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Podcast: Excess Salt Leads to Autoimmune Disease

By The Paleo Diet Team
February 27, 2014
Podcast: Excess Salt Leads to Autoimmune Disease image

Dr. Loren Cordain: I'm Loren Cordain, Founder of the Paleo movement.

Shelley Schlender: I'm Shelley Schlender. This is The Pale Diet Podcast for May, 2013.

Dr. Loren Cordain: Coming up, you probably know that access salt can lead to high blood pressure, but did you know that too much salt might lead to thinner bones and autoimmune disease?

Shelley Schlender: Loren Cordain, it's distressing for me to hear that you don't like salt because bacon tastes very good.

Dr. Loren Cordain: Well there's no doubt that bacon tastes very good, but what I would suggest is that you go to the health food store or Whole Foods or wherever, and get the non-salted version, and you'll be in a lot better shape.

Shelley Schlender: Why is salt such a big deal? It tastes awfully good.

Dr. Loren Cordain: We have a natural craving for salt. It's built into us, but in the environment that we evolved, the Stone Age environment, salt was very, very rate. We couldn't get it unlimited quantities. Whereas in the western world we put salt in virtually all processed foods. An ear marker of salt is salt that gets into your urine. If you have a lot of in your urine then that tells us that you're not compliant with the Paleo Diet because you're eating processed food because salt's put in everything. In the western world, in the United States, we typically consumer about ten grams of salt per day.

Shelley Schlender: That's about two teaspoons of salt a day.

Dr. Loren Cordain: Yeah you're right, and most of it comes from processed foods. About seventy percent of those ten grams comes from foods that are packaged, come in a cardboard box or plastic or you name it. Any processed foods they usually put salt in it. They even put salt in bread.

Shelley Schlender: That's the kind of salt that you can't really even taste. It's salting your body but it isn't giving you the flavor.

Dr. Loren Cordain: You're right, that's the number one source of salt. Of all processed foods in the U.S. diet comes from bread and baked goods.


Shelley Schlender: I've heard in some cases, while it helps preserve the food, the taste is masked partly by adding in sugar. It's a double whammy, more salt and more sugar.

Dr. Loren Cordain: Yeah, and I think our taste buds become numb or immune to salt after having it from basically since the time we're weaned until we die, is we put it in everything. Everybody is just used to this taste. Food processors and packagers realize it and they combine salt with sugar and starch to make things like chips and what have you.

Many people that are doing Paleo seem to think that if they get salt from sea salt everything will be okay, but sea salt contains virtually the same amount of sodium chloride as done regular iodized salt. It's not just the sodium ion that's problematic with salt. Both the sodium and the chloride ion contribute to the health problems associated with salt. The biggest of which is high blood pressure.

When we look at high blood pressure, not all people are salt sensitive. Roughly 30 – 50% of hypertensive or people with high blood pressure are sensitive to salt; smaller numbers for people that are normotensive or don't have high blood pressure or are salt sensitive.

The people that are salt sensitive, their blood pressure goes up with salt, and the ones that are not salt sensitive, theirs doesn't, but the big caveat here and the most important factor is that when we cut the salt out of our diet, whether it reduces blood pressure or not, which is a good thing if it does. It tends to reduce all-cause mortality from all cardiovascular events. In a number meta-analysis, these are large population studies, show that there's roughly a thirty percent reduction in cardiovascular mortality when you lower salt in your diet.


Shelley Schlender: That's quite a bit. Now does it depend partly on what other foods someone is eating with the salt? If a person eats more vegetables, nice green leafy vegetables with lots of potassium and magnesium. Does that reduce the impact of salt?

Dr. Loren Cordain: Yeah you're absolutely right Shelley, and that's an important factor. Animal studies as well as human studies indicate that if you can concomitantly eat a high potassium diet and you're taking in salt, it seems to reduce the effects of the salt and actually makes everything better.

That's what's so beautiful about the contemporary Paleo Diet, is that if you do it properly you're getting a third to a little bit less than half of your calories from fruits and vegetables every single day. If you do that, that will ensure that you have high potassium in your diet, and if you eliminate or significantly reduce processed foods, then you're going to be reducing the salt in your diet. For most people that does the trick.

Shelley Schlender: What happens when they do that?

Dr. Loren Cordain: They effectively are lowering the amount of salt, both sodium and chloride in their diet, and they're elevating potassium. Our kidneys seem to function much better as does our system that maintains blood pressure and other factors, when we have high potassium and low salt in the diet. Magnesium is also another good one too. Magnesium is found in high concentrations in fruits, and vegetables, and nuts. It also tends to work together with potassium to keep blood pressure and cardiovascular events under control.

Shelley Schlender: Now if somebody is not prone to high blood pressure are there still reasons to reduce salt in the diet?

Dr. Loren Cordain: Absolutely. Once again, people that thing they're eating Paleo, but they're still consuming salt, and I see on many recipes that are online and on blogs and so forth, so called Paleo recipes that include sea salt. Well sea salt as I mentioned earlier is just as good a source of sodium chloride as is just regular table salt.


Shelley Schlender: When you said just as good, you mean just as bad?

Dr. Loren Cordain: Just as bad, exactly. What are some other health effects? Everybody knows about high blood pressure, we know about strokes. A stroke is a cardiovascular event in the brain. You can reduce your probability of getting a stroke by increasing the fruits and veggies, lower the processed foods and the salt. Those two are fairly well known. Kidney disease. People that experience problems with their kidneys also can benefit by lowering the salt intake and increasing potassium intake.

There's a little known syndrome called Meniere's Syndrome.

Shelley Schlender: That's the syndrome that makes me dizzy just to think about it.

Dr. Loren Cordain: It makes you dizzy and it causes ringing in your ears. There is some evidence that it is an autoimmune disease. Clinical trials show that lowering salt in the diet seems to help many of these people. There's another disease that we all have heard of which is called osteoporosis. Clinical trials in women who have developed osteoporosis, if you reduce the salt in their diet their bone mineral density starts to increase, and they don't excrete as much calcium.

When you eat a high salt diet the chloride ion ends up in the kidney being treated as acid, and so to counter that acid effect we take alkaline salts, calcium salts from the bones, to neutralize the net acidity. High salt diets then cause a condition called calciuria in which we excrete calcium in our urine. By reducing the salt in the diet, then we can lower the calcium in the urine and increase bone mineral density.

Shelley Schlender: Well that's a lot of reasons to reduce salt. There are some forms of Paleo Diets where perhaps salt isn't as much of an issue such as the very high fat almost no carb diet of the Inuits.


The Inuit people did tend to like to melt sea ice so that they could have a little bit of salt in their diet.

Dr. Loren Cordain: Yeah and I think that, that diet on coastal living people was probably fairly common. I think any modern humans that live near the ocean probably would have done that, but most inland living hunter gatherers, they simply didn't have salt sources because it's so difficult and rare to find salt inland; the only exceptions are dried lake beds and places like that but for the most part salt is very, very rare in the terrestrial environment; whereas potassium is extremely common.

The way our kidneys evolved was to be able to handle high potassium loads, and whenever we got sodium we tended to sequester it because it was so rare. What we've done evolutionarily is we've completely reversed the kidney function where sodium now is the common element, and potassium is rare because we eat so little fruits and vegetables.

Before we finish with this topic there's one other recent development on salt. This is only discovered in the last, oh probably six months or so. There was a series of papers that were published in nature and some other high impact journals showing that salt actually is one of the causes of autoimmune disease. For Paleo people that are eating sea salt in their recipes, that's another consideration. Particularly those with autoimmune disease.

Shelley Schlender: Well Loren Cordain, what is the reason that the researchers were suspecting that salt could make a difference in an autoimmune disease?

Dr. Loren Cordain: It's a complicated explanation that probably goes beyond the background of most of our listeners, but it has to do with our genome, looking at specific elements at the molecular level in our genome that seem to be turned out in autoimmune disease.


A very cool model was built by scientists only within the last year, that allowed them to see which specific genes were being turned on.

Shelley Schlender: Instead of salting their food for dinner they salted the DNA and watched to see which one of the genes got messed up, and a lot of them did?

Dr. Loren Cordain: That's absolutely right Shelley. This is really exciting times because it's the first time they've been able to look at this at the genetic model, and one of the very first factors that came out was a mechanism that regulates salt in our body. It's now almost beyond doubt that salt tends to promote autoimmune diseases in people with autoimmune disease. Now we're not sure which specific autoimmune disease, but I'm sure in the next few years that'll eventually come out, and it's probably all of them.

Getting salt out of the diet is not just good for your blood pressure, for cardiovascular events, for osteoporosis, acid based balance, your kidney, but now we're finding that reducing salt in the diet is a very good idea for people that are susceptible to autoimmune diseases.

Shelley Schlender: The sneaky thing is, that most salt is in processed foods where you don't even know it's there. You can't even taste it. I gather that if somebody cooks food and just sprinkles a little bit of salt on their food afterward, that's not nearly as much salt as in most processed things?

Dr. Loren Cordain: Yeah, I think we mentioned that earlier. Of the ten grams of salt that we get on a daily basis, about seventy percent comes in processed food, and of all processed foods, bread and baked goods are some of the highest sources of salt, but since most Paleo people don't eat bread or baked goods then they potentially would be getting it from other processed food. If you don't eat processed foods you really aren't going to get much salt in your diet.


Shelley Schlender: I've found that I can find pork belly these days, and pork belly is pretty close to bacon, and then all I have to do is sprinkle a little bit of salt on it and it's probably even tastier.

Dr. Loren Cordain: Well I'll tell you what. If you do, do that Shelley, make sure you have a big half of a cantaloupe for breakfast along with that pork belly and you'll be in great shape because a half of a cantaloupe is going to give you enough potassium to counter any effects of a little bit of sprinkling of salt on your pork belly.

That's all for this edition of The Paleo Diet Podcast. Visit my website for past episodes and for hotlinks to the experts and studies that we talked about today.

Shelley Schlender: Our theme music is by Chapman Stick soloist Bob Culbertson.

Dr. Loren Cordain: If you want to send me questions or comments the place to go is

Shelley Schlender: For The Paleo Diet Podcast, I'm Shelley Schlender.

Dr. Loren Cordain: I'm Loren Cordain.

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