Sodium

salt
(Elizabeth ) #1

How much salt/sodium, and give it to me in tbsp or tsp, should I be consuming…thanks for the insight guys🥰

(You've tried everything else; why not try bacon?) #2

There are some recent studies out (last four or five years) that all suggest in the range of 4-6 g sodium, or 10-15 g NaCl. Per day, and including sodium/salt already in food.

(Carl Keller) #3

Based on a study of over 100k people across 17 countries, “an estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than either a higher or lower estimated level of sodium intake.” Another study looked at ~275k people and found that between 2,645mg and 4,945mg of sodium per day was the optimal range.

And since we are constantly flushing sodium when we eat ketogenically, we need more than the average person whose carb based diet helps them retain this mineral better. It’s likely closer to 8000 mg per day. (4000mg is 4 grams which is about 1 teaspoon).

(Elizabeth ) #4

Thanks for the insight! Much appreciated🤗

(Mark Rhodes) #5

You might be interested in this book The Salt Fix which was discussed on the 2KD podcast #71

#6

The question is already answered.

But I might add Dr Phinney et al. have said on keto the kidney no longer retains sodium, it now actively gets rid of it. He also said, there is no place in the body to store sodium except in the blood, so there’s no reservoir (and the kidney is getting rid of it), so you need to top up sodium daily.

(Steaks b4 cakes! 🥩🥂) #7

Absolutely you do. I’m still rather stunned by the amount my body requires in order for me to function on a daily basis! :joy:

(Bob M) #8

The evidence on salt is terrible:

If they want us to restrict salt, they need to do a large randomized controlled trial. Until then, we have no idea how much salt is good or bad. And for us keto people, we probably need more than the average person.

(Full Metal KETO AF) #9

@ctviggen I agree with you Bob, I watched a video PaulL linked in another thread and took something from it. The link with potassium was interesting and the science behind salt restriction is as faulty as the Low-Fat concept was. I am still struggling with consuming 1/2 oz of salt daily though and I like my food salty, sometimes I overdo it when cooking I am told by others. But I have taken to swallowing 5 grams of Himalayan pink rock salt after dinner every night to keep my legs and arms from cramping. I still think I might be falling short of the recommended 15 grams a day though.

(Steaks b4 cakes! 🥩🥂) #10

My mum said the same thing about my cooking lately too! She says it’s too salty for her - I never liked my food salted too much but just lately I have become accustomed to it…I wonder if it’s a natural thing for us ketoers to desire more salt? I crave salty foods a lot more lately, so I trust that’s my body’s way of telling me to get more in.

(You've tried everything else; why not try bacon?) #11
(Bob M) #12

Not sure where to start with this one, Paul. The used a single sample and assumed the sodium intake was constant for 56 months (on average). A huge assumption. They did a follow up urinalysis, but only on a small subset of people. These were two different trials testing not sodium (or potassium) but other drugs:

All participants in ONTARGET (Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial)16 and the TRANSCEND (Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease)17 trials who provided a baseline urinary sample were included in the current analyses.

And they combined the outputs to look solely at sodium and potassium.

There were 2,057 deaths from CV causes, or 2,057/28,800 = 7.1%. I tried to extract the actual risk from their “Mortality” section, but for the life of me, I can’t figure out how many people were in each group.

So, I gave up.

Again, it’s observational and not interventional. Interesting, possibly showing that reduced sodium = bad, but other than that, I personally would toss it.

(You've tried everything else; why not try bacon?) #13

That, alas is standard practice in nutrition research. They justify using the morning void as a surrogate for full-sample collection in another paper. As Peter points out in one of his statistical posts on the Hyperlipid blog, a large n ( = 28,880 in this study) will tend to smooth out noise from individual variation. He says you either need very many samples or very many participants. I am not a statistician, so take all this for what it’s worth.

Personally, I’d like to see continuous sampling data from an implanted monitor. None of this relying-on-people-to-bring-in-samples business! (But even then, you get no data when the chips are down. Nyuck, nyuck!)

(You've tried everything else; why not try bacon?) #14

They divided them into percentiles by amount of sodium excreted, so 288 or 289 per percentile.

(Bob M) #15

The problems with this study (even ignoring what I pointed out above, which is that two different groups of people undergoing two different tests were subjected to the same criteria, which is likely not true on its face), is that the people eating the highest amount of salt are also likely eating the worst diet. How does your salt get that high if you’re eating meat and vegetables? It won’t.

Then, perhaps the people eating the lowest amount of salt are eating that way because they are sick. That is, they have been told to eat that way due to “high” blood pressure, “high” cholesterol, some angina, etc. The so-called healthy user effect (in this case, maybe the “sick” user effect).

You begin adding all this up, and the study isn’t worth the paper it’s printed on. (Or, the digital bits it’s wasting in the cybersphere.)

Anyway, this is to what I was referring:

Mortality. Overall, 3430 (11.9%) participants died during follow-up, of which 2057 deaths (60%) were from a CV cause. Compared with baseline sodium excretion of 4 to 5.99 g per day (6.3% with CV death), higher baseline sodium excretion (9.7%; [HR, 1.53; 95% CI, 1.26-1.86] for 7-8 g/d, 11.2%; [HR, 1.66; 95% CI, 1.31-2.10] for >8 g/d) and lower sodium excretion (8.6%; [HR, 1.19; 95% CI, 1.02-1.39] for 2-2.99 g/d, 10.6%; [HR, 1.37; 95% CI, 1.09-1.73] for <2 g/d) were associated with an increased risk of CV death.

2057 people died of CV. The baseline secreters had 6.3% with CV death and the higher baseline secreters had 9.7% CV deaths. How many baseline secreters were there? How many higher baseline secreters were there? What is the death rate for these? From this information, what is the ACTUAL risk (not relative risk)?

I always look at the actual risk, as the relative risk is often meaningless.

I can’t figure out actual risk with the information given, unless I’m missing data that’s there but I don’t see.

(Bob M) #16

Maybe I was too harsh on that study. If what you want to do with the results of that study is to hypothesize that perhaps too low or too high salt intake is bad, and this should be evaluated by a follow-up RCT, then it would be worthwhile. Otherwise, it’s worthless. It CANNOT prove causation. (Well, unless it meets the Bradford-Hill criteria, and this comes nowhere close to meeting those.)

(You've tried everything else; why not try bacon?) #17

I’m curious what you thought of Mente’s presentation of the data in that video.