DEAR DR. DONOHUE: Salt confuses me. From one doctor I hear that I should cut down on salt because it can cause high blood pressure. From another, I hear that the link between salt and high blood pressure is not proven and that I can eat all the salt and salty foods I want. Who is right? – V.K.

ANSWER: The salt story is daunting, because the chemistry involved is complicated and because different recommendations are given by different experts.

Salt is one atom of sodium, Na, and one atom of chloride, Cl. Its chemical initials are NaCl. “Sodium chloride” is the chemical name. When speaking of salt and health, often the word chosen to represent salt is just “sodium.”

Close to 25 percent of the population are sensitive to salt and will experience a rise in blood pressure if they use too much of it. Of the people with high blood pressure, about 50 percent are salt-sensitive. Their blood pressure rises with salt use and it comes down with salt restriction.

Most of the salt we eat comes in prepared foods – soups, processed meats and obviously salty foods such as pretzels, potato chips and pickles. Only a fraction of the daily intake comes from using the saltshaker. Don’t take this to mean that people are at liberty to use the saltshaker with abandon. It would be much better not to put the saltshaker on the table and not to add salt in preparing foods. We all seem to have a salt addiction.

The usual diet in developed countries contains between 4,000 and 6,000 mg of sodium a day. The daily sodium limit should be 2,400 mg, the amount in 1 teaspoon. That is the total amount of sodium, not just the sodium added from the saltshaker.

A partial list of high-sodium foods includes: one hot dog, 700 mg; 3 ounces corned beef, 800; a frozen chicken or turkey dinner, 1,000-2,000 (but a fresh poultry dinner has only 90); 1 tablespoon soy sauce, 1,000; 1 ounce of pretzels, 450; 1 cup salted nuts, 600-1,200; a 2-ounce pickle, 700.

It’s not hard to exceed the recommended amount if a person pays no attention to salt intake.

The doctor who told you to cut down on salt was right.

DEAR DR. DONOHUE: I have been trying to learn the truth about sea salt and table salt. A nutritionist claims that one can eat all the sea salt that he or she wants.

Recently I have developed high blood pressure and have been told to watch my salt intake. Is it true that we can have all the sea salt we want? – G.

ANSWER: Sea salt is salt, the very same stuff that table salt is. When salt water evaporates, it leaves a residue of salt.

Sea salt has small amount of magnesium, sulfur and calcium. Those minerals are lost when sea salt is processed for human consumption.

You cannot eat all the sea salt you want and keep control of your blood pressure.

The sodium and potassium (sodium’s close relative) facts are spelled out in the pamphlet on these two minerals. Readers can obtain a copy by writing: Dr. Donohue – No. 202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Please advise people with epilepsy to have their blood folic acid level checked. Anticonvulsant medicines cause a folic acid deficiency. Such a deficiency increases the likelihood of having seizures. I can testify to it because my seizures stopped when I began taking folic acid. – N.A.

ANSWER: Some seizure-control medicines can interfere with folic acid absorption. Dilantin, phenobarbital and primidone are examples.

Folic acid is a B vitamin, and it is also known as folate. A folic acid deficiency leads to an anemia similar to pernicious anemia, the anemia that comes from too little vitamin B-12.

The recommended adult daily dose of folic acid is 400 micrograms; for pregnant women it is 600.

On behalf of those who have seizures, I thank you for the tip.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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