OverHyped vs. UnderHyped Vol. 1

One of my clients and mentors Professor Scott Galloway’s most recent presentation at Code featured overhyped and underhyped concepts in the world of tech and business. This inspired me to consider all of the overhyped and underhyped areas of health, nutrition, and exercise. In my first edition of Overhyped vs. Underhyped, I’d like to tackle Water (overhyped) and Salt (underhyped).

Why is water overhyped? Anecdotally, I have seen few clients that I work with not consume any water. Again, I am biased because I don’t usually work with traditional western population. I am usually working with or consulting fitter populations who already have a basic idea of hydration. As a baseline, I try to have clients drink 1/2 their bodyweight in ounces each day in fluid (i.e. 180lb. person would drink 90 ounces, roughly, 11 glasses of water daily). Consuming adequate water doesn’t worry me too much as this benchmark doesn’t factor in fluids we take in from food. Watermelon for instance is 92% water. So if you eat 12oz. of watermelon, you just consumed over a cup of fluid. If you are eating a diet that is filled with fruits and veggies and you are at least considering your water intake, you are probably fine with your hydration. That’s why I believe for most ageless athletes, hydration is overhyped.

Why is salt underhyped? Since ageless athletes and more fit populations consume more whole foods (not processed foods), they consume minimal amounts of salt (if they aren’t supplementing or salting their foods). In fact, the majority of our sodium intake in western diets, over 70%, comes from packaged, processed foods and restaurant meals. Since whole foods are minimally processed, you aren’t taking in much salt. “But isn’t salt bad for me?” you may ask. Actually, if you didn’t have any salt, you’d be dead. “But what about high blood pressure? Doesn’t a diet high in sodium cause by blood pressure to sky rocket?” The theory is that high sodium diets cause the body to retain extra water, which puts stress on the heart and blood vessels and can cause blood pressure to rise. For this reason, some providers tell their patients to limit salt to 2,300 mg a day (or less) (whole30.com). Roughly 1 in 4 people are salt sensitive, meaning increases in sodium will cause your blood pressure to increase (if your healthcare practitioner has diagnosed you as sensitive, listen to them!). However, if you find yourself in any of the following categories, you may see benefit increasing salt:

• Those following a low-carbohydrate or keto diet since they excrete more sodium

• Those who are nursing and thus losing water and electrolytes at feedings

• Those who sweat a lot and/or workout in hot/humid climates

• Strength and endurance athletes

• Those under chronic stress, experiencing “adrenal fatigue” (known as HPA-axis dysfunction) may feel better since low sodium levels elevates stress hormones.

• Those with low blood pressure may find it helps with orthostatic hypotension (feeling dizzy upon standing)

In the near future, I will be interviewing the CEO of a great company LMNT, that specializes in salt supplementation, so stay tuned!

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Is Salt Bad For You?

Countries have fought for hundreds of years for access to salt, and for good reason.  Table salt, made up of NaCl (sodium chloride), is essential for our survival.  Sodium drives basic cellular processes of the body including nerve and muscle function and is involved in the regulation of fluids in the body. Sodium also plays a role in the body's control of blood pressure and volume.  In recent years however, it has been in vogue to avoid salt like the plague.  Where does salt=bad come from?  There are two likely sources. 

First, heart and vascular doctors see increased sodium levels in patients with cardiovascular disease.  The correlation between sodium and high blood pressure isn’t so cut and dry however.   From nutrition and performance specialist and best-selling author Robb Wolf, “We know mechanistically, that sodium is important in blood pressure, we know that blood pressure is important for cardiovascular disease. But what got missed in that story is that the reason why the body hangs on to this sodium in the first place is we're just generally over-eating and maybe over-eating too many carbs. And when our insulin levels elevate, we become insulin resistant, then we tend to retain sodium. Insulin causes an upregulation in the production of a hormone called aldosterone. Aldosterone causes the kidneys to retain sodium. And so it's interesting because there is a reason to be concerned about sodium and blood pressure, but it's not really the way that we've been looking at things.”  What Robb is saying is that high blood pressure, in most individuals, is due to overconsumption of food and increased insulin levels rather than elevated levels of sodium.  

Second, anecdotally, people feel bloated and heavier after heavy doses of sodium.  The thinking goes, if I feel bloated after meals rich in sodium, I should avoid salt all together.  This idea doesn’t pan out though.  The issue is that most people who over consume salt also, in  most cases, are eating a lot of processed foods to get that salt in their body (ie. fried foods).  If you were to salt let say, a baked potato, the body wouldn’t respond in the same way as eating deep fried chicken tenders (excess fat and refined carbohydrates).  Moreover, once you have stabilized your salt intake, after a few days the body’s osmolarity will equalize, and the excess water retention will diminish.

For my nutrition clients, I don’t spend too much time obsessing about salt, but when they ask, I recommend lightly salting their food at meals (unless they have found to be hypersensitive to sodium. Which is ~1% of the population).   I don’t spend as much time focusing on salt with clients as they usually have much bigger issues like food quality, portions, and variety to worry about.

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