Life and Greatness

Eating more salt might save your life? Not so much

The Salt Fix is the latest book attempting to overturn well-established dietary advice, but it leaves a bad taste, says Anthony Warner

By Anthony Warner

Newspaper headlines might lead you to wrongly believe that paradigm shifts in the world of nutrition occur regularly. Barely a week goes by without someone proclaiming that everything we know about diet needs turning on its head.

Despite this, one truth has remained pretty much accepted. Keeping our intake of salt down to around 6 grams per day is generally accepted as good for health, and features in dietary advice worldwide.

Apparently, this has left a gap in the market, because nothing attracts attention more than questioning the nutritional orthodoxy. Enter James DiNicolantonio, a US-based researcher who has made other controversial claims. 

His book The Salt Fix attempts to upend the orthodoxy, as its subtitle makes clear: Why the experts got it all wrong – and how eating more [salt] might save your life.

He asserts that despite what public health organizations have been telling us for decades, eating more salt than recommended is not, in most cases, linked to high blood pressure and to the risk of heart disease and stroke.

On the contrary, he says, it can help protect against heart disease, as well as insulin resistance, diabetes, and kidney disease.

The book’s references include dated research, fantastic opinion pieces, and occasional anecdotes, to back up the central argument that we’ve been getting bad advice on salt for decades. 

This runs counter to overwhelming evidence to the contrary. Key studies that support the book’s premise are criticised by leading medical bodies.

Leading public health experts say the totality of evidence is what’s important, and that this shows a still-robust link between a high-salt diet and disease.

DiNicolantonio meanders off into even more marginal territory with talk of dietary sugar causing excessive growth of the yeast candida. However, claims of common chronic illness related to candida growth have been dismissed as a pseudoscientific condition not supported in any serious medical literature.

Making the headlines

Regrettably, titles that suggest a paradigm shift are always likely to generate publicity. Because of its headline-grabbing approach, The Salt Fix received far more column inches than the repeated research findings that support guidelines on salt.

The public interacts with the world of nutrition to the extent that rarely occurs in other scientific fields. Despite dietary advice remaining remarkably consistent over the years, those who go against the grain tend to dominate coverage.

This matters. A recent World Health Organization report estimated that cutting salt intake to its recommended level could result in 2.5 million fewer deaths worldwide each year. 

The evidence for health benefits from salt reduction is perhaps stronger than that for dietary advice on almost any other foodstuff, including sugar, saturated fat or even fruit and vegetables.

A high-profile challenge based on such underwhelming evidence is therefore at best ill-advised, and at worst dangerous.