Can You Stop Worrying About Salt and High Blood Pressure?

Could slashing salt hurt your heart? If a string of health headlines yelling "Too little salt could be bad for you" has made you think sodium's okay, listen up. New claims questioning the link between salt intake and high blood pressure aren't telling you the whole story. We will!

Yes, your body needs sodium. Salt regulates blood pressure and keeps your muscles and nerves humming. But like Christmas carols crooned by chipmunks, more isn't better. A small percent of people with high blood pressure are extremely salt-sensitive. If you're among them (take our test below), sodium launches your blood pressure into the stratosphere. Halving your salt intake cuts your heart-attack risk by 30% or more. (It also reduces your risk of some cancers.)

A third of adults who aren't extremely salt-sensitive also have hypertension. They, too, need to watch salt, though not as intensely. For everyone else, we YOU Docs strongly believe many other nutrients are far more important. That doesn't mean we think it's fine to eat "salt bombs" (check the list ahead), but you don't need to count every milligram either.

As for those salt's-good studies, here's the deal:

• One analysis reviewed seven studies and found that reducing sodium didn't reduce fatal heart attacks.
• Another looked at 167 studies and concluded that low-salt eating did nudge pressure lower but seemed to increase risky blood fats.
• The third analyzed two big studies of 29,000 people with heart disease or at high risk for it. High and low sodium seemed to increase fatal heart attacks.

Sounds convincing, right? It certainly meets our three-study criteria for trustworthy research. But hold on.

First, test your salt sensitivity. Get an inexpensive home blood-pressure monitor, which costs about $20 at a big-box store. Take a couple of readings, then follow the eating guidelines below for 4 weeks. Re-check. If your BP has dropped, chances are salt was driving it up. (Note: Your risk is genetically higher if you're African-American.) Keep sodium below 1,500 mg per day (about 3/4 teaspoon of table salt). Test how salt savvy you are.

Rearrange your plate. Put fresh produce and whole grains front and center, lean protein (fish, skinless white meat poultry) and no-fat dairy on the side. Eating this way gives you plenty of pressure-lowering potassium, magnesium, and calcium, and automatically knocks salty processed foods off your plate (80% of our sodium is from processed and restaurant foods).

Sidestep the top 10 salt bombs. The biggest sources of sodium in our diets are pizza (meat-topped or plain), white bread, processed cheese, hot dogs, spaghetti with pre-made sauce, ham, ketchup, salty snacks (corn chips, etc.), noodle soups, and mac 'n' cheese. Who eats more salt than anyone? This list is a clue.)

Watch your waist. There's evidence that inflammation fueled by body fat -- especially belly fat -- makes cells soak up sodium, which can ignite blood pressure. Half of all people with high BP are overweight.

Put sodium in its place. Unless you're salt-sensitive, put it low on your list of healthy-eating priorities. Worry first about getting enough good omega-3 fats from nuts, fish, canola oil; plenty of 100% whole grains; lots of fruits and vegetables; and nearly no saturated fat, trans fats, or added sugars/syrups.

Walk every day. Just 30 minutes daily cuts your odds for salt-triggered high blood pressure by 38%. You're probably muttering, "Those YOU Docs think walking helps just about everything." It does.

Why do some people really, really love salt? It's in your genes.