Kempner Rice Diet

[Blossom]

More from my notes:
“Hunter-gatherer intake of calcium, for instance, was estimated as roughly twice current values (10) largely due to greater consumption of vegetables and fruits. Hunter-gatherer consumption of electrolytes was essentially the inverse of modern tendencies, with relatively elevated levels of potassium and greatly reduced (by nearly an order of magnitude) intake of sodium. This observation is explained both by the high potassium content of wild game and uncultivated plants and the fact that hunter-gatherers typically had no access to sodium chloride other than that contained in their primary foods (12).


https://escholarship.org/content/qt4wc9g8g4/qt4wc9g8g4.pdf?t=krne6g



The diet of our hunter-gatherer ancestors consisted mainly of fruit, vegetables and game, and provided small amounts of sodium (Na+) and large amounts of potassium (K+). During the late Palaeolithic times, estimated dietary Na+ intake was ∼30 mmol/day (∼690 mg/day) and dietary K+ intake was ∼280 mmol/day (∼11 g/day) [1]. This is very different from our current diet, which contains large amounts of Na+ and small amounts of K+.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769543/



Salt

The total quantity of salt included in the typical US diet amounts to 9.6 g/d (Table 1). About 75% of the daily salt intake in Western populations is derived from salt added to processed foods by manufacturers; 15% comes from discretionary sources (ie, cooking and table salt use), and the remainder (10%) occurs naturally in basic foodstuffs (50). Hence, 90% of the salt in the typical US diet comes from manufactured salt that is added to the food supply.

The systematic mining, manufacture, and transportation of salt have their origin in the Neolithic Period. The earliest salt use is argued to have taken place on Lake Yuncheng in the Northern Province of Shanxi, China, by 6000 BC (51). In Europe the earliest evidence of salt exploitation comes from salt mines at Cardona, Spain, dating to 6200–5600 BP (52). It is likely that Paleolithic (the old stone age which began 2.6 million years ago and ended 10000–12000 y ago) or Holocene (10000 y ago to the present) hunter-gatherers living in coastal areas may have dipped food in seawater or used dried seawater salt in a manner similar to nearly all Polynesian societies at the time of European contact (53). However, the inland living Maori of New Zealand lost the salt habit (53), and the most recently studied inland hunter-gatherers add no or little salt to their food on a daily basis (54). Furthermore, there is no evidence that Paleolithic people undertook salt extraction or took interest in inland salt deposits (55). Collectively, this evidence suggests that the high salt consumption (≈10 g/d) in Western societies has minimal or no evolutionary precedent in hominin species before the Neolithic period.


https://www.sciencedirect.com/science/article/pii/S0002916523275462

 

[Blossom]

I’ve basically come to the conclusion that regardless of what dietary pattern (omnivore, vegetarian, vegan, carnivore, pescatarian….) a person follows having abundant potassium intake in relation to sodium is what our bodies are expecting and most adapted to handle. I don’t think it’s far fetched that many problems could be linked to this imbalance. Certainly there are situations in sickness where more or less of one or the other is warranted though. Ultra processed convenience foods seem to be the real culprit here. We are wired to seek out salt just like calories as a survival mechanism but in our day we don’t have to look far because food manufacturers add it to nearly everything. It seems Kempner was really onto something because having people eat rice and fruit while taking in salt would have required the body to break down muscle for protein to make urea to process and excrete the sodium so he certainly spared his patients from this potential side effect. I don’t think most people need to go to those extremes though and can see a positive shift just by gradually moving towards more abundant potassium in relation to sodium. Here’s a handy calculator for those interested:

Sodium to Potassium Ratio Calculator - Calculator Pack

Sodium and Potassium are two important minerals that play a major role in the proper functioning of our body. Maintaining a proper balance between these two minerals is very essen…

calculatorpack.com

I’ve personally been aiming for less than 1 and generally fall at around 0.25 these days.

 

[mosaic01]

@Blossom: Luckily I had this reply saved that did not make it into the backup:

Potassium definitely plays a big role.

I found this interesting comment in a paper from 1958 by Lewis K. Dahl:

In other words, it was well known that salt increases stress-hormones (cortisol).

Anyway, since you mentioned the Renin-angiotensin system, I remembered that there is an increased focus on the relationship between ME/CFS and the RAS, with one of the observations that angiotensin 2 is too high but does not signal an increase of aldosterone, so blood volumes remains too low.

I then tried to find discussions around salt and CFS, but the only goal of doctors and patients involved is usually to increase salt as much as possible.

The leading CFS-researchers in Germany published this study in 2022 though:

Muscle sodium content before and after exercise was higher in ME/CFS than in healthy controls. Furthermore, our findings indicate an inverse correlation between muscle sodium content and handgrip strength. These findings provide evidence that sodium overload may play a role in the pathophysiology of ME/CFS and may allow for potential therapeutic targeting.

Muscle sodium content in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Journal of Translational Medicine

Background Muscle fatigue and pain are key symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Although the pathophysiology is not yet fully understood, there is ample evidence for hypoperfusion which may result in electrolyte imbalance and sodium overload in muscles...

translational-medicine.biomedcentral.com

“… high intracellular sodium levels are the main cause for the exercise intolerance”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058748/pdf/12967_2021_Article_2833.pdf

The intracellular sodium then leads to calcium influx and overload as well. The paper also talks about energy waste in skeletal muscle by overstimulation
of thermogenesis, which could be related to salt I think.

Another study discovered that CFS patients have 10% less potassium in their body compared to healthy people:

In line with a diminished activity of the Na+/K+-ATPase total body potassium was found decreased by about 10% in a group of patients with severe fatigue [54].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058748/#CR54

A low potassium and high sodium diet could lead to increased loss of potassium, and as a compensatory mechanism the body shuffles sodium into the cell, to protect against more potassium loss via the kidneys, since potassium is needed to excrete sodium.

So your comment on resetting the renin-angiotensin system by avoiding salt alltogether for a time makes me wonder whether that would actually be an appropriate therapy for ME/CFS, alongside a low vA diet that is also high in potassium (+5g). The potassium stores need to be refilled, and the sodium needs to be excreted from the cells.

Then there is this:

The new research found excessive salt levels can dampen mitochondrial activities in our immune cells. Mitochrondia are present in almost all cells in the human body and are a little like tiny power plants. One of their main functions is to produce a molecule called adenosine triphosphate (ATP), through a series of chemical reactions called the respiratory chain.

“The fundamental finding of our study is that a molecule as small as the sodium ion can be extremely efficient at inhibiting an enzyme that plays a crucial role in the respiratory chain,” says Kempa. “When these ions flood into the mitochondria – and they do this under a variety of physiological conditions – they regulate the central part of the electron transport chain.”

Alongside these in vitro experiments the researchers set out to study this mechanism in human subjects. One experiment involved healthy subjects eating a pizza containing 10 grams of salt. Blood was taken from the subjects three and eight hours after eating.

Studying monocytes in the blood samples the researchers found mitochondrial activity was dampened three hours after eating the meal high in salt.

New insights into how too much salt disrupts immune cell function

A new study is offering novel insights into the effects of too much salt on certain immune cells. The research reveals how salt can dampen mitochondrial functions, disrupting normal immune cell activity and potentially promoting inflammation.

newatlas.com

Also:

"The Spanish Society of Cardiology (SEC) warns that salt can already be considered a drug, not only because of the harmful effects it has on our health, but also because of its highly addictive capacity.

Thus, a study carried out on mice by the universities of Duke and Melbourne showed that the need to consume salt was the same as that related to addiction to cocaine or opiates such as heroin. Using brain imaging, it was observed that the same area of the brain was activated in both processes. Thus, when these drugs or salt were consumed, profound changes were produced in certain nerve cells of the hypothalamus, causing an increase in the size and number of neurons as well as in two specific proteins related to addiction and pleasure (dopamine and orexin)."

La sal, una droga tan adictiva como la cocaína

La sal, una droga tan adictiva como la cocaína

secardiologia.es

 

[mosaic01]

I also found a bit more:

"The connection between cognitive impairment and excessive intake of table salt, a staple in food seasoning, is well established."

"The involvement of angiotensin II (Ang II)—a hormone that plays a key role in regulating blood pressure and fluid balance—and its receptor “AT1”, as well as that of the physiologically important lipid molecule prostaglandin E2 (PGE2 and its receptor “EP1” in hypertension and neurotoxicity is well-recognized."

A Pinch Too Much: How Salt Consumption May Influence Your Cognitive Health

Researchers have pinpointed two essential physiological mechanisms that are involved in hypertension induced by high salt consumption and cognitive and emotional impairment. Defined as a deterioration of cognitive functions such as thinking, remembering, and reasoning, dementia is highly common i

scitechdaily.com

https://doi.org/10.1111/bph.16093

"Iadecola and team fed a group of mice the equivalent of a human diet high in salt for a period of 12 weeks.

After the first few weeks, endothelial dysfunction, as well as a reduction in the blood flow to the brain, could be noticed in the mice. Additionally, behavioral tests revealed cognitive decline in the rodents."

What too much salt can do to your brain

A new study shows how too much salt reduces the blood flow to the brain and leads to cognitive impairment in mice. The findings are applicable to humans.

www.medicalnewstoday.com

"Excessive dietary salt can impair cerebral blood flow regulation, resulting in cognitive dysfunction in mice. A ‘gut–brain’ pathway is implicated that links expansion of TH17 lymphocytes in small intestine to elevated bloodstream interleukin-17, which impairs brain perfusion by decreasing nitric oxide production in brain vascular endothelium."

Skip the salt: your brain might thank you - Nature Neuroscience

Excessive dietary salt can impair cerebral blood flow regulation, resulting in cognitive dysfunction in mice. A ‘gut–brain’ pathway is implicated that links expansion of TH17 lymphocytes in small intestine to elevated bloodstream interleukin-17, which impairs brain perfusion by decreasing nitric...

www.nature.com

"A first-of-its-kind study led by researchers at Georgia State reveals surprising new information about the relationship between neuron activity and blood flow deep in the brain, as well as how the brain is affected by salt consumption."

"The findings took us by surprise because we saw vasoconstriction, which is the opposite of what most people described in the cortex in response to a sensory stimulus," said Stern. "Reduced blood flow is normally observed in the cortex in the case of diseases like Alzheimer's or after a stroke or ischemia."

""If you chronically ingest a lot of salt, you'll have hyperactivation of vasopressin neurons. This mechanism can then induce excessive hypoxia, which could lead to tissue damage in the brain," said Stern. "If we can better understand this process, we can devise novel targets to stop this hypoxia-dependent activation and perhaps improve the outcomes of people with salt-dependent high blood pressure.""

Surprising findings on how salt affects blood flow in the brain

Researchers reveal surprising new information about the relationship between neuron activity and blood flow deep in the brain, as well as how the brain is affected by salt consumption.

www.sciencedaily.com

 

[mosaic01]

A couple quotes from the paper by Dahl ("Salt intake and salt need"), who is considered the most important figure in hypertension research connecting salt with disease:

View attachment 62549View attachment 62548 View attachment 62550

Together with the empirical evidence by Walter Kempner, this pretty much proves that the actual sodium requirement of healthy humans can be met by a diet that contains no added salt at all.

I think there's sufficient data to say that added salt is most of the times unnecessary and probably harmful on a diet that also contains meat, as 100g of muscle (no matter whether beef, lamb, pork, fish, etc.) contain roughly 70mg sodium and thus a meat-based diet will provide sufficient sodium.

The body is able to conserve sodium perfectly even when faced with extremely low intake, suggesting that regularly eating salt is not part of our biological make up, and should not be considered food.

It is absurd that in light of a physiological requirement of just 50-200mg, the authorities back then merely took the average intake and used that as the requirement, which is 20-50 times as much.

View attachment 62551

The body tries to get rid of the extra salt, wasting potassium, magnesium and calcium during the process and harming the kidneys.

"High sodium intake is associated with increased urinary potassium excretion (...) Low sodium intake is associated with decreased renal potassium excretion"

https://www.sciencedirect.com/topics/immunology-and-microbiology/potassium-excretion

"A high salt diet can increase the amount of calcium lost in urine"

Salt and the Kidneys - Action on Salt

www.actiononsalt.org.uk

"Magnesium retention was higher with the low-sodium diet (50.1 ± 44.0 mg/d) than with the high-sodium diet (39.3 ± 49.8 mg/d) (P < 0.05)"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628374/

A change in perspective is required. The difference between 50mg and 150mg of sodium in the diet is already massive. One has to think in terms of mg, not grams.

The attached paper from 1956 contains commentary on salt and shows how much the scientific debate has degenerated within the last 80 years. It even mentions that the protein catabolism of salt was common knowledge back then, and is not a new discovery by Jens Titze.

Basically salt and cortisone are almost interchangebly in their effects, surprisingly.

View attachment 1717265482289.png

 

[Dolomite]

I never used salt in baking or cooking for a good 30 years. I did eat peanut butter and some other prepared foods that likely had salt but I never added any while cooking or at the table. I really don't know that it helped me at the time. When I started following Peat recommendations I started using salt. Now after reading this thread I have decided to quit using salt again to see if it makes a difference. I already have low blood pressure (eg. 95/60). But if it will help me use potassium, magnesium and calcium more efficiently that would be great.

 

[Blossom]

@Dolomite, good for you!
I found this information when the forum was down.

https://nap.nationalacademies.org/read/10925/chapter/8

“In addition to reporting average responses in groups of individuals, some trials have also reported the blood pressure responses of individual participants (Table 6-5). An apparent rise in blood pressure in some individuals when sodium intake is reduced has been interpreted as a pressor response, potentially as a result of an over-active renin-angiotensin-aldosterone system. However, an alternative explanation is that an apparent rise in blood pressure reflects intrinsic blood pressure variability or imprecision in blood pressure measurement. This phenomenon is illustrated by analyses of the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial, which assessed blood pressure change across two points in time, separated by at least a month, when there was no change in diet or sodium level (Figure 6-2a), as well as blood pressure change when sodium was markedly reduced (Figure 6-2b) (Obarzanek et al., 2003). In both situations, there was a wide, Gaussian distribution of blood pressure change. Furthermore, the standard deviation of the distribution of change in blood pressure was similar, 8.4 versus 8.6 mm Hg, respectively, suggesting that much of the variability in blood pressure response to a reduced sodium intake (including an apparent increase in blood pressure in some individuals) results from random factors unrelated to sodium intake. A similar distribution of blood pressure changes was likewise evident in an intervention study (Miller et al., 1987) that measured blood pressure carefully and on multiple occasions pre- and postintervention (see Figure 6-3), as well as in other trials (Ruppert et al., 1991). In such studies, reports that certain individuals experienced a rise in blood pressure (Table 6-5) must be interpreted very carefully. Nonetheless, the group of individuals whose blood pressure apparently rises likely differs, on average, from the group of individuals whose blood pressure falls. Specifically, those individuals with an apparent rise in blood pressure experience a greater activation of the renin-angiotensin-aldosterone axis than those whose blood pressure falls (Egan et al., 1994; Weinberger et al., 1993a).

Ruppert and colleagues (1991) reported that while a rise in plasma renin activity and aldosterone concentration were observed in all subjects placed on a reduced sodium diet, the largest increases were observed in those whose blood pressure increased. Those who have the greatest reduction in blood pressure as a result of a reduced sodium intake appear to have a less responsive renin-angiotensin-aldosterone system (Cappuccio et al. 1997; He et al., 1998, 2001; Weinberger et al., 1993a).

Given the above considerations, an apparent rise in blood pressure in response to a reduced sodium intake cannot be used as an indicator of adequate sodium intake.
National Academies of Sciences, Engineering, and Medicine. 2005. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press. https://doi.org/10.17226/10925.”
It’s the first time I’ve read about others having a similar blood pressure increase when they reduced salt.

 

[Blossom]

I was also able to check out a physical copy of the book Salt, Diet & Health Neptune’s Poisoned Chalice through the university library where a family member is taking classes. I highly recommend it although it’s hard to come by and costs around $200 usd (or more) to purchase.

 

[Dolomite]

@Blossom I will be interested to see if my blood pressure goes up. It has always been low except for a short time at menopause. I hope it solves my insomnia.

 

[Blossom]

@Dolomite, mine stays at 90-100/60-70 these days so it never goes too low or too high since I made the switch (unless I eat higher sodium due to eating at a restaurant or at someone’s home). Usually in those situations it takes me a couple days to get back to normal .

 

[Blossom]

I’m probably going to ruffle some feathers here but I’ve wondered if regular salt or aspirin or both combined could have contributed to Peat’s (rumored?) stroke.

 

[Dolomite]

I’m probably going to ruffle some feathers here but I’ve wondered if regular salt or aspirin or both combined could have contributed to Peat’s (rumored?) stroke.

Sure, I think aspirin is implicated in strokes. Peat recommended keeping cortisol low but said coffee and salt, which we are learning raises cortisol, are good. Blood thinners like aspirin affect the coagulation system. It may seem good to have no clotting but the body makes and dissolves clots all of the time. I guess if using vasoconstrictors like caffeine and salt a person might feel the need for a blood thinner.

 

[Ras]

I was also able to check out a physical copy of the book Salt, Diet & Health Neptune’s Poisoned Chalice through the university library where a family member is taking classes. I highly recommend it although it’s hard to come by and costs around $200 usd (or more) to purchase.

That book is here:

Salt, diet and health : Neptune's poisoned chalice : the origins of high blood pressure : MacGregor, Graham : Free Download, Borrow, and Streaming : Internet Archive

xi, 233 pages : 24 cm

archive.org

 

[mosaic01]

I was also able to check out a physical copy of the book Salt, Diet & Health Neptune’s Poisoned Chalice through the university library where a family member is taking classes. I highly recommend it although it’s hard to come by and costs around $200 usd (or more) to purchase.

Wow, that book is such a gold mine.

For example, because the topic of calcium came up here:

For many years it has been known that if salt intake is increased there is a large increase in the excretion of calcium in the urine. Unlike salt, calcium is only partly absorbed from the gut. Very large changes in calcium intake in the food only give rise to small changes in calcium absorption and therefore, only small changes in calcium excretion by the kidney. Within the range of salt intake that is eaten currently it turns out that the amount of salt in the diet is a more important factor regulating calcium excretion by the kidney, than the calcium intake itself.

(page 181)

A high salt diet doubles calcium excretion in healthy volunteers.

 

[Blossom]

@mosaic01, yes indeed. It’s quite crucial for maintaining bone density with age. There’s a whole section on it with a cool image in Neptune’s Poisoned Chalice. I’ll probably start posting pictures from the book.
On another note-this abstract is interesting although it’s from mice. If anyone has access to the full article that would be fantastic!

Dietary salt promotes cognitive impairment through tau phosphorylation - Nature

A high-salt diet in mice induces cognitive impairment through a signalling cascade that culminates in increased phosphorylation of tau.

www.nature.com

 

[Blossom]

That book is here:

Salt, diet and health : Neptune's poisoned chalice : the origins of high blood pressure : MacGregor, Graham : Free Download, Borrow, and Streaming : Internet Archive

xi, 233 pages : 24 cm

archive.org

Fantastic! Thank you so much!!!

 

[Blossom]

A couple quotes from the paper by Dahl ("Salt intake and salt need"), who is considered the most important figure in hypertension research connecting salt with disease:

View attachment 62549View attachment 62548 View attachment 62550

Together with the empirical evidence by Walter Kempner, this pretty much proves that the actual sodium requirement of healthy humans can be met by a diet that contains no added salt at all.

I think there's sufficient data to say that added salt is most of the times unnecessary and probably harmful on a diet that also contains meat, as 100g of muscle (no matter whether beef, lamb, pork, fish, etc.) contain roughly 70mg sodium and thus a meat-based diet will provide sufficient sodium.

The body is able to conserve sodium perfectly even when faced with extremely low intake, suggesting that regularly eating salt is not part of our biological make up, and should not be considered food.

It is absurd that in light of a physiological requirement of just 50-200mg, the authorities back then merely took the average intake and used that as the requirement, which is 20-50 times as much.

View attachment 62551

The body tries to get rid of the extra salt, wasting potassium, magnesium and calcium during the process and harming the kidneys.

"High sodium intake is associated with increased urinary potassium excretion (...) Low sodium intake is associated with decreased renal potassium excretion"

https://www.sciencedirect.com/topics/immunology-and-microbiology/potassium-excretion

"A high salt diet can increase the amount of calcium lost in urine"

Salt and the Kidneys - Action on Salt

www.actiononsalt.org.uk

"Magnesium retention was higher with the low-sodium diet (50.1 ± 44.0 mg/d) than with the high-sodium diet (39.3 ± 49.8 mg/d) (P < 0.05)"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628374/

A change in perspective is required. The difference between 50mg and 150mg of sodium in the diet is already massive. One has to think in terms of mg, not grams.

The attached paper from 1956 contains commentary on salt and shows how much the scientific debate has degenerated within the last 80 years. It even mentions that the protein catabolism of salt was common knowledge back then, and is not a new discovery by Jens Titze.

Basically salt and cortisone are almost interchangebly in their effects, surprisingly.

View attachment 62556

I forgot to thank you for this sir! It explains perfectly why I noticed my body was able to manage my electrolyte balance beautifully when I stopped added salt and any processed foods with salt.

 

[Blossom]

Here’s a good one on osteoporosis.

https://www.sciencedirect.com/science/article/pii/S0022316622095621?via%3Dihub

“From the above considerations, it would behoove us to consider both the inordinate dietary sodium chloride load and the habitual dietary net acid load of contemporary American diets among the many factors contributing to the pathogenesis of osteopenia and osteoporosis in the aging population. To what extent Americans realistically will restrict sodium chloride intake remains uncertain, and to what extent such restriction is necessary if Americans will substantially increase potassium intake and its associated bicarbonate precursors remains uncertain. However, both decreasing sodium chloride intake and increasing potassium- and bicarbonate-rich precursors may likely not just help the aging skeleton but provide other potential health benefits as well.”

 

[mosaic01]

I forgot to thank you for this sir! It explains perfectly why I noticed my body was able to manage my electrolyte balance beautifully when I stopped added salt and any processed foods with salt.

You're welcome.

I went from around 8-10g salt to zero after reading this thread, and I love how my sense of taste changes. Before, when I was eating meat, it tasted bland without salt. Now it actually tastes pretty salty, as I can now taste the small amounts of sodium in it. Pretty fascinating!

I am pretty sure that's how it's meant to be.

Herbivores in the wild sometimes seek out salt licks, where they are eaten by carnivores, who are not interested in the salt at all.

It's wild how the scientific consensus on hypertension, disease and salt has been completely ignored and now even lots of people involved in health politics completely ignore the facts and just talk about "moderation". And everyone involved knows that as long as the industry is allowed to put so much salt into processed foods, nothing will ever change. I was getting 3-5g salt due to bread rolls alone.

A no-salt diet may also be important when on a low vitamin A diet that does not have much calcium.

 

[Blossom]

@mosaic01, Wow, that’s a huge change! Congratulations!!!
I’m pretty blown away by the benefits of eating no added salt myself. I’m pretty sure at this point (being conservative) that salt has been an issue for me since childhood and accounts for 33% or more of my vague and mysterious issues. Salt poisoning is hiding in plain sight and most of the people trying to sound the alarm are ignored or ridiculed. People do not want to hear about it or change their salt habits because it’s very addictive. Life honestly really is so much better without it though in my experience.