It has been known for decades that dietary sodium is significantly associated with hypertension and coronary heart disease.  Despite this knowledge, Americans continue to consume more sodium, most of it coming from processed foods.  Various approaches have been used to help individuals modify their behavior, one of the most popular of which is the DASH diet.  Given what we know, you would think that a low-sodium diet would be especially popular with “alternative” practitioners.  After all, what could be more “natural” than lifestyle modification (a mainstay of real medicine since…well…forever).

But as any clinician knows, it’s much easier to get someone to take something than to eliminate something.  Lifestyle modification is difficult, but achievable to a degree as experience has shown with cholesterol, smoking, and other modifiable risk factors.  A recent study in the New England Journal of Medicine evaluated what the possible effect would be of lowering U.S. sodium consumption to 3g/day.  The authors found that, “Modest reductions in dietary salt could substantially reduce cardiovascular events and medical costs and should be a public health target.”

It really could be that simple: a combination of education and regulation could save lives and money.  And you would think the altmed folks could get behind something like this.  But taking simple, cheap recommendations and turning them into something “alternative” (and profitable) is a specialty of modern shamans.

A good example of this is a “holistic family practice” in the Midwest U.S. From the FAQs on their website:

Q:Should I eliminate salt in my diet?
A:The correct form of salt is an extremely important substance for our body. There is a big difference between refined salt and unrefined salt. As I discuss in Salt: Your Way To Health, refined salt is a toxic substance that needs to be avoided. Refined salt has no minerals and is contaminated with substances such as ferrocyanide. Unrefined salt has over 80 minerals in it. I have found unrefined salt a wonderful addition to a healthy holistic regimen.

If that sounds fishy to you, good.  You have probably already noticed the most glaring error: that refined salt contains “no minerals”.  Of course, sodium chloride is a mineral (as are potassium chloride, potassium iodide, etc.).  Following the link to his book is revealing because his special salt can cure all kinds of problems. And, to make your life easier, he sells just the right salt.  One of his special salts is called “Celtic Sea Salt”, which, at $6.00/lb, “balances the body and can help with adrenal exhuastion, low blood pressure, and mineral deficiencies.”  Links to evidence?  None.  Price of typical American table salt? Less than a dollar per pound (not that you should be using added salt in any significant quantity anyway).

This is typical of the altmed movement.  They accuse real medicine of being a profit-driven juggernaut that ignores simple treatments, but then promote their own useless and expensive nostrums. It would be comical if it weren’t real people who suffer.


Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, & Goldman L (2010). Projected effect of dietary salt reductions on future cardiovascular disease. The New England journal of medicine, 362 (7), 590-9 PMID: 20089957

Posted by Peter Lipson

Peter A. Lipson, MD is a practicing internist and teaching physician in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital. He currently maintains a private practice, and serves as a teaching physician at a large community hospital He also maintains appointments as a Clinical Assistant Professor of Medicine at Wayne State University School of Medicine and at Oakland University William Beaumont School of Medicine, the first being a large, established medical school, the latter being a newly-formed medical school which will soon be accepting its first class of students.  He blogs at White Coat Underground at the Scientopia blog network. A primary goal of his writing is to illuminate the differences between science-based medicine and everything else.  His perspective as a primary care physician and his daily interaction with real patients gives him what he hopes is special insight into the current "De-lightenment" in medicine.  As new media evolve, pseudo-scientific, deceptive, and immoral health practices become more and more available to patients, making his job all that much more difficult---and all that much more interesting. Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else. Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public. Dr. Lipson receives no compensation for his writing. Dr. Lipson's posts for Science-Based Medicine are archived here.