Breaking news in this weeks Journal of the American Medical Association. And once again, I feel vindicated, having for years bucked an ever growing call to vilify salt as an evil demon that needed to be avoided by everyone at all costs.

It turns out that in this 8 year study on over 3600 individuals, the ones that consumed the most salt had the lowest number of deaths from heart attacks, while those with the lowest salt intake had the highest rates! In fact, the low salt consumers had 5X the number of fatal heart attacks compared to the high salt consumers. All this despite a slight increase in blood pressure seen in the high salt consumers.

How is this possible? Well first of all let's clarify that this was a study of people that did NOT have heart disease or kidney disease, two groups of people that ABSOLUTELY shoud avoid excessive salt intake. But in people with normal hearts, cutting salt intake could concievably trigger the body to secrete stimulating hormones such as epinephrine or norepinephrine to keep the blood pressure from falling too low. It could also signal the kidney to retain salt and water at abnormally high rates through the renin-angiotensin system. All these could create subtle but cumulative stresses on the heart, which could possibly explain the results.

What's the bottom line? I think the real message is that we in the medical profession have to break the habit of trying to treat every patient like they are built EXACTLY THE SAME. Simple solutions are fraught with danger, especially when faced with complex problems. We are progressing into an age where we can begin to look deep into the genetic code to begin customizing therapies based on individual genetic makeup. But we still often fall victim to the dogma of the "one size fits all" approach to treating our patients.

So rejoice friends! If you are one of the great numbers of people with healthy hearts and healthy kidneys, salt is no longer your enemy. While I still wouldn't advocate pouring salt on everything you eat, a moderate amount of salt can increase the palatability of your food and just might result in you being satisfied with smaller portions. Just remember to always check with your personal physician to see if you are someone who can break the chains of a salt restricted life.