9 ms·

> tons of salt Outside of causing an imbalance (which would require a LOT of salt), there’s nothing bad about a lot of salt. People have been eating tons of sa

> tons of salt Outside of causing an imbalance (which would require a LOT of salt), there’s nothing bad about a lot of salt. People have been eating tons of salt for centuries. > refined flower Not sure what definition you’re using here so this might not be ideal, but probably fine. People have been milling for centuries. > soya lecithins Made in a lab about 100 years ago, and its primary use is to increase profits via long shelf life (increasing shelf life could be a noble goal, ie freezers are great). We have billionaires flying private jets around. Redo some resource allocation and we don’t need soya lecithins. Much modernity has 0 respect for Chestetons fence. On top of that, nutrition science is basically a social science in terms of accuracy (not a dig, it’s very hard). Many “advances” today are purely profit motivated and don’t pay enough respect to the people’s wellbeing. We should be skeptical of changes done to make the rich richer.

KempyKolibri 1y ago
Let’s do this one at a time, starting with salt. What’s your goalpost for evidence here, I.e. what would it take to convince you that salt consumption above the levels indicated in dietary guidelines is harmful?
- zjzjzxkx 1y ago
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- lithocarpus 1y ago
  Actual studies that isolate salt consumption as a variable and show worse outcomes from more salt would be a start. Every study I've looked into that purported to show salt was a problem did not isolate salt, and the most likely reason IMHO that the "less salt" group did better was because they ate less ultra processed food and more natural food.
  - KempyKolibri 1y ago
    So DASH-sodium (https://www.jacc.org/doi/10.1016/j.jacc.2021.03.320 https://www.jacc.org/doi/10.1016/j.jacc.2021.03.320) seems like it meets those goalposts? As does TOHP (https://doi.org/10.1136/bmj.39147.604896.55 https://doi.org/10.1136/bmj.39147.604896.55). When we scale out to what I believe to be a superior intervention - replacement of sodium with potassium, we have really robust data. The SASS trial (https://www.nejm.org/doi/full/10.1056/NEJMoa2105675 https://www.nejm.org/doi/full/10.1056/NEJMoa2105675) showed reductions in stroke and CVD incidence from consuming salt substitute, along with reduction in all cause mortality. I have a real salt taste - if I had no care for health outcomes I’d absolutely cover my food in it! However I think the evidence in favour of reducing or, ideally, replacing it with potassium-heavy substitutes is really convincing.
    - lithocarpus 1y ago
      Thanks - I'd not seen DASH-sodium but only the DASH study whose samples it's based on. Having read the study now: DASH-sodium barely indicates anything about sodium independently. It looks at three biomarkers which _correlate_ with cardiovascular disease, and finds that reducing sodium from high to low levels for four weeks reduced one of those biomarkers by 19%, _increased_ another biomarker by 9%, and didn't change the third. You could say that this suggests higher sodium increases cardiovascular disease risk but that seems like a stretch when if you'd picked a slightly different set of CVD-correlated biomarkers you would have got exactly the opposite result. Even if the results had been more convincing, the methods are not - it's an extremely short term study and looks only at correlative biomarkers and not at actual health outcomes. There's no meaningful way to quantify the impact based on this. The potassium study is indeed interesting. It shows among people who already have CVD, a reduced risk of death of 12%. I think it's pretty well known that modern diets have a significant electrolyte imbalance, i.e. not enough potassium per sodium. I do supplement potassium for this reason sometimes and recommend it, though I'd prefer to just have a ton of natural nutrient dense food available and not feel like I need to. So we're in agreement on that one. That said I don't take that study to strongly show that sodium is a primary driver of CVD - it could just as easily be interpreted that the lack of potassium due to lack of real natural food is a cause of CVD (potassium being mostly in nutrient dense greens, and grass fed meat (i.e. animals that ate more natural diets i.e. greens)). So, thank you - this helps my understanding of the whole topic - not that I know the answers, but it does make me more curious about sodium/potassium electrolyte imbalance being a factor in CVD. Ideally this would be fixed with a healthier diet but it can be hard/expensive to get enough nutrient dense foods. Edit: oops - I missed the TOHP study - but that's one where they don't isolate sodium: > The active intervention, described in detail elsewhere,22 involved dietary and behavioural counselling on how to identify sodium in the diet, self monitor intake, and select or prepare lower sodium foods and condiments suited to personal preferences. Individual and weekly group counselling sessions were provided during the first three months, with additional counselling and support less frequently for the remainder of follow-up.

KempyKolibri 1y ago

Let’s do this one at a time, starting with salt. What’s your goalpost for evidence here, I.e. what would it take to convince you that salt consumption above the levels indicated in dietary guidelines is harmful?

zjzjzxkx 1y ago
[dead]
lithocarpus 1y ago
Actual studies that isolate salt consumption as a variable and show worse outcomes from more salt would be a start. Every study I've looked into that purported to show salt was a problem did not isolate salt, and the most likely reason IMHO that the "less salt" group did better was because they ate less ultra processed food and more natural food.
- KempyKolibri 1y ago
  So DASH-sodium (https://www.jacc.org/doi/10.1016/j.jacc.2021.03.320 https://www.jacc.org/doi/10.1016/j.jacc.2021.03.320) seems like it meets those goalposts? As does TOHP (https://doi.org/10.1136/bmj.39147.604896.55 https://doi.org/10.1136/bmj.39147.604896.55). When we scale out to what I believe to be a superior intervention - replacement of sodium with potassium, we have really robust data. The SASS trial (https://www.nejm.org/doi/full/10.1056/NEJMoa2105675 https://www.nejm.org/doi/full/10.1056/NEJMoa2105675) showed reductions in stroke and CVD incidence from consuming salt substitute, along with reduction in all cause mortality. I have a real salt taste - if I had no care for health outcomes I’d absolutely cover my food in it! However I think the evidence in favour of reducing or, ideally, replacing it with potassium-heavy substitutes is really convincing.
  - lithocarpus 1y ago
    Thanks - I'd not seen DASH-sodium but only the DASH study whose samples it's based on. Having read the study now: DASH-sodium barely indicates anything about sodium independently. It looks at three biomarkers which _correlate_ with cardiovascular disease, and finds that reducing sodium from high to low levels for four weeks reduced one of those biomarkers by 19%, _increased_ another biomarker by 9%, and didn't change the third. You could say that this suggests higher sodium increases cardiovascular disease risk but that seems like a stretch when if you'd picked a slightly different set of CVD-correlated biomarkers you would have got exactly the opposite result. Even if the results had been more convincing, the methods are not - it's an extremely short term study and looks only at correlative biomarkers and not at actual health outcomes. There's no meaningful way to quantify the impact based on this. The potassium study is indeed interesting. It shows among people who already have CVD, a reduced risk of death of 12%. I think it's pretty well known that modern diets have a significant electrolyte imbalance, i.e. not enough potassium per sodium. I do supplement potassium for this reason sometimes and recommend it, though I'd prefer to just have a ton of natural nutrient dense food available and not feel like I need to. So we're in agreement on that one. That said I don't take that study to strongly show that sodium is a primary driver of CVD - it could just as easily be interpreted that the lack of potassium due to lack of real natural food is a cause of CVD (potassium being mostly in nutrient dense greens, and grass fed meat (i.e. animals that ate more natural diets i.e. greens)). So, thank you - this helps my understanding of the whole topic - not that I know the answers, but it does make me more curious about sodium/potassium electrolyte imbalance being a factor in CVD. Ideally this would be fixed with a healthier diet but it can be hard/expensive to get enough nutrient dense foods. Edit: oops - I missed the TOHP study - but that's one where they don't isolate sodium: > The active intervention, described in detail elsewhere,22 involved dietary and behavioural counselling on how to identify sodium in the diet, self monitor intake, and select or prepare lower sodium foods and condiments suited to personal preferences. Individual and weekly group counselling sessions were provided during the first three months, with additional counselling and support less frequently for the remainder of follow-up.