Steven Nissen, MD
Steven Nissen, MD, chairman, department of cardiovascular medicine, Cleveland Clinic. He has more than 35 years of experience as a physician and is world-renowned for his work as a cardiologist, patient advocate and researcher.
When it comes to salt and your health, science seems to point left, right, up and down at the same time…
Who’s right? Should healthy people restrict sodium to prevent high blood pressure and heart disease? Can you believe the studies that point to a different conclusion? What if your blood pressure is high or edging up—should you watch your sodium?
For commonsense grounded in science, we turned to one of the top heart specialists in the world, Steven Nissen, MD, chairman of the department of cardiovascular medicine at the Cleveland Clinic.
Oddly enough, Dr. Nissen doesn’t put much faith in either the government’s public health campaign to get us to consume less sodium—or in the conflicting studies that suggest that a low-sodium lifestyle won’t help and might harm.
Here’s why: Bad studies. Or rather, the lack of good studies. “The science is extraordinarily murky,” Dr. Nissen said. “The estimates used to come up with recommendations come not from clinical trials but from dietary recall studies, which are terribly unreliable, and from computer estimates that simulate what the effects might be.”
In contrast, he pointed to Mediterranean diet studies. These are based on randomized double-blind clinical trials in which one group ate the diet for years and another group ate a different diet. These well-designed trials have proved that the Mediterranean diet can prevent heart disease.
There’s no such research that shows that cutting sodium consumption in healthy people without high blood pressure will lead to any health benefit, Dr. Nissen said. “We’re not all the same—biology doesn’t work that way. We have unique genetics and environments. If you’re a construction worker in Houston in the summer, for example, I’m not sure that salt restriction is a good idea for you.
“I don’t think we should make societal decisions without real data. I have trouble with people who want to say, as a public policy, ‘Whether you like it or not, and whether you have high blood pressure or not, we’re taking the salt out of your diet.’”
Here are Dr. Nissen’s recommendations based on what is known scientifically…
Ironically, by eating in this style, you might actually take in less sodium than you do now—without resorting to low-sodium and salt-free products. That’s because about three-quarters of the sodium in our diet comes from processed foods, not whole foods that we cook at home—even if we salt them.
“I don’t eat a lot of processed foods—I don’t eat my dinner out of cans,” said Dr. Nissen. He’ll regularly make an omelet with eggs, which, in spite of earlier concerns about cholesterol, are very healthy foods, he said. He eats dairy products—and is also fond of almond milk. “I have apples and pears sitting in a great big bowl, and when I’m hungry in between meals, I’ll have one. If you eat like that, you won’t overload on salt.”
“I love corn on the cob,” he added, “and I don’t feel guilty if I eat a couple of ears of corn with a little butter—sprinkled with salt.”