Why Your Doctor Still Thinks Salt Is Bad (And Why He Might Be Wrong) - PART 4
With such compelling evidence piling up, one might wonder: Why do mainstream organisations still tell us to restrict salt so much? There are a few reasons the “salt is evil” narrative persists in conventional guidelines, despite the evolving science:
Inertia and Caution in Public Health:
Large organisations (like the WHO, American Heart Association, etc.) tend to be conservative in changing guidelines. They often operate on a “precautionary principle” since some (outdated) data suggest salt can raise blood pressure, and high blood pressure is a major killer; they err on the side of telling everyone to eat less salt “just in case.”
It can take many years (and multiple definitive trials) before old recommendations are reversed. Recall that the low-salt guidelines have been in place since the late 1970s; admitting that they might have been overzealous or oversimplified is not something that happens overnight.
In 2013, an Institute of Medicine committee reviewed the evidence and found insufficient evidence that cutting sodium below 2,300 mg per day improved health outcomes, and some evidence of potential harm at very low intakes[1].
This was a bombshell acknowledgement. Yet, public messaging didn’t catch up; agencies largely continued to push for <2,300 mg and even 1,500 mg targets. Bureaucracy and the slow turning of the ship mean new research can take decades to filter down to the average doctor’s advice or national dietary guidelines.
Focus on Simplistic Population Strategies:
Mainstream public health loves one-size-fits-all solutions (like blanket salt reduction) because they are easy to communicate and implement at scale (e.g., via processed food reformulation).
It’s much simpler to tell food companies “lower the salt in everything” than to educate millions of individuals about nuanced concepts like insulin, potassium balance, or genetic salt sensitivity. Even if the benefit of low salt is tiny for most people, officials argue that at a population level, a tiny reduction in blood pressure for many could mean fewer strokes overall.
However, this utilitarian approach can backfire, as it ignores biochemical individuality and can introduce other risks. For example, Scientific American noted that low-salt policies based on shaky data are ultimately unfair – they promise big public health gains based on “wild extrapolations” that haven’t been proven[2][3].
Functional medicine, by contrast, prefers personalised strategies and addressing root causes (e.g., why someone has high blood pressure, rather than reflexively blaming salt).
The lag in mainstream advice partly comes from clinging to a simplistic model (salt -> BP -> fix BP by cutting salt) rather than embracing the complexity revealed by new evidence (like the roles of sugar, obesity, stress, and nutrient deficiencies in hypertension).
Fear of Mixed Messaging:
Public health authorities might also be wary of reversing course because they fear confusion or unintended consequences.
Telling people “you don’t have to worry so much about salt” could be misinterpreted as “go eat all the potato chips you want!” Clearly, that’s not what the new science implies – it’s advocating moderation and context, not high-salt junk food diets.
But nuance is hard to convey in mass messaging. There’s concern that softening the stance on salt might lead to people overeating processed foods or that it would undermine trust (“they told us salt was bad for decades and now they say it’s fine?!”).
So, we end up with a bit of a nanny-state approach: the guidelines stay ultra-strict “just to be safe,” underestimating the public’s ability to handle a more refined message. The irony is that while harping on salt, mainstream advice often fails to emphasise other critical factors (like eating more potassium-rich foods or cutting sugar) that may have much larger impacts on cardiovascular health.
Industry and Institutional Momentum:
Entire public health campaigns and initiatives have been built around sodium reduction (from “shake the habit” slogans to food manufacturing standards). There’s institutional momentum – and sometimes financial incentives – tied to these efforts.
Non-profit organisations and government programs have invested in salt-reduction awareness. Admitting that the benefit is marginal or that focus should shift elsewhere might threaten budgets or credibility of those programs.
This isn’t to suggest a grand conspiracy, but rather that once a narrative sets in, a lot of careers and policies ride on it, making reversal a slow process.
From a functional medicine perspective, this situation is frustrating. Functional and integrative practitioners tend to stay more current with nutrition science and often incorporate new findings faster. They’re also more comfortable with individualised recommendations.
So, while your GP or national health department might still repeat “eat less salt,” a functional medicine doc or nutritionist might tell you: “Actually, your blood pressure issues likely have more to do with your insulin resistance and lack of magnesium than salt per se.
Let’s reduce your refined carb intake, get you on some magnesium and potassium-rich foods, and you can season your healthy meals to taste.”
This approach targets root causes (poor diet quality, excess sugar, stress, mineral imbalances) rather than vilifying a single nutrient (sodium) in isolation.
Bottom line:
Mainstream advice hasn’t yet caught up to the science due to institutional inertia, fear of changing the message, and the appeal of simple but flawed solutions.
However, you don’t have to wait for official guidelines to catch up. By educating yourself (as you’re doing now), you can make informed choices based on current evidence and a deeper understanding of your body’s needs – even if that means doing something “unorthodox” like sprinkling a bit more salt on your veggies without guilt.
