Last week marked the end of the integrative medicine course that we teach at the medical school. Once again, it generated a lot of discussion and debate among the students, which is always a good thing. One of my favorite lectures is the one about food as medicine. It included a number of controversial principles, and one of them was that salt may not be so bad after all.

A recent study has reached the same conclusion and, not surprisingly, it has made headlines. The European study followed 3681 people with high blood pressure for 7.9 years and compared their sodium excretion (which is a good measure of how much they consumed) with their risk of death or heart attack. Interestingly, the more salt they consumed, the lower their risk.

This is not the first study to find that avoiding salt might not be as important as you’ve been told. While there have been no really solid long-term clinical trials studying salt, a number of so-called observational studies have shown mixed results. A recent systematic review found 11 salt studies. Four of them found that lower salt intake reduced the risk of heart disease, but in five studies there was no benefit and in two others people who ate less salt actually did worse.

Humans have been consciously adding salt to their food since prehistoric times. Archeologists have identified Neolithic saltworks in Romania and China, where salt was probably made for meat preservation. Salt is one of the basic human tastes and sodium is an essential minerals we need for proper function of the nervous system and the heart. Regular table salt is sodium chloride, but we recommend that our patients switch to sea salt. This contains potassium and magnesium salts, which are important because most of us are deficient in both.

Sodium, potassium, magnesium and other electrolytes are important for preventing dehydration, and they stabilize allergic response. They are also part of the self-care protocol for treating adrenal fatigue, which is common in people who have chronic fatigue, muscle pain, feelings of hypoglycemia and brain fog and postural dizziness.

As I have followed the public health debate about salt, blood pressure and heart disease risk, I have been surprised and disappointed by the deafening silence regarding lead toxicity. This is probably not the only cause of the hypertension epidemic, but it certainly kills more people than salt ever has. The Normative Aging Study is the most recent large study to link lead to mortality found that people with the most lead stored in their bones had more than twice the dying of any cause and more than five times the risk of dying of a heart attack or stroke.

Most people agree that clean, safe drinking water should be considered a basic human right. Unfortunately, we are still told that our water is safe as long as it is microbe-free. The truth is that 1 in 3 Ontarians drink water that contains lead, and it is a health risk that is beyond doubt. The lead in our water comes from the pipes that it flows in. If the pipes in your home were installed before 1980, chances are that they contain lead. Many people live on streets where the water travels in old lead pipes.

I take lead out of people with chelation therapy, which is the only solution for people over 40 whose lifetime lead burden is slowly leaking out of their bones. But that should not be the solution for our children. Lead also affects the brain, and good evidence has linked lead to lower IQ scores in kids for over 20 years – even at ‘normal’ blood levels of lead. Not to mention the fluoride, chlorine, pesticides, industrial pollutants and other contaminants that are in our water. No one has estimated the cost of replacing the pipes in the street … or what it would save in healthcare costs … but this needs to be done.

But I digress. To conclude on high blood pressure ... other factors that are recognized and treated by integrative doctors include psychological stress, allergies, scars that irritate the nervous system and even plaque in the tiny arteries of the kidneys. A number of alternative therapies have been proven to lower blood pressure, including coenzyme Q10, chocolate, meditation and handgrip exercises. It gives me a lot of satisfaction to help patients normalize their blood pressure naturally, allowing them to discontinue unnecessary drugs.

It also gives me a lot of satisfaction to eat salt.

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