Understand Salt’s Impact On Your Heart

Joel Fuhrman, MD

My pleasure.

Joel Kahn, MD, FACC

It’s been great to talk about a topic that, you know, you can’t live in a Western society and walk into a restaurant or a vending machine or a grocery store and not be exposed to the potential of being flooded with salt as an added ingredient. So we’re going to focus on salt for this topic. How bad is salt for our health? What do we need to know? What do we need to learn?

Joel Fuhrman, MD

I’m saying to people that it’s very bad that they really got to get the salt out of their diet. It’s an appetite stimulant. It makes it stimulates both thirst and hunger, and it makes you retain fluid and it leads to increased body fat independent of its effect on calories. It’s like hard to believe. It makes you weigh more even though it doesn’t, even if you’re not eating more calories, it makes you weigh more and more fat in the body. It also makes you lose minerals because as you take extra sodium, now, your sweat has a lot of sodium in it and your urine has a lot of sodium. And you’re always pushing out sodium. The body can’t selectively excrete sodium independently of other minerals and has to take all the minerals along with it. So now you going to exercise and get a cramp in your leg and you’re chronically going to be deficient in other minerals because your diet is so high in sodium. What I’m saying is there are a lot of mechanisms via which salt damages your health over and above it that most people are aware of. It raises blood pressure but has a lot of other dangerous effects on the body besides the fact it just raises blood pressure. 

The World Health Organization reports that they did a March 9th, 2023 report said that sodium, that if the world’s population decreased its sodium content sodium intake by 30% that would save seven million lives. We’re talking about how many people, how many millions of lives like 20 million people die every year because of excess sodium intake and they’re brainwashed by false information and people lying to them telling them that salt is just okay for them or even necessary. Natural foods contain plenty of sodium, other primates, chimpanzees, and gorillas don’t salt their food. Humans have been on the planet for 100,000 years. We’ve only used salt for the last few thousand years. It was used in more ancient civilizations that we have records of, but it’s very small amounts. It has been increased, salt intake has been consumed 15 to 20 times as much compared to what it was used 500 years ago or before that time. Salt was very hard to come by before 500 years ago. That’s why it was so valuable. But the point is, humans never use salt in the manner and in the amounts it’s used today. It’s a major cause of increased cardiovascular death and shortened lifespans.

Joel Kahn, MD, FACC

Oh, wow. Foods have natural salt. What about natural salts?

Joel Fuhrman, MD

Yes. Food gives, like when we eat vegetables and beans and nuts and grain, mushrooms and onions and wheat, we get sodium. But natural foods all have about less than half the amount of sodium per calorie. Like 200 calories of vegetables are not going to give you more than about 80 to 100 milligrams of sodium. So if you’re eating, let’s say, 2000 calories a day of food, you’re getting about 800 milligrams of sodium, less than half of the amount of calories from sodium. Taking about 1500 calories a day. You’re getting about 600 to 700 milligrams of sodium from the natural food. That’s the exact amount humans need. Humans need about 500 milligrams of sodium a day around that level. The exact amount you get from natural food and you need the amount of sodium proportional to the amount of calories you need. When you eat you need more calories with more physical activity, you need a little more sodium and you get that exact percent increase in the extra calories you need. So nature did not make a mistake. Nature puts the precise amount of calories, of amount of minerals in food that humans need when we eat real food. But the extra sodium we put in, so in other words, our diet is not deficient in sodium. If we don’t salt our food we’re getting sodium from the food. But it’s the additional sodium that we get from additives that pushes up to over a thousand a day. That’s where the danger occurs. 

You know what’s the most ridiculous thing is that The American Heart Association and The American College of Cardiology, your compatriots here tell people with high blood pressure or heart disease to cut their sodium down to below 1500 milligrams a day. And I’m saying that’s like telling that’s like a lung doctor telling people who have lung cancer to quit smoking. My objection to that is, if cardiologists and cardiac specialists recognize that lower sodium is beneficial then why don’t we have everybody learn it in the schoolrooms and why don’t we have the whole population learn to keep their sodium down? Why do we wait until people are sick and have advanced disease and then tell them to cut their sodium down? They are developing diseases. We don’t wait. Should people develop severe disease and then tell them to fix the sodium? We should be able to fix it before they develop the disease. So it should be. We were successful in educating children not to smoke cigarettes because of smoking cessation and the use of cigarette smoke, as the use of children and young adults smoking has gone down by more than 80% in the last decade. So much less people smoke cigarettes because of the educational system on how we’ve tried to incorporate anti-smoking messages in the school room but we’re not incorporating the anti-salt message in the school room. We’re waiting until people get seriously ill and then we’re telling them to cut back on sodium. 

Joel Kahn, MD, FACC

Absolutely. It makes perfect sense. It’s all about being reactive. So when we talk about one of your more famous teachings, G-BOMBS. I mean, we’re not talking about salted versions. There’s going to be a small amount of sodium chloride in natural foods like G-BOMBS, reens, Beans, Onions, Mushrooms, Berries, and Seeds but just enough to maintain optimal health and optimal blood pressure.

Joel Fuhrman, MD

That’s right. I mean, you know, what’s interesting is that there was a global burden of disease study in 2019 that showed that 22% of all deaths worldwide are caused by high-sodium diets. We’re talking about major degrees of morbidity and mortality. And what I’m saying here is that exposure to sodium doesn’t just raise blood pressure. It also is an irritant to the endothelial lining of blood vessels. It causes microvascular injury like microvascular pinpoint hemorrhaging, which over the decades and years and years of excess salt intake has the effect of weakening the lining of blood vessels and perhaps increasing the risk of a hemorrhage or an aneurysm or a rupture of the blood vessel wall. And we know that it’s lifetime exposure to sodium that increases the risk of hemorrhage. And it’s lifetime exposure to smoking that increases your risk of a smoking-related cardiovascular death or lung cancer death, too. 

In other words, it’s the doctor’s quarterback years. How many years of those three packs a day to day determines the risk. It’s how many decades and years of the high sodium diet and that cumulative risk and I’m really suggesting the people that they’ve got to stop their sodium now and because it’s a process that damages the blood vessels for decades and decades and decades, they can’t wait till they’re 80 years old and then cut the sodium out. It’s not going to work well. You’re not going to protect yourself. You have to. Now’s the day to make the change. Now’s the day to start to put the years in off the sodium, to allow the blood vessels to start to protect themselves. And, you know, so we’re talking here about the fact that not waiting till you have high blood pressure because people are going to hear that because this is what people say.

They say I don’t have to watch sodium because my blood pressure my blood pressure is low or I’m not salt-responsive so I can eat all the salt I want. My blood pressure doesn’t go up and they think it’s okay for them because they don’t have high blood pressure to lead salt. 

And I’m saying, well, number one, most 90% of Americans over the age of 70 have high blood pressure anyway. And even all these people who think their blood pressure is okay, they’re going to go to the doctor one day, and the doctor going to say high blood pressure. The person’s going to say, well, I never had high blood pressure. I don’t have high blood pressure. I’m always been told by it’s low and all of a sudden high now. Well, the sympathetic tone eventually flips over and it starts to go up in later life. And they caused that by thinking they were okay with eating salt, even though they had low blood pressure. If only they can’t think it’s okay because their blood pressure is okay to still consume. So because eventually it’s going to go up and it’s still causing microvascular damage to the blood vessels and it suppresses immune function and it increases the risk of autoimmune disease and it increases the risk of stomach cancer and it increases the risk of hemorrhagic stroke, even irrespective of its effect on blood pressure.

So we’re talking here about the dangerous effects of high blood pressure, of salt eating, and now’s the time for people to cut it out because it also deadens your taste buds and people will enjoy the natural flavor of food when they get used to getting salt at a diet for a few months. It’s like people come to my retreat in San Diego and we feed them all delicious recipes without salt. And after they’re here a month, they say, oh, the chefs up their game. The food is so fantastic. And I’m sorry it was that way last month too. It’s just that you thought it was within you took a while for you to build the taste muscle back by cutting out the salt. And also when they cut out the salt, it doesn’t just build the taste muscle back for salt. It allows the body to experience other flavors they weren’t getting the benefit of by having their diet be so high in salt.

Joel Kahn, MD, FACC

Okay. A lot of people are very excited about fermented foods, pickles, sauerkraut, and pickled vegetables, but they’re often brimming in salt. Do you have any experience or comments about that?

Joel Fuhrman, MD

My comments are, is that you can make pickles out of cucumbers with vinegar. You can pickle things with spices and vinegar like we do here. You don’t have to put salt in foods to make something pickled to make that flavor or to make something fermented. But yes, I’m on avoiding the use of avoiding the use of those highly salted fermented foods. And don’t forget that salt increases the rigidity of blood vessels, especially in the brain. It causes what’s called cerebral small vessel disease. It impairs endothelial function. And of course, you know, this age-related climb in blood pressure begins in childhood. So let’s be clear here that if we look at populations that don’t salt their food, like the Yąnomamö Indians in the Amazon jungles who don’t salt their food, you see the childhood blood pressure levels are the same when you measure toddlers or teenagers they’re the same blood pressure.

In this country, teenagers have higher blood pressure than toddlers. The blood pressure starts to go up. The levels of teenagers may not be above the level of medication when we medicate a person but they’re not normal for a teenager. We start to see the damage, the blood vessels occur all through life, and in these populations that don’t salt their food. These primitive populations that are isolated from human civilization centers they don’t see the blood pressure in the elderly or the middle-aged people being any higher than children. They see the chronic low blood pressure of 90 over 60, 90 over 70, and 100 over 60. They see those levels consistent all through life, and that’s consistent with my experience because I see a person 30 years ago with high blood pressure and put them on a Nutritarian diet with no salt, and over the years their blood pressure gradually goes down to 100 over 70 or 90 over 60. They don’t start. They’ve got much lower blood pressure, and even though the blood pressure was high and they required medication over two or three decades, the blood pressure slowly reverses itself to normal again, as we see in the Yąnomamö Indians. So we’re saying here that people vastly underestimate the damage from Salt occurring all through life and also that food tastes better without it. And now that you’re off, sort of while you’re not even going to like to have any salt in your diet, it’s going to make you thirsty, makes you not sleep at night. So now is the time to attack this and do it right. And that’s really the purpose of us doing the summit is to really motivate people to make a significant change, to protect their lives and save lives.

Joel Kahn, MD, FACC

I know you are a big fan of seasonings and spices. Any particular ones? I mean, of course, you have a veggie zest on your website with garlic and herb seasoning blends. Do you encourage people to substitute their salt for items like that?

Joel Fuhrman, MD

For sure. And we also, you know, use vinegar to flavor things to give them a salty flavor. But my favorite like spice to give things flavor is to use roasted garlic. I put so many things with the roasted garlic, you know, and I want and I roasted garlic with a paper on it. I want people to buy the whole garlic bowl and roast the bulb at like 325 for like half an hour because the paper and the coating help the garlic maintain its nutrient levels. And then they can take the paper, a little of paper off. They can use this rate on a knife and cut the root end off and they can squeeze it and pop the garlic out like toothpaste. It pops right out of the whole bulb like giving birth to a baby. Pops right out. That’s my, but using roasted garlic and dressings and sauces and I make all types of different sauces. I’ll make like a, like a cherry concentrate drizzle on top of asparagus or something, or I’ll make a roasted sesame garlic on top of a, you know, on top of broccolini or zucchini or we threw in yesterday we fried onions, we put a little of the of like a vinaigrette of vinaigrette in the fried onion. And we put that on top of chopped zucchini. You know, there’s we get incredibly great flavors without having to use salt.

Joel Kahn, MD, FACC

Okay. Well, I think this is important and really, again, what you said from that international study, the global burden of disease that where, you know, maybe diabetes was the number one killer of men and women, maybe as high cholesterol. But actually the data was it’s high blood pressure. And we’re talking about millions and millions of people. And this recognition about salt and salt hidden in so many foods. Read your labels please, everybody, and find these great strategies for learning from Dr. Joel Fuhrman.

Joel Fuhrman, MD

And also produce doesn’t have labels. We should be eating foods that don’t have labels that are natural produce and the other next thing is about celtic salt, rock salt, sea salt, and the salt from the Rock of Gibraltar, the back of the moon, and all the nonsense people think to make natural salts, to think the rock, whenever the same amounts of sodium and mineral content are insignificant. It doesn’t matter what the mineral content is. Heroin is still heroin, even though it contains minerals in it.

Joel Kahn, MD, FACC

Now, that is a powerful and profound statement about a lot of nonsense out there about pink salts and the other Himalayan salts all over the world. You can say Celtic or Celtic and Himalayan. So thank you. I think everybody took a lot of notes on that and learned a lot and will make some habit changes so that you can naturally have excellent and healthy blood pressure just by simply putting the salt shaker out of your kitchen and getting rid of it permanently. We’re going to come back with Dr. Fuhrman and go a little deeper into some questions about salt. For those in our general audience. Thank you so much for listening to Reversing Heart Disease Naturally Summit with Dr. Joel Fuhrman and for the premium members we will be back in just a moment. So hang on. All right. Welcome back. Premium members, thank you for your support for Reversing Heart Disease Naturally Summit. We still have the world-famous Dr. Joel Fuhrman with us. We’re still talking about salt. Salt whether it’s pink or from the moon. I think we’ve heard what Dr. Fuhrman said and why we want to make a big focus in our Nutritarian diet to have a low-salt or no-salt approach. So, Dr. Fuhrman, you were mentioning that there are populations that do well, but they don’t have the amount of salt that the Western diet, the American diet has. Maybe let’s start there and just share with the audience a bit more about this sort of myth about the need for salt. And I want to talk to you about one micronutrient in a minute, but you go forward.

Joel Fuhrman, MD

Yeah. So we want to say that this myth that’s built up that humans need salt or need to add salt to their diet, which keep in mind that throughout human existence on the planet, for the hundred thousands of years, it’s only been in recent history that we’ve used significant amounts of salt. We’re talking about the last few thousand years, the last 3000 years, and even 500 years ago, they used about the population uses less than 1/20 the amount of salt. So most of the years we’re talking about tiny amounts of added salt, not the huge amounts we see today in the diet, which is so dangerous and that primitive populations, including primitive early human species like cavemen and Neanderthal man and Cro-Magnon man and early primates, did not salt their food. And there are pockets of civil today in the modern world, like the Cassava Islands study and on the print, and populations that are more isolated from human civilization that don’t salt their food and there are people that don’t use salt. So I know when these populations are studied as we said, they don’t have heart disease. 

In the Cassava Islands study, they also showed that there was almost no heart disease on the islands. People are eating natural foods that don’t salt their food. So it is such a big contributor to heart disease and the question is how much is okay or how much is still in the range of little enough that’s safe? And we’re talking here about, you know, using in 1/20 the amount or a little bit tiny bits. Okay. It’s not that a little bit poisonous. It’s the large amounts that are poisonous. You know, if I have a piece of Ezekiel bread or a little bit of mustard or a little bit of a healthy ketchup or something, or whether it’s tomato sauce, it has some sodium in it. I’m looking at the label and making sure I add within a couple of hundred, 200, or 300 over and above what my natural food diet contains. I still have some leeway to eat something that’s in a jar or where to put a sauce or something. But I’m not going to pick the tomato sauce that has 800 milligrams of sodium. I’m going to buy the one that has, you know, 250 milligrams of sodium per cup. So I can take a little bit and only add an extra 100, you know. So in other words, we’re saying here that the diet’s going to give you somewhere between 500 and usually 800 milligrams of sodium per day with no added salt. And then if you add a little bit of sodium to your diet, a couple of hundred, you’ll still be like under a thousand a day because that’s what the studies show. They show and these are studies are done, you know, a study by cardiology groups looking at the increased risk of heart disease with lower salt intake these days.

So cardiovascular deaths go down when sodium intake goes from 3000 to 2000 to 1500 to 1000. And after 1000 to kind of levels off, it’s when you still see benefits. When people drop from 5000 to 1000. But once you go below a thousand, generally speaking, it’s you’re fine. But in any case, what I’m saying here is that the American College of Cardiology says 1500 because they didn’t think 1500 was ideal. They knew when the literature when you read the whole papers that a thousand was ideal. They picked 1500 they thought they couldn’t get anybody to would be willing to give it all the salt up to 2000 and I’m saying the diet tastes great you learn how to cook. It does great at keeping under 1000 we can. And if we have heart disease, why not do what’s scientifically determined to be the best for your future? And that’s you use no salt or just if you’re going to use it, use something with salt in it and it’s under a few hundred milligrams. That’s it.

Joel Kahn, MD, FACC

Okay. I just have one follow-up question because many people get the majority of their iodine from the iodized salt brand obviously, we know as Martin’s. I know in your multivitamin for men and women you have iodine any just parting comments about the importance of iodine in health and how to get it if we’re not using iodized salt.

Joel Fuhrman, MD

Right? Both too little iodine and too much iodine could both be a problem. Both too and a little too much. You want to hit that sweet spot of just a little bit like between 103 hundred micrograms a day. The iodized salt is 150 micrograms so we’re not going to salt the food, we are getting some iodine from natural foods particularly when they’re grown in coastal areas. But to make sure people, nobody gets iodine deficiency, we do recommend people expose themselves to at least 100 to take the RDA and you can get that these vegan foods that you can use them kelp is high in iodine and other seaweeds but you know we use our sup our supplement has 150 micrograms of iodine and most people use that RDA so they don’t have to rely on salt for their iodine. And that’s what we recommend to do. Take a supplement, read a little seaweed or a little kelp but don’t rely on salt for your iodine.

Joel Kahn, MD, FACC

Okay, excellent. Excellent input and important iodine. I’m familiar it has some role in breast health, prostate health, and cancer health. And of course, most people would come up with our thyroid health. So don’t be a iodine deficient human. And we’ve heard the good wisdom, don’t overdo it either. Have that sweet spot. So thank you, Dr. Joel Fuhrman. This really, really information-packed conversation about salt and why we want to focus on it and get our blood pressure naturally to the right level. This has been Reversing Heart Disease Naturally. Thank you for your attention. And we’re going to bring back Dr. Fuhrman throughout this summit because it is so lucky that we have him as a resource. We’ll see you in another session.