The Salt Fix Book Summary

This weekend I read the book The Salt Fix: Why the Experts Got it All Wrong – and How Eating More Might Save Your Life by Dr. James DiNicolantonio. I wasn’t sure I would get much value from the book since I’ve known for a decade now that the science behind the salt restriction recommendations was weak. But I did learn a lot.

Before I get to the summary, my quick review is that the author made a solid case that most of us do not need to restrict salt and in fact, some could benefit from a higher salt intake. (He did mention three cases where reduced salt intake might be appropriate: Hyperaldosteronism, Cushing’s disease, and Liddle syndrome.)

The part of the book I didn’t care for was his demonization of sugar as THE driver of obesity and other health ailments. Sugar likely plays a role in obesity and diabetes, but it is not the sole driver. See the charts on Carbohydrate, Sugar, and Obesity in America and then try to explain that sugar is THE cause of obesity and diabetes. Doesn’t work so well. Which means it is either something else or a combination of factors.

Notes for The Salt Fix

  • Cold extremities might be a signal that you need more salt.
  • Chronic salt depletion can increase insulin levels because insulin helps the kidneys retain more sodium.
  • 8-10 grams of salt = 3-4 grams of sodium
  • A person with normal kidney function and normal blood pressure can “easily” excrete 10x as much salt as a person would normally consume in a day.
  • Early evolution foods were aquatic and had much higher levels of salt than the foods most commonly consumed today.
  • “On average, our kidneys may filter between 3.2 – 3.6 pounds of salt (1.28 and 1.44 pounds of sodium) per day.” (p 28)
  • Low salt intake stresses the kidneys and results in lower energy to avoid sweating. This could lead to weight gain.
  • Romans consumed 25 grams of salt daily. 16th century Europeans 40 grams a day and 18th century Europeans 70 grams a day.
  • Salt is anti-microbial. (As someone with extensive fermentation experience, I knew this.) This means that salt can protect from food-borne illnesses. Foods with lower salt levels tend to have a shorter shelf life.
  • Increasing potassium can help regulate blood pressure, which helps reduce hypertension.
  • Low carb dieters need an additional 2 grams of salt a day.
  • Higher salt intake reduces stress/anxiety. (Remember my sleep dust post?) 
  • Salt is non-addictive. The body senses when it has enough and can sweat out the excess.
  • Some people need more salt than others. People that exercise more and those of us that consume a fair amount of caffeine. If you sweat more in general, you’ll need more salt. This could be from a hot environment or sauna use. (Side note: During Army Basic training in the Georgia heat, my fellow soldiers and I, occasionally had to drink a full canteen of water with added salt.)
  • The Salt Thermostat is a concept that the body has a set point for salt. This is a complex system that helps protect the body so it has the ideal salt level. When salt levels drop, the craving for salt increases.
  • Consuming salt prior to and during exercise can help the body cool off faster due to increased blood circulation.
  • More salt is needed during pregnancy and for breastfeeding mothers.
  • The book lists 22 ways in which sugar causes salt depletion. (Some of these are a reach, but the take-home lesson is increasing salt and decreasing sugar is good advice for most people.)
  • Higher salt is good for the skin when it is sweated out. It can fight off bacterial infections.
  • The end of the book covers the pros and cons of different salts. The author likes Redmond Sea Salt the best.

Although it is not mentioned in the book, Dr. DiNicolantonio covered how salt might be preventive in tooth decay in the article This Surprising Mineral Can Counteract The Effects Of Sugar.

Another interesting tidbit from that article:

Salt also helps with digestion. Indeed, salt is made up of two essential minerals: sodium and chloride. Chloride is needed in the production of stomach acid, helping with digestion of food and absorbing nutrients

Although I have not been avoiding salt, I think I could increase my intake a little. Normally, I wake up and drink a few glasses of water, then drink coffee, and then go to the gym. What I’ll experiment with is consuming 3-5 grams of salt with water before my coffee and exercise.

salt fix book

The Salt Fix: Why the Experts Got It All Wrong–and How Eating More Might Save Your Life by James DiNicolantonio

UPDATE JUNE 2021: Check out Fact-checking The Salt Fix for a deeper dive into the claims made in the book.


Add yours

  1. @MAS
    Since I know you’ve previously researched about sugar, and you disagreed with the sugar part of this book, but found the salt part interesting/persuasive, I was reminded of the Gell-Mann amnesia effect.

  2. @Jim – Agreed about the salt part, although I read something after I posted this that said that increasing potassium would be a better choice than increasing sodium for many. I’ll do both.

  3. I’m curious about what you read on potassium. It looks to me like the recommended daily intake would require insane amounts of the most potassium-rich foods. Do people actually meet the RDA of 4700 mg for most adults? Maybe just getting “more” and not worrying about specific amounts is a good way to start, as I am not a big fan of manufactured supplements generally speaking. I would love to hear more of your thoughts on this.

  4. @Rod – I followed a lead on Twitter that stated correcting potassium deficiency should come before one increases sodium. That lead me to this article, which states 98% of Americans are deficient.

    Correcting both are probably wise actions, but it may be that correcting potassium has a greater health benefit.

  5. Honestly, if someone says this about sugar, he loses credibility, especially the way he says it – like teenage magazine writer. We can’t be sure anything else is accurate either. Salt was mentioned at medschool related to strokes. Might be the evidence is weak for other diseases, like hypertension in general. Anyway, salt – food reward, might increase your calorie intake.

    If I were to rely on a “food guru”, I’d probably pick someone like Stephan Guyenet or Kevin Hall.

  6. @Ondrej – Agreed.

    After this post went out, I saw the author of the book posting some nonsense on Twitter saying sugar is the new smoking.

    Total loss of credibility.

  7. Asiyah Mujahid

    Apr 1, 2019 — 7:07 pm

    So, curious as to how your experiment with salt went and are you still working it?

  8. @Asiyah – Adding more salt had no effect on anything that I could tell. After a few weeks, I lost interest in the experiment.

  9. After long years of dealing with hypertension I wonder why doctors did not bring up the pottassium element in my discussions with them and all of them kept telling me to cut down on salt and keep using blood pressure pills and we all know the negative side effects of these pills. I lost faith in doctors and should resort to dietitions for consultation. Damn it

  10. this is a helpful post. for people like me, 10 grams of salt may be highly beneficial. it is so individualized. I have cold extremities, easily become light headed and dizzy, and low BP. I also have low stomach acid. will keep increasing! thank you

  11. Angie Portillo

    May 29, 2021 — 11:10 am

    I do over 2 teaspoons of Salt per day and it has made a difference in my digestion. There are times I crave more, I probably slacked off a little in the amount for the previous day.
    I even brush my teeth by grinding it.
    Side note: when I’ve eaten a dessert, seldom do. I make sure I have a cup of warm salt water afterward.

  12. James DiNicolantonio states that Romans consumed 25 grams of salt daily and 16th century Europeans 40 grams a day and 18th century Europeans 70 grams a day.

    Then he says that we are all wired to naturally and effortlessly seek and consume a diet of 3,000-4,000mg sodium (i.e. 7.5-10g salt) per day, if given free access to salt. I.E. we don’t have to think about our salt intake, just add salt to taste and you will magically end up in the 3,000-4,000mg/day range.

    The problem is: these statements clearly contradict each other.

    I’ve done a thorough fact-checking of the 50 of the main claims in The Salt Fix and (spoiler) not many of the claims survive dissection: (no ads, no affiliate links)

    Take care and stay healthy!

  13. @Pierre – Thanks for the the article link. I added it to the main post. You did a great job reviewing the book. And your website looks super sharp.

  14. Jose Villalobos

    Jul 14, 2022 — 4:10 am

    The obesity epidemic began with the low-fat diet trend. Lower fat necessarily means higher carbs.

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