Did you know that salt was once a form of currency?⁵ That’s right. The salt in our kitchens used to be someone’s paycheck!

While salt has different value today, it remains relevant in every day life. Salt, also known as sodium chloride, is more than added flavor. Sodium is an essential electrolyte our bodies need for optimal functioning. But there is a fine balance. Too much dietary salt may increase risk of certain health conditions, including high blood pressure, stroke, and heart disease. But too little has potential health consequences as well. Now, you might be asking yourself “How much is ok? Do I need to be counting? And can I add it to the dinner dish tonight!?”.

Buckle up! Today I am revealing the truth about salt. I will review the recommended daily value including supporting literature, tips on consuming salt in moderation and as part of a healthy diet, and compare the different types of salt.

Recommended Daily Value

It is generally recommended to consume less than 2300 mg of salt per day². That’s just one teaspoon. On average Americans consume >3300 mg/day. Most dietary salt does not come from added flavor while cooking. It comes from processed foods such as: deli meats, packaged snacks, soups, pizza, burgers, even those “healthy” frozen meals.

Let’s back it up, where does this recommended daily value come from? It is actually based on old evidence and conjecture. There are limited studies accurately evaluating healthy sodium consumption. However, some literature supports a sweet spot of 3-5 g of dietary salt per day⁶.

A study with 28,800 participants published in JAMA in 2011 evaluated sodium and potassium urine excretion and cardiovascular risk. It found that there were decreased cardiac events in those with sodium urinary excretion between 4 and 6 g per day. While increased cardiac events occurred in those with <3 g or >7 g per day.⁷ How does this correlate with sodium ingested? On average 93% of ingested sodium is excreted in urine over a 24 hour period⁴.

What does it all mean? Are we underestimating sodium requirements? I agree, it’s confusing and hard to say with certainty at this time. But what we do know is: there are certain populations who may want to monitor sodium intake more closely.

Special Considerations:

Sweat- the average person loses anywhere from 200-2000 mg of salt per liter of sweat. (Highly variable, I know.) Therefore, if you are performing vigorous exercise or out in the heat, it is important to replenish those salt stores. While drinking water is essential, an electrolyte beverage may be more advantageous in those circumstances. My favorite product is LMNT which has no added sugar and 1000 mg of sodium (+ other electrolytes) per packet. It is available in packets making your dose easily customizable. Check them out here https://drinklmnt.com/products/lmnt-recharge-electrolyte-drink?variant=16358367199266

Heart health- according to the American Heart Association (AHA) those with high blood pressure, heart failure, and other specific cardiac conditions may benefit from <1500 mg of sodium/day. Improvement in high blood pressure may be seen with sodium restriction of <1000 mg/day. However, this is patient specific and should always be discussed with your doctor/specialist.

Kidney disease- similar to those with with cardiac related health conditions, those with kidney disease should also restrict sodium. The general recommendation is <1500 mg of sodium/day^3. However, this is patient specific and should always be discussed with your doctor/specialist.

Eat Less Salt- Processed Foods

You have heard it before, “processed foods are bad”. Here is yet another reason. Are we blaming heart disease on salt when the blame really lies on processed foods? Try reducing, restricting, reading labels, and preparing your own food when you can.

Below includes popular foods with added salt, many of which are processed.

• deli meat
• soups
• cured meats
• frozen foods
• packaged snacks
• condiments/dressings
• pre-made dishes

Different Types of Salt

After overhearing a conversation deliberating which salt is the healthiest, I decided to bring the discussion here. Below I break down the 3 main salt categories.

	Table Salt	Sea Salt	Pink Himalayan
Origin	salt mines	evaporated sea water	salt mine near Himalayan Mountains
Processing	extensive processing	minimally processed	minimally processed
Nutrition	iodine	minerals	minerals
Taste/Texture	mild, fine	potent, coarse	potent, coarse

So which is the healthiest? Yes, I said it above, eating minimally processed foods is ideal. Plus the minerals in sea and pink himalayan salt sound appealing. But in reality, the quantity of salt consumed is so small, as are those added minerals. One could argue table salt is better because of the added iodine to prevent iodine deficiency. However, eating seafood, dairy, and eggs prevent iodine deficiency just as well. That being said, all salt is about the same. Just follow your taste buds and don’t do too much.

In Conclusion

Salt (aka sodium chloride) is part of our every day life. Whether you’re adding it in the kitchen, eating a burger out, or even buying frozen veggies, salt is present. It often gets a bad reputation but it’s not all bad! Sodium is an electrolyte needed for optimal body functioning. Current organizational recommendations regarding daily value suggest <2300 mg. However, there is conflicting literature supporting 3-6 g of dietary salt intake per day. I can’t, with certainty, identify that “sweet spot” but it is reasonable to recommend <5 g of salt per day. Additionally, daily dietary salt requirements vary based on activity level and pre-existing health conditions. There are different types of salt with various positive health claims. However, with such small quantities consumed, it doesn’t much matter. Let your taste buds choose. And yes, add a little to your dinner dish tonight. 😉

I know, that was a lot of info. Please reach out with questions, comments, or for further discussion.

**Don’t forget to check out the counterpart to this post, The Sweet Truth https://lrxwellness.com/the-sweet-truth-sugar-and-sugar-substitutes/

Lindsey, PharmD, BCPS

References

¹American Heart Association. (2024, January 5). Sea salt vs. table salt. www.heart.org. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/sea-salt-vs-table-salt

²FDA. (2024, March 5). Sodium in your diet. U.S. Food and Drug Administration. https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet

³How much sodium is safe for kidney patients?. National Kidney Foundation. (2024, August 12). https://www.kidney.org/news-stories/how-much-sodium-safe-kidney-patients

⁴Lucko, A. M., Doktorchik, C., Woodward, M., Cogswell, M., Neal, B., Rabi, D., Anderson, C., He, F. J., MacGregor, G. A., L’Abbe, M., Arcand, J., Whelton, P. K., McLean, R., & Campbell, N. R. (2018). Percentage of ingested sodium excreted in 24‐hour urine collections: A systematic review and meta‐analysis. The Journal of Clinical Hypertension, 20(9), 1220–1229. https://doi.org/10.1111/jch.13353

⁵McCaffery, J. (2021, March 30). 13 things you probably never knew about salt. Reader’s Digest. https://www.rd.com/list/facts-about-salt/

⁶Mente, A., O’Donnell, M., & Yusuf, S. (2021). Sodium intake and health: What should we recommend based on the current evidence? Nutrients, 13(9), 3232. https://doi.org/10.3390/nu13093232

⁷O’Donnell, M. J., Yusuf, S., Mente, A., Gao, P., Mann, J. F., Teo, K., McQueen, M., Sleight, P., Sharma, A. M., Dans, A., Probstfield, J., & Schmieder, R. E. (2011). Urinary sodium and potassium excretion and risk of cardiovascular events. JAMA, 306(20). https://doi.org/10.1001/jama.2011.1729

⁸Pearson, K. (2023, February 9). Is Pink Himalayan salt better than regular salt?. Healthline. https://www.healthline.com/nutrition/pink-himalayan-salt