Risks of high salt intake outweigh benefits

By Dr. John Aronen

An article in the December 2002 issue of Handball magazine caught my attention, for it discussed muscle cramps and proper steps to take to prevent them.

I have always wondered about muscle cramps, for in my 25-plus years of dealing with athletes I have never been able to come to any conclusion other than the onset of cramps is typically associated with extreme overstress or fatigue of one or more muscle groups.

There are a plethora of theories as to why muscle cramps occur, such as low potassium. But none of these theories have scientific data to back them up.

Most recent studies have shown that muscle make-up–the type of muscle fibers with which you are genetically gifted–is the primary determinant as to whether you will be capable of enduring extensive bouts of strenuous activity without incurring muscle cramps.

Adequate hydration before participation has been shown to be beneficial in reducing the incidence of muscle cramps in endurance events. The rule to follow is that you are adequately hydrated when your urine is colorless.

Additionally, alcohol and caffeine, which are diuretics and result in an increased loss of fluids through urination, inhibit adequate hydration. Thus, drinking beer the night before a match and coffee in the morning the day of a match hinder your chances of being adequately hydrated. Of course, drinking beer the night before a match is relatively uncommon in handball players!

Which leads me to comment on the article, which discussed the possible relationship between muscle cramps and large losses of sodium and fluid.

The author stated that “since sodium is an important mineral in initiating signals from nerves and actions that lead to movement in the muscles, a deficit of this element” could cause cramps. Part of the recommendation to solve this problem was to add sodium to meals.

The only reason I am commenting on the article is because of my concern that handball players may follow the recommendations regarding the “addition of salt to their diet.”

Hypertension, or high blood pressure, is a major health problem worldwide. Hypertension has been identified as a major contributor to many serious health problems, such as heart attacks, kidney failure and strokes.

The incidence of hypertension increases with age, with about 50 percent of people in their 50s having elevated blood pressure. Of the people with hypertension, about 95 percent-plus fall into the category of having essential hypertension–in other words, you have it, but the exact reason you have it cannot be determined.

What can be determined are factors that contribute to your hypertension and measures that should be taken to address these factors. The most common factors include excessive daily intake of salt, being overweight and stress.

The Food and Drug Administration recommends no more than 2,400 milligrams (mg) of sodium daily. Each day people consume more sodium from the salt in their normal diet than the amount that has been determined as safe by the FDA.

There is salt in almost every food we eat and beverage we drink. For instance, one slice of bread has 120 mg of sodium and one tablespoon of catsup has 190 mg of sodium. This is why a low-sodium diet is recommended for anyone with high blood pressure.

In recognizing that the majority of handball players are close to or over 50 and, should I say, a “well-documented” percentage are overweight, the addition of salt to meals does not strike me as a good idea for most people.

The moral of the story is to have your blood pressure checked regularly and, if you are diagnosed with hypertension, take your medications on a regular basis, adhere to a low-sodium diet, keep your weight under control instead of under your shirt, avoid episodes of typically self-induced stress, hydrate yourself adequately with water before playing a match and rehydrate with water between matches.

And watch that salt intake.