Recent Posts

Nutrition during pregnancy!

Nutrition during pregnancy!

I am pregnant! For those of you that do not know, I am pregnant! Currently hovering around 26 weeks and feeling great. This has been quite the journey. My husband and I always wanted kids. It was just a matter of time. Our original plan…

The dangers of under-eating.  My story with Hypothalamic  Ammenorea

The dangers of under-eating. My story with Hypothalamic Ammenorea

Intro After getting off birth control the end of June 2022, my period did not come back. In fact, it took almost 6 months to come back. It took me a few months to realize what was going on. I was not eating enough food…

We wrote a book!

We wrote a book!

My husband and I wrote a lifestyle/cook ebook! Available for purchase today! To purchase the book, click this link (the preferred link- we will be compensated more this way!). You can also purchase it on amazon here.

Here’s a quick description on what to expect:

Are you confused on what a healthy diet and lifestyle looks like? Want to feel better, increase energy, or lose weight? Looking for healthy recipes that are simple but also taste really good?

You are in the right place!

Married couple Jillian Buckley, Registered Dietitian, and her husband Michael Buckley, Architect, are passionate about feeling good and cooking awesome food. Through years of experience, they have developed a few key concepts that apply to anyone.

You will learn:

  • How to construct a delicious, healthy diet!
  • How to improve your sleep!
  • How to structure movement into your busy life!

And the best part, you get twenty eight of their favorite recipes for delicious weeknight meals!

Plus, our weekly shopping guide is inside!

Also the books in big font with lots of nice pictures on each page for easy and fun reading. 😃

Posted below are the first 4 pictures of the book to give you an idea of what to expect!

Huberman Lab podcast notes- How to Lose Fat with Science Based Tools.

Huberman Lab podcast notes- How to Lose Fat with Science Based Tools.

Hello everyone! I wrote notes for a Huberman Lab podcast episode that came out a few months back. The episode is called, “How to Lose Fat with Science Based Tools”. A link to the episode can be found here on Spotify. For those of you…

Why I stopped drinking alcohol

Why I stopped drinking alcohol

INTRO! I stopped drinking alcohol over two months ago.  I feel great and I do not have a desire to drink.  However, I am not here swear off alcohol forever.  I am just in a place where I am not interested.  I do want to…

Do carbs make us fat?

Do carbs make us fat?

Do carbs make us fat?  Is there something about carbs that is inherently more fattening than other macronutrients? I certainly believed in this in the past.  However through some personal, professional and educational experience, I changed my mind. In this article, I will break down why I do not think carbs are more fattening than other macronutrients.

Why this interests me!

I have been through it all.  I have tried all the diets. Vegan, low-carb, keto, carnivore.  But not for weight loss necessarily.  I have always been pretty satisfied with my weight. I have always had a normal BMI. Do not get me wrong, I have had some insecurities with my body in the past (that is for another post). But the primary reason for experimenting with different diets was due to curiosity. I wanted to know what diet was optimal for health. I wanted to know what diet would work best for my clients so they can reach their goals.

Let’s quickly summarize my dietary shifts!  Post-college, I looked down upon low-carb diets.  I thought carbs were 100% essential.  I did not understand the theory low-carb advocates were basing their claims off of. It completely contradicted my dietary approach. I practiced a generally healthy diet and dabbled in vegetarianism/vegan a few years later. This all changed when I met my husband. He practiced a low-carb diet along with some fasting.  We debated about it at first. I was totally against the idea. I had pretty strong dogma in the opposite direction. But curiosity got the best of me. I dove in. And the more I dug in, the more it made sense.  Carbs stimulate the release of insulin which shuts off fat burning and causes people to slowly gain weight.  I looked around me and the theory seemed to make sense.  All the adults in my life ate a decent percentage of their calories from carbs. Most of these adults were over-weight. I figured out the obesity crisis, it was all due to people eating carbs every day!

As you can see, my rationale was vague and driven by emotion. Looking back, I was being dogmatic (yet again!) but did not understand it at the time. It is so funny to me now because there were contradictions all around me, even with myself! I ate a moderate amount of carbs my whole life. I was a normal weight. In addition, I knew a decent amount of adults on a high-carb diets who were normal weight. Lastly I knew people who gained weight on low-carb diets. Shouldn’t that be enough to doubt the theory? But the power of dogma man, it hits people like me hard!

So ignored the clear contradictions and decided to advocate for this dietary approach. I also applied it myself. As you can see in my previous blog posts, I was hooked.

However after 1-2 years on this diet, I did gain a little weight.  Not much, about 5-10 pounds. I was not terribly concerned about this (I have come a long way in body acceptance) but it did get me questioning this approach.  How could I gain weight if this model was true?  I started to question the dogma. I began to experiment with my diet again. I simply started counting calories. I appropriately minimized my calories. Just enough to stimulate steady/slow weight loss. It worked and I lost the little weight I gained. No issues with hunger!

During this time, I also noticed that some of my clients on low-carb diets were gaining weight or plateauing. I knew it was time to dig deeper into the research. I needed to understand the issues of the carb insulin model of obesity (CIM)- the theory that was driving low-carb advocates to believe carbs were fattening.

Here is what I discovered!

What is the carb insulin model of obesity?

The carb insulin model (CIM) of obesity theorizes that diets higher in carbs are particularly fattening due to the fact that they raise insulin.  In this theory, it is explained that insulin directs the partioning of energy towards a storage of fat in adipose tissue.  Fuels are partitioned away from metabolically active tissues, resulting in internal starvation.  In response, hunger and appetite increase and metabolism is suppressed.  This starvation causes us to want to eat more.  

Issues with the carb insulin model of obesity

Protein also cases a release in insulin

The carb insulin model claims that pumping insulin continuously causes obesity. Therefore, reducing carbs that trigger insulin would improve obesity. However, protein also triggers insulin release. So why are we focusing solely on carbs impact on insulin if protein triggers it as well?

Another thing to note is that high-protein diets are very effective for weight loss. It has been shown that a higher ratio of protein in the diet can improve satiety, aiding in weight loss. If insulin was the main driver of obesity, and protein stimulates insulin, how can we explain the effectiveness of high-protein diets on improved satiety and weight loss?

No internal starvation

The CIM is predicated on this idea that after a high glycemic meal, there is a low availability of fuels in the blood stream (fats and carbs). This internal starvation triggers hungers.

This is somewhat true, but not as impactful as people may think. Yes after a very high-carb low-fat meal, sometimes we can experience post-prandial hypoglycemia. This is when glucose goes lower than pre-meal values. This results in symptoms of shakiness and dizziness that create the desire to want to consume carbs. This is because our body likes glucose to stay in a certain range. If it goes lower than this preferred range, our body freaks out a bit. However, most people are not just eating lots of carbs in isolation. Therefore, they are usually not experiencing this post-prandial hypoglycemia. If you do not feel shakiness or dizziness 3-4 hours after a meal that contains carbs, than you are not experiencing this “internal starvation.”

I have a lot of experience assessing client’s glucose data. 100s of people at this point. When people consume a modest amount of carbs with meals along with carbs and fat, they are usually not experiencing these huge spikes and crashes. Glucose goes up and down back to where it was before the meal. So a balanced meal of protein (chicken, fish, eggs), fats (fatty meat, avocado, oil, cheese) and carbs (rice, apples, potatoes) usually does not result in reactive hypoglycemia, triggering an intense desire for carbs 3-4 hours later.

Another issue with this idea is that obese people (the people that this theory is primarily targeting) do not have less energy availability in the blood stream. In fact, they have too much energy in the blood stream (1,2, 3, 4) .

In addition, insulin has been studied to regulate hunger. It is speculated in animal research that elevated insulin signals to the brain to reduce intake. The fact that there is research that demonstrates how insulin actually improves hunger contradicts another aspect of this theory.

Hunger is complicated

You may read the above statement and think wow insulin inhibits hunger, I should eat a high carb diet! But hunger is quite complicated and MANY hormones play a role in it. Leptin, CCK, ghrelin, amylin, GLP-1 are other hormones that play a role in regulating hunger.

It is actually believed that when examining all of the hormones involved in metabolism, Leptin may be the most influential. Not insulin. But that is a topic for another article. You can find some good information on leptin’s impact on hunger here.

We should not narrowly focus on one particular hormone as it relates to hunger. As we can see, so many hormones influence hunger. Focusing on one can be counter-productive and take us away from the big picture.

More contradictory information

Semaglutide is one of the most effective pharmaceutical obesity treatments on the market. This drug induces large reductions in fat mass. This is due to appetite suppression. This drug significantly increases insulin secretion. However over the long term, it improves insulin sensitivity due to weight loss. 

I think drugs like this are very interesting. It demonstrates how complex insulin sensitivity is. Improving insulin sensitivity is not as simple as reducing the amount of insulin that is secreted. Clearly this is not the case if a drug increases insulin secretion but insulin sensitivity improves with time.

But doesn’t insulin inhibit fat burning?

Yes technically insulin inhibits fat burning (lipolysis), in the moment. Lipolysis is when fatty acids are released from fat cells and moved into the blood stream for energy. But this is simply because in that moment, the body does not need to burn body fat because carbs are available for fuel. But after those carbs are burned, and insulin lowers in a few hours, lipolysis continues to build up again.

Insulin stimulates lipogenesis (the creation of fat). Fatty acids are moved from the blood stream into fat cells where they are stored for later use. In addition, insulin can promote carbs to be converted to fat for storage (de novo lipogenesis). BUT this only happens when carbs are consumed in excess.

Again it is really important to look at the big picture. Fat burn/storage is constantly in flux. That is why it is important to look at the average of this flux, not just one moment in time!

Insulin’s main job is not to make you fat!

You may read the above statement and still come to the conclusion that carbs should never be consumed. If carbs stimulate insulin and insulin promotes fat storage and inhibits fat from being burned, shouldn’t we just avoid carbs?

Insulin is not trying to make you fat. It is simply partitioning nutrients that are burned. Instead of burning the fat on your body, insulin is inhibiting fat burn in the moment so that carbs and protein can be burned for fuel. Your body just wants to use what is accessible.

I like the following example that I found through this blog post on prescisionnutrition.com. Say you have to buy some soda. You have $10 in your pocket but $100 in the bank. You would use the money in your pocket right? It is just easier access!

It is also important to note that our hormones are complicated. When insulin is elevated, it is not like other fat burning hormones are completely shut off. Lipolysis (the breakdown of fat) can be stimulated by hormones like glucagon, epinephrine, norepinephrine, growth hormone and cortisol. Lipogensis (the creation of fat) can be inhibited by leptin, growth hormone, cortisol. These hormones can all be activated at the same time as insulin. It is not like they completely go away when insulin is active.

So as we can see, there are many hormones involved in metabolism and weight loss independent of insulin. Another one of these hormones is Fibroblast growth factor-21. This hormone decreases appetite, decreases carbs burned for energy, increase fat burn, improves glucose control, increase brown fat activity. All the stuff that we want!

Overeating excessive carbs actually stimulates this hormone. However, overeating fat does not. Under certain conditions, FGF-21 can override insulin to stimulate lipolysis (fat burning).

So if insulin is the end all be all, how does this hormone fit into this model?

That is why I think it is important to think of insulin more like a dimmer rather than an on-and -off switch (another analogy I stole from precision nutrition article). Sure insulin may slightly reduce the impact of fat burning/fat storage hormones momentarily but it does not entirely.

Insulin decreases in diabetes

As insulin resistance progresses, insulin secretion actually decreases. According to the CIM, we should see weight loss accompany this decrease in insulin. However this is not the case. We usually see an increase in weight gain as insulin resistance progresses as people develop diabetes.

Fat can be stored without insulin

If you fixate on insulin so much, you may think that this is the only hormone involved in fat storage. Why consume carbs if they drive up the fat storage hormone insulin? With this mind set, you may replace carbs with fat. However, fat can also be stored as fat without insulin. Dietary fat can be stored as fat via a protein called acylation stimulating protein (ASP). It is also important to note that 98% of fat in our fat cells comes from dietary fat. Only 2% comes from dietary carbs.

Does insulin reduce our metabolism?

Metabolism is related very strongly to body size. The larger you are, the higher your metabolism. The smaller you are, the lower.

When we lose weight, our metabolism decreases with weight loss. Typically, this reduction is even greater than you would expect. So say you went from 200 lbs to 150 lbs. At your new weight of 150 lbs, your metabolism is lower than someone who stayed at 150 lbs their whole life.

This is called metabolic adaptation. This metabolic adaptation where BMR decreases is why weight loss is so difficult for so many people.

The CIM argues that elevated insulin is the cause of this. The idea is that since insulin directs fatty acids out of the blood stream toward fat cells and away from metabolically active tissue like muscle, metabolic rate is decreased.

However, research shows the opposite of this! Insulin actually increases fatty acid intake in the muscle.

There has also been studies done on this topic. In 2017, Kevin Hall examined 32 calorie-matched controlled-feeding studies that compared low-carb and low-fat diets and their impact on energy expenditure.

Energy expenditure was 26 calories higher on the high-carb diet. So slightly more calories were burned on the high-carb diet!

There was some criticism of the study however. One was that the studies only lasted 2.5 weeks. According to low-carb proponents like Dr. Ludwig, fat-adaption takes 2-3 weeks. Keep in mind that there is no valid way to determine if someone is fat-adapted.

CIM propenents like to cite Ludwig’s study which lasted longer, at 20 weeks.

Ludwig study

In 2018, Ludwig had particiapnts lose 10.5% of their body weight on a calorie-restricted diet (45% carbs- not low carb) in 9-10 weeks. The dieters then switched their diet after the 9-10 weeks. For the following 20 weeks, the dieters were put into 3 groups. Low-carb (20% carbs), moderate carbs (40% carbs) and high carb (60% carbs).

The participants on the low-carb diet expended 278 calories more per day compared to high-carb dieters. Moderate-carb dieters burned 131 Calories more per day than high-carb dieters.

There were a few issues with this study though. One is that the reporting materials and statistical analysis faced scrutiny. Another issue is that the participants were not in a controlled setting. They did not practice this diet under supervision. So it is hard to know if they actually followed this.

Lastly, the participants on the low-carb diet did not lose more weight than the higher carb diet.

More studies!

Metabolic-ward studies are where participants stay onsite for the duration of the trial. In one study, 17 male-participants lived in a metabolic ward for 2 months. Everything they ate was controlled. They spent the first 4 weeks on a high-carb diet. They spent the next 4 weeks on a low-carb diet. Calories and protein were the same. There was a negative calorie balance of 300 calories per day. When people were on the high-carb diet, they produced 22% more insulin throughout the day, an increase in 53 calories burned per day, and lost on average 4 lbs. On the low-carb diet, there was no change in insulin, no change in energy and they lost on average 3 lbs.

So yes both diets produced some weight loss. But even with less insulin on the low-carb diet, there was not an advantage in weight loss and improved metabolism.

Conclusion

I do not want people to read this blog post and conclude I am against low-carb diets. Far from the case. I have found a lot of success with my clients on low-carb diets. Many studies support that low-carb diets are awesome for weight loss, at least in the short term. I think they are effective for many reasons. One is that they make restriction easy. Cutting out carbs is mentally easier than counting every calorie you consume. I notice this when I explain calorie counting to my friends, family and clients. It can start to stress them out. I can totally understand why they would be more drawn to simpler rules. In addition, low-carb diets tend to be higher in protein. Higher protein diets have been shown to be more satiating, further reducing caloric intake. Lastly many people who switch to a low-carb diets end up eliminating more processed foods. We have a tendency to overeat processed foods relative to whole foods. The combination of refined fat + sugar is particularly attractive to our brains. By cutting out these foods out, a caloric deficit is easier.

I also want to note that out of all the diets I have counseled people on, it appears that a moderate to low carb diet is the most effective in terms of satiety and weight loss. Sure I have seen other diets work. Yes I understand the research. But in my experience, 33-40% of calories from carbs (or less) is a good sweet spot.

With all this said, I have come to the conclusion that there is nothing magical about low-carb diets. At the end of the day, weight loss comes down to calories. I wish I could say the answer was sexier than that!

So why did I spend so much time breaking this down? One, I think believing that certain foods are more fattening than others can create a negative relationship with food. By eliminating foods, it can drive anxiety around food. Stress management is important to health as well. In my experience, the more that we can eliminate anxiety around food, the healthier we tend to be. I have also found that eliminating foods can increase the propensity to binge on them. The more novel we make a food, the more appealing it appears to be. This can increase the propensity to binge. There is always a way to incorporate in the foods we love and maintain good health. I find it refreshing to know that consuming 1 cookie is not going to make me gain 5 lbs on the spot. If I am aiming for 1600 calories per day to lose weight and I have 200 calories left at the end of the day, I can eat that cookie and still lose weight. Yes I understand cookies are less micronutrient dense and less satiating than chicken.

But let’s be realistic, are we going to avoid sweets forever? No. Typically what I see people try to eliminate these foods they end up binging on them later. Now is that healthy? Learning how to eat these foods in moderation is key to success. Learning that this is just a food and there is nothing novel about it will reduce the drive to binge.

So what is my recommendation for weight loss? If you want to lose weight, I recommend a calorie-restricted diet that is high in protein. To determine your caloric-needs to facilitate weight loss, I recommend checking out this article I did on the topic. But let’s be real, the journey to weight-loss is hard. It is more complex than just reducing calories. There is a lot of psychological change that must be made as well. That is why I will be developing a step-by-step guide on how to reach your weight-loss goals. My plan is not only explain how to calorie restrict, but how how develop habit changes and cook as well. Tune in for that soon!

Also if you want to learn more about the issues of the CIM of obesity, I recommend checking out this and this. Both articles were super helpful in developing this post.

Hope you enjoy!

Gut health and glucose

Gut health and glucose

Background  What is the gut?  The gut is a long hollow tube that starts at the mouth and ends at the rectum.   Think of the gut like a row of dominos.  If the first does not fall, the others will not either.   Why care?  Digestion …

Calorie and macro tracking to maintain and/or lose weight

Calorie and macro tracking to maintain and/or lose weight

Why bother counting calories and macros? I am not the biggest fan of counting calories.  For weight loss and maintenance, my general recommendation is to focus on foods high in protein and low in fat and carbs.  This information is usually enough for weight maintenance or…

The Salt Fix- a book review

The Salt Fix- a book review

What is “The Salt Fix” and why should you care?

During my nutrition education, I was educated to believe that excessive consumption of salt leads to hypertension. This seemed to make intuitive sense at the time. I associated salty foods with processed foods such as french fries and fried chicken. Therefore, I conflated the deleterious effects of processed foods with salt. However after digging into the science a bit deeper, I have come to realize that salt may not be as bad as I originally thought. In fact, we may need to be consuming more to achieve optimal health.

The Salt Fix is a book written by Dr. James DiNicolantonio, a Cardiovascular Research Scientist and Doctor of Pharmacy at Saint Luke’s Mid American Heart Institute in Kansas City, Missouri. He has published over 200 scientific papers in the medical literature. The Salt Fix is about why our preconcieved notions about salt are wrong. According to Dr. James DiNicolantonio, salt intake is in fact not the driver of hypertension. Sugar and processed carbs are. In this book review, I will go over Dr. DiNocolantonio’s main points and my thoughts as to why I think the concepts of this book are important.

What is salt and why is it important?

Salt is an essential nutrient composed of sodium and chloride. Essential nutrient means that we must consume it in order to live. Without consuming salt, we would be dead. Sodium is needed for many functions in the body including:

  • maintenance of optimal blood in the body
  • by the heart to pump blood
  • digestion
  • cell-to-cell communication
  • bone formation and strength
  • prevention of dehydration.

When dissolved into water, Na+ is the main positively charged electrolyte and Cl- is the main negatively charged electrolyte in our blood. They have the highest concentration in our blood compared to any other electrolyte. 99% of the electrolyte concentration of our body consists of Na+ and Cl-.

Our bodies have the same mineral concentration of NaCl (salt) as the ocean. In order for us to survive outside the ocean, we evolved to develop salt regulating systems such as skin, adrenal glands and kidneys to maintain a specific concentration. Without a specific concentration of these essential nutrients, we die.

“Compared to the dramatic changes in the form, structure, and function of organs that occurred during vertebrate evolution, the fact that the electrolyte makeup of the extracellular fluid has generally remained constant suggest that salt balance is an evolutionary adaptation.”

The Salt Fix by Dr. James DiNicolantonio, p. 17

Our hypothalamus, a part of our reptilian brain, both receives and transmits signals that drives us to drink water and obtain salt.

Our adrenal glands produce hormones that also regulate our salt balance. During times of stress, our adrenal glands produce cortisol that causes a release of sodium from our skin to help us have more energy. Aldosterone is another hormone produced from the adrenal glands that helps us reabsorb salt from the kidneys when sodium in the blood is low.

Our kidneys work hard to maintain a certain salt balance. 70% of the basal energy expended by the kidneys is used to reabsorb salt. On average, the kidneys filter between 3.2 to 3.6 lbs of salt per day. This is 150x the amount of salt we consume daily. We are told that 2,300mg of salt is too high but our kidneys filter this much every 5 minutes. The amount of salt we consume is a drop in the bucket compared to what the kidneys deal with.

History of salt consumption

Humans have been consciously mining salt for at least 8,000 years. Salt mining started in China but spread to other parts of the word such as Egypt, Jerusalem, Italy, Spain and Greece. These countries also traded salty foods such as fish, fish eggs, olives and cured meats. Here are some interesting facts about our history of salt consumption and it’s correlation with heart disease:

  • The average Roman consumed about 25g of salt (10mg of sodium) per day.
  • 16th century Europeans consumed about 40g of salt (16mg of sodium) per day. 18th century Europeans consumed 70g of salt (28mg of sodium) per day.
  • 1500s in Europe, people consumed about 40-100g of salt per day. First report of heart disease did not occur until the mid-1600s.
  • Overall, consumption of salt was at least 2-10x more than today.
  • At least 14 countries consume a higher salt diet but have lower rates of CVD (coronary vascular disease).
  • Japan, France and South Korea have some of the lowest rates of death due to coronary artery disease
  • The average Korean eats 4,000mg of salt per day.
  • In one Korean study, the group that consumed the most sodium had a 13.5% lower prevalence of hypertension compared to the group consuming the lowest amount of sodium.
  • US Army rations are a good reflection of our previous salt intake. The army rations of the War of 1812, the Mexican War and Civil War included 18 grams (7,200 mg sodium) per day.
  • Compared to the 1900s, hypertension if about 3x as high despite salt intake being the same.
  • History of hypertension in the US:
    • Early 1900s, 5-10% of the population
    • 1939 in Chicago- 11-13% of the population
    • 1975- 25% of population
    • 2004- 31% of population
    • 2014- 1 in 3 Americans have hypertension

Taking into account these historical facts, we can intuit that hypertension is probably not predominantly driven by excessive salt intake. Why does our government tell us to restrict our salt intake? What is the evidence for this recommendation?

The salt-blood pressure hypothesis

Since the 1977 Dietary Goals, Americans have been told to restrict our salt consumption. This stems from the “salt-blood pressure hypothesis” that has been theorized since the 1900s. The theory is that when we eat more salt, we get more thirsty. Increased thirst leads to drinking more water. This leads to us retaining water to dilute the saltiness of the blood.

However when we look at the actual data, there is little to support this theory. We have only been able to show a slight increase in blood pressure with increased salt intake in SOME people. We have extrapolated this data to an entire population, not considering the potential harms of severe salt restriction. According to Dr. James DiNicolantonio, 80% of people with normal blood pressure, 75% of people with prehypertension and 55% of people with hypertension are not sensitive to the blood pressure raising effects of salt. In one systematic review of eight randomized controlled trials looking at salt restriction of greater than 6 months, there was a decrease in blood pressure by only -1.3mmHg in people with normal blood pressure and -2.9 mmHg in people with hypertension. Studies have consistently shown that during a true blood volume expansion, it takes 75 minutes for blood pressure to increase. That is more than enough time for the kidneys to excrete excess salt and water.

Clearly, lowering salt intake is not the most effective lever to pull to reduce blood pressure. What may be a better tool? What is the root cause of hypertension?

What raises blood pressure? Sugar!

According to Dr. James DiNicolantonio, there is a stronger correlation between sugar intake and hypertension compared to sodium intake. Here is a brief history of Americas sugar consumption throughout the years:

  • 1776- 4 lbs per person per year. Equivalent to 1 tsp of sugar in coffee per day
  • 1909-1913- 76 lbs per person per year.
  • 1950- 100 lbs per person per year.
  • Increase of 30 fold from 1776-2002.

As previously stated, out salt intake has not increased in recent years and has dropped 2-3 X less than previous centuries. Therefore, sugar is more strongly correlated with our increase in hypertension, not salt. Lets look into why that may be!

How sugar may increase blood pressure

It has been know for some time now that people with diabetes are more likely to develop high blood pressure. The reason being is that many diabetics have hyperinsulinemia, meaning they have chronically high insulin. Insulin is a hormone excreted from the pancreas that shuttles sugar out of the blood stream into cells. When it is high all the time, insulin resistance can develop which leads to diabetes. 80% of people with hypertension have insulin resistance.

Why would chronically high insulin lead to hypertension? Insulin stimulates the reabsorption of sodium in the kidneys. Rather than excreting the normal amount of sodium in the urine, the kidneys reabsorb sodium when insulin is high. This constant reabsorption of sodium causes high blood pressure.

Another way in which sugar increases risk of developing hypertension is through a rise in cortisol. Cortisol is a hormone excreted out of our adrenal glands when we are stressed. Excess cortisol in the body has been known to increase hypertension in those with certain conditions such as Cushings Syndrome, chronic renal failure and hypertension. One way in which cortisol increases risk of hypertension is through causing insulin to rise. Again insulin signals to the kidneys to reabsorb sodium. If sodium is constantly being reabsorbed and never released, this can result in high blood pressure.

Weight reduction has also been shown to reduce blood pressure. In one study, 25 obese people were randomized to either eat a normal sodium intake of 2,760 mg of sodium per day or a low sodium intake of 920mg per day. Both groups consumed a reduced calorie diet. Both groups blood pressure fell equally with the weight. Weight loss also reduces insulin in the body, therefore reducing the reabsorption of sodium, decreasing blood pressure.

So we now know that sodium is an essential nutrient. We also know now that sodium is not as influential on raising blood pressure as we previously thought. Why should we consume a certain amount of salt? What are the consequences of a low salt diet?

Consequences of a low salt diet

There are many potential consequences to consuming a low salt diet. When we do not consume an adequate amount of salt, our body activates rescue systems to retain water and salt. The body responds to low salt intake by increasing substances such as renin and aldosterone along with noradrenalin and adrenalin to reabsorb salt and maintain proper blood volume. However there are consequences to chronically activating these systems. One consequence is increased heart rate. Increased heart rate increases our risk of developing heart disease by putting more pressure on the arteries and decreasing the amount of oxygenated blood that gets into the heart.

Sodium is necessary for proper blood volume. When intake is low, blood volume is reduced. Studies have shown a decrease in blood volume by 10 to 15 % on a low sodium diet. Low blood volume can lead to problems with the cardiovascular and central nervous system, thermoregulation issues, metabolic abnormalities and heat stroke.

Low sodium in the blood (hyponatremia) is a very serious condition. In fact, it is the most common electrolyte abnormality. 65% of cases are cause by gastrointestinal disorders. In the elderly, hyponatremia is over 31 X as prevalent as hypernatremia. Mild hyponatremia puts you at high risk of cardiovascular events. Symptoms of hyponatremia include anorexia, cramping, nausea, vomiting, headache, irritibaility and disorientation. Neurological symptoms such as seizures, coma and brain damage can also occur. Hyponatremia can be caused by many conditions such as medications, diseases and overexercising in the heat. Hyponatremia is not usually caused simply by under consuming salt. Again this is because the body has systems in place to increase sodium reabsorption and maintain normal sodium levels. However it is interesting to examine the dire consequences of low blood sodium. It demonstrates just how essential this nutrient is.

So if low sodium diets are so dangerous, how much salt should we be consuming to maintain optimal health?

How much salt should we be consuming?

Optimal range is between 3-6 grams per day (1 1/3 to 2 2/3 tsp of salt). The only people who should be limiting their salt intake are people who have diseases that make them especially sensitive to the negative effects of sodium on their blood pressure. Listed below are the exceptions:

  • Hyperaldosterosim
  • Cushings Disease
  • Liddle Syndrom

People with these conditions have hormonal disregulation, preventing sodium from properly excreting from the body. For the rest of us, the body is very good at excreting excessively consumed salt or storing it in the skin and organs.

Listed below are conditions in which one should be consuming MORE salt. The conditions listed below deplete the body of sodium, increasing our need to consume more:

  • Overconsumption of sugar
    • Leads to kidney problems causing salt wasting
  • Chronic diseases like hypothyrodism, adrenal insufficiency & congestive heart failure.
  • Antidepressant and anti-psychotic medications
    • Cause hyponatremia by triggering over secretion of antidiuretic hormone, leading to water retention. This dilutes sodium in the blood.
  • Diuretic medications
    • Loss of water and sodium from kidneys
  • Over consumption of coffee.
    • Coffee acts as a natural diuretic, flushing water and salt from the kidneys.
  • Intense exercise
    • Depletes the body of sodium through sweat.
  • Low carb and intermittent fasting diets.
    • These diets dramatically reduce insulin in the body, causing more sodium to be excreted.
  • Traumatic events (burns, trauma, hemorrhage)
    • Injured regions draw in more water to aid in healing process. Less fluid is available to other areas. An increase in sodium would help carry fluid throughout the body.
  • Hyponatremia (low sodium in blood) treatment.
    • Most cases are caused by gastrointestinal disorders but are also caused by certain medications and diseases. Low sodium in the blood is the most common electrolyte abormality.
  • Diarrhea
    • Cause loss of fluid and sodium

As stated earlier, in most conditions, the kidneys are very good at excreting any excessive salt. But there are many conditions that deplete the body of salt, prompting us to increase our intake to help our body work its best. Proper salt intake allows out body to have proper blood circulation. This is important so that our cells can receive the oxygen and nutrients they need to work their best. Overall, in my perspective, the benefits of adequate salt intake very much outweigh the potential side effect of a slight increase in blood pressure.

Summary, my thoughts

The Salt Fix had a profound effect on shifting my perspective on salt’s effect on blood pressure. Sure, salt may raise blood pressure in SOME genetically susceptible people. However this effect is a lot less than one would assume. Additionally most people do not experience a rise in blood pressure and some people even see an increase! Our bodies are very capable of excreting excessively consumed sodium. The side effects of limited salt intake could be potentially dangerous as the body has to activate rescue systems such as renin aldosterone along with norepinephrine and epinephrine to reabsorb salt. Over activation of these systems can result in increased heart rate, increasing our risk of heart disease. The very thing we are trying to prevent with a low salt diet! A more effective lever for reducing blood pressure is reducing intake of sugar/ refined carbs and weight loss. Reducing our consumption of sugar/refined carb and reducing weight reduces insulin. A decrease in insulin reduces sodium retention, causing blood pressure to reduce naturally. Adequate salt intake is necessary for adequate blood flow, maintaining adequate blood in the body, cell-to-cell communication and carrying out electrical impulses.

If you are on a low carb or fasting diet, excessively exercising or on certain medications (SSRIs), you may benefit from adding a little more salt to your diet. If you have further questions about this, feel free to reach out to me or check out Dr. James DiNicolantonio’s Book. Thanks for checking out my page!

How to make your own Caesar Salad!

How to make your own Caesar Salad!

What is Caesar Salad? Caesar Salad is a leafy green salad that consists of romaine lettuce with a dressing of egg yolks emulsified with olive oil and lemon juice mixed in with anchovies, garlic, dijon mustard, parmesan cheese, salt and black pepper. The salad was…