Humans have a natural tendency throughout their history (from the Stone Age to exponential technologies) to oversimplify complex environments, and as a result they do not evaluate all risks in the best way (or some at all). The reasons for their actions are very complex, and I don’t want to go into all their forms in this series of blogs. However, I do want to address here one specific pattern of decision making and risk assessment that people are fond of (also) in the medical and dietary fields.
So what is the mythical problem? It is the matching of unknown inputs to known outputs, or in other words – confusing causality with correlation. Nassim Nicholas Taleb described this phenomenon very nicely in his book The Black Swan and called it the “narrative fallacy”, or translated as “the fallacy of narrative”. The narrative fallacy describes the tendency of a person to invent a story (input) that illusorily justifies the existence of a phenomenon (output), with the result that the person himself thinks that he understands the phenomenon well enough.
An observant individual has surely caught another individual afflicted with the narrative fallacy at least once in his or her lifetime. Whether it was when he saw an angry gentleman at a bus stop shouting that the cause of his bad financial situation was solely due to such and such a politician, or when a despondent lady at the physiotherapist’s complained that her bulging intervertebral discs were the result of genetics.
However, since this blog series is about nutrition, I’m going to relate the fallacy of narrative exclusively in the context of food.
In the series “Medicine under the guise of dietary narrative”, I want to cover four of the most essential nutrients that I believe are highly misperceived in our civilization, and as a result, many of them are wrongly damned, adored, or ignored, or dosed incorrectly. Or a little of everything.
Humans have a natural tendency throughout their history (from the Stone Age to exponential technologies) to oversimplify complex environments, and as a result they do not evaluate all risks in the best way (or some at all). The reasons for their actions are very complex, and I don’t want to go into all their forms in this series of blogs. However, I do want to address here one specific pattern of decision making and risk assessment that people are fond of (also) in the medical and dietary fields.
So what is the mythical problem? It is the matching of unknown inputs to known outputs, or in other words – confusing causality with correlation. Nassim Nicholas Taleb described this phenomenon very nicely in his book The Black Swan and called it the “narrative fallacy”, or translated as “the fallacy of narrative”. The narrative fallacy describes the tendency of a person to invent a story (input) that illusorily justifies the existence of a phenomenon (output), with the result that the person himself thinks that he understands the phenomenon well enough.
An observant individual has surely caught another individual afflicted with the narrative fallacy at least once in his or her lifetime. Whether it was when he saw an angry gentleman at a bus stop shouting that the cause of his bad financial situation was solely due to such and such a politician, or when a despondent lady at the physiotherapist’s complained that her bulging intervertebral discs were the result of genetics.
However, since this blog series is about nutrition, I’m going to relate the fallacy of narrative exclusively in the context of food.
In the series “Medicine under the guise of dietary narrative”, I want to cover four of the most essential nutrients that I believe are highly misperceived in our civilization, and as a result, many of them are wrongly damned, adored, or ignored, or dosed incorrectly. Or a little of everything.
This section (3) deals specifically with salt and its nutritional subcategories – sodium and potassium.
“Salt will kill you!” – hissed the doctor
Just as each of us has encountered the cholesterol criticism at least once in our lives (which I wrote about in the first part of this blog series), each of us has also encountered the salt criticism. And of course, as it happens, that hatred is not only found in the interactional setting of two complaining, perfumed grandmothers waiting at a bus stop, but it is also found among the so-called “experts” in the field of medicine and nutrition who like to boast more than one college degree.
And if the poor average person, ignorant of the complexity of the world and its contexts (and dealing with the consequences of his problems by visiting titled doctors) decides to listen to such experts, he can certainly do himself more harm than good.
Studies tell us that too little salt in the diet is just as, if not more, dangerous than too much salt in the diet. The human body simply needs salt to function as such, and the ideal amount of salt intake obviously depends on a quantum of variables such as genetics, sweating rate and associated physical activity, etc.
I would venture to say that many people have a problem with extremely low salt intake these days. This is especially true for people in ketosis or people with reduced adrenal function.
For example, in my very early days with ketotic eating and ditching carbs, I didn’t have the best time at all. I found it hard to think, my limbs were poorly circulated, and the molecules of my sweat gland secretions picked up by my own olfactory receptors (or worse, other people’s receptors) indicated that my body pH was not quite normal. And it was the imbalance of salts that was to blame.
Wait a minute! But, after all, the doctor says that salt will kill us and that high salt intake is associated with high blood pressure, heart enlargement and other such nastiness.
Yes, that’s true. But only partial, as the world is a bit more complex than most doctors and their patients think. A better piece of advice from a doctor would be to admit that the key to high blood pressure is precisely an imbalance of the two essential salt minerals, sodium and potassium.
(And this is what I’ll discuss more in the chapter “What does a potassium deficiency do to the body?”).
Why does an imbalance arise?
Just like the imbalance between omega-3 and omega-6 fatty acids that I wrote about in my last blog, our culture is the one to blame for the imbalance in salt components too. We have domesticated salt and have learned to use the cheaper, more readily available and somewhat distorted offshoot.
In fact, there is a huge difference between table salt and sea or mountain (Himalayan) salt.
Such Himalayan salt is about 84 per cent sodium chloride. The rest of it is made up of naturally occurring minerals, which the human body also needs. Classic table salt, which rolls around on every grandmother’s table along with peanuts and hardened peppermint candies, contains up to 97 per cent sodium chloride. And the rest of it is a tasty bonus in the form of moisture-absorbing chemicals, anti-caking agents and similar crap (often containing aluminium) that are no longer of any use to the human body.
The fact that most sapients add table salt to their food, however, is not the only problem. A huge source of table salt, and all its nasty shapes and forms, is also the abundance of processed foods. Whether it’s a semi-finished product, or practically any product that has been salted by someone other than its buyer, it is highly likely to contain that not-so-good salt. And, moreover, in no small quantity.
So, we could say that one of the two main causes of sodium-potassium imbalance is the overconsumption of processed foods, in which salt is used not only to satisfy the culturally-fetishized tastes of the sapients, but also to increase the shelf-life of the semi-finished products.
However, the second main cause is also the low consumption of foods containing potassium.
So which foods contain the most potassium? Vegetables and fruit, after all. Unfortunately, there is no really properly saturated and rich source of potassium with which we could easily cover our daily consumption. And that’s why we need to eat quite a lot of vegetables and fruits to balance our own salt intake.
(And this is also why, in the long run, the carnivore diet is, as I have empirically discovered, a manifestation of pure insanity.)
It is estimated that our less culturally marked ancestors consumed up to about 11 grams of potassium per day, and their sodium intake exceeded one gram only very rarely. Today, 2.5-7.5 grams of salt per day are commonly consumed, while potassium intake is considerably lower.
As a country of not exactly the best nutritional extremes, the USA is again a case in point, where the recommended daily intake of potassium is 4.7 grams, with less than 2% of the population meeting this value. The majority of the US population has a daily average potassium intake of around 2.5 grams.
What does a potassium deficiency do to the body?
Well, every little kid knows that salt attracts water. This is also the principle behind the preservation of meat with salt, which in a way also takes place in the human bloodstream – the increased amount of salt binds water to itself, which increases the volume of blood. And increased blood volume means higher blood pressure (since the volume of the arteries no longer increases with blood volume).
As mentioned above, from an evolutionary standpoint, salt was a pretty big rarity, which is why our bodies cling to it so diligently. Oh, and one of the cool ways to increase your sodium excretion is to increase your potassium intake.
But in addition to sodium and potassium, we shouldn’t forget the impact of nitric oxide, which, although it looks very inconspicuous, does a lot of important things. Its role is to relax blood vessels and thus regulate blood pressure. Importantly, the sodium and potassium content of the blood has a direct influence on the activity of nitric oxide. Sodium suppresses nitric oxide activity and as a result makes our blood vessels less elastic. Potassium, on the other hand, increases nitric oxide activity, thus relaxing the blood vessels and lowering blood pressure.
Thus, increased salt intake alone is certainly not the only cause of high blood pressure. Potassium deficiency also plays a role and, of course, so do many other factors that we often encounter around us (e.g. stress, lack of exercise, lack of magnesium, poor blood circulation, cigarettes, alcohol and other civilisational excesses).
How to repair the sodium-potassium ratio?
Increasing your potassium intake (via fruit and vegetables) is a much more consistent and safer solution than reducing your salt intake to critically low levels in the first place (which, by the way, is probably what every doctor will recommend if they measure your blood pressure). Eating natural salt-mountain or sea salt, without added chemicals, and limiting processed foods is also an obvious choice. I myself use only unprocessed sea salt crystals (which are so coarse that I’ve often nearly bitten my tongue off while chewing on them) and Himalayan salt, which was not mined with any dynamite.
But how much salt do we need? If you want instructions from me a lá Mr. Bukovsky’s spreadsheet, you won’t get them. No ideal tabular value even exists. Much more important is to perceive my body (I just wrote about perception in my review of the Oura ring) and experimentally find out what works for me and under what conditions. And if you’re craving something salty, feel free to have salt, but use real salt and balance it thoroughly with potassium.
And that’s why it’s extremely important to increase your intake of foods that contain plenty of potassium. My top potassium source is definitely avocados, which are also mega-super fatty(!) and have a potassium value of about 1 gram per piece. And if I have to give avocados a full advertisement, I mustn’t forget that besides being megasuper-fatty, it also has a minimum of carbohydrates and a high content of other useful nutrients (folate, vitamin E, lutein, fiber, etc.).
In addition to avocados as a source of potassium, I don’t skip coconut milk, sweet potatoes with skin, bananas (not too many and not overripe!), hokkaido squash, or oyster mushrooms. Kefir milk is also a pretty good source of potassium, but as I wrote in my microbiome blog – I’ve also cut out kefir due to my complete elimination of dairy (except butter). I’ve replaced it with tibicos, which don’t have much potassium anymore though.
Plus, there’s nothing wrong with people with increased physical activity getting a nice binge on potassium supplementation as well. In that case, potassium in the form of citrate is the best option. You can get it in any wanna-be nutritional supplement store or even in a pharmacy, but as it usually happens, the quality of the product corresponds to the place of purchase and that is why it is usually capsules. Citrate potassium in powder form, which allows dosage according to the need and is also more cost-effective than some capsules, can be easily found for example on brainmarket.sk or through the e-shop of Mr. Marian Černý AKA “Obchod Pračloveka”.
WARNING: Citrate potassium should always be taken with food, as it can cause hypoglycemia. And this is one of the reasons for its pill-taking – the pills in the aforementioned wanna-be-shops with nutritional supplements contain a maximum of 99 mg of citrate potassium.
