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Comment by chasebank | Hacker News Reader

This article references salt consumption multiple times. I thought that was a myth of the past. Salt consumption has almost zero to do with blood pressure. IIRC, it's primarily based on eating more calories than one burns.

As always, eat less, move more.

https://www.scientificamerican.com/article/its-time-to-end-t...

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> I thought that was a myth of the past. Salt consumption has almost zero to do with blood pressure.

Not accurate. Salt affects different people differently. But for many people, it raises their blood pressure substantially, but only transiently, much like caffeine.

For most people the root cause of high blood pressure is going to be weight or lack of exercise, absent other risk factors. So if your morning blood is normally 100 / 60, then reasonable quantities of salt aren't going to raise your blood pressure enough for long enough to cause vascular damage. But if your baseline blood pressure is closer to pre-hypertensive or worse, then eating too much salt is going to raise your blood pressure enough to cause artery damage, and eventually heart disease.

I'm actually curious about this: if that's true, why do hospitals still do low-salt diets for critical heart disease patients?

Because if you are a critical heart patient, salt then can matter a lot.

Unfortunately a lot of people suffer from being per-diabetic, which really just means, "you have diabetes, we don't want to say that because: denial" and a lot of guidelines used for "healthy" people don't apply to you, because you're not healthy.

Well there is one aspect where pre-diabetes differs from being fully diagnosed with Type 2 Diabetes, and that's the fact that you're not at the point of no return. Pre-diabetics, if they make appropriate lifestyle changes, still have a chance at reversing course and not living with diabetes for the rest of their life.

I don't disagree with you, but being pre-dabetic is an uphill battle to then get healthy again, as you are most likely trying to reverse many years of lifestyle habits that have lead you down the road towards diabetes. A car crash in slow-motion. That takes an incredible amount of will power and I applaud anyone that's on that journey, especially since you have to go well against the status quo.

I've at least heard that T2D is somewhat reversible given drastic diet changes, fasting, bariatric surgery - but a moon-shot for sure.

Another aspect that differs is that pre-diabetics bodies are still functioning. They are closer to not being able to keep up, but if they couldn't, then they'd be diabetic.

True, but being tested correctly as "pre-diabetic" isn't so straightforward, as getting sugar/glucose levels at rest doesn't tell the whole story - ie: there's no such thing as having a mild case of diabetes.

Take this with a grain of... of salt,

https://www.youtube.com/watch?v=6zZBiTfIp4Q

I think he makes a good point that the proper tests for diabetes is much more involved than what most people get prescribed, or what they will tolerate, as it can take the entire day. (he says a lot more - I'm not standing by everything he's saying)

Easy access to almost over the counter and cheap continual glucose monitors may reveal better patterns to catch pre-diabetic symptoms faster (my hope).

Hospitals and the medical system in general are always the last to get a memo about health. I wouldn't touch a good chunk of hospital meals with a ten-foot pole even when I'm in perfect health; the fact that any hospital is feeding patients shit like this[1][2][many such examples] borders on malpractice.

[1] https://twitter.com/DrBenRodgers/status/1508084691269738503 (someone having a diabetic emergency, no less!)

[2] https://twitter.com/moreyraortho/status/1635779523651473409

Because salt is fine for the normal person. Someone in the hospital with critical heart disease issues is not normal.

Salt is how your kidneys generate osmotic pressure to regulate the water levels in your blood. Critical heart disease patients are very sensitive to changes in blood pressure. Healthy people are much less so.

You could be sued for doing something that was potentially considered unsafe by some studies. Business wise it's better to just "play it safe" here with low sodium meals.

Since they also do it in countries where lawsuits are not a risk you need to care about I doubt this is the reason.

My understanding is that salt leading to high blood pressure is a problem that affects some people, but not all.

Bad habits are hard to break

What if a diet high in salt is fine for healthy patients but dangerous for patients with heart disease? You can make the same argument for a diet high in sugar for healthy active individuals. It wouldn't be good for those with diabetes.

The difference is, a diet high in (refined) sugar is terrible for all humans, both healthy and unhealthy.

Agreed. The anti-sodium crowd has done some real damage to nutritional education IMO.

People who train intensely wind up with a sodium deficiency due to this propaganda. You can welcome 6-10g/day into your diet if you just sweat through exercise. Problem is, most aren't doing that.

> I thought that was a myth of the past.

When in heart failure, a low-salt diet is optimal for long-term survival. This has little (but some) to do with blood pressure and lot more to do with water retention when your circulation is already failing.

There are at least some studies that link salt to increased appetite. Which shouldn't be a shock - eating tasty things makes you want to eat more.

But in this case journalists like padding out lists of unhealthy ingredients.

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