Salt And Keto: Friend Or Foe?

Salt has been a highly prized commodity for centuries, but in recent times, it has gone from something treasured to something feared. Health authorities have been advising us to cut back on our salt intake to lower blood pressure and reduce the risk of heart disease. However, is this advice to reduce our salt intake necessary or even safe for everyone?

When following a keto diet, it is especially important to consider your salt intake. The keto diet is a high-fat, very low-carb diet, and because carbs are in almost everything, it can be a challenging diet to follow. One of the common pitfalls of the keto diet is not salting your food enough.

When you restrict carbohydrates, your body begins to process electrolytes differently. This is because when insulin levels are low, the kidneys excrete more sodium. Since there is a delicate balance between sodium and other electrolytes in the body, the loss of sodium may disrupt levels of other electrolytes. This can lead to symptoms such as difficulty concentrating, heart palpitations, and muscle cramping.

To avoid these symptoms, it is recommended to add more salt to your food. Most people on a low-carb diet will likely feel best with 3–7 grams of sodium (7–17 grams of salt, or about 1-3 teaspoons) per day. However, if you have certain medical conditions such as hypertension, kidney disease, or congestive heart failure, you may need to be more cautious about your sodium intake.

In addition to salting your food, you can also drink bone broth or eat salted nuts and seeds to increase your sodium intake. Sea salt and Himalayan pink salt are also good options as they contain additional minerals such as potassium, magnesium, and calcium.

So, if you're following a keto diet, don't be afraid to add a little extra salt to your meals!

Salt and the keto flu

The keto flu is a common experience for people who have just started a keto diet. It is not an actual flu, but it can feel like one, with symptoms such as tiredness, fatigue, stomach pains, and dizziness. The keto flu is caused by the body's response to a sudden restriction of carbohydrates.

The keto flu can be avoided or its symptoms reduced by increasing your intake of salt and water. This is because when insulin levels drop, the body starts to excrete more sodium in the urine, along with water. This can lead to dehydration, which is responsible for many of the keto flu symptoms.

• Drink a glass of water with half a teaspoon of salt stirred into it when you experience keto flu symptoms.
• Drink bone broth or bouillon, which are high in sodium.
• Increase your overall water intake. Aim for a minimum of 2.5 litres of fluid every day during the first week of keto.
• Eat more salty foods, such as olives, pickles, and sauerkraut.
• Take a magnesium supplement, as magnesium can help with sleep quality and increase insulin sensitivity.

It is important to note that the keto flu usually goes away on its own within a few days to a week as the body adapts to the new diet. However, taking these steps to increase salt and water intake can help reduce the severity and duration of the keto flu.

Sodium and potassium

When you start a keto diet, your body's sodium levels can drop. This is because keto diets eliminate many packaged products with a high sodium content, and because decreasing levels of insulin cause the kidneys to release excess water, along with sodium and other minerals. This can lead to dehydration and electrolyte imbalance, causing symptoms such as lethargy, irritability, and constipation.

To avoid these issues, it's recommended to increase your salt intake when starting a keto diet. Most keto diet specialists suggest that followers should aim to eat two to four grams of sodium (2000-4000 mg) a day. This can be achieved by manually salting food, using products such as salted butter or bullion, or eating bacon. You can also try drinking bone broth, or eating sea vegetables like kelp, salted nuts and seeds, or taking an exogenous ketone base.

However, it's important to note that the type of salt you use matters. Plain table salt is highly processed and treated with anti-caking agents. Instead, opt for high-quality sea salt or Himalayan pink salt, which contain additional minerals such as potassium, calcium, and magnesium.

Salt and hydration

Salt is essential to the body's hydration process. Sodium, a critical electrolyte, draws water into cells, ensuring water moves in and out of cells properly and supporting essential bodily functions. During exercise or sweating, electrolytes like sodium are lost, and adding a small amount of salt to drinking water helps replenish these lost electrolytes, promoting better water absorption and preventing dehydration.

However, it is important to note that consuming too much sodium and salt can lead to negative health consequences, including high blood pressure, heart disease, kidney disease, and stroke. Therefore, it is crucial to be mindful of one's overall sodium intake and maintain a balanced diet.

When following a keto or low-carb diet, individuals may have an increased need for salt due to changes in how the kidneys handle sodium. With a decrease in carb intake, insulin levels drop significantly, leading to the kidneys excreting more sodium and water. As a result, individuals may experience the "keto flu," with symptoms like headache, fatigue, and weakness. To combat this, it is recommended to increase salt intake, especially during the first few weeks of a ketogenic diet, in hot weather, or after strenuous physical activity.

For those on a keto or low-carb diet, consuming about 4,000 to 7,000 milligrams of sodium (about 2 to 3 teaspoons of salt) is usually sufficient to get through the adaptation phase and can be maintained beyond, depending on individual needs. Some ways to boost sodium intake include drinking salty broth, adding salt to food or water, eating salty keto foods like olives and pickles, and choosing standard instead of low-sodium sauces.

It is important to note that those with certain medical conditions, such as elevated blood pressure, kidney disease, or congestive heart failure, should talk to their doctor before increasing their sodium intake. Overall, while salt is important for hydration, it should be consumed in moderation, and a balanced diet that includes electrolytes like sodium, potassium, and chloride is crucial for maintaining proper hydration.

Salt and insulin resistance

Insulin resistance is a key component of the metabolic syndrome, which includes hypertension, obesity, and dyslipidemia. Insulin resistance strongly correlates with salt sensitivity of blood pressure (SSBP), affecting nearly 50% of salt-sensitive people.

Low salt diets have been found to increase insulin resistance in healthy subjects. The effect of dietary salt intake on insulin sensitivity has been controversial, with some studies showing an increase in insulin resistance with low salt diets, while others found no such effect or a decrease in insulin resistance.

Low salt diets are associated with higher aldosterone and norepinephrine levels, which may contribute to an increase in insulin resistance. Low salt diets also regulate the expression of glucose transporter type-4 (GLUT4), the insulin receptors in fat cells, resulting in decreased insulin resistance.

High salt diets are considered a public health problem. High dietary salt intake is associated with higher blood pressure, a known cardiovascular disease risk factor. However, the impact of our findings on the pathogenesis of diabetes and cardiovascular disease needs further investigation.

Salt and blood pressure

The American Heart Association recommends a daily sodium intake of no more than 2,300 milligrams, which is equivalent to about 1 teaspoon of salt. However, this recommendation has been criticised by some researchers and physicians, who argue that the guidelines are too restrictive and not based on enough evidence.

Some studies have shown that reducing sodium intake can lead to a modest decrease in blood pressure, especially for those with hypertension. On the other hand, other studies have found that restricting sodium increases the risk of heart disease and can lead to negative health consequences such as increased insulin resistance and hormone dysregulation.

It is important to note that salt and sodium intake are not the only factors affecting blood pressure. Weight, physical activity, diet, and other lifestyle choices also play a significant role in blood pressure regulation. Additionally, the type of salt consumed matters, with high-quality sea salt or Himalayan salt containing trace minerals that can provide additional health benefits.

Overall, while salt can affect blood pressure, the relationship is complex and depends on various individual factors. It is always advisable to consult with a healthcare professional to determine the appropriate salt and sodium intake for your specific needs and health status.

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