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 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, me and my fellow soldiers occasionally had to drink a full canteen of salt water.)
  • 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, 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 (Amazon USA, Amazon UK, Amazon Canada)

PUFA is Still the Common Enemy in Nutrition

It has been 4 years since I did my 3-part series on the problem with PUFA (Polyunsaturated Fats) that kicked off with The Common Enemy in Nutrition. Although I have altered my opinion on many things related to health and fitness, I still strongly believe that cooking oils are to be minimized for a better health outcome.

I trimmed these charts from a larger one by Kevin Bass that I saw on Twitter this week. They outline the increase in fats and obesity in America since 1970.

PUFA Calories Obesity

PUFA Obesity Oils

As I explained in the previous post Oh Noozs It’s Da EVIL Sugar Lobby!, it isn’t the sugar. In another tweet, Bass shows Americans are only consuming 34 more calories of sugar a day since 1970, whereas we are consuming 229 more calories of added fats and oils.

The low-carb community loves to repeat the message that when Americans followed a low-fat diet they got heavier turns out to be false. During the supposedly low-fat era of the 1980s and 1990s, Americans increased their consumption of calories from fat. Then when the “low-fat era” ended, all brakes were off and fat calories spiked. And the nation got fatter.

I see this spike in calories stemming from a shift in where we consume most of our meals. Look at the chart below, which tracks what percentage of our food we eat away from home.

Food Away From Home

Doesn’t that line look a lot like the climbing obesity rate?

Makes sense. When we go out to eat, we are often getting food cooked in cheap vegetable oils. High heat, fast cooking, and fried foods. Then to feel better, we order a Diet Coke, because SUGAR IS EVIL. Oh NOOZS!

The Solution

Forget all the Omega-6 math. Just follow my Peasant Diet. Eat at home cheaply prepared meals that require no cooking oils. Almost all my meals are cooked in liquid or in a pressure cooker. No oils needed.

Stay away from restaurants as much as you can. When you do go, think about how the food will be prepared and order the option that doesn’t use cooking oils.

You’ll not only lean out but you’ll also save money. Winning!

Oh Noozs It’s Da EVIL Sugar Lobby!

The latest battle in the never-ending Carb Wars involves a narrative that the sugar lobby was suppressing scientists from publishing research that was unfavorable to sugar. As with any lobby group, there may be some truth, but what is implied – especially by the low-carbers – in this conspiracy is that sugar must be toxic and that we the people have been the clueless victims.

It is mostly nonsense. Nobody in their right mind was fooled into thinking that eating a lot of sugar was a good idea. From my earliest memories as a child – long before the arrival of the public Internet – we knew to limit our sugar consumption. My parent knew. My grandparents knew. My great-grandparents knew.

These stories remind me of a conversation I had with my father about the warning labels on cigarette packs. He was smoking two packs a day and said the labels just stated clearly what every smoker already knew. When you wake up coughing out dark-colored phlegm, you learn quickly that smoking isn’t healthy.

Well before the Internet, I had an aunt with diabetes that knew she needed to stop her sugar intake. But she loved desserts and soft drinks. She went blind and later died. She knew. There was no sugar lobby conspiracy that plotted to kill her for profits.

We need to grow the hell up as a nation and stop falling for these neatly packaged conspiracy theories. The low-carb zealots are all over this story as if it explains everything. Evil sugar people destroyed the health of a nation by hiding the truth about sugar. Really?

A little game I have been playing to accelerate my decision-making process is to first say “Imagine it is 1995” and then decide. Very often that ends up being the best choice. Before the public Internet, apps, and broadband, we used common sense and intuition to guide us. My dad knew smoking was bad long before the labeling laws and my aunt knew her excess intake sugar was going to kill her.

And in the event, a low-carb zealot is reading this post and ketogenic smoke is coming out of their ears, I’ve copied this chart from Carbohydrate, Sugar, and Obesity in America on Whole Health Source.

Obesity vs Sugar

Sugar consumption has dropped significantly since 1999 yet obesity continued to rise. Oh nooz, I guess Big Sugar isn’t to blame for that extra weight we as a nation have gained since the start of the 21st century.

Where are the calories coming from then? Not other carbs. Those peaked in 1999 as well. Must be fat then, because if it was protein, the obesity rate would have fallen. Oops, there goes a big chunk of the narrative that the evil sugar lobby is tricking us into killing ourselves for their profit.

My dad and aunt both took responsibility for their poor health outcomes. If you’re heavy, it is because you ate too much. Even if you were clueless about what was in your food, you had a feedback mechanism of seeing your waist size increase to tell you that you were on the wrong path. Imagine it is 1995. Use your common sense.