The forest for the trees

I am well-versed in the recommendations that came down this year from the American Heart Association for Americans to limit sodium to 1,500 milligrams a day. To compare, a half-teaspoon of salt contains 1,200 milligrams. Other national health authorities, such as the National Heart, Lung and Blood Institute and the Centers for Disease Control and Prevention more or less followed suit, with some not going quite so far as to say that all Americans should go as low as 1,500 mg.
So, the it didn’t surprise me that a study published last week suggesting that a low-sodium diet might increase the risk of death from a heart attack or stroke caused quite a kerfuffle. The study results also didn’t surprise me much, because it’s never been shown conclusively that eating a lot of salt (sodium) causes high blood pressure* (a serious risk factor for heart disease, heart attack and stroke). 
As I was reading the New York Times article about the study, and the related controversy, I started thinking that a high-sodium diet is indeed probably not the problem…the problem is the types of foods that people who consume a lot of sodium tend to eat! Contrary to what most people think, the salt shaker is not the big problem, it’s the fast food and the junk food and the processed foods found in the center aisles of the grocery store. But groups like the AHA and the CDC can’t get people to stop eating this junk and start eating  vegetables, fruits, whole grains, non-sugary yogurt, beans and healthier fats. They also can’t get them to reach and maintain a healthy weight and exercise for 30 minutes, five days a week.
Trying to convince Americans to lower their sodium is like a Hail Mary pass. It’s like, “Let’s get everyone to focus on one single tree (sodium) instead of the whole forest (a healthy lifestyle).”
But how often has focusing on one single nutrient (either avoiding it or eating more of it) actually proved to be beneficial? (Not counting situations like vitamin C and scurvy or thiamine (vitamin B1) and beriberi.) Antioxidant vitamins are important for health, but most studies looking for benefits from taking those vitamins in pill form have been a bust. Beta carotene increased the risk of lung cancer in smokers, vitamin E supplementation increased the risk of dying. 
(I recently learned that the likely problem with vitamin E is that there are actually several forms of vitamin E. When you get this vitamin naturally, in food, you are consuming all the varieties. When you take it in pill form, you are getting one variety, and getting that one variety at high levels can prevent your body from absorbing the other varieties as it encounters them in food. Again…failing to see the forest for the trees.)
A balanced, nutritious diet, together with regular exercise and stress reduction, can be powerful medicine. Many of the chronic diseases plaguing us today (diabetes, heart disease, cancer) are largely lifestyle-based. The average American watches more than five hours of television a day, so when people say they don’t have time to do some kind of exercise that moves their muscles, makes them breathe harder and gets their heart rate up for a half-hour a day, I kind of want to say, “Liar, liar, pants on fire.”
Food can be a force for good health, but it’s a clear case of the whole being greater than the sum of its parts. Single nutrients aren’t magic. Neither is green tea. Or dark chocolate. Or red wine. Or pomegranates. Or acai berries. Or any other “health promoting” food darling du jour. Do all of those food have healthful properties? Heck yeah! But you need to place them appropriately in the bigger picture of a healthy diet and lifestyle. Sorry, but green tea will not save you from a daily fast food habit. So why is it that people won’t, or “can’t,” give up the fast food monkey on their backs? I’ll talk about that tomorrow.
*When you eat a lot of sodium, your body retains water in order to dilute the sodium. Some of this retained fluid is in your bloodstream, increasing your blood volume. Increased blood volume increases the pressure on the walls of your blood vessels (think of a trickling stream vs. a roaring river). This is, of course temporary, but the question is whether repeated (or constant) “temporary” increases in blood pressure lead to bonafide high blood pressure (hypertension). It appears that some people are more “salt sensitive” than others, so for some people, sodium might very well cause high blood pressure. For other people, sodium is not really a problem.