Is that happening in humans as well? Yanomami Indians doesn’t develop high blood pressure with age with no sodium added to food and while being fit and active. What do you think about this?
10.1161@01.CIR.52.1.146.pdf (1.3 MB)
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I think it happens in humans as well. Table 1 in this study Urinary angiotensin excretion during sodium restriction and diuretics - PubMed shows that angiotensin II levels in plasma doubled in humans on a very low sodium diet. I should mention that this sodium restriction was extreme. They got only 230 mg of sodium for 4 days, which is super low, but it indicates that too low is harmful.
As for the study on the indians. I haven’t looked into it in detail but note that the abstract states that plasma renin activities were elevated and comparable to those of subjects placed for brief periods on low sodium diets. Renin increases angiotensin II so it’s possible they had elevated angiotensin II much like the people on the low sodium diet in the study I linked to above.
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But the Yanomami Indians BP was ~105/70 from 0-50+ yrs old, and didn’t increase with age, instead was stable how is that consistent with this claim?
I’ll take a look.
I’m not sure why it didn’t increase with age but there are several other confounding factors that influence blood pressure besides angiotensin II so it’s hard to say.
105/70 is remarkably low though, it’s not like you can have such a BP throughout life by exercising or being fit. My hypothesis is that low sodium without hypertension is the default and the reason hypertension increase with age is because we add it to the diet.
Perhaps. But n=1: my BP has crept up with age (the last 4-5 years or so), but I definitely have not seen any increase of salt in my diet. There are all sorts of oddities though, so I can’t be sure of what is what. For example, I have what would be regarded as a pretty low salt diet - I do not add salt to any of my food, and I practically don’t consume processed food. Potentially higher salt items I consume is canned salmon and sardines in olive oil from TJ’s 1-2 times a week, and once every three weeks or so, I’ll have some olives. And yet, get this: gradually, the sodium and chloride levels on my CMP have crept up to the point where on my last test 08/08/25, my sodium is flagged as high 147 (ref. range 134-144) and chloride flagged high at 107 (ref. range 96-106) - what?? Plus, I am on empagliflozin 25mg/day which is supposed to get rid of sodium - and instead it’s going UP?? With my salt intake in diet? I thought maybe I’m mildly dehydrated at the time of the blood draw, but that’s not what the urine test shows or other biomarkers. Just bizarre. Has me freaked out to be honest. So maybe my BP has crept up in concert with some kind of insane sodium chloride retention for some weird reason. Can’t make heads or tails of it.
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By adding it to the diet I mean anything that wasn’t there naturally, I don’t mean not using a salt shaker at the table. To eat that way you can’t eat any restaurant foods, any store bought bread, etc. Is that way you meant? Is there any sardines or salmon without added salt?
I’m not sure SGLT2 inhibitors is supposed to get rid of sodium.
I wonder what the effects of sodium Vs chloride are. I supplement with a lot of sodium. More recently I have been around 136 on sodium and 99 on chloride. I don’t add NaCl to food, but I eat some food where it is added.
Absolutely I mean that. I rarely eat at restaurants. Yes, there is salt in the canned salmon and sardines, but you have to look at the overall diet - these are consumed 1-2 times a week. This is not a daily thing. I would bet that my diet has relatively very little salt, other than what naturally occurs in vegetables, coffee etc. - I almost never eat store bought bread (or bread in general), although I do eat Wasa bread crisps a couple of times a week (they contain very little salt). And I drink a fair amount roughly 3.5 liters of liquids (mostly green tea or herbal teas and coffee) in addition to whatever liquids are in food. Good hydration, low salt diet - what right do I have to have elevated sodium and chloride? Insane.
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That’s impressive lifestyle. I can’t think of anything other than some of the pharmaceuticals you use have that effect as they’re powerful drugs, if it happened recently and we won’t claim aging (@desertshores stopped a pharma drug or awhile after a vaccine and it removed a side effect doctors said was aging), especially rapa and empagliflozin. Statins are pretty unique in being very specific to HMGCR inhibition, while people don’t really know how empagliflozin works for many of the diseases it can prevent or treat.
I’m feel slightly biased against pharma though.
I in turn am slightly biased for pharma - but will turn on a dime if a given med doesn’t work or has unacceptable sides. Anyhow, I’m about to start telmisartan 20mg/day, possibly escalate to 40mg/day if I can’t get my BP to low teens at least 111-119 SBP and 70-75 DBP. I’ll see how I feel on telmisartan as it’s not just about the BP numbers - if you feel like cr@p, low energy, or hypotensive then it’s not worth it. In an ideal world, I’d love 105/65 and feeling great. Maybe telmi can get me there, maybe not. We’ll see.
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I’ve found a couple of brands of sardines on amazon with no added salt that have less than 100mg per tin. I’ve also found canned tuna without salt but no salmon yet. I’ve mostly been buying frozen salmon because of that issue. If anyone is aware of canned salmon without added salt please share!
I actually declined the IV saline due to it’s sodium content during past hospital stays.
To your point, a few years ago I had a doctor who told me to start salting my food!
And eureka, it turns out I was not the worst cook in the world, I just wasn’t using any salt :).
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If it was 200 years earlier they would suggest using blood leeches.
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Most standard wellness blood tests include a sodium measurement. Unless you are hypertensive, I wouldn’t be going for the lowest salt intake.
@Beth is right; unsalted food tastes like sh*t to most of us.
Yes, I salt my food, especially steak. I usually don’t salt vegetables like peas, carrots, sweet potatoes, etc., but I do put butter on them.
Some people are hypersensitive to salt due to genetic factors. Thank goodness, I’m not one of them.
I don’t advocate my diet for anyone. If you like unsalted food, be my guest.
My latest results 08/01/2025
As per the Mayo Clinic, a healthy blood sodium level is between 135 and 145 millimoles per liter (mmol/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.
To paraphrase an old medical joke: The doctor gives a list of things for the patient to do, including no salt, added sugar, etc.
The patient responds, “Will it make me live longer?”
Doctor: Maybe, but it will sure seem like it.
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Blood sodium level is not the biomarker for optimal sodium intake.
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There are a numerous things I’ve pondered about the impact of salt on our health over the last couple of years. I’d probably go back to school and make this area my life’s work if I was 20-30 years younger. We seem to understand very little about what effects our modern high intakes have over a lifetime not to mention understanding the individual differences.
Regarding the issue of high blood sodium in the context of a low/no added salt diet I’ve wondered if there could possibly be a situation of our body accessing stored tissue sodium for usage or disposal? In the book Waterlogged the author pointed out that long distance runners tap into their bile salts if sodium is needed during a long run so it doesn’t really seem like a far fetched speculation. I have mentioned it before that I personally think BSA (body surface area) could be an unappreciated factor in how much and for how long a person can get by eating typical western pattern diet amounts of salt without having issues.
There’s definitely something going on with hyponatremia risk that I don’t understand but would like to of course. I had it very mildly once a few years ago before going on a no added salt diet and the solution for me was largely to drink less plain water. I tried eating more salt but it backfired. It almost seemed like the more salt I consumed the harder my body worked to get rid of it and I lost other electrolytes in the process. Once I started a no added salt diet my body was able to regulate everything seamlessly on its own-as it should be. It makes me wonder if once our stores are full to max capacity if things become deranged. I sure hope there are some scientists out there interested in these things and it gets researched in my lifetime.
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It’s funny, but I used to worry about hyponatremia. That’s because of my low salt diet - not by design, just a result of no processed food, no added salt, F&V predominant - and a fairly high liquid intake. I also took note of the fact that I was exercising with a lot of sweat in the heat, both jogging and weight circuit training, living in SoCal. Researching this a bit, I found that the body makes adjustments dependent on your sodium status - for example, your sweat will have much lower sodium content if your sodium status is low. This is also why serum levels of sodium and chloride must be interpreted with caution, because they are not necessarily reflective of your salt status in tissues, the body makes a great effort to keep the blood sodium and chloride levels within a pretty tight band.
Obviously hyponatremia is a concern, especially for those who lose a lot of liquid and keep replenishing with inadequate electrolytes. Done in a short period of time you can experience acute events.
Harder to evaluate is the less obvious subclinical effects of long term salt intake in both directions. Plus there certainly are also individual differences. I wish I knew more about this subject… so much research to do, so little time to do it in.
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“Blood sodium level is not the biomarker for optimal sodium intake.”
Well, you are at least admitting that there is an optimal sodium intake, not necessarily lower.
I think the impact of an individual’s salt intake is the most important
“Blood pressure response (salt sensitivity testing)”
Part of the problem is semantics. Most people can monitor how salt affects their blood pressure. If it easily raises your blood pressure, you need to cut back on salt. I am not sure how vital “optimal sodium level” is.
" Best available biomarker:
24-hour Urinary Sodium Excretion
~90–95% of ingested sodium is excreted in urine, so this is considered the gold standard for estimating sodium intake.
Limitations:
Requires complete 24h urine collection (hard to do correctly).
High day-to-day variability, so repeated collections are needed for accuracy."
One surrogate recognized by WHO:
“Urinary sodium-to-potassium ratio (Na⁺/K⁺):
Considered more predictive of blood pressure and cardiovascular outcomes than sodium alone.
WHO and some researchers recommend it as a practical marker.”
This is still a urinary test.
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