The Salt Fix: Why the Experts Got It All Wrong—and How Eating More Might Save Your Life

Why the Experts Got It All Wrong—and How Eating More Might Save Your Life

By John Ker
 In his book, “The Salt Fix: Why the Experts Got It All Wrong—and How Eating More Might Save Your Life, ” Dr. James DiNicolantonio says that cutting salt from our diets has actually worsened the problem it was supposed to prevent: high blood pressure. He says that eating more salt will lower most people’s blood pressure and reduce the risk of heart problems.

     What’s more, the author says that cutting down on salt actually hurts athletic performances. That got our attention. If that’s true, that might help explain why America’s top male mountain bikers do not do nearly as well in cross-country mountain bike races as the riders from other countries, where salt consumption is higher.
   Dr. DiNicolantonio is a doctor of pharmacy and a cardiovascular research scientist who has spent years researching this subject and writing for medical journals. In his book, Dr. DiNicolantonio says that the low-salt advice we’ve been hearing for at least 40 years has actually helped to bring about the epidemic levels of high blood pressure, obesity and heart disease that we see in America.  What’s more, the author cites over 500 published sources in his book to back up his claims.

      One reason this book may be of particular interest to mountain bikers is that the author also says that adding more salt to our diets will increase endurance, while low-salt diets will reduce endurance by keeping the athletes’ bodies from cooling down properly, which makes them feel tired more quickly. Reduced salt levels cause athletes to get leg cramps, too. If he’s right about what he says, and he presents a good case for his claims, that might explain why Americans have not done nearly as well as Europeans in major cycling events for the past 20 to 30 years.
     Doctor DiNicolantonio re-examines over 100 years of research in this book. He goes into great detail to back up his claim that the low-salt recommendations we’ve heard in America—dating all the way back to 1904—were flawed from the very beginning.
     The author reveals that the three countries with the lowest rates of heart disease deaths in the world—Japan, France, and South Korea—all eat very high-salt diets. If high salt levels were really bad for our hearts, as we’ve been told by our doctors for so many years, why do the countries that eat the most salt have the lowest rates of heart disease? That simply doesn’t make sense.

     South Koreans eat very large quantities of salt compared to other nations, says the author, yet they have  very low rates of heart disease and hypertension. “This is known as the ‘Korean Paradox,’ says Dr. DiNicolantonio, “although you could swap out Korea for any one of thirteen other countries and get a lot more ‘paradoxes’ regarding high salt intakes.” The people of Switzerland also consume high levels of salt and they also have very low rates of heart disease, the author says. It might be worth noting that Switzerland and France, two of the highest salt-consuming countries in the world, are two of the strongest countries in the world in cycling, with Elite Men from those two countries winning the XCO (Cross-Country Olympic) gold medals in the UCI Mountain Bike World Championships in 13 of the past 15 years.

     The author makes the point that when our bodies’ salt levels are lower, we get exhausted faster, which would be a major problem in bike racing and other endurance sports. The author also explains how low-salt levels in our bodies might contribute to the development of arthritis in our bodies by causing acid to build up in our cartilage, which can trigger inflammation.

 Dr. DiNicolantonio also says that when our salt levels are low, this also increases anxiety levels in our brains, which will cause people to eat more foods, especially ones sweetened with sugar, which can temporarily reduce their anxiety,  but also cause them to gain weight, make them more likely to develop diabetes, and raise their blood pressure. Dr. DiNicolantonio says that it’s not salt but sugar that has brought on the epidemic of high blood pressure and heart disease in America. That point has also been made by another researcher, Gary Taubes, who wrote the book, “The Case Against Sugar,” a few years ago.

Mood disorders can also result from low-salt levels, Dr. DiNicolantonio claims, a fact which has likely contributed to America’s wide-scale issues with depression, alcohol, and drug abuse. Cutting back on salt can also hurt reproductive capabilities for both men and women, which might explain the declining birth rates in America, says Dr. DiNicolantonio.

     The author says that it’s extremely important to have higher salt levels in the body when exercising—especially in warm weather when we’re losing more salt through perspiration. The author says that most people have no problem dealing with higher-than-normal levels of salt in their bodies. He says that our bodies are actually designed to store extra salt beneath the skin and in other places, including our bones, since a lack of salt can kill us. These extra salt reserves, he says, can help protect us from getting infections in cuts in the skin, as well as protecting us from hyponatremia—the potentially deadly problem of having too little salt in one’s body. That is a danger that marathon runners, cyclists, and triathletes can encounter if they drink too much water and the salt levels in their blood get too low.

     The author says that having too little salt in our bodies can also lead to osteoporosis. When our salt levels get too low, he says, our bodies will draw sodium out of our bones to make up for the shortfall in salt (sodium chloride). That might explain why osteoporosis is so common among the elderly, whose doctors have been putting them on low-salt diets for years.  What’s more, the author claims that consuming more salt than we need for our bodies is not a problem since excess salt, even as much as ten times our normal consumption, is easily excreted by our kidneys.


     The author of the book goes to battle against the conventional medical wisdom of the past 40 years, but I have a good reason to believe what he says. I became interested in this subject about eight years ago when my now-late mother, who was close to 90 years old at the time, called her doctor’s office to make an appointment because she was feeling extremely weak. The doctor’s office couldn’t give her an appointment for another two weeks. My mother, who lived alone, was afraid she wouldn’t last two more weeks if she didn’t see a doctor soon, so she called 911. An ambulance came and took her to the hospital. The medical staff tested her and found that her salt level was dangerously low. The doctors gave her saline solution intravenously. After that, the doctors advised her to start drinking Gatorade every day, eat salty snacks, and add more salt to her food to keep the problem from happening again. Ironically, three decades earlier, her regular doctor had discovered that she had high blood pressure and told her she needed to cut down on her salt consumption. She had been doing that for 30 years before learning that the her salt level had gotten so low that it could kill her. (According to the book, the elderly are much more likely to die as a result of low-salt levels than they are from high-salt levels. Additonally, low-salt levels can make it more likely for an older person’s legs to give out when walking. Then, because of osteoporosis, which can also be caused by low-salt diets, the elderly are more likely to break their hips when they fall, which is a common cause of death in older Americans.


     After reading some of Dr. DiNicolantonio’s arguments for adding more salt to our diets, I started adding more salt to my own diet to see what would happen. I’ve now been consuming more salt each day for the last month and a half, putting extra salt on my food and even adding salt to my coffee and tea. I usually add about 1/4 teaspoon of salt for each 8-ounce mug of coffee or tea that I drink, and I usually drink 4 or 5 mugs a day, having some of both.  I drink my coffee with a large dose of heavy whipping cream, too–a habit that I got into when I was experimenting with a high-fat, low-carb diet a few years ago (a diet that helped me drop about 25 pounds of excess flab and get back down to my high schoo weight). I drink green tea with nothing else in it except for my addition of salt. I now add the salt to my coffee and tea (and sometimes even to glasses of water). I do so mainly for the enhanced mental alertness that I have experienced with the increased salt consumption, which was something I discovered after I tried it. My energy levels have improved, my mental sharpness has gotten better, and my blood pressure has dropped,  just as the author of the book suggested it would (my blood pressure recently dropped down to around 99/66; my blood pressure figures were usually around 110/74 before). My resting heart rate has also dropped about 10 points. That’s good, too, because the author says that a high-fat, low-carb, fat-burning (ketogenic) diet tends to raise a person’s heart rate, and I had recently noticed that had happened with me. The lowering of both blood pressure and heart rate with increased salt consumption are two things that the author says will happen to most people when they consume more salt. Be careful, though. There are some people for whom that is not the case, he says, so it is important that you consult your doctor if you’re thinking about trying this yourself.

     Despite his cautionary warnings, the author says that most athletes will find that their endurance will improve when they eat more salt.

     On page 136 of his book, Dr. DiNicolantonio suggests that when the temperature is below 80 degrees Fahrenheit, athletes should consume 1/2 teaspoon of salt prior to exercise and another 1/2 teaspoon every hour while exercising.

     When the temperature is 80 to 90 degrees Fahrenheit, Dr. DiNicolantonio recommends that athletes take 1/2 to 1 teaspoon of salt prior to exercise and the same amount every hour thereafter while exercising.

     When the temperature is 90 degrees Fahrenheit or above, the author recommends consuming 1 to 2 teaspoons of salt prior to exercise and a similar amount every hour thereafter.

     Dr. DiNicolantonio suggests that athletes can carry a small bag of salt when exercising; by consuming dill pickles , olives or pickle juice; or by adding salt to water with lemon or lime juice. He says that salted water by itself can be tough to drink.

     Interestingly, Dr. DiNicolantonio thinks that there may be a connection between low salt consumption and both autism and schizophrenia. He mentions that children with autism often crave salt, which suggests that they don’t have enough salt in their bodies. Since salt is the most important electrolyte in the brain, it makes sense that low salt levels could interfere with mental functions.

     While the author’s recommendation to eat more salt is the exact opposite of what we’ve been told by health authorities for many years, the evidence the author cites in his book is impressive. What’s more, my own experience in testing his claims was enough to convince me that he’s probably right.

     I recently told Kate Courtney’s mechanic, Brad Copeland, about the author’s contention that athletes should up their salt intake to enhance their performances, and I suggested that he might want to discuss the subject with Kate. Brad told me that he’s never seen anybody eat as much salt as Kate. That got me thinking: maybe that’s part of the reason why she was able to win the UCI World Championship last year and score victories in three of the first four World Cup races this year.

     Will adding more salt to their diets make other mountain bike racers stronger? We don’t know, but the possibility might be worth exploring. Still, we recommend that anyone who wants to try this out should do so under a doctor’s supervision.


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