August 1, 2019

Healthy Salt?

But I always thought that salt is salt?

Peter N. Landless & Zeno L. Charles-Marcel

The attendant at our local health food store said that some types of salt are more healthful than others and have less negative effects on heart disease and blood pressure. I have hypertension, but I always thought that salt is salt. Isn’t it?

As with many health issues today, what once appeared to be quite straightforward has become “complicated.” Even the word “salt” has different meanings depending on its use in regular language or in chemistry, for instance. We assume that we’re dealing here with the common, nonchemistry use of the word, which refers to “a crystalline food seasoning or preservative that gives seawater its characteristic taste.” In general use, “salt” and “sodium” are synonymous, even though salt is really only 40 percent sodium and 60 percent chloride. There’s evidence that chloride itself may also be an important link between salt and blood pressure, but we’ll concentrate on sodium in our response.

The sodium content in salt is thought to be responsible for salt’s effects on health. Sodium is involved in many important biochemical and physiological functions of our cells, tissues, organs, and systems. Flawed methodology of some high-profile studies a few years ago produced some confusion as to the effects of varied dietary intakes of sodium on heart disease, strokes, blood pressure, and overall death rates. Nonetheless, current evidence shows that as the
amount of dietary salt increases, so does the risk of cardiovascular disease. So it’s relevant to know if all types of salt are equivalent.

The claims that “some types of salt are healthier than others” is potentially true but not generally so. Salt varieties all have roughly the same amount of sodium by weight; so they will be expected to have the similar sodium-related health effects depending on the amount ingested. Nonetheless, each type of salt has a different sodium content by volume, so one teaspoon of table salt has about twice the amount of sodium as does one teaspoon of kosher salt (see table). So following a recipe and substituting one kind of salt for another may not only give different taste outcomes; it also may confer different health risks because the amount of sodium will vary—although not because of the inherent properties of the specific type of salt (sodium) itself.

A little salt is essential for life, but too much is dangerous, regardless of the source. Choose the type of salt for its culinary properties, not for speculated health benefits that are likely to be insignificant compared to an overall healthful, balanced diet. Also, it’s important to be careful about where we get our health advice.

Type of saltPercent of sodium by weightSalt in grams per teaspoonSodium content per teaspoonSpecial feature
Table salt (iodized)~ 396~ 2325iodine and anti-clumping chemicals added
Sea salt~385~ 1870potassium, iron, zinc included
Kosher salt~ 383~ 1120 
Pink Himalayan salt~ 375~ 1870iron oxide

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.