Salt, or sodium chloride, is an essential nutrient that our bodies need to function properly. However, there has been considerable debate around whether consuming too much salt can negatively impact cholesterol levels and heart health. This article will examine the evidence around salt and cholesterol, looking at the following key questions:
Does eating too much salt raise cholesterol levels?
How does salt affect cholesterol?
What is the relationship between salt, cholesterol, and heart disease risk?
Should you limit salt to reduce cholesterol?
Conclusion
Does eating too much salt raise cholesterol levels?
There is mixed evidence when it comes to the impact of dietary salt on cholesterol levels. Some studies have found that increased salt intake is associated with higher total cholesterol, LDL “bad” cholesterol, and triglyceride levels. For example, a 2011 meta-analysis of 13 studies found that for every 2,300 mg/day increase in sodium intake, there was a 4.3 mg/dL increase in total cholesterol levels.
However, other studies have not found a significant relationship between salt consumption and cholesterol levels. A large 2019 study in over 93,000 Korean adults did not find any association between sodium intake and total, LDL, or HDL “good” cholesterol levels.
Overall, the evidence seems to suggest that extremely high salt intakes well above the recommended limits may potentially negatively impact cholesterol levels. However, for most people consuming moderate amounts of salt, there does not appear to be a major detrimental effect on cholesterol.
How does salt affect cholesterol?
There are a few mechanisms by which excess salt intake could theoretically influence cholesterol levels:
Increased fluid retention:
Consuming too much salt causes the body to retain more fluid to help dilute the excess sodium. This increased fluid volume puts more pressure on blood vessel walls, which signals the liver to produce more cholesterol to help strengthen the vascular system.
Changes in lipid metabolism:
High salt intake may alter enzymes involved in lipid metabolism, leading to increased production of LDL cholesterol by the liver. Sodium also appears to impair the ability of cells to take up LDL cholesterol from the bloodstream.
High blood pressure:
Excess sodium is known to increase blood pressure. High blood pressure causes damage to blood vessels, which can increase accumulation of LDL cholesterol in the walls of arteries.
Inflammation:
High salt intake may promote inflammatory processes in the body, including increasing white blood cell count. Inflammation plays a key role in the development of atherosclerosis and buildup of cholesterol in arteries.
However, the changes seen are generally small and it’s uncertain if they are clinically relevant, especially for individuals without extremely high salt intakes. More research is still needed on the biological mechanisms linking salt and cholesterol.
What is the relationship between salt, cholesterol, and heart disease risk?
While excess salt may have a small effect on cholesterol levels, the bigger concern is the impact on high blood pressure. Elevated blood pressure is a major risk factor for heart attack, stroke, and cardiovascular disease.
There is very strong evidence from many studies that reducing sodium intake lowers blood pressure, especially in individuals with hypertension. Even a modest reduction of 1,200 mg per day can significantly reduce blood pressure.
Lowering blood pressure reduces the risk of cardiovascular events like heart attacks. It also reduces strain on blood vessels, lowering atherosclerotic damage that can lead to cholesterol buildup.
Therefore, limiting salt intake is recommended primarily for lowering blood pressure and cardiovascular risk, rather than just focusing on cholesterol. The American Heart Association recommends consuming less than 2,300 mg of sodium per day as part of an overall heart-healthy dietary pattern.
Should you limit salt to reduce cholesterol?
Based on the current evidence, limiting salt intake is unlikely to lead to major reductions in cholesterol levels for most people. For individuals with normal cholesterol levels, restricting sodium is not usually required solely for the purpose of lowering cholesterol.
However, those with high blood pressure, heart disease, or risk factors like diabetes and obesity may benefit from moderately reducing salt intake as part of a comprehensive lifestyle approach to support heart health. Even without huge impacts on cholesterol, lowering sodium consumption can still improve cardiovascular risk by reducing blood pressure.
Here are some tips for moderately reducing salt intake:
Eat more fresh, unprocessed foods
| Food | Sodium |
|---|---|
| 1 apple | 0 mg |
| 3 oz chicken breast | 74 mg |
| 1 cup brown rice | 10 mg |
Limit processed, packaged, and restaurant foods
| Food | Sodium |
|---|---|
| 1 frozen dinner | 800-1,500 mg |
| 1 cup canned soup | 500-1,200 mg |
| Fast food burger | 500-1,500 mg |
Read nutrition labels and choose low-sodium options
Use spices, herbs, lemon, vinegar instead of salt for flavor
Rinse canned foods before cooking or eating
In addition to watching sodium, having an overall balanced diet rich in vegetables, fruits, whole grains, lean proteins, and healthy fats can support lower cholesterol levels and heart health. Exercise and maintaining a healthy weight are also important.
If cholesterol levels remain high despite lifestyle changes, medications may be needed for more effective reduction of LDL cholesterol. Work with your healthcare provider to determine the best treatment options for your individual health needs.
Conclusion
In summary, excess sodium intake does appear to have a small negative effect on cholesterol levels, especially at very high amounts above the recommended limit. However, for most people eating a moderate salt diet, lowering sodium is unlikely to significantly improve cholesterol.
The greater impact of reducing salt is on lowering elevated blood pressure, which reduces the risk of cardiovascular disease events like heart attack and stroke. Therefore, limiting sodium should be viewed as more important for lowering cardiovascular risk rather than just as a strategy for reducing cholesterol.
As part of an overall heart-healthy lifestyle, restricting sodium along with following a balanced diet, exercising, and maintaining normal weight can support improvements in cholesterol as well as greater heart health. Work with your doctor to determine appropriate dietary and lifestyle changes to reduce your individual risk and keep your heart healthy.