Tag Archives: sodium

Introduction

The olive tree (Olea europaea) is native to the Mediterranean basin and is cultivated in many other parts of the world.  The fruit of the olive tree is a drupe (a stone fruit) in which a hard inner seed is surrounded by a fleshy outer portion.  The olive has a low sugar content (2.6 – 6%) compared with other drupes (apricots, peaches, plum etc., which may contain 12% or more sugar).  Olives maintain a high oil content (12 – 30%) depending on the time of year and variety of olive harvested (1).  The olive fruit generally cannot be consumed directly from the tree because it contains a strong bitter component, oleuropein, which can be removed or lessened in concentrations by a series of processing techniques that vary considerably from region to region, but almost always involve treating the olives in brine or salt water.  Depending on local methods and customs, the fruit is first generally treated in sodium or potassium hydroxide (lye).  The olives are put into brine solutions and then rinsed in water.

Table olives are classified by the International Olive Council (IOC) into three groups according to the degree of ripeness achieved before harvesting (1):  

  1. Green olives are picked when they have obtained full size, but before the ripening cycle has begun; they are usually shades of green to yellow.
  2. Semi-ripe or turning-color olives are picked at the beginning of the ripening cycle, when the color has begun to change from green to multicolor shades of red to brown. Only the skin is colorful, as the flesh of the fruit lacks pigmentation at this stage, unlike that of ripe olives.
  3. Black olives or ripe olives are picked at full maturity when fully ripe. They are found in assorted shades of purple to brown to black. 

Green Olives

Green olives are processed in two principal ways: with fermentation (Spanish or Sevillian Type) and without fermentation (Picholine or American Type) (1).  

Spanish or Sevillian Type
The olives are treated in diluted lye solutions (sodium hydroxide or potassium hydroxide) to eliminate the oleuropein and transform sugars into form organic acids that aid in subsequent fermentation, and to also increase the permeability of the fruit. The lye concentrations vary from 2% to 3.5%, depending on the ripeness of the olives, the temperature, the variety, and the quality of the water. The olives remain in this solution until the lye has penetrated two thirds of the way through the flesh. The lye is then replaced by water, which removes any remaining residue, and the process is repeated, eliminating the oleuropein but keeping sufficient sugars which are necessary for subsequent fermentation.

Fermentation is carried out in inert containers in which the olives are covered with brine. The brine causes the release of the fruit cell juices, forming a culture medium suitable for fermentation. Brine concentrations are 9 – 10% to begin with, but rapidly drop to 5% because of the olive’s content of interchangeable water.

At first the contaminating Gram-negative bacteria multiply, but after a week and a half they disappear.  At a pH of 6 and upwards, lactobacilli develop until the Gram-negative bacteria disappear, and the brine attains a pH of 4.5. The lactobacilli produce lactic acid from the olive’s glucose, and when the fermentable sugars are spent, fermentation stops.

When properly fermented, olives keep for lengthy periods. The original brine is replaced and the olives are packed in barrels, tin or glass containers. Sometimes they are pitted or stuffed with anchovies, pimento, nuts and other food items. The most commonly consumed Spanish varieties are Manzanillo, Gordal and Moroccan Picholine (1).

Picholine Type
Olives belonging to the Picholine variety from Languedoc and Lucques in southern France are prepared in this manner, as are other varieties from Morocco and Algeria (1).  The bitter tasting oleuropein of the olives is removed by treating them in a 3 – 3.5 % lye solution (sodium or potassium hydroxide) until the lye has penetrated three-quarters of the way through the flesh. They are rinsed several times over the next day or two, and then placed into a 5 to 6% brine solution for two days. A second 7% brine solution is prepared, and acidity is corrected with citric acid (pH 4.5). After 8-10 days they are ready to be eaten and retain their intense green color. Before shipment, the olives are washed repeatedly, sorted, and packed in suitable containers in 5 to 6 % brine solutions (1).

 

Semi-Ripe Olives

Semi-ripe olives are harvested when their color is starting to change. They are picked before full maturity, when the flesh is quite firm and oil formation has not concluded.  Olives suitable for processing as green olives are selected as they enter the factory, then placed into brine at concentrations between 2.5 and 10 percent depending upon fruit size (1).

The olives are placed in large concrete tanks containing a 2 percent lye solution. When the olives are prepared for the market, they are placed in low-concentration lye and then washed in water that is injected with compressed air. Further treatments in dilute lye, each followed by aeration in water, facilitate penetration of the lye through the flesh to the pit. Next, the olives are washed to eliminate lye residue and lower the pH close to neutral. Solutions of 0.1 percent ferrous gluconate or lactate are often applied to California dark olives to enhance fruit darkening by oxidation.  After placement in brine for a few days, the olives are ready for canning. Heat processing in the form of temperature and pressure-controlled sterilization is fundamental to ensure the olives keep properly (1).

 

Ripe Olives

Ripe olives are harvested when the fruit is close to full ripeness, once it has attained the maximal color and oil content corresponding to the particular variety. The are many types of ripe olive processing techniques depending on local tastes.  Two of these are outlined below.

Black Olives in Brine
These olives are typical of eastern Mediterranean countries.  In Greece they are produced from the Conservolea variety, and in Turkey they are made from the Gemlik variety. The fruit is picked by hand when the fruit is black ripe, but before the olives over ripen. They have to be transported as quickly as possible to the processing plant where they are sorted, washed and immersed into tanks and vats containing an 8-10 % brine solution. At the start of fermentation, the tanks are tightly sealed to prevent the olives from being exposed to air. The brine stimulates the microbial activity for fermentation and also reduces the bitterness of the oleuropein. As the fermentation process takes over, if the brine solution drops below 6 %, it is increased back to 8-10% while homogenizing the brine solution with a pump.   

When the bitterness of the oleuropein has been sufficiently weakened, the fruit is sold. The olives’ color may fade during brining, but is later corrected by aerating the olives and by treating them with 0.1 percent ferrous gluconate or lactate to increase oxidation to make them a deeper black. Lastly, the olives are selected and packed into barrels, cans or jars which are filled with 8 percent brine. Theses olives are popular because of their slightly bitter taste and aroma.

They may also be packed in vinegar (25 percent of the brine volume); be heat processed and a little oil are then added to form a surface layer. The Kalamata olive variety from Greece is prepared in this way.

Black Olives in Dry Salt
Black olives in dry salt are also of Greek origin, and they are prepared using overripe olives of the Megaritiki variety. They are washed and placed in baskets with alternating layers of dry salt equivalent to 15 percent of the weight of the olives. The end product is not bitter, but salty, and it looks like a raisin.

 

Why Olives Are Not Paleo, But Olive Oil Is

From the information the International Olive Council has provided above (1), you can easily see that extensive processing is required to remove the bitter compound (oleuropein) from raw, fresh olives.  To make fresh olives edible requires massive additions of salt at nearly every stage of processing.   

Table 1 shows the high sodium (Na+) and low potassium (K+) content of processed olives.  A 500 kcal serving of green olives would supply you with 5,365 mg of Na+, whereas the same serving of jumbo black olives would give you 4,537 mg of Na+, and a 500 kcal serving of black olives would provide 3,196 mg of Na+.  The recommended daily intake of Na+ is 2300 mg for adult men and women (3-6).  Accordingly, even modest consumption of olives gives you way too much Na+ and not enough K+.

Table 1. Na+ and K+ content of olives (drupes) and olive oil (2)

Olives

Na+ mg/

1000 kcal

K+ mg/

1000 kcal

K+/Na+  

(mg/mg)

Green Olives

10731

290

0.027

Jumbo Black olives

9074

111

0.012

Black Olives

6391

70

0.011

Olive Oil

2.26

1.13

0.500

 

Now contrast the Na+ concentrations in a comparable 1000 kcal serving of olive oil to that found in whole olives.   A 1000 kcal serving of olive oil only contains 2.26 mg of Na+, or 4,748 times less Na+ than found in a 1000 kcal serving of green olives.

As I mentioned earlier, olives are member of the stone fruit (drupe) family.  Table 2 compares the Na+ and K+ concentrations of fresh drupes to processed olives.  Note that fresh drupes contain very low concentrations of Na+, comparable to olive oil, but additionally they  contain high concentrations of the health promoting ion K+.  A high K+/Na+ ratio is a universal characteristic of both wild and domesticated plant foods (7), and K+ is typically 5-10 times higher than Na+ in hunter gatherer diets (7-11).

Table 2. Na+ and K+ content of other drupes (stone fruit), including apricots, peaches, plums and nectarines (2)

  Drupes (stone fruits)

Na+ (mg)/

1000 kcal

K+ (mg)/

1000 kcal

K+/Na+ (mg/mg)

Apricot

21

5396

259.00

Nectarine

2

4568

2849.20

Peach

2

4872

2850.00

Plum

1

3413

2591.50

 

It is obvious that all olives contain much more Na+ than K+ (on average 18.5 times more Na+ than K+) compared to unadulterated, non-salted olive oil.  Clearly, the K+/Na+ ratios in processed olives lie far beyond the evolutionary normative values which conditioned our species’ genome (8-16).  Accordingly, it is not surprising that randomized controlled trials of salt consumption in humans as well as epidemiological studies (17-24) support the notion that added salt (be it sea salt or refined salt) from olives or any other processed food promotes cardiovascular disease, cancer, autoimmunity, chronic inflammation, immune system dysfunction, and ill health (17-51).

References

1.”About Olives”. International Olive Council. Retrieved September 5, 2017.  http://www.internationaloliveoil.org/estaticos/view/77-about-olives
2.Axxya systems. Nutritionist Pro. http://www.nutritionistpro.com/
3.Centers for Disease Control and Prevention (CDC). Vital signs: food categories contributing the most to sodium consumption – United States, 2007-2008. MMWR Morb Mortal Wkly Rep. 2012 Feb 10;61(5):92-8.
4.McDonough AA, Veiras LC, Guevara CA, Ralph DL. Cardiovascular benefits associated with higher dietary K+ vs. lower dietary Na+: evidence from population and mechanistic studies. Am J Physiol Endocrinol Metab. 2017 Apr 1;312(4): E348-E356.
5.Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE, Lim S, Danaei G, Ezzati M, Powles J, et al.  Global burden of diseases nutrition and chronic diseases expert group.
Global sodium consumption and death from cardiovascular causes. N Engl J Med. 2014 Aug 14;371(7):624-34
6.He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2013 Apr 30;(4):CD004937
7.http://thepaleodiet.com/further-evidence-against-a-high-sodium-paleo-diet/
8.Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr 2005;81:341-54
9.Jansson B. Human diet before modern times.   In: Sodium: “No!” Potassium: “Yes!”. Sodium increases and potassium decreases cancer risk.  Unpublished book manuscript, 1997, Chapter 2 pp. 1-20.
10.Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13.
11.Sebastian A, Frassetto LA, Sellmeyer DE, Morris RC Jr. The evolution-informed optimal dietary potassium intake of human beings greatly exceeds current and recommended intakes. Semin Nephrol. 2006 Nov;26(6):447-53
12.Gleibermann L. Blood pressure and dietary salt in human populations. Ecol Food Nutr 1973;2:143-56
13.Dahl L. Possible role of salt intake in the development of hypertension. In: Cottier P. Bock KD eds. Essential hypertension: an international symposiu. Berlin: Springer-Verlag. 1960:53-65.
14.Froment A. Milon H, Gravier C. Relationship of sodium intake and arterial hypertension. Contribution of geographical epidemiology. Rev Epidemiol Sante Publique 1979;27:437-54.
15.Shaper AG. Communities without hypertension. In: Shaper AG, Hutt MSR, Fejfar Z eds. Cardiovascular disease in the tropics. London: British Medical Association. 1974:77-83.
16.Denton D. The hunger for salt: an anthropological, physiological and medical analysis. Chapter 27, Salt intake and high blood pressure in man. Primitive peoples, unacculturated societies: with some comparisons. Berlin: SpringVerlag, 1982, 556-578.
17.O’Donnell M1, Mente A, Rangarajan S et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014 Aug 14;371(7):612-23.
18.Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmüller C, Macgregor GA, de Wardener HE. Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A. 2009 Feb 24;106(8):2829-34
19.Aaron KJ, Sanders PW. Role of dietary salt and potassium intake in cardiovascular health and disease: a review of the evidence. Mayo Clin Proc. 2013 Sep;88(9):987-95.
20.McDonough AA, Veiras LC, Guevara CA, Ralph DL. Cardiovascular benefits associated with higher dietary K<sup>+</sup> vs. lower dietary Na<sup>+</sup>: evidence from population and mechanistic studies. Am J Physiol Endocrinol Metab. 2017 Apr 1;312(4):E348-E356.
21.McDonough AA, Youn JH. Potassium Homeostasis: The Knowns, the Unknowns, and the Health Benefits. Physiology (Bethesda). 2017 Mar;32(2):100-111
22.Du S, Batis C, Wang H, Zhang B, Zhang J, Popkin BM. Understanding the patterns and trends of sodium intake, potassium intake, and sodium to potassium ratio and their effect on hypertension in China. Am J Clin Nutr. 2014 Feb;99(2):334-43.
23.Drewnowski A, Maillot M, Rehm C. Reducing the sodium-potassium ratio in the US diet: a challenge for public health. Am J Clin Nutr. 2012 Aug;96(2):439-44.
24.Fang Y, Mu JJ, He LC, Wang SC, Liu ZQ. Salt loading on plasma asymmetrical dimethylarginine and the protective role of potassium supplement in normotensive salt-sensitive asians. Hypertension. 2006 Oct;48(4):724-9
25.Jantsch J, Schatz V, Friedrich D et al. Cutaneous Na+ storage strengthens the antimicrobial barrier function of the skin and boosts macrophage-driven host defense. Cell Metab. 2015 Mar 3;21(3):493-501.
26.Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, Linker RA, Muller DN, Hafler DA.  Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nature. 2013 Apr 25;496(7446):518-22
27.Hucke S, Eschborn M, Liebmann M, Herold M, Freise N, Engbers A, Ehling P, Meuth SG, Roth J, Kuhlmann T, Wiendl H, Klotz L. Sodium chloride promotes pro-inflammatory macrophage polarization thereby aggravating CNS autoimmunity. J Autoimmun. 2016 Feb;67:90-101.
28.Zostawa J, Adamczyk J, Sowa P, Adamczyk-Sowa M. The influence of sodium on pathophysiology of multiple sclerosis. Neurol Sci. 2017 Mar;38(3):389-398.
29.Dmitrieva NI, Burg MB. Elevated sodium and dehydration stimulate inflammatory signaling in endothelial cells and promote atherosclerosis. PLoS One. 2015 Jun 4;10(6): e0128870. doi: 10.1371/journal.pone.0128870.
30.Schatz V, Neubert P, Schröder A, Binger K, Gebhard M, Müller DN, Luft FC, Titze J, Jantsch J. Elementary immunology: Na+ as a regulator of immunity. Pediatr Nephrol. 2017 Feb;32(2):201-210.
31.Hernandez AL, Kitz A, Wu C, Lowther DE, Rodriguez DM, Vudattu N, Deng S, Herold KC, Kuchroo VK, Kleinewietfeld M, Hafler DA. Sodium chloride inhibits the suppressive function of FOXP3+ regulatory T cells. J Clin Invest. 2015 Nov 2;125(11):4212-22.
32.Yi B, Titze J, Rykova M, Feuerecker M, Vassilieva G, Nichiporuk I, Schelling G, Morukov B, Choukèr A. Effects of dietary salt levels on monocytic cells and immune responses in healthy human subjects: a longitudinal study. Transl Res. 2015 Jul;166(1):103-10.
33.Zhou X, Zhang L, Ji WJ, Yuan F, Guo ZZ, Pang B, Luo T, Liu X, Zhang WC, Jiang TM, Zhang Z, Li YM. Variation in dietary salt intake induces coordinated dynamics of monocyte subsets and monocyte-platelet aggregates in humans: implications in end organ inflammation. PLoS One. 2013 Apr 4;8(4):e60332.
34.Zhou X, Yuan F, Ji WJ, Guo ZZ, Zhang L, Lu RY, Liu X, Liu HM, Zhang WC, Jiang TM, Zhang Z, Li YM. High-salt intake induced visceral adipose tissue hypoxia and its association with circulating monocyte subsets in humans. Obesity (Silver Spring). 2014 Jun;22(6):1470-6.
35.Wu C, Yosef N, Thalhamer T, Zhu C, Xiao S, Kishi Y, Regev A, Kuchroo VK. Induction of pathogenic TH17 cells by inducible salt-sensing kinase SGK1. Nature. 2013 Apr 25;496(7446):513-7.
36.Kostyk AG, Dahl KM, Wynes MW, Whittaker LA, Weiss DJ, Loi R, Riches DW. Regulation of chemokine expression by NaCl occurs independently of cystic fibrosis transmembrane conductance regulator in macrophages. Am J Pathol. 2006 Jul;169(1):12-20.
37.Lang KS, Fillon S, Schneider D, Rammensee HG, Lang F. Stimulation of TNF alpha expression by hyperosmotic stress. Pflugers Arch. 2002 Mar;443(5-6):798-803.
38.Ip WK, Medzhitov R. Macrophages monitor tissue osmolarity and induce inflammatory response through NLRP3 and NLRC4 inflammasome activation. Nat Commun. 2015 May 11;6:6931.
39.Foss JD, Kirabo A, Harrison DG. Do high-salt microenvironments drive hypertensive inflammation? Am J Physiol Regul Integr Comp Physiol. 2017 Jan 1;312(1):R1-R4
40.Binger KJ, Gebhardt M, Heinig M et al. High salt reduces the activation of IL-4- and IL-13-stimulated macrophages. J Clin Invest. 2015 Nov 2;125(11):4223-38
41.Min B, Fairchild RL. Over-salting ruins the balance of the immune menu.  J Clin Invest. 2015 Nov 2;125(11):4002-4.
42.Amara S, Tiriveedhi V. Inflammatory role of high salt level in tumor microenvironment (Review).  Int J Oncol. 2017 May;50(5):1477-1481
43.Amara S, Alotaibi D, Tiriveedhi V. NFAT5/STAT3 interaction mediates synergism of high salt with IL-17 towards induction of VEGF-A expression in breast cancer cells. Oncol Lett. 2016 Aug;12(2):933-943
44.Amara S, Zheng M, Tiriveedhi V. Oleanolic acid inhibits high salt-induced exaggeration of warburg-like metabolism in breast cancer cells. Cell Biochem Biophys. 2016 Sep;74(3):427-34.
45.Amara S, Whalen M, Tiriveedhi V. High salt induces anti-inflammatory MΦ2-like phenotype in peripheral macrophages. Biochem Biophys Rep. 2016 Sep;7:1-9
46.Amara S, Ivy MT, Myles EL, Tiriveedhi V. Sodium channel γENaC mediates IL-17 synergized high salt induced inflammatory stress in breast cancer cells. Cell Immunol. 2016 Apr; 302:1-10
47.Davies RJ, Sandle GI, Thompson SM. Inhibition of the Na+,K(+)-ATPase pump during induction of experimental colon cancer. Cancer Biochem Biophys. 1991 Aug;12(2):81-94.
48.Thompson, Davies RJ.  A high potassium diet prevents transepithelial depolarization in experimental colon cancer. In: Vitamins and Minerals in the Prevention and Treatment of Cancer, (Maryce M. Jacobs, Ed.), CRC Press, Boston, 1991, p 263.
49.Fine BP, Hansen KA, Walters TR, Denny TN.  Dietary sodium deprivation inhibits cellular proliferation: evidence for circulating factor(s). In: Vitamins and Minerals in the Prevention and Treatment of Cancer, (Maryce M. Jacobs, Ed.), CRC Press, Boston, 1991, p 276.
50.Fine BP, Ponzio NM, Denny TN, Maher E, Walters TR. Restriction of tumor growth in mice by sodium-deficient diet. Cancer Res. 1988 Jun 15;48(12):3445-8.
51.Davies RJ, Daly JM. Potassium depletion and malignant transformation of villous adenomas of the colon and rectum. Cancer. 1984 Mar 15;53(6):1260-4.

 

Sodium Levels | The Paleo Diet

For the majority of people, the problem with sodium is too much of it, not too little. National health organizations and the Paleo diet agree that high levels of dietary sodium should be avoided for healthy blood pressure levels and to reduce the risks of cardiovascular disease.1 However, diets too low in sodium are also dangerous, especially for athletes engaged in endurance sports.  Fortunately, it is possible for athletes to keep their sodium levels in check, without added processed foods, while still following the Paleo diet.

Understanding the Importance of Sodium in the Body

Although the Paleo diet is in inherently a low sodium lifestyle, dietary sodium, from naturally rich sodium foods and no common table salt, is necessary for everyday bodily functions.2 Muscles, including both the skeletal and cardiac types, need sodium to function properly. Twitches, cramps, spasms, and muscle weakness can occur when sodium levels are too low. The nervous system also uses electrolytes, such as ions of sodium, potassium and chloride, to transmit nerve impulses across cell membranes and to trigger muscle contractions.3 Sodium, in conjunction with potassium, is also necessary to maintain normal blood pressure, blood volume, and to balance bodily fluids.4 If that balance is disturbed, problems like heat-related illnesses and hyponatremia, low blood sodium (<130 mmol/L), may occur.5

Do Athletes Require More Dietary Sodium?

One major concern for athletes, especially those engaged in endurance activities, is that high sweat rates in athletes result in loss of both fluids and sodium.6 Low blood sodium can also occur in people who drink too much water, eat too little food, or take medications that deplete the body’s supply of water.7 Research indicates that the amount of sodium consumed in the days prior to exercise, might be more important in maintaining the proper levels during exercise, then in specific supplementation during the activity.8

Additionally, avoiding sodium rich beverages and foods during physical activity has been shown to not impact performance,9 ingesting sodium prior or during intense or prolonged physical activities is linked to an improved rate of absorption of water and carbohydrate in the small intestines.10 An athlete can encourage proper blood serum sodium levels by drinking for thirst and eating whole fruit, such as oranges, for a gradual fructose release.

Pre-and-Post Workout Meals

Pre-and-post workout meals can provide the necessary recovery nutrients rather than turning to processed supplements that are often sickeningly sweet, and contain many unnecessary additives and refined sugars. Surprisingly, they don’t contain exorbitant amounts of sodium. For example, a scoop of powdered electrolyte supplement contains 14 mg of sodium,11 compared to the 97mg available in a dash of table salt.12 An athlete concerned about maintaining adequate sodium levels during their exercise program can focus including naturally sodium-rich foods to their pre-workout meal, and focusing on the main principles of the Paleo diet. Our favorite sodium-rich and Paleo foods include:13

  • 1 large celery stalk (50 mg)
  • 1 beet (65 mg)
  • 4 oz. lamb chop (65 mg)
  • 4 oz. chicken breast (70 mg)
  • 4 oz. grass-fed ground beef (75 mg)
  • 1 cup of spinach (125 mg)
  • 1 cup of Swiss chard (300 mg)

By simply following a Paleo diet, focused on eating a wide variety of mineral rich vegetables, animal organs, and bone broth will supply the necessary nutrients to maintain adequate sodium levels, for both the weekend warrior and the elite endurance athlete under most training conditions. Traditional hunter-gathers participate in rigorous and demanding physical activities required by their hunting, gathering, and foraging lifestyles without needing to supplement their diets with table salt, or electrolyte supplements, to meet their sodium requirements. Dietary sodium is not quite the villain he has been made out to be. However, we don’t need to overcompensate with sodium-rich supplements when a regular Paleo diet offers enough of this essential nutrient to support most individuals, even those who are avid exercisers.

References

1. Mattes, R. D., and D. Donnelly. “Relative contributions of dietary sodium sources.” Journal of the American College of Nutrition 10.4 (1991): 383-393.

2. Centers for Disease Control and Prevention (CDC. “Usual sodium intakes compared with current dietary guidelines—United States, 2005-2008.” MMWR. Morbidity and mortality weekly report 60.41 (2011): 1413.

3. Brodal, Per. The central nervous system: structure and function. Oxford University Press, 2004.

4. Blaustein, M. P. “Sodium ions, calcium ions, blood pressure regulation, and hypertension: a reassessment and a hypothesis.” American Journal of Physiology-Cell Physiology 232.5 (1977): C165-C173.

5. Noakes, T. D., et al. “The incidence of hyponatremia during prolonged ultraendurance exercise.” Medicine and Science in Sports and Exercise 22.2 (1990): 165-170.

6. Godek, S. Fowkes, A. R. Bartolozzi, and J. J. Godek. “Sweat rate and fluid turnover in American football players compared with runners in a hot and humid environment.” British journal of sports medicine 39.4 (2005): 205-211.

7. Noakes, Timothy D. “The hyponatremia of exercise.” International journal of sport nutrition 2.3 (1992): 205-228.

8. Stofan, John R., et al. “Sweat and sodium losses in NCAA football players: a precursor to heat cramps?.” International journal of sport nutrition and exercise metabolism 15.6 (2005): 641.

9. Merson, Stuart J., Ronald J. Maughan, and Susan M. Shirreffs. “Rehydration with drinks differing in sodium concentration and recovery from moderate exercise-induced hypohydration in man.” European journal of applied physiology 103.5 (2008): 585-594.

10. Murray, Robert. “The effects of consuming carbohydrate-electrolyte beverages on gastric emptying and fluid absorption during and following exercise.” Sports Medicine 4.5 (1987): 322-351.

11. Available at: http://nutritiondata.self.com/facts/beverages/9232/2. Accessed on October 7, 2015.

12. Avaialble at: http://nutritiondata.self.com/facts/spices-and-herbs/216/2. Accessed on October 7, 2015.

13. http://nutritiondata.self.com/

New Studies on Salt: Adverse Influence Upon Immunity, Inflammation and Autoimmunity | The Paleo Diet

INTRODUCTION

The Paleo community clearly is not in complete agreement on all dietary issues. One of the more touchy topics is added dietary salt.  A number of popular (non-scientific/non-peer review) bloggers advocate the use of refined salt or various forms of sea salt added to recipes and meals.1 Highly salted meats such as bacon are wildly popular in the Paleosphere.2 Other concentrated, salty foods such as cheese, olives, canned sardines, tuna, anchovies, caviar, salted nuts, manufactured jerky, canned tomato paste, and other salted, processed foods frequently find their way into so-called Paleo diets. You will be hard pressed to find a Paleo diet cookbook anywhere that is completely free of added, salt – that is, except for one The Real Paleo Diet Cookbook (Houghton, Mifflin, Harcourt, New York, 2015).

I have written extensively on the health problems associated with added dietary salt – be it refined salt or sea salt. In the past two years startling, animal and human studies demonstrate that salt added to our diets doesn’t merely increase the risk for stroke, hypertension and heart disease,3, 4, 5, 6 but it also adversely affects immune function, promotes chronic inflammation and represents a previously unrecognized dietary factor in the pathogenesis of autoimmune diseases.7, 8, 9, 10, 11, 12

SODIUM CONSUMPTION: THE EVOLUTIONARY/ANTHROPOLOGICAL EVIDENCE

The USDA daily recommended intake of sodium is 2300 mg. However, it must be remembered that dietary sodium and dietary salt are not equivalent. 1 gram (1000 mg) of salt (NaCl) = 390 mg of sodium.  Hence 2300 mg of sodium would equal 5.9 grams of salt (NaCl).

In perhaps the most comprehensive study of hunter gatherers and non-westernized people worldwide, Denton demonstrated that their average dietary salt intake ranged from 0.6 grams to 2.9 grams of salt (NaCl) per day or 234 to 1131 mg of daily sodium.13 These numbers are derived from population wide urinary sodium excretion rates and are considerably lower than the USDA recommended value of 2300 mg sodium per day, and much lower than the wildly speculative values (3000 to 7000 mg sodium per day or 7.7 to 17.9 grams of daily salt) suggested by a non-scientific/non-peer review Paleo blogger.1

SODIUM CONSUMPTION: EVIDENCE FROM CONTEMPORARY, NON-PROCESSED FOODS

Consider Figure 1 below which demonstrates the sodium content of four contemporary Paleo foods: meat/seafoods (n=8), fruit (n=20) and vegetables (n=18). Note that meat/seafood averages 694 mg of sodium per 1000 kcal, vegetables 764 mg sodium per 1000 kcal and fruit 54 mg of sodium per 1000 kcal.

New Studies on Salt: Adverse Influence Upon Immunity, Inflammation and Autoimmunity | The Paleo Diet

Figure 1.  The Sodium Content of Contemporary Paleo Foods to Processed Foods.

Accordingly, contemporary Paleo diets averaging 55% to 66% of daily calories (range 2200 to 3000 kcal) from animal foods and the balance from plant foods would contain sodium intakes ranging from 1600 to 2200 mg.  These calculations show that unless processed foods containing added salt are consumed, it would be difficult to obtain the USDA 2300 mg recommendation for  daily sodium, and almost impossible to obtain a popular bloggers’ advice (3000 to 7000 mg sodium).1

If fruits were primarily consumed in lieu of vegetables for contemporary Paleo diets, the range of daily sodium intake would be lower still (900 to 1200 mg) which falls within the values of historically studied fully, non-westernized populations.13 With contemporary Paleo foods (fresh fruits, vegetables, meats, seafood, eggs, nuts etc.) and no added salt, you will be obtaining not only sufficient sodium intakes, but also therapeutically lower sodium intakes that are consistent with values that conditioned our species’ genome over millions of years of evolutionary wisdom.

Lowered, or no consumption of added, manufactured dietary salt will lessen your risk for hypertension, stroke and cardiovascular disease,3, 4, 5, 6 certain cancers,14, 15, 16 and now autoimmune and immune diseases, as well as multiple diseases involving chronic low level, systemic inflammation.7, 8, 9, 10, 11, 12

DIETARY SODIUM: ADVERSE EFFECTS UPON INFLAMMATION, IMMUNOLOGICAL FUNCTION AND AUTOIMMUNITY

I have now laid out the necessary foundation for the focus of this article. So, let’s get back into the topic at hand.

Unexpectedly, experimental studies in the past two years have provided powerful, new evidence that high salt diets cannot solely be related to hypertension, stroke , cardiovascular disease3, 4, 5, 6 and cancer,14, 15, 16 but also to diseases involving dysfunction of the immune system, chronic systemic inflammation and autoimmunity.7, 8, 9, 10, 11, 12

Let’s not forget that cardiovascular disease, cancer and autoimmune diseases cannot proceed without chronic, low level inflammation, or that the typical U.S diet is a high salt diet.17 Would it be surprising that the typical western diet which includes 70 % or more of its calories as salt laden processed foods17 and 10 to 12 grams of sodium per day5, 7, 17 might have any adverse effects upon the immune system and diseases of chronic inflammation?

The evolutionary discordance template18, 19 would predict that any recently introduced dietary elements found in concentrations many standard deviations above or below those which conditioned the human genome over 2 million years of evolutionary experience, might adversely impact contemporary health and well being. Indeed is the case for immunity, inflammation and autoimmunity.

ANALYSIS OF RECENT STUDIES

In April of 2013, before my recent retirement from CSU, I awoke to a flurry of emails from scientific colleagues around the world as well as from a few of my graduate students regarding two astounding papers that had just been published in the prestigious scientific journal, Nature.8, 9  These papers represented the first experimental evidence indicating that high salt diets fundamentally altered the immune system of experimental animals in a manner that promoted autoimmune disease.

Over the past decade, numerous studies (human, animal and tissue) have implicated a specific component of the immune system (Th17 or T Helper Cell 17) in a wide variety of autoimmune diseases.20, 21, 22, 23 The two papers on salt and autoimmunity published in Nature8, 9 were crucial, because for the first time empirical evidence demonstrated that high dietary intakes of salt were capable of up-regulating (increasing) Th17 cells in experimental animals and promoting autoimmunity.

OK – no big deal – these were just animal studies and until human studies were conducted, the link between dietary salt and the immune system, chronic low level inflammation and autoimmunity was tenuous.  The currency of science to demonstrate causality between diet and disease requires not just animal studies, but also tissue studies, epidemiological studies and most importantly experimental randomized controlled human trials.

Science typically moves slowly, but occasionally good ideas are rapidly pounced upon by scientists and researchers, thereby resulting in major leaps of knowledge.  Such was the case with salt and autoimmunity. Concurrent with the two animal studies on dietary salt and immune function,8, 9 came the first human study published by Zhou and colleagues, also in April of 2013.11 Their study showed that after a 7 day (short term) high salt diet (> 15  NaCl/day) compared to a lower salt (< 5 g NaCl/day), markers (CD14++ and CD16+) of pro-inflammatory immune responses increased.  CD14++ and CD16+ are molecules expressed on certain immune system cells called monocytes/macrophages. Normally, these cells produce pro-inflammatory cytokines (hormones) when bacterial infection occurs24, 25 or with autoimmune diseases.26, 27  Surprisingly, even a short term (7 day) high salt diet11 caused the human immune system to become inflamed, just as if it were being attacked by foreign pathogens24, 25 or during autoimmunity.26, 27

In the most powerful human study to date, Yi and colleagues have convincingly demonstrated that a high salt diet (12 g per day) promoted a pro-inflammatory immune response whereas a lower salt intake (6 g per day) reduced these effects and caused beneficial immune system changes. The sophistication and high scientific validity of this experiment occurred because it was conducted under metabolic ward conditions over a long (205 day) duration for a simulated spaceflight program (Mars520 Mission).7

With metabolic ward conditions, each and every meal or snack are exclusively provided to test subjects.  Consequently all nutrients (including sodium) are under strict control. During the experiment in an enclosed environment, daily salt intake was solely modified from 12 g/day to 9 g/day to 6 g/day for 50 + 10 days and then reversed back to 12 g/day for 30 days. During the high salt (12 g/day) stages of the experiment, the pro-inflammatory cytokines (localized hormones) IL-6 and IL-23 increased whereas the anti-inflammatory cytokine, IL-10 decreased. Further the high salt diet caused an expansion of white blood cells (monocytes) that occur during chronic inflammation, autoimmune diseases and cancer. On the low salt (6 g/day) diet, these deleterious immune system changes were reversed. Interestingly, during the high salt phase of this experiment, IL-17 was higher than during the low salt phase (P= 0.08). As I have mentioned earlier, numerous studies (human, animal and tissue) have implicated this specific component (Th-17) of the immune system in a wide variety of autoimmune diseases.20, 21, 22, 23

So, there you have it.  The most powerful and scientifically valid study in humans has indisputably demonstrated that a high salt diet promotes chronic inflammation and adversely affects the immune system.  Note that the high salt (12 g/day) phase of this experiment actually represents the normal (10-12 g/day) salt intake in the U.S.5, 7, 17 and that cardiovascular disease, cancer and autoimmune diseases cannot proceed without chronic inflammation.  It is not only irresponsible for certain Paleo bloggers1 to promote high salt diets, but potentially life threatening.

 

REFERENCES

[1] Kresser K. Shaking Up The Salt Myth: Healthy Salt Recommendations. May 4, 2012.

[2] Huntley T.  The Path to Culinary Bliss: Home Cured Bacon.

[3] Strazzullo P, D’Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009 Nov 24;339:b4567. doi: 10.1136/bmj.b4567.

[4] Aaron KJ, Sanders PW. Role of dietary salt and potassium intake in cardiovascular health and disease: a review of the evidence.  Mayo Clin Proc. 2013 Sep;88(9):987-95.

[5] He FJ, MacGregor GA. A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens. 2009 Jun;23(6):363-84.

[6] Ando K, Kawarazaki H, Miura K, Matsuura H, Watanabe Y, Yoshita K, Kawamura M, Kusaka M, Kai H, Tsuchihashi T, Kawano Y. [Scientific statement] Report of the Salt Reduction Committee of the Japanese Society of Hypertension(1) Role of salt in hypertension and cardiovascular diseases. Hypertens Res. 2013 Dec;36(12):1009-19.

[7] Yi B, Titze J, Rykova M, Feuerecker M, Vassilieva G, Nichiporuk I, Schelling G, Morukov B, Choukèr A. Effects of dietary salt levels on monocytic cells and immune responses in healthy human subjects: a longitudinal study. Transl Res. 2015 Jul;166(1):103-10.

[8] Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, Linker RA, Muller DN, Hafler DA.  Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nature. 2013 Apr 25;496(7446):518-22.

[9] Wu C, Yosef N, Thalhamer T, Zhu C, Xiao S, Kishi Y, Regev A, Kuchroo VK. Induction of pathogenic TH17 cells by inducible salt-sensing kinase SGK1. Nature. 2013 Apr 25;496(7446):513-7.

[10] O’Shea JJ, Jones RG. Autoimmunity: Rubbing salt in the wound. Nature. 2013 Apr 25;496(7446):437-9.

[11] Zhou X1, Zhang L, Ji WJ, Yuan F, Guo ZZ, Pang B, Luo T, Liu X, Zhang WC, Jiang TM, Zhang Z, Li YM. Variation in dietary salt intake induces coordinated dynamics of monocyte subsets and monocyte-platelet aggregates in humans: implications in end organ inflammation.  PLoS One. 2013 Apr 4;8(4):e60332. doi: 10.1371/journal.pone.0060332. Print 2013.

[12] van der Meer JW1, Netea MG. A salty taste to autoimmunity. N Engl J Med. 2013 Jun 27;368(26):2520-1.

[13] Denton D.  Salt intake and high blood pressure in man. Primitive peoples, unacculturated societies: with comparisons.  In: The Hunger for Salt, An Anthropological, Physiological and Medical Analysis. Springer-Verlag, New York, 1984, pp. 556-584).

[14] D’Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr. 2012 Aug;31(4):489-98.

[15] Ge S, Feng X, Shen L, Wei Z, Zhu Q, Sun J. Association between Habitual Dietary Salt Intake and Risk of Gastric Cancer: A Systematic Review of Observational Studies.  Gastroenterol Res Pract. 2012;2012:808120. doi: 10.1155/2012/808120. Epub 2012 Oct 22.

[16] Hu J, La Vecchia C, Morrison H, Negri E, Mery L; Canadian Cancer Registries Epidemiology Research Group. Salt, processed meat and the risk of cancer. Eur J Cancer Prev. 2011 Mar;20(2):132-9.

[17] Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O’Keefe JH, Brand-Miller J. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005 Feb;81(2):341-54.

[18] Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010 Dec;25(6):594-602.

[19] Frassetto L1, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging–the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet.  Eur J Nutr. 2001 Oct;40(5):200-13.

[20] Burkett PR, Meyer Zu Horste G, Kuchroo VK. Pouring fuel on the fire: Th17 cells, the environment, and autoimmunity. J Clin Invest. 2015 Jun 1;125(6):2211-9.

[21] Ryu H, Chung Y. Regulation of IL-17 in atherosclerosis and related autoimmunity. Cytokine. 2015 Apr 15. pii: S1043-4666(15)00126-X. doi: 10.1016/j.cyto.2015.03.009. [Epub ahead of print]

[22] Li D, Guo B, Wu H, Tan L, Chang C, Lu Q. Interleukin-17 in systemic lupus erythematosus: A comprehensive review.  Autoimmunity. 2015 Apr 20:1-9. [Epub ahead of print]

[23] Patel DD , Lee DM, Kolbinger F, Antoni C. Effect of IL-17A blockade with secukinumab in autoimmune diseases. Ann Rheum Dis. 2013 Apr;72 Suppl 2:ii116-23. doi: 10.1136/annrheumdis-2012-202371. Epub 2012 Dec 19.

[24] Rietschel ET, Schletter J, Weidemann B, El-Samalouti V, Mattern T, Zähringer U, Seydel U, Brade H, Flad HD, Kusumoto S, Gupta D, Dziarski R, Ulmer AJ. Lipopolysaccharide and peptidoglycan: CD14-dependent bacterial inducers of inflammation. Microb Drug Resist. 1998 Spring;4(1):37-44.

[25] Scherberich JE1, Nockher WA. CD14++ monocytes, CD14+/CD16+ subset and soluble CD14 as biological markers of inflammatory systemic diseases and monitoring immunosuppressive therapy. Clin Chem Lab Med. 1999 Mar;37(3):209-13.

[26] Chuluundorj D, Harding SA, Abernethy D, La Flamme AC. Expansion and preferential activation of the CD14(+)CD16(+) monocyte subset during multiple sclerosis.  Immunol Cell Biol. 2014 Jul;92(6):509-17.

[27] Kawanaka N1, Yamamura M, Aita T, Morita Y, Okamoto A, Kawashima M, Iwahashi M, Ueno A, Ohmoto Y, Makino H. CD14+,CD16+ blood monocytes and joint inflammation in rheumatoid arthritis. Arthritis Rheum. 2002 Oct;46(10):2578-86.

Add Salt and Stop Gaining Weight? | The Paleo Diet

“In a study that seems to defy conventional dietary wisdom, scientists have found that adding high salt to a high-fat diet actually prevents weight gain in mice.”1

So, after all this time, is adding salt to the diet not really as consequential as we thought?  Can we just douse our food with it, eat whatever foods we fancy and then magically stay lean and fit? Let’s investigate.

The researchers hypothesized that fat and salt, both tasty and easy to overeat, would collectively increase food consumption and promote weight gain. They tested the hypothesis by feeding groups of mice different diets: normal or high-fat chow with varying levels of salt. To their surprise, the mice on the high-fat diet with the lowest salt gained the most weight.

But how can this be? Don’t we need to eat a diet lower in fat and salt, per USDA recommendations,2 in order to be as healthy as possible?

“Our findings, in conjunction with other studies, are showing that there is a wide range of dietary efficiency, or absorption of calories, in the populations, and that may contribute to resistance or sensitivity to weight gain”, says Michael Lutter, MD, PhD, co-senior study author and UI assistant professor of psychiatry.

Well, that certainly makes sense. Humans certainly are not all cut from the same cloth. We have to factor in genetic variability, and nature versus nurture, in terms of what we we’re fed growing up and whether our upbringing favored activity and exercise.

Furthermore, we need to consider what we are eating in the grand scheme of things. How does this affect our macronutrient ratios and consequently what is our body using for its fuel source? For example, if we eat a ‘healthy’ diet with many servings of natural fruit during the day, we provide our body with a constant, steady stream of carbohydrates. This prevents the body from tapping into stored fat which requires the body to put forth significantly more effort. If, however, we begin the process of becoming fat adapted, we force the body to do the latter and turn to fat as its primary fuel source.3

Many of us who are already in sync with the recommendations of a real Paleo diet are comfortable with the recommendation to eat a diet higher in fat. But, the mention of adding salt really throws us a curve ball! After all, added salt is linked to a host of negative side effects including high blood pressure, osteoporosis and kidney stones, stomach cancer, stroke, Menierre’s Syndrome, insomnia, motion sickness, asthma and exercise induced asthma.4

A brief glance at our colleagues, friends and family’s food habits, provide all the proof we need that the typical American is following a diet far too high in sodium. It’s a fair bet most could do with, at the very least, weaning off the salt, by cutting back on the salt shaker and simultaneously omitting processed foodstuffs. But, this begs the question, how should athletes balance their Paleo diets and replace electrolytes through sweat?

Rehydrating with pure water without also replenishing salts can be potentially fatal and lead to hyponatremia, a condition that can occur when the level of sodium in your blood is abnormally low. Drinking too much water during endurance sports causes the sodium in your body to become diluted. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life threatening.5 Other side effects may include lightheadedness, fatigue, headaches and constipation.

Moreover, on a low carb diet where the body becomes reliant on fat as its fuel, more salt is used in the process when insulin levels go down and the body starts shedding excess sodium and water along with it. On a high carb diet, insulin signals the cells to store fat and the kidneys to hold on to sodium, which is why people often get rid of excess bloat within a few days of low-carb eating.6

But again, if sodium is a crucial electrolyte in the body, how do we replace it? Presuming you’re following a healthy, high in fat, but void of refined, processed carbs and with adequate wild proteins and local veggies Paleo diet, adding a few pinches of salt to a recovery drink is permitted7 and may, in some instances, be a part of preventing weight gain. The general takeaway is not to simply add salt and watch the pounds melt away. Rather, train your body to become fat adapted in conjunction with following a real Paleo approach.

These findings “may lead to the developments of new anti-obesity treatments” and “may support continued and nuanced discussions of public policies regarding dietary nutrient recommendations.”

Let’s hope the new treatments go beyond a new pill or surgery, and the recommendations are evidenced by science versus the current guidelines deterring us as a society to truly follow a path to optimal health!

 

REFERENCES

[1] ScienceDaily. ScienceDaily, n.d. Web. 15 June 2015.

[2] “Dietary Guidelines.” Dietary Guidelines. N.p., n.d. Web. 15 June 2015.

[3] Volek, Jeff, Stephen D. Phinney, Eric Kossoff, Jacqueline A. Eberstein, and Jimmy Moore. The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable. Lexington, KY: Beyond Obesity, 2011. Print.

[4] “Sea Salt: Between the Devil and the Deep Blue Sea.” The Paleo Diet. N.p., 20 Apr. 2014. Web. 15 June 2015.

[5] “Hyponatremia.” – Mayo Clinic. N.p., n.d. Web. 15 June 2015.

[6] “Insulin’s Impact on Renal Sodium Transport and Blood Pressure in Health, Obesity, and Diabetes.” Insulin’s Impact on Renal Sodium Transport and Blood Pressure in Health, Obesity, and Diabetes. N.p., n.d. Web. 15 June 2015.

[7] Cordain, Loren, and Joe Friel. “Stages III, IV, V: Eating After Exercise.” The Paleo Diet for Athletes: The Ancient Nutritional Formula for Peak Athletic Performance. New York: Rodale, 2012. 56-57. Print.

Wine | The Paleo Diet

There are numerous geographic locations worldwide with growing numbers of of centenarians.

Environmental factors including diet, exercise, fresh air, sunshine, occupation, psychological factors including positive outlook, meaningful life roles, close family ties, spiritual perspective and hereditary factors all work synergistically to promote a long, healthy lifespan. It would be difficult or impossible to quantify the precise role each of these elements may play in maximizing human longevity.

Nevertheless, consumption of compounds called polyphenols found in many plants, particularly a compound called resveratrol has been shown to extend the lifespan of certain short lived experimental animals. Resveratrol is a polyphenol found in grape skins (among many other plants and plant parts) and functions to protect the plant or grape from environmental damage like insect predation, fungi, and UV radiation from sunlight.

The Cannonau grape from Sardinia is the local name for a grape known worldwide as the Grenache grape. Cannonau grape skins are known to produce high concentrations of resveratrol, perhaps because of the high UV exposure they experience in Sardinia.The grapes also contain flavanols and procyanidins, which together with polyphenols – powerful antioxidants with cardiovascular benefits, according to an article, as written, by the prominent heart surgeon and Professor at Columbia University’s College of Physicians and Surgeons, Dr. Mehmet Oz. Wine from Cannonau grapes in Sardinia is made in the traditional sense where the grape skins remain for 8-10 days with the juice to produce a higher resveratrol content. Resveratrol stimulates compounds in cells called sirtuins which are known to extend lifespan in experimental animals under caloric restriction.

In conducting research for his book, Blue Zones, Dan Buettner in conjunction with National Geographic, determined that Cannonau wine does in fact play a role in the longevity of the Sardinian population, with an unusually high percentage of centenarians. Dr. Oz credited this to a Mediterranean diet rich in fruits, vegetables, meat and cheese from grass – fed animals, physically active jobs and red wines, made from the little – known, indigenous grape called Cannonau.

It is possible that a high resveratrol intake from red wine made with Cannonau grapes may in part contribute to increased longevity, however, no controlled human or primate experiments have ever been conducted to substantiate this hypothesis. In all of my books, I have always permitted people to drink a glass of wine with dinner every so often, as it is part of the 85:15 rule which permits occasional “cheating”. The key here is moderation.

I’m often asked what my position is on commercial wines, like  Holland Marsala Cooking Wine. Marsala contains a substantial amount of salt. Two tablespoons (30 ml) of this cooking wine contains 190 mg of sodium which translates to 483 mg of salt. The typical western diet contains about 10 grams of salt, whereas hunter-gatherer diets may contain less than 1.0 gram of salt. As you might have already guessed, Marsala Cooking Wine is very “un-Paleo” because of it’s high salt content.

Moreover, it contains two preservatives, potassium sorbate and potassium metabisulfite. Sulfites are sulfur based compounds that may occur naturally or are added to a food as a preservative. Sulfites can cause allergies. The FDA estimates that of 100 people one is sensitive to sulfites and their use on fresh fruits and vegetables was banned in 1986. Sulfite containing ingredients in processed foods include: sulfur dioxide, potassium bisulfite, potassium metabisulfite, sodium bisulfite, sodium metabisulfite, sodium sulfite.

Most commercial wines contain added sulfites to extend their shelf life, just read the label. The exception to this rule are organic wines which are made without sulfites. There are many other organic wineries that produce sulfite-free wines like Frey Vineyards from Mendocino, CA who produce a variety of sulfite-free wines that are both Paleo and are reasonably priced.

When you take the guesswork out, you can put your mind to rest. Read the labels and keep it in moderation.

Cordially,

Loren Cordain, Ph.D., Professor Emeritus

References

1. Sanna G, Ledda S, Manca G, Franco MA. Characterization of the content of antioxidant substances in the wines of Sardinia. J Commodity Sci Technol Quality 2008;47 (I-IV), 5-25.

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