How to Lower Your Sodium Intake

Reduction of salt consumption by just 15 percent could save the lives of millions. If we cut our salt intake by half a teaspoon a day, which is achievable simply by avoiding salty foods and not adding salt to our food, we might prevent 22 percent of stroke deaths and 16 percent of fatal heart attacks—potentially helping more than if we were able to successfully treat people with blood pressure pills. As I discuss in my video Salt of the Earth: Sodium and Plant-Based Diets, an intervention in our kitchens may be more powerful than interventions in our pharmacies. One little dietary tweak could help more than billions of dollars worth of drugs.

What would that mean in the United States? Tens of thousands of lives saved every year. On a public-health scale, this simple step “could be as beneficial as interventions aimed at smoking cessation, weight reduction, and the use of drug therapy for people with hypertension or hypercholesterolemia,” that is, giving people medications to lower blood pressure and cholesterol. And, that’s not even getting people down to the target. 

A study I profile in my video shows 3.8 grams per day as the recommended upper limit of salt intake for African-Americans, those with hypertension, and adults over 40. For all other adults the maximum is 5.8 daily grams, an upper limit that is exceeded by most Americans over the age of 3. Processed foods have so much added salt that even if we avoid the saltiest foods and don’t add our own salt, salt levels would go down yet still exceed the recommended upper limit. Even that change, however, might save up to nearly a hundred thousand American lives every year.

“Given that approximately 75% of dietary salt comes from processed foods, the individual approach is probably impractical.” So what is our best course of action? We need to get food companies to stop killing so many people. The good news is “several U.S. manufacturers are reducing the salt content of certain foods,” but the bad news is that “other manufacturers are increasing the salt levels in their products. For example, the addition of salt to poultry, meats, and fish appears to be occurring on a massive scale.”

The number-one source of sodium for kids and teens is pizza and, for adults over 51, bread. Between the ages of 20 and 50, however, the greatest contribution of sodium to the diet is not canned soups, pretzels, or potato chips, but chicken, due to all the salt and other additives that are injected into the meat.

This is one of the reasons that, in general, animal foods contain higher amounts of sodium than plant foods. Given the sources of sodium, complying with recommendations for salt reduction would in part “require large deviations from current eating behaviors.” More specifically, we’re talking about a sharp increase in vegetables, fruits, beans, and whole grains, and lower intakes of meats and refined grain products. Indeed, “[a]s might be expected, reducing the allowed amount of sodium led to a precipitous drop” in meat consumption for men and women of all ages. It’s no wonder why there’s so much industry pressure to confuse people about sodium.

The U.S. Dietary Guidelines recommend getting under 2,300 milligrams of sodium a day, while the American Heart Association recommends no more than 1,500 mg/day. How do vegetarians do compared with nonvegetarians? Well, nonvegetarians get nearly 3,500 mg/day, the equivalent of about a teaspoon and a half of table salt. Vegetarians did better, but, at around 3,000 mg/day, came in at double the American Heart Association limit.

In Europe, it looks like vegetarians do even better, slipping under the U.S. Dietary Guidelines’ 2,300 mg cut-off, but it appears the only dietary group that nails the American Heart Association recommendation are vegans—that is, those eating the most plant-based of diets.


This is part of my extended series on sodium, which includes:

If you’re already cutting out processed foods and still not reaching your blood pressure goals, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Achieve Food Synergy

There are thousands of phytochemicals that will never make it onto the side of a cereal box but may play a role in reducing the risk of chronic diseases—and those are just the ones we know about. Whole plant foods have consistently been found to be protective, so it’s reasonable for scientists to try to find the “magic bullet” active ingredient that can be sold in a pill, but “[p]ills or tablets simply cannot mimic this balanced natural combination of phytochemicals present in fruits and vegetables.” When isolated out, the compound may lose its activity or behave differently. The antioxidant and anticancer activities of plant foods are thought to derive from the “additive and synergistic effects of phytochemicals in fruits and vegetables,” meaning the whole may be greater than the sum of its parts. This helps explain why a pill can’t replace the complex combination of phytochemicals present in whole plant foods.

As T. Colin Campbell has pointed out, more than a hundred trials “overwhelmingly show no long-term benefit for vitamin supplements, along with worrisome findings that certain vitamins may even increase disease occurrence for diabetes, heart disease, and cancer.” Supplementation with fish oil, for example, appears useless or, even worse, “posing increased risk for diabetes,” yet the science doesn’t seem to matter. People continue to buy them. “The public desire for quick fixes through pills…is overwhelming, especially when money can be made.”

Each plant has thousands of different phytochemicals, as well as entirely different phytonutrient profiles. So, there may be synergistic effects when eating different foods together, too. Eating beta-carotene in carrot form is more beneficial than in pill form. because of all the other compounds in the carrot that may synergize with the beta-carotene. Well, when we dip that carrot in hummus, we suddenly have the thousands of carrot compounds mixing with the thousands of chickpea compounds. So what happens if we mix different fruits with different vegetables or different beans?

As you can see in my video Food Synergy, combining foods across different categories increased the likelihood of synergy. For example, a study showed the antioxidant powers of raspberries and adzuki beans. If there were a strictly additive effect, the expected combined antioxidant power would simply be that of the raspberries plus that of the adzuki beans. However, the observed combined antioxidant power was actually greater than the sum of one plus the other.

What about cancer-fighting effects? The study was repeated, but, this time, different combinations of food were dripped on breast cancer cells growing in a petri dish. For some foods, the same synergistic effects were found. Grapes, for example, can suppress the growth of breast cancer cells about 30 percent, but onions worked even better, cutting breast cancer cell growth in half. One would assume that if we added half the grapes with half the onion, we’d get a result somewhere in the middle between the two. Instead, the researchers found that cancer cell growth was suppressed by up to 70 percent with that combination. The whole plus the whole was greater than the sum of the whole parts. Given these findings, did the researchers recommend people eat a variety of foods? Perhaps adding some raisins along with chopped red onions to our next salad? Where’s the money in that? No, the reason the researchers were investigating the different types of interactions was “to identify mixtures that hold synergistic interactions that can ultimately lead to the development of functional foods”—maybe something like grape-flavored Funyuns.


Why should we care about the antioxidant power of foods? See

If you’re not familiar with this concept of reductionism, be sure to check out some of these other videos: Industry Response to Plants Not Pills, Why Is Nutrition So Commercialized?, and Reductionism and the Deficiency Mentality.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How Not to Die from Cancer

After Dr. Dean Ornish conquered our number-one killer, heart disease, he moved on to killer number-two. What happens if cancer is put on a plant-based diet? Ornish and colleagues found that the progression of early-stage prostate cancer could be reversed with a plant-based diet and other healthy lifestyle behaviors.

If the blood of those eating the Standard American Diet is dripped onto cancer cells growing in a petri dish, cancer growth is cut down about 9 percent. And if they’ve followed a plant-based diet for a year? Their blood can slash cancer growth by 70 percent. So the blood circulating thgouhout the bodies of those eating plant-based diets had nearly eight times the stopping power when it came to suppressing cancer cell growth.

That was for cell growth of prostate cancer, the leading cancer-killer specific to men. In younger women, breast cancer is the top cancer-killer. Researchers wanted to repeat the study with women using breast cancer cells, but they didn’t want to wait a whole year to get the results. Women are dying now. So they figured they’d see what a plant-based diet could do after just two weeks against three different types of human breast cancer.

As you can see in my video How Not to Die from Cancer, the study showed cancer growth started out at 100 percent, but then dropped after the subjects ate a plant-based diet for 14 days. A layer of breast cancer cells was laid down in a petri dish, and then blood from women eating the Standard American Diet was dripped on it. As you can see in the video, even the blood of women eating pretty poor diets had some ability to break down cancer. After just two weeks of eating healthfully, though, blood was drawn from those same women—so they effectively acted as their own controls—and was dripped on a new carpet of breast cancer cells. You can see for yourself that only a few individual cancer cells remained. Their bodies cleaned up. After only 14 days on a plant-based diet, their bloodstream became that much more hostile to cancer.

Slowing down the growth of cancer cells is nice, but getting rid of them all together is even better. This is what’s called apoptosis, programmed cell death. After eating healthfully, the women’s own bodies were able to somehow reprogram the cancer cells, forcing them into early retirement.

In my video, you can see what’s called TUNEL imaging, which allows researchers to measure DNA fragmentation, or cell death. With this technology, dying cancer cells appear as little white spots. From the start of the study, you can see one small white speck in the upper left of the image, showing that the blood of an average woman on a typical American diet can knock off a few breast cancer cells. After 14 days of healthy, plant-based living, however, her blood turned that one small white speck into a multitude of white spots. It’s as if she’s an entirely different woman inside! The same blood now coursing through these women’s bodies gained the power to significantly slow down and even stop breast cancer cell growth after just two weeks of eating a plant-based diet.

What kind of blood do we want in our body? What kind of immune system? Do we want blood that just rolls over when new cancer cells pop up, or do we want blood circulating to every nook and cranny of our body with the power to slow down and stop them?

The dramatic strengthening of cancer defenses shown in the study was after 14 days of a plant-based diet—and exercise.The researchers had the women walking 30 to 60 minutes a day. Given there were two factors, how do we know what role the diet played? Researchers decided to put it to the test.

In my video, you can see a chart that first shows how blood taken from those who ate a plant-based diet and had a routine of mild exercise, such as walking every day, over an average of 14 years, exhibited significant cancer cell clearance. The researchers then compared the substantial cancer-stopping power of plant eaters to that of an average sedentary American, which you can see is basically nonexistent.

The researchers also analyzed a third group. Instead of 14 years on a plant-based diet, they had 14 years on a Standard American Diet, but they also had 14 years of daily, strenuous, hour-long exercise, like calisthenics. They wanted to know if you exercised hard enough and long enough could you rival some strolling plant eaters.

The answer? There’s no question that exercise helped, but literally 5,000 hours in the gym was no match for a plant-based diet.

Once again using TUNEL imaging to analyze cancer cell death, the researchers found that even if you are a couch potato eating fried potatoes, your body isn’t totally defenseless. Your bloodstream can kill off some cancer cells, which you can see in my video as a couple white spots in the first image of that series. If you exercise for 5,000 hours, you can kill many more cancer cells, evidenced by the many more white specks appearing throughout that image. But nothing appears to kick more cancer tush than a plant-based diet, as that image is filled with white spots indicating cancer cells killed off.

Why is this the case? We think it’s because animal proteins, such as meat, egg white, and dairy protein, increase the level of insulin-like growth factor-1 (IGF-1), a cancer-promoting growth hormone involved in the “acquisition or progress of malignant tumors.”

In my video, you can see the results of a study that nailed IGF-1 as the villain. Just as in the previous studies, subjects went on a plant-based diet and cancer-cell growth dropped, while cancer-cell death shot up. This experiment, however, had a kicker: It added back to the cancer just the amount of IGF-1 that had been banished from your body as a result of eating and living healthier. In doing so, it effectively erased the “diet and exercise” effect. It’s as if the subjects had never started eating healthfully at all, with the cancer-cell growth rates and death rates returning to the same levels as before the plant-based diet intervention.

The reason one of the largest prospective studies on diet and cancer found “the incidence of all cancers combined was lower among vegetarians than among meat eaters” may be because they eat less animal protein, and thereby end up with less IGF-1, which means less cancer growth.

How much less cancer growth? A study found that middle-aged men and women with high protein intakes had a 75 percent increase in overall mortality and a fourfold increase in the risk of dying specifically from cancer. Does the protein source matter? Yes. It was specifically animal protein, which makes sense, given their higher IGF-1 levels.

The academic institution where the study was done sent out a press release with a memorable opening line: “That chicken wing you’re eating could be as deadly as a cigarette.” It went on to explain that “eating a diet rich in animal proteins during middle age makes you four times more likely to die from cancer…—a mortality risk factor comparable to smoking.”

What was the response to the revelation that diets high in meat, eggs, and dairy could be as harmful to health as smoking? One nutrition scientist replied it was “‘potentially even dangerous’ to compare the effects of smoking with the effect of meat and cheese,” but why? Because, they argued, a smoker might think “‘why bother quitting smoking if my cheese and ham sandwich is just as bad for me?’”

This reminds me of a famous Philip Morris cigarette ad that tried to downplay the risks of second-hand smoke. The ad included a chart with “everyday activities” and “reported relative risk,” in an attempt to say second-hand smoke wasn’t all that bad. The chart showed that while it increases the risk of lung cancer by 19 percent, drinking one or two glasses of milk every day may be three times as bad with a 62 percent higher risk of lung cancer. Lung cancer risk could be doubled if you frequently cook with oil, and heart disease risk tripled if you eat non-vegetarian or multiplied six-fold by eating lots of meat and dairy. Philip Morris’s conclusion? “Let’s keep a sense of perspective.” The “risk of lung cancer from second-hand tobacco smoke [was put] well below the risk reported by other studies for many everyday items and activities.”

That’s like saying, “Don’t worry about getting stabbed, because getting shot is so much worse.” Two risks don’t make a right.

Of course, you’ll note Philip Morris stopped throwing dairy under the bus once it purchased Kraft Foods.


The first time someone visits NutritionFacts.org can be overwhelming. With videos on more than 2,000 health topics, where do you even begin? Imagine stumbling onto the site not knowing what to expect and the new video-of-the-day is about how a particular spice can be effective in treating a particular form of arthritis. It would be easy to miss the forest for the trees, which is precisely why I created a series of overview videos that are essentially taken straight from my live, hour-long 2016 presentation How Not to Die: Preventing, Arresting, and Reversing Our Top 15 Killers.

The other videos in this overview series are:

Inspired to learn more about the role diet may play in preventing and treating cancer? Check out these other popular videos on the topic:

I’ve also produced an entire series on mammograms. You can find all of those videos here.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: