is the same as regular refined salt. Likewise, they don't specifically study people who only take salt cooked together with food. To them, it does not make any difference. So they don't bother to find out if there is any difference in the relationship between regular salt and natural sea salt and high blood pressure.

Macrobiotic practitioners are not alone, however. Observations of people in less developed societies, where the salt is unrefined and unprocessed, also show no link between salt and high blood pressure. It should be noted here that people in lesser developed societies also tend not to sprinkle salt directly onto cooked food. This is more a modern, Western habit.

Potassium salt and high blood pressure

What scientists have studied is the effect of artificially formulated high potassium salt that contains less sodium chloride and more potassium chloride. And here, they have confirmed that high potassium salt does help to reduce blood pressure. Click the following link for a more detailed discussion about the relationship between high potassium salt and high blood pressure.

This should not be surprising because potassium deficiency is recognised in medical science as one of the elements that causes blood pressure levels. So it helps to supplement with potassium, either with high potassium salt or by eating plenty of vegetables, since vegetables are rich in potassium.

In fact, medical science recognises many factors that can cause high blood pressure:

• stress
• sedentary lifestyle and lack of exercise
• obesity, especially around the waist
• smoking
• alcohol consumption
• potassium deficiency
• etc

There are so many possible causes that scientists do not know what, exactly, causes high blood pressure. Salt is just one of many possibilities. And the relationship between salt and high blood pressure is far more complex that what is commonly presented.

On the one hand, people who take plenty of salt (refined salt) do have a higher tendency to develop high blood pressure. On the other hand, restricting their salt intake does not always produce good results. Some medical studies show that restricting salt intake only reduces blood pressure levels by an average of one or two points.

To make sense of this complexity, doctors have come up with the term "salt sensitive". They say that people who are salt sensitive will exhibit a greater relationship between salt and high blood pressure, while people who are not salt sensitive will not show much of a relationship.

The bottom line is that excessive salt intake may or may not increase blood pressure, and reducing salt intake may or may not decrease blood pressure. Yet for some reason, the medical profession focuses on this weak link between salt and high blood pressure and makes salt out to be the "bad guy".

This is a great shame. Salt is actually vital for health, provided it is natural sea salt, used in the right way. But with all the negative talk, many people today have forgotten about the benefits of natural sea salt.