Skip wrote:In his 2008 newsletter, Dr. McDougall states:
"A basic diet of starches, vegetables, and fruits (the McDougall Diet) with no added sodium provides less than 500 mg of sodium daily. Adding a half-teaspoon of salt to the surface of your McDougall dishes daily adds about 1100 mg of sodium—making the total daily intake 1600 mg. The “low-sodium diet” fed to a hospitalized patient, following a massive heart attack, under the expert guidance of doctors and dietitians, contains 2000 mg of sodium. Now you understand why I am comfortable putting the saltshaker on the dining tables at our programs."
I checked the cronometer and it says that the rda for sodium is minimum 500 and max 2300 mg per day. So if you follow the McDougall plan and attempt to be SOS free, you may not be getting the rda of sodium which may lead to problems......this is what I glean from this discussion. I wonder how the people who are SOS free feel about this?
A WFPB diet provides about 250-500 depending on the restrictiveness and/or variety. Based on my analysis of the McDougall diet, I say around 350-500 and it would have to be fairly limited and/or restrictive to get down to 200-250 or less.
There is no RDA/DRI for sodium but there is a recommended safe minimum of 500 mg/day though the bare minimum need is estimated to be about 115 or so buy that is under ideal conditions with "maximal adaption and without active sweating" and not recommend as a goal to aim for
"Thus, a minimum average requirement for adults can be estimated under conditions of maximal adaptation and without active sweating as no more than 5 mEq/day, which corresponds to 115 mg of sodium or approximately 300 mg of sodium chloride per day. "Recommended Dietary Allowances 10th Edition
Subcommittee on the Tenth Edition of the RDAs Food and Nutrition Board Commission on Life Sciences
National Research Council
ISBN: 0-309-53606-5, 302 pages, 6 x 9, (1989
http://www.nap.edu/catalog/1349.htmlP 253
The 1500 is the Adequate intake which is actually 1200-1500 depending on age and health.
"The Adequate Intake (AI) is set instead of an RDA if sufficient scientific evidence is not available to calculate an EAR. The AI is based on observed or experimentally determined estimates of nutrient intake by a group (or groups) of healthy people." The AHA, ACC, NHLB, etc all use the 1500 too.
https://www.nap.edu/read/10925/chapter/8#270"The AI for sodium is set for young adults at 1.5 g (65 mmol)/day (3.8 g of sodium chloride) to ensure that the overall diet provides an adequate intake of other important nutrients and to cover sodium sweat losses in unacclimatized individuals who are exposed to high temperatures or who become physically active as recommended in other dietary reference intakes (DRI) reports. This AI does not apply to individuals who lose large volumes of sodium in sweat, such as competitive athletes and workers exposed to extreme heat stress (e.g., foundry workers and fire fighters). The AI for sodium for older adults and the elderly is somewhat less, based on lower energy intakes, and is set at 1.3 g (55 mmol)/day for men and women 50 through 70 years of age, and at 1.2 g (50 mmol)/day for those 71 years of age and older. "The 2300 is the Tolerable Upper Limits. This is defined as
"The highest level of nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population. As intake increases above the UL, the risk of adverse effects increases."https://www.nap.edu/read/10925/chapter/8#271"The adverse effects of higher levels of sodium intake on blood pressure provide the scientific rationale for setting the Tolerable Upper Intake Level (UL). Because the relationship between sodium intake and blood pressure is progressive and continuous without an apparent threshold, it is difficult to precisely set a UL, especially because other environmental factors (weight, exercise, potassium intake, dietary pattern, and alcohol intake) and genetic factors also affect blood pressure. For adults, a UL of 2.3 g (100 mmol)/day is set. In dose-response trials, this level was commonly the next level above the AI that was tested. It should be noted that the UL is not a recommended intake and, as with other ULs, there is no benefit to consuming levels above the AI."So, if you follow the program as recommended, including a variety of foods from the recommended food groups, you should be close to 300-500. If you add in a 1/2 tsp of salt, you are adding in about 1100 which puts you at 1450-1650.
These are the numbers my guidelines are based on. They are the same guidelines used by Dr's Mcdougall, Klaper, Lederman, Esselstyn, E2, WFM, Pritikin, etc.
This is not recommending the unbridled use of salt, nor is it saying you must hit the 1500-2300 range but showing that most people can easily add "up to" a .25 to .5 tsp and not worry. If you are adding it at the table to the top of the food, even just 200 mg (the amount in one of the small .5 gram salt packets) can taste like quite a bit. So, using 1-3 of those packets a day is a simple way of measuring it and staying around 700-1000.
Here are comments from a recent discussion on this very issue from my colleague Jay Kenny, PhD, who in my mind, knows more about this topic then anyone, and has written several CEU programs on it.
"The vast majority of people can probably get by just fine on 200 to 500mg sodium/day although this level would be dangerous for those taking diuretics, some other drugs and some medical problems including those with seriously impaired renal function. I think shooting for 500 to 1000mg sodium daily is likely a safe and effective target for most people to avoid elevated BP/HTN who want to control their BP without drugs. If one were to eat a diet composed largely of whole fruits, nuts, whole grains, and beans with no added salt or other foods with appreciable amounts of sodium then sodium deficiency is plausible [NOTE: JSN - Depending on the variety and restrictiveness] as these foods have so little sodium intake could fall below 200mg/day which may be insufficient for some people.
People whose adrenals that cannot make enough aldosterone who are not being treated with aldosterone certainly would not want to be on a low-salt diet as their ability to retain salt is severely compromised. They can become hyponatremic even on a normal American diet sometimes. A lot of vomiting might trigger low chloride levels in someone who cannot keep any food down. People with cystic fibrosis lose a lot more sodium in their sweat and cannot adapt as normal people so might have problems on a very low-salt intake. But as long as one has normal adrenal function and normal renal function and are not taking drugs like diuretics worrying about sodium deficiency is a waste of time. Walter Kempner used to put people with malignant HTN on a diet of rice and fruit and sugar which must have less than 200mg of sodium but not for long. He would add some chicken or fish and vegetables and these had sufficient sodium to prevent deficiency. Clearly people can consume zero sodium on a fast for a week or more."Most of this is covered in the Salt thread. If you follow my guidelines you will be able to add some salt, end up around 500-1100 and not risk your health from too little or too much.
As we say at the program,
"the food is your medicine and as Julie Andrews sang, 'just a (very little) spoonful of sugar (and/or salt) helps the medicine go down' "
In Health
Jeff