Keto Chat Episode 58: Dr James DiNicolantonio The Salt Fix

Transcription

Carole Freeman: Welcome everyone to another episode of Keto Chat. I am your host Carole Freeman, the creator of The Fast Track to Keto Success Program. I have the honor, the privilege today of interviewing Dr. DiNicolantonio, or James as he said I can call him.

Now, if you don’t know who he is yet, you’re going to love the information he’s going to share with us today because he is a cardiovascular research scientist and a Doctor of Pharmacy at St. Luke’s Mid America Heart Institute in Kansas City, Missouri. He’s a well-respected and internationally-known scientist, an expert on health and nutrition. He has contributed extensively to health policy and has even testified in front of the Canadian Senate regarding the harms of added sugar.

Welcome, welcome today. I’m so excited you’re here.

Dr James: Thanks so much for having me on.

Carole Freeman: Where are you joining us from?

Dr James: I’m joining us, Rochester, New York right now.

Carole Freeman: Okay. How’s your weather out there?

Dr James: It’s raining, not-

Carole Freeman: Oh, really?

Dr James: Honestly, I probably needed a break from the sun, though. I’d been getting my sun in and my vitamin D for the summer.

Carole Freeman: Oh, good. Raining. All right. Well yeah, don’t want to make too much vitamin D.

You’re a pharmacist. How did you get on that path? Does that run in your family or you have … How’d you get interested in that?

Dr James: Yeah, it does. Actually, my great-grandfather, he started the whole pharmacist lineage in my family. He graduated from the University of Buffalo. I think it was 1928, and-

Carole Freeman: Oh, wow.

Dr James: … my mom graduated from there and my older brother, and then I did, so it was just kind of, it’s in the family blood, so to say.

Carole Freeman: It’s in the blood. Okay. Are there like, do you guys get together at family gatherings and tell pharmacist stories and-

Dr James: Yeah, just silly pharmacist jokes that no one else who isn’t a pharmacist wouldn’t laugh at.

Carole Freeman: Oh, man. Now I want to know what those jokes are but like you said, we probably won’t get them.

Well, so you just followed the family lineage. What’s your, if you don’t mind sharing, what’s your personal health history. What’s your, what led you into writing this great that we’re going to talk a lot about, The Salt Fix.

Dr James: I really started getting interested in salt in high school when I wrestled and I ran cross country, so I knew that my performance really suffered if I didn’t up my salt intake. A lot of athletes inherently know that, but very few are actually dosing themselves with salt prior to exercise, even though you lose a ton of salt and iodine through sweat.

Even back then, I knew that just the low-salt advice for everyone just never made much sense. To me, that’s where it started. What I ended up doing is I started researching, obviously, medicine, is what I first was interested in. I started realizing that a lot of the recommendations, even medications, was not evidence-based. Once I mastered that field and published a bunch of studies, medications, I started getting more focused on nutrition.

What ended up happening, I was actually, it was like six years ago, I was bench pressing by myself, lifting heavy weight, and I tore my pectoralis tendon. Now I couldn’t-

Carole Freeman: Oh man.

Dr James: Yeah, now I couldn’t lift heavy and eat all the junk food that I wanted, so I literally had to figure out from a nutrition standpoint how can I eat something that I’m not just going to be able to burn off those calories and build all this muscle. Yeah, sure, I could handle three, four hundred grams of carbs when I was bench pressing 300 lbs. When that went away, it forced me to learn to eat healthy and start digging into the evidence. That was another spark, kind of, for me why I got into nutrition.

The real, what really happened, when I was a clinical pharmacist and … Well, when I was working in the community as a pharmacist, I was having patients coming up to me saying that they were dizzy, light-headed, their doctor put them on this low-salt diet, and [Ann 00:04:10] threw them on a salt-depleting diuretic just in the, hoping that’s going to lower their blood pressure. They were just feeling really miserable. Fatigue, exercise intolerance, muscle spasms.

I kind of let them know, I said, “You should go back to your doctor. Tell them how you’re feeling. Maybe get your sodium levels checked,” and patients were coming back to me saying, “You were right. Our sodium levels are super low, and the doctor said I could add salt back to my diet. They cut the diuretics completely out, or just reduced the dose, and the symptoms instantly improved.” When I saw that type of quick response and improvement in health, I really knew I was on to something.

Started researching and publishing in this field for about five years now, and specifically researched about three years for the book.

Carole Freeman: Oh, wow. That’s super impressive. There’s so much in there that I was, just really eye opening. One of the reasons I wanted to talk to you was this information needs to get out there. There’s so much that we’ve got wrong the last 40 or 50 years about nutrition, and our population health is really suffering because of that. I’m glad that you wrote this book because so many people need to know that salt isn’t the poison that we’ve been told it is. I love your stories in your book as well where you share examples like that where patients were coming in and complaining those symptoms.

I’m wondering. I’ve never had that experience where my pharmacist even talked to me very much, let alone listen to what I was saying. Is that new in pharmacists that you have that kind of relationship with your patients?

Dr James: Yeah, well, not, not really. What ended up happening, I’ve always been interested in research and publishing and I even started back in pharmacy school actually doing research. What ended up happening was I started realizing that information is power.

One patient of mine came up to me, single mom, she had had a stroke, and she was just extremely worried because she said, “Dr. D, if I have another stroke, I don’t know what’s going to happen to my kids.”

I had recently read some research that about 90% of people with stroke have some type of sleep apnea.

Carole Freeman: Oh, wow.

Dr James: I started going through some questions with her, like do you snore at night, do you wake up at night, do you feel refreshed in the morning, to you have a headache in the morning? Answered all the questions that indicated sleep apnea. I told her, “Why don’t you go to your doctor, let him know you’re having these symptoms, maybe get tested.” She ended up having one of the worst cases of sleep apnea.

I was like directly having this really large impact on my patients because of the information that I was researching, and so I started having these deeper conversations because of that research in my interest, and almost selfishly, it was such a gratification helping these people out. It sparked more research and more interest in nutrition.

Carole Freeman: Nice. That’s a really cool story. It’s amazing. You’re right. That’s just completely transformed her health, but not only that, but you let those kids have their mom around for longer, which is maybe more important.

I mentioned about so much of what we’ve got about nutrition has been wrong for the last 40 years, and so how is it that we got it so wrong about salt as well?

Dr James: It is kind of crazy when you think about it because everybody is now dealing with this nutritional whiplash. All of a sudden, cholesterol’s okay, and all of a sudden, high-fat diets are probably okay, the Mediterranean diet that’s high in fat is all of a sudden being vindicated. Now, salt and essential mineral. Why did we even demonize it? That was one of the questions that I really wanted to answer in my book right away.

It honestly all stems back from these 1977 dietary goals where six dietary recommendations were put out to every single American based on just opinion, not fact. They never did systematic reviews and meta-analysis or clinical studies back in 1977. Literally, if you were an opinion leader, and you said, “You know what, I think red meat is terrible for you, I think we should eat a high-carb diet. I think we should cut down fat. I think we should eliminate salt.” That’s literally what happened, and so now that we’re starting to gain evidence, we’re starting to question the 40 years of the low salt advice.

That’s kind of the, I kind of walk through even more than just the last 40 years. In the book, I go through over a hundred-year history of the, quote-unquote “salt wars” that people on both sides have been fighting this fight for so long, but to be honest, nobody has any proof that cutting salt intake is going to reduce strokes, heart attacks, prolong life, and so many people are feeling better upping their salt intake. That’s literally just what it comes down to. There’s no evidence for it, and there’s good evidence that it’s actually harmful.

Carole Freeman: I remember back in school learning about the DASH diet, which was, somebody had hypertension, that’s what you put them on was the DASH diet, and then when we went through the research on it, it said that people who followed it really well, which it’s a really hard diet to cut your salt that much, they saw a 10% reduction in their blood pressure going on that really rigorous diet.

I thought, well, okay, so somebody’s got like 190/110 blood pressure, and they get a 10% reduction from all this hard work. Is it even worth it? Is it even doing anything? That was my first clue into like, salt reduction isn’t really helping anybody get any healthier, and nevermind the fact that blood pressure, the salt isn’t causing, what’s causing the stroke and heart attack and things like that.

Dr James: Yeah. No, that a perfect example. The DASH diet is kind of what a lot of the low-salt advocates pin their hats on. Well, low salt lowers blood pressure. In the book, I kind of say, “Well, yeah. I mean, I can give you one glass of water per day and lower your blood pressure and deplete your blood volume and cause you to have dehydration. That doesn’t mean you’re healthier,” and that’s exactly what’s happening when people cut their salt intake. They’re literally just dehydrating themselves. It’s not even a good thing.

Carole Freeman: Oh yeah.

Dr James: When you can take that away from them, what are they left with? Really, the book, I try to unravel everything else that every, all harms of low salt that they’ve conveniently swept under the rug. When you add up all the harms and you see that the benefit isn’t even really a benefit, people can start understanding that low salt is absolutely terrible for you. It’s probably even worse than sugar.

Not having enough of this essential mineral seems to have the exact same effects as consuming too much sugar, like causing insulin resistance and increasing insulin levels. Honestly, salt’s like the antidote to sugar, and I have a few chapters covering that.

Carole Freeman: Yeah, well, let’s dive into that a little more because I’m sure there’s some people that, and especially those recommendations you were talking about that were made, they were, “Oh, these are prudent. We’re just … This is smart thing that we’re doing to protect everybody. Reduce their salt,” and I’m sure there’s some people that, “Oh, I’ve been following this low-salt diet. I’ve been avoiding salt for so long. How could it be bad? How could it possibly be bad for me?”

Dr James: Right. Well, if you take a look at what’s going on globally, there is a tremendous heat wave happening across the globe. In The New York Times, there was basically an article in India how the highest temperatures they’ve ever hit, and in the UK, same thing, West Coast of United States. Literally people can lose between 14 and 18,000 milligrams of sodium just standing out in the heat every day, and yet we’re told to consume less than 23,000 milligrams. Literally people are dying of salt deficiency in the heat because they’re following this low-salt advice. It’s honestly insanity.

Just from that aspect … We know exercise is healthy and we sweat out a ton of salt in our sweat, and that’s what keeps us cool. Honestly, the studies show that even out to eight hours that the salt concentration in your sweat doesn’t even go down. It remains high for eight hours. I haven’t seen studies going longer than eight hours, but for eight hours, the salt concentration in your sweat is still very high. Doesn’t dip.

That shows you that you can really become depleted in salt very quickly. If we’re trying to exercise and we’re trying be healthy or people consume a lot of caffeine, we’re slowly depleting ourselves of salt. Caffeine is a huge salt waster. When I started learning all these things that almost every American is doing … 90% of Americans are consuming some form of caffeine, and we can lose up to a full teaspoon of salt in just four hours in the urine consuming four cups of coffee. It’s a-

Carole Freeman: Wow.

Dr James: … pretty tremendous loss. When you start adding up everything that can cause salt loss, you can start to see that, wow, maybe I really shouldn’t be consciously restricting my salt intake.

Carole Freeman: Well, how about energy take. That’s a big, hot trend in some of the younger folks now is four, five, six energy drinks in a day. That’s a, I don’t know what the math is, but I think each one of those is the equivalent of four cups of coffee or something, isn’t it?

Dr James: Yeah, it’s like every week, they come out with something higher in caffeine, and it’s just a bigger salt waster. Literally 10% of Americans are consuming over a thousand milligrams of caffeine, which is an insane amount of caffeine.

Carole Freeman: Oh, wow.

Dr James: 90 milligrams in a cup of coffee, so 10% of Americans to be consuming over a thousand milligrams is astronomical. I’ve never seen studies looking at the salt loss at that type of amount, but I can only imagine one and a half probably teaspoons of salt you’re going to lose by consuming that much, maybe even more. Yeah-

Carole Freeman: Wow.

Dr James: … definitely a big issue.

Carole Freeman: Yeah, yeah. What are some of the health risks, like what’s associated with the inadequate salt intake?

Dr James: Probably one of the coolest things that I discovered when we cut our salt intake is we obviously become deficient in salt, so the body will start pulling sodium from the bone in order to maintain adequate blood sodium levels so you don’t have like an arrhythmia or you … Basically, the body fights to keep normal blood sodium level, so you can have a normal blood sodium level and actually be deficient in salt.

That’s, the body’s just pulling sodium and chloride from places in the body, and one of the places is bone. Problem is, the osteoclast aren’t super smart. They’re not just going to strip sodium from the bone. The end up pulling magnesium and calcium with them. What ends up happening then is your blood levels of calcium and magnesium go up on low-salt diets, and so it tricks the body into thinking you have too much calcium and magnesium. It shuts down-

Carole Freeman: Ah.

Dr James: Yeah, it shuts down the absorption of calcium and magnesium and then it spits more out in the urine. Literally, low-salt diets have been shown to lead to negative calcium and magnesium balance, like literally cause you to have calcium and magnesium deficiency.

If you talk to any health care practitioner, they’re always harping on, “Well, calcium is the really beneficial mineral and magnesium, that’s really beneficial too.” Well, that means that salt is really beneficial because if you don’t have enough, you’re going to be deficient in both of those minerals.

It gets way worse. Aldosterone levels increase when we cut our salt intake, and that spits more magnesium out the urine. Aldosterone actually causes the kidneys to lose magnesium. The body’s very smart. When it doesn’t have enough salt, it’ll reduce the salt concentration in your sweat, and it’ll start kicking out more calcium and more magnesium, so low-salt diets are a huge, huge calcium and magnesium waster.

Carole Freeman: Yeah, so it’s painting a picture for me that could explain a lot of why we have such a epidemic of osteoporosis and osteopenia in women that have done such a good job at following low-fat and low-salt diets for all these years. It’s just much more complex or missing. It’s not that they weren’t eating enough calcium.

Dr James: No, 100%. Sodium is extremely important. It actually drives vitamin C into the bone. Vitamin C is super important for forming collagen and creating bone strength, and it drives vitamin C into the brain as well. Honestly, when I was learning and researching all the uses of sodium in the body, it honestly just blew my mind. It’s crazy how important sodium is, but it drives so many molecules in and out of cells. It’s honestly unbelievable.

Carole Freeman: Yeah, it, and it … I think most people have no idea that it’s actually an essential mineral. It’s a essential nutrient that we need, not just something that’s stuck on the pretzels that we eat.

I … One of my clients, oh gosh. She just had kind of a stomach flu type thing where she wasn’t keeping any solid foods down for a couple of days, and her doctor told her to, “Make sure you drink some Gatorade and eat some pretzels so you can get some salt.” She’s like, “Well, why don’t I just have some salt then? Have a salty broth or something.” He’s like, “Well, you need … ” They just not even, they weren’t even thinking about other ways of being able to get salt, like we’re so programmed that salt comes in junk food, so that’s the only way we get salt.

Dr James: Right, yeah, like it’s okay to recommend salt with a high-carb intake, but we shouldn’t be recommending salt just alone because salt’s not good for us, so somehow, high-carb diets are going to wipe out the quote-unquote “harms” of salt. It just-

Carole Freeman: Yeah, yeah.

Dr James: [crosstalk 00:17:26]

Carole Freeman: I worked alongside dietitians in the past that that was their primary go-to of, well, how you eat less salt is eat less processed foods because they didn’t think about any other way that it could actually be beneficial for them to.

Osteoporosis. What other health things have you run into or conditions and diseases that are very strongly likely correlated with lower salt intake?

Dr James: Yeah, well, low-salt intake honestly probably causes the very disease states that we think it prevents, so low-salt diets probably cause hypertension, atherosclerosis, strokes, [crosstalk 00:18:06]-

Carole Freeman: People’s minds right now are just exploding, right?

Dr James: Yeah. I mean, it’s, because what ends up happening, when we cut our salt intake, all the artery-stiffening hormones increase, like by three-fold, and we block those hormones with medications to reduce strokes and heart attacks. Those hormones are called renin, angiotensin II, aldosterone. They stiffen the arteries. It can lead to left-ventricular hypertrophy and heart failure. They increase atherosclerosis formation. I mean, low-salt diets in animals actually increase atherosclerosis.

When you also look at, low-salt diets actually chronically activate the stress hormones, noradrenaline and adrenaline. Almost everybody’s going to have an increase in heart rate when they cut their salt intake, and that almost always outweighs any type of blood pressure lowering effect, which we’ve already said it’s probably a bad thing, right?

Carole Freeman: Yeah.

Dr James: To even, in the book, I kind of compare, well, what’s more important? A one point reduction on blood pressure or a four beat per minute increase in heart rate? That’s not even getting into the insulin resistance and the increase in artery stiffening hormones and all these other harms that are happening on low-salt intakes like negative calcium and magnesium balance.

I honestly believe that low-salt diets cause hypertension and cardiovascular disease. They’re tremendously stressful and hard because they raise heart rate, and they’re very stressful on the kidneys.

One of the very eye-opening points I realized how our bodies handle salt is our blood is extremely salty and the kidneys are constantly filtering our salty blood out. They actually have to actively reabsorb three and a half pounds of salt every single day, so the heart-

Carole Freeman: Three and a half pounds. That’s amazing.

Dr James: Three and a half pounds. Three and a half pounds of salt, so it’s filtering a teaspoon of salt, which is supposedly terrible for us, every five minutes. It’s like a joke.

Carole Freeman: When you put that in perspective, it’s just, it’s crazy making. It’s so funny.

Dr James: Yeah, and the body has to keep and hold on to that salty blood, and if it loses any of the salt, it freaks out. It’s very easy to let extra salt go. Requires no energy on the body, but to have to reabsorb all the, reabsorb salt when you’re on a low-salt diet is a tremendous amount of energy, so the kidney spends 60% of their basal metabolic rate just reabsorbing salt constantly.

If you eat more, the kidneys are like, “Yes. I don’t have to reabsorb more salt. I can just let some freely pass without having to actively reabsorb it.” We’ve always feared salt as being like a salt bomb on the kidneys, and it’s actually a relief on the kidneys.

Carole Freeman: Oh, wow. Yeah, that’s a totally different perspective too. One of the big things I learned from your book was talking about the relation with insulin and the kidneys’ control over salt as well. I imagine you think, you can see that low salt can lead to insulin resistant. Is it a chicken and an egg thing, like, you know?

Dr James: Yeah. It basically … How you can kind of look at it is insulin helps the kidneys retain more salt, so when we cut our salt intake, if we have a higher elevated level of insulin, that’s helping the kidneys retain more. The body becomes insulin resistant to raise insulin levels to help the kidneys reabsorb more salt. What’s crazy is the blood vessels become resistant to the vasodilating properties of insulin, and so literally your peripheral vascular resistance, like the stiffening of your arteries goes up on low-salt diets, and that’s because it’s trying to maintain blood volume. You can’t just … The arteries don’t want to dilate because blood volume is down. They gotta constrict.

Now the heart’s pumping against a more constricted artery and that can stress the heart out even more on top of the high heart rate, so literally, low-salt diets may actually lead to heart failure because if you’re pumping your heart rate … I’ve seen studies that have shown low-salt diets increase heart rate for more than 25%. If someone’s heart rate is 80 beats per minute, and it’s increasing it by 25, that’s a 20 beat per minute increase. That is an insane rise in heart rate, and you’re doing that every single minute, 20 beats per minute, every single minute more for the rest of your life.

If supposedly we only have a set amount of heart beats, low-salt diets are going to, they’re going to put you to your grave a lot quicker if that’s true, right?

Carole Freeman: Oh my gosh, yes. Oh, yeah. Wow, wow, wow. Knowing all this and all the different correlations to disease states, who do you recommend in your book to consume more salt?

Dr James: Well, I kind of go through how the ketogenic diet and starting the ketogenic diet can lead to Atkins flu or keto flu. Some people know what that is. They’ve experienced it. Honestly, most people who start a ketogenic diet do experience it, and honestly, it prevents a lot of people from continuing on because it’s very scary, especially the first week.

What ends up happening is people are consuming like 400 grams of carbs, and they just want to just fly down to 60 or less. What ends up happening is your insulin levels just, they basically sky fall. Some people’s kidneys have become so dependent on insulin to reabsorb salt that when they drop the insulin, the kidneys are just spilling salt.

If you talk to some of the leading experts, most people who are starting or initiating a ketogenic diet, they need an additional about two grams of sodium per day for the first week, and then about an additional gram of sodium per day for the next week, but some people who have really bad insulin resistance, and their kidneys have been so dependent on insulin to reabsorb salt, they may spill salt for a lot longer, so you really gotta go with your symptomatology.

If you’re still feeling dizzy or your heart rate’s jacked up or you have exercise intolerance, your muscle spasm, all these kind of volume-depleting type of signals, that’s a signal that you’re losing too much salt as well.

Carole Freeman: Yeah, and I teach my clients to think of salt as their master electrolyte because a lot of people out there that don’t know exactly how to do a ketogenic diet quite right will just say, “Well, make sure you’re supplementing with electrolytes. What I’ve found is that if people keep their sodium in check that they don’t need to supplement with a lot of those for the reasons you were talking about it. Doesn’t signal the body that they need to release magnesium and calcium from the bones at the same time. I found that that’s really great, but the heart rate one, I didn’t think of that one being correlated to. That’s another one that’s really important to notice because I know sometimes people start out with a ketogenic diet, and they can’t figure out, like, “Why is my heart racing all the time?” Not enough salt.

Dr James: Yeah. Yeah, exactly. Another patient population, so to speak, that is, obviously need more salt is people who exercise. I kind of go through, in the book, how much salt we lose per hour of exercise, but we also lose a lot of iodine, and only certain salts have good amounts of iodine. We actually lose a tremendous amount of iodine. The average person’s going to lose 50 micrograms, and we can lose a hundred or more micrograms of iodine per hour of exercise.

Thirty countries currently are considered iodine deficient. About 50 to 60 are iodine insufficient. When you start adding exercise and people are sweating out iodine, and then they’re told to go on a low-salt diet, it’s crazy, but when you are deficient in iodine, you become hypothyroid, so your metabolism is literally suffering because you’re not getting enough salt because salt real good, certain good salts provide iodine.

I cover some salts, in the book, that have good amounts and which ones are my favorite, but that’s another question I’m always getting is, what salt is the best salt?

Carole Freeman: Yeah, yeah, because I’ve had family members that say they don’t want to have, consume sea salt because they need the iodine, and so then they’re consuming table salt because of that, which, it’s going to be a lot more iodine in it than some of the sea salts out there, depends on how refined they are. I like the recommendations that you make in the book too because you actually spell it out. I hadn’t seen that before where anybody’d shown the actual analysis of what level iodine were in the different types of sea salt.

Dr James: Yeah, when I started researching the difference, I never really thought there was such a big difference between just table salt and other salts. Inherently, most people don’t really think there’s a difference, and I actually do, but I will say that I think some of the claims on Himalayan salt are a little overboard. The Himalayan salts, “Well, we got 84 minerals.”

In my mineral analysis, I show you that a lot of them are honestly a joke when it comes to the actual amount, but iodine is one that is real, so Himalayan salt absolutely has good amounts of iodine, but it’s such a wide range.

I’ve seen batches that have had less than a hundred micrograms per 10 grams of salt, and I’ve seen other batches with a thousand micrograms or one milligram, so tremendous range, which is why I stay away from Himalayan. But Himalayan might actually even have some heavy metals in it and there’s some other type of, there’s some other, I think it’s like uranium or some other crazy metals that you really don’t want, so I kind of stay away from Himalayan, like they have a few radioactive metals.

But there’s two salts that I really like. In the book, I do cover Redmond, and Redmond is from an ancient [inaudible 00:27:37] of ocean baths, so you’re getting a salt that doesn’t have the microplastics in it from modern day sea salts, from modern day oceans. I never even thought about that. Who would’ve thought salt is so nuance?

Carole Freeman: Yeah, yeah.

Dr James: Like the location of salt can actually make a difference in regarding heavy metals and microplastics. Another salt that I recently discovered is Ancient Lakes Magnesium Infused Salt. That is from an ancient lake as well, so it’s-

Carole Freeman: Okay. I’ll write that one down here.

Dr James: Yeah, it’s from Lake Debra in Australia. It’s really cool how the lake was formed. Basically, over three million years, a sea breeze carried the salt 500 kilometers inland and just created this ancient lake-

Carole Freeman: Wow.

Dr James: … and they infuse this salt with this magnesium brine underneath the salt crust. It’s got the highest magnesium I’ve ever seen of any salt-

Carole Freeman: Wow.

Dr James: … and so Celtic has always claimed to be the highest. It’s got about 40 milligrams of magnesium per 10 grams of salt, but the Ancient Lakes Magnesium Infused Salt has 44 milligrams of magnesium per 10 grams of salt, but it also has really good levels of iodine as well, and so you don’t normally see that. You don’t normally see a high-magnesium salt with good amounts of iodine. Celtic has basically no iodine, but it’s got-

Carole Freeman: Okay.

Dr James: …. good amount of magnesium.

Carole Freeman: Ah.

Dr James: [crosstalk 00:28:57] is a little bit, it’s more of a wet salt. I really like it for workouts. Right now, it comes in pouches, and I’ll take … Who wants to take a salt shaker to the gym. You honestly look insane. But it’s got this cool little pouch, and it’s got such unique flavor, like it’s the most intense flavor, so it really activates and hits me for working out, so I really like that one before I work out.

Carole Freeman: I want to ask you about the dextrose, the sugar that’s in table salt. Now, there’s a … I posted something about how dextrose in table salt, and it struck the biggest debate I’ve ever had on my own Facebook page about people saying, “Well, you have to have it because of the iodine that’s in there,” and what I could dig up was that the reason they say that they add dextrose to table salt is to protect the iodine, but I couldn’t find any mechanism of action for that. The salts you’re talking about, they’re high in iodine, they don’t have to have sugar in there to protect them. Do you have any idea if that’s true, why they put that in there?

Dr James: Yeah, that would make no sense because even the table salt without iodine, they add dextrose to it, and like you said, all the salts with iodine, they don’t have dextrose. I’ve never seen anything remotely to indicate that it’s going to protect the iodine in there, so no, I think that’s pretty much a false statement.

Carole Freeman: I figured it just had to do with food manufacturers knowing that they just add a little bit of sugar to anything, people think it taste better, and they’ll prefer that brand over other ones, so it might’ve been just along the lines of the whole sugar cereal wars where everything, sugar just got thrown into everything or [crosstalk 00:30:48].

Dr James: Yeah, right? They even put sugar in cigarettes. It’s crazy. Honestly, before, I never even looked at the back of a Morton Salt. I never even knew they put in dextrose, but yeah, in any type of food manufacturer’s mind, if I add sugar, it’s going to cause people to like it more, and it’s cheap, so why not throw it in there right?

Carole Freeman: Yeah, yeah. It’s interesting that that’s still out there on their websites is the reason the sugar’s in there is to protect the iodine but I even had a friend of mine that was really into the science stuff, and she started looking into animal feed, which has salt, iodine, and she said, “They don’t put sugar in that, so why is it that they have to put it in human salt?” All right, so-

Dr James: [crosstalk 00:31:27] because they would rather have humans addicted to the dextrose than animals, right?

Carole Freeman: Yeah, yeah, yeah. Oh, man. Could you imagine the animals having all their, the sugar addiction.

Speaking of sugar addiction, let’s talk about what you found about how low salt is associated sugar and drug addiction.

Dr James: I like to preface it by saying this isn’t just some theory. I have an entire chapter with over a hundred references on this topic. I actually wrote an entire article in Vice about this topic. It’s one of the most interesting in the topics in the book is that literally salt deficiency can potentially drive sugar and drug addiction, and there’s actually really good evidence behind it. Even animal studies show that when they deplete animals of salt, it actually cross-sensitizes with drugs of abuse. It makes, literally, drugs like amphetamine and cocaine more addictive.

If you think about it, we’ve always known that if an animal’s depleted in salt, they somehow know to go and find a salt lick. How the heck do they know to do that? They’re not smart and intelligent, and they’re not like, “Oh, I’m going to find that white stuff that saves me when I’m deficient.” The brain actually activates a reward system when animals become depleted in salt. That’s the saving mechanism, and so you get more cravings, and when you find that substance, you actually consume more of it because you have an activated reward in the brain, and so that’s the body’s smart way of getting that essential mineral so animals don’t die.

Same thing applies with humans. People want to say, they want to say that that happens to animals, and yet they want to ignore that same biological mechanism, that connection in the brain with salt intake, and that reward system can be hijacked then by sugar and drugs of abuse when it’s activated when we’re eating low-salt diets or when we’re salt deficient, and so that can be potentially why people are struggling to cut their carbs is they’re cutting their carbs, they’re salt deficient, and now their reward system is even more activated for carbs, so they’re like freaking out. They’re craving carbs even more when they try to cut them because they’re spilling more salt. It’s like this perpetual, vicious cycle.

Carole Freeman: Okay, yeah, so low-sodium intake is going to increase your cravings for sugar and carbs. Now, have you seen, can it reverse that? If somebody’s already gone down that path of drug addiction and they’re in recovery, and carb addiction, trying to be in recovery. Can increasing salts counteract that or is it too late?

Dr James: When you think about it, what ends up happening when you start consuming sugar is you start basically releasing endogenous opioids. Your body actually becomes addicted to your own opioids that you’re releasing. What ends up happening too is you’re also releasing dopamine, and so the constant high levels of dopamine eventually cause you to have a deficiency in dopamine.

What ends up happening is the body literally has a withdrawal. It’s not like you’re strung out, but you literally, your brain is deficient in dopamine during periods when you’re not consuming sugar. When you slowly stop consuming sugar, you can start fixing that change in your dopamine levels, and you can start to become less addicted to the endogenous opioids. When you up your salt intake, your endogenous opioids are going to be less addictive because your reward system is now down regulated when you up your salt intake.

Carole Freeman: If they could just have a bunch of containers of salt around addiction center, or recovery centers instead of all the sugar and sweets and cigarettes and coffee that are doing the opposite of taking, causing them to excrete even more salt. We probably see-

Dr James: Yeah, no, in … There’s the other aspect is a physiological addiction. When you become insulin resistant, you start not being able to tap into your own fat stores and your own protein stores. Literally, your body starts only being able to efficiently utilize carbohydrate and sugar, so you’re craving that molecule, that macronutrient because you’re insulin resistant, because it’s the only macronutrient you can efficiently utilize.

When you go on a low-salt diet, you’re making your insulin resistance much worse, and so that can also potentially be causing you to be craving more sugar because you’re ending up not utilizing other macronutrients well, so you crave it more, and then if you’re more insulin resistant, you’re going to have higher, basically peaks, when you consume carbs, you’re going to crash, and then that vicious cycle just continues.

Carole Freeman: Yeah. It’s making me wonder, can we consume too much salt because I know some of the people that I work with, they’re like, “Great. Salt is a cure-all for everything, and now I’m just going to eat spoonfuls of it.” Can we consume too much?

Dr James: Yeah so, honestly, in general, no. You can’t. For the last 10,000 years, we’ve consumed an extremely high-salt diet because salt was our only food preservative. We didn’t have refrigerators. We consume … In Sweden, the average person was estimated to consume a hundred grams of salt per day, and so-

Carole Freeman: Wow.

Dr James: … we only consume eight, about eight grams of salt per day. Literally everything was salted. Even a couple of a hundred years ago, in Europe in the 1700s, the average consumption was 70 grams, so about 10 times what we consume now. In the 1500s, it was 40 grams. The Romans consumed 25 grams of salt. The longest living people on the planet right now, Japan and South Korea, they consume the highest amounts of salt.

Can we consume more salt? I would say if we do, we may live longer. Can we over consume salt? The clinical studies that I have looked at, they’ve tested about 90 grams of salt, and the kidneys just get rid of it, no problem. Like we said, because they filter three and a half pounds of salt per day, and so unless you have some really specific disease state … I go through the book, some people have Liddle’s Syndrome, and you just treat it with a medication, or some people have Cushing’s and you can just treat it with a medication. You don’t need to limit salt and where food is bland.

Some people have really high aldosterone levels. You can just remove the tumor in the adrenal glands that are causing you to secret high amounts of aldosterone, or you can take spironolactone. You don’t have to limit salt. Only certain people are going to over-retain salt. Again, it’s the wrong crystal that we’ve blamed because sugar can cause us to not only over retain salt, but in the book, I show that after a while, sugar can lead to, 22 ways how sugar leads to salt deficiency because sugar literally can damage the kidneys where the kidneys start spilling salt, and they damage the intestine and cause us not being able to absorb salt well. I counsel patients with autoimmune diseases, with inflammatory bowel diseases like Crohn’s, Ulcerative Colitis. They don’t absorb salt well, and so they are really at risk of salt deficiency.

We were talking about some of the anecdotes. I literally have two family members who were put on low-salt diets. They both wound up with severely low sodium levels in the blood to the point where they literally almost died, and severe dehydration, had to be hospitalized.

One of my family members had their colon removed, and the colon helps us absorb salt. It’s just kind of crazy how a lot of medications cause us to lose salt and a lot of disease states cause us to lose salt.

Honestly, even looking at just low sodium levels in the blood, it’s the most common electrolyte abnormality both the in-patient and the out-patient setting, and then when you start looking at actual people that are deficient in salts, just symptomatically where they have elevated B1s and even though they’re consuming normal amounts of water, or they have elevations in heart rate when going from a seated to a standing position or they’re really dizzy. You start adding up, millions and millions of people are probably deficient in salt, even if they have normal blood sodium levels.

Carole Freeman: Yeah, right, right. I have found, clinically working with people, that they can tolerate about half a teaspoon at any one time as far as they’re just trying to take a shot of salt. They try to do more than that, they end up with diarrhea, nausea, and maybe even vomiting, but as far as, they could do that probably every hour and that wouldn’t be too much, but.

Dr James: Yeah, no, and what’s cool is I got some cool ways in the book how to, because trying to take it straight up can be difficult. I can do garlic salt straight up better than I can do just plain salt, but what’s really crazy is there was a study published in The Lancet. They took over 2,000 pregnant women, and they compared low salt thinking that would be beneficial to high salt. Low salt doubled miscarriages, it tripled perinatal deaths, so children-

Carole Freeman: Oh, wow.

Dr James: … dying between day zero and thirty, three times the death rate in those mothers who are restricting their salt intake. Their babies were dying at three times the rate. It literally, the salt treated their preeclampsia. They were giving these women up to 300 to 400 grams of salt a day to treat their preeclampsia.

I wouldn’t recommend that much. That’s kind of crazy. I think they went overboard, but they got these people to tolerate it by doing mixtures of lemon, lime, lemonade, stuff like that. There’s ways to integrate salt. Like you said, trying to take it straight up, probably most people are only going to be able to tolerate half a teaspoon, but there’s ways to do it if you need to consume more.

Carole Freeman: Yeah, like heated broth ends up being a really good way because it dissolves in there. I found that’s a much easier way for people to get a lot more in. They enjoy the taste of it too.

I want to ask you too about, in your book you recommend that people just follow their taste for salt and their cravings for salt, but I have run across several, especially women, that have been doing a really good job at following low-salt recommendations forever. They don’t salt their food, they don’t use salt cooking, and they find that they just don’t like the taste of salt. They say they’re just turned off of them, because their taste buds are so used to searching for salt in the food that they’re eating.

What do you say about that when people have just followed the low-salt diet forever, and they just say they don’t even a taste for salt anymore?

Dr James: I think what ends up happening is when you follow a low-salt diet, you become deficient in a lot of minerals. A lot of those minerals actually help with your tastes, so-

Carole Freeman: Oh, yeah.

Dr James: [crosstalk 00:42:02] like a deficiency in zinc causes, messes up your taste receptors, and there’s other mineral deficiencies that can cause that as well. That’s potentially what’s going on. What’s cool about salt, it’s the only taste out of our five tastes that if you get too much, the taste receptors actually flip and provide us an aversion signals, and everybody knows that. Everybody who’s consumed too much salt, it goes like, “Whoa, that’s way too salty.” No one has ever gone, “Whoa, that’s way too sugary. I don’t want that nother piece of cake or another chocolate chip cookie.” We want more of that taste, so-

Carole Freeman: That steak is too meaty. Whoa.

Dr James: Yeah, yeah, that’s, exactly. But no, salt, just again, because it’s an essential mineral, our body has so many defense mechanisms of controlling, not getting enough, and if we get too much, kind of down regulating those receptors on the tongue.

Carole Freeman: Yeah, yeah. Well, and the whole exit strategy as well, like the body getting rid of it too much if you take it all at one time as well, which it does with a lot of minerals. Yeah, that’s great.

I have a silly thought for you. You’re talking about the blood being really, really salty, so what if vampires have had it right all along, that we need to be consuming blood as one of our salts. There are societies actually that do that, right? That’s one of the places that they get their salt is from the blood of animals.

Dr James: Yeah, no, the Maasai do that, and they actually have been known to drink the urine of their cattle to get salt. One of the biggest misconceptions, even in the paleo world, is that there was this really main paper from the fathers, the two fathers of basically the paleo movement. It was published, I think, like in 1978. It was, I think it was Eaton and Boyd were the two authors in the New England Journal of Medicine. They said that even if you consume an all-meat diet, you’re only going to get 1,400 milligrams of sodium. Some of the low-salt advocates say, “Well, even if we consumed meat, we would’ve never been consuming 3,000 milligrams, we only consume 1,400.”

The problem is, is that paper didn’t look at salty sources like blood, which we did consume. We consume the entire animal back for the last three million years. We consume blood and interstitial fluid and organs and skin, all salty, but that was left out of the paper. We also consume salty insects, and we would go to salt licks. We weren’t, animals weren’t the only, whatever you want to call them, organisms going to salt licks. Humans would either follow animals to salt licks or they would just find them themselves, and if they were deficient, they knew where that salt lick was.

That’s just another kind of dogma that I’m trying to break as well in the paleo world is that from an evolutionary perspective, even if we didn’t live near the coast and didn’t consume salty seafood, we can get it through insects, through animals, even tiger nuts. There’s was one study that tested six different batches. Five of the six tiger nuts had about 3,000 milligrams of sodium per three and a half ounces, and tiger nuts were absolutely available during evolutionary times. You could just pluck them out of the ground and consume them.

There’s … We actually consume salty soils too. Clays, the pits of trees have a lot of salt, and I kind of go in the book how gorillas would follow elephants, elephants would uproot trees to get at the salty soil. They would even go into caves to lick the salt off the caves.

From an evolutionary perspective, it’s not difficult to get a lot of salt.

Carole Freeman: I wonder, you have me thinking now about our family dog. He’s an eight-month-old puppy. He’s actually my son’s dog, and they try really hard to give him a really optimal diet, but I’m wondering maybe he needs some more salt as well, because I don’t think they add salt to dog food, and he’s been licking the water around my plants and things like that. It makes me wonder, like is he trying to get the salty soil? Is he, is he, need more salt?

Dr James: Yeah, it’s funny too. If you go out for a run, anyone who has a pet knows, a dog will absolutely start licking you.

Carole Freeman: Yes.

Dr James: [crosstalk 00:46:14], I don’t know if it happens with cats too. Maybe. But I know dogs for sure because I have a dog. My dog will definitely start licking me, probably for the salt. I don’t know, I don’t know if they sweat, though, like humans, though, if they lose salt like we do, but.

Carole Freeman: I wonder if we put out of bowl of salty water for it … Now I’m going to, I’m going to do that tonight and see what he does, see if he likes that because I had the idea of like, well, salt’s bad for dogs and so don’t give them any bacon or anything like that.

Dr James: Well, just don’t do too much. Maybe research how dogs sweat because I don’t know if they sweat out salt like-

Carole Freeman: They-

Dr James: … we do.

Carole Freeman: They sweat out their tongue, I know that, that they don’t normally there but-

Dr James: That’s true. That’s a good point.

Carole Freeman: … I’m curious, then, yeah, if they have the same salt taste receptor that they would seek out that salt.

Dr James: Yeah, they were definitely not eating kibbles dog food. They were definitely getting sources of salt in blood for sure.

Carole Freeman: Yeah, yeah. Yeah, that’s totally … I’m really, really curious about that so that’s great.

Well, so let’s … Speaking of running and your dog licking you when you’re all salty, let’s dive into the sports side of this. How do people make sure they get enough salt? I have a really interesting story about that is when I was in school, our professor shared with us about hyponatremia, low sodium or severe sodium deficiency, what would be acute sodium in athletes. She and herself had been into martial arts and experienced it during a match.

I knew the story of it, and then we also have the tragic story of the radio show where the woman, it was drink your, drink … What was it? Hold Your Wee for a Wii. Did you hear about that story that … It was some radio show in California, I don’t know, 10 or 15 years ago where they had a competition where they invited people to come and drink lots and lots of water, and whoever could not go to the bathroom the longest was going to win the Wii.

It was on-air broadcast. This woman ended up dying of hyponatremia because she had drank so much water and then didn’t urinate. She diluted her sodium so much that she died of excess water. I always think about this one. People have these external ideas of like, we have to drink a gallon of water every day, these weird numbers that people come up with of the amount of water you have to drink while they’re not exercising or anything like that.

I, myself then, I was doing a bicycle training a few summers ago here in the Seattle area, and it was mid 80s, and we were out riding like 30 or 40 miles in the heat. I’m a natural whole foodist and everybody else is drinking Gatorade. I’m like, “That’s garbage. I just got my seaweed snacks. That’s going to be enough for me,” and I wasn’t an experienced athlete or anything like that.

At the end of the drive home afterwards, I was like, I feel really funny. I started getting tunnel vision. I couldn’t figure out what the heck was going on, but I remembered the story that my professor told me about, the experience of what hyponatremia is, and I’m like, oh my gosh, I gotta pull over and buy some Gatorade or something. I stopped at a convenient store and I still remember pulling two things out of the cooler and trying to decide whether I wanted artificial dye or artificial something else.

I finally just grabbed one of them. I went home that night, and I started putting salt into cups of water, and I just drank, I don’t know how much teaspoons of salt they drank that night, but it was like the best tasting beverage I’d ever had was just salt and water that night.

I think it’s highly underrated is how much sodium people lose when they’re exercising, and they think if they’re just drinking Gatorade or just drinking lots of water that they’re going to be okay, but tell us more, then, about how much salt should somebody be consuming, even just the, somebody who just goes to the gym once in a while.

Dr James: Yeah, I think you bring up a good point is that everybody is consuming water. They think that’s enough when they’re sweating. They just forget that they lose a ton of salt in their sweat. That adds to the problem because it’s diluting the sodium levels in the blood. What’s also happening is when you don’t get enough salt, you can’t get rid of that extra water without the salt, and so your body’s retaining more water because of that in that aspect.

There’s a few things … I guess in general, most people are going to lose about a half a teaspoon of salt per hour of exercise. It depends on your activity level. It depends on the temperature outside, your clothing, your genetics, how much salt you’ve been consuming. If you’re really deficient in salt, you’re not going to sweat out as much. If you’re eating good amounts, you’re going to sweat out a little bit more.

There’s a ton of factors, but in general, that’s a good rule of thumb is about a half a teaspoon of salt per hour of exercise. But when you start getting into temperatures like 90 and above, you can start losing a teaspoon or more of salt per hour, and-

Carole Freeman: [crosstalk 00:51:15]

Dr James: … so, in the book, I show how one person lost about three teaspoons of salt in just one hour of soccer practice when the, I think the temperature’s around 95, 96, something like that, so that’s a tremendous amount of salt. If we’re told to consume less than a teaspoon, and some people could be losing three teaspoons in an hour of exercise? If you’re … Let’s say you follow the low-salt advice. You’re consuming two grams of sodium, and you sweated out 6,000 milligrams. That’s 4,000 milligrams. That’s more than what’s in an entire liter of your blood, and if you just have a 10% drop in your blood level of sodium, you can literally die.

If you don’t have sodium stores to pull from, you can literally kill someone pretty quickly if they’re restricting their salt intake in the heat. That’s kind of what’s happening right now around the world is there’s a lot of people dying. They just saying they’re dying of the heat wave.

It’s actually they’re dying because they’re not putting back the salt that they’re being depleted of. Everyone’s drinking the water and making the situation potentially worse by not adding the salt back.

Carole Freeman: Is that really what heat stroke or heat exhaustion is or is it more complicated than that?

Dr James: Yeah, no, that’s pretty much exactly what it is. Ancel Keys actually showed that in 1940s. He was good for something.

But yeah, your core temperature goes up on a low-salt diet in the heat, and part of the reason why is salt allows your blood vessels to dilate, which you can release more heat, and it improves blood circulation. You can sweat more, and so you’re producing more sweat. That’s how we thermoregulate. Your core body temperature goes up when you are on a low-salt diet in the heat, and if you just add the salt back, your core body temperature will go down.

People always use the term heat stroke, and really, maybe it should be like salt-deficiency stroke, but it’s pretty interesting.

Carole Freeman: Yeah, wow. I’ve got a lot of friends that live in the Phoenix area and they’re 110, 120s right now. When you’re there, they talk about, “Hydrate, make sure you hydrate,” but they lose, leave out the part of, part of hydration is getting more salt as well so I’ll make sure I share this video with them too.

Make sure you guys eat more salt.

Dr James: Yeah, no. You were … You brought up a good point too, is like, when you went to the store to try to figure out, well, what am I going to even take? You were kind of comparing one evil to another. Artificial Gatorade this or … People can … What I do is, I make like a keto aid, like a lemon-lime salt mixture and without the sugar, and [inaudible 00:53:46]. A lot of people enjoy the lime with the salt. A lot of people alcoholic beverages with lime and salt as well. It just kind of seems to go hand in hand.

Carole Freeman: Yeah, well, and that reminds me, when I was in Austin, Texas, what was it, last month or the month before for Paleo FX, my first time there, and we stopped in one of the convenient stores to get some water and stuff, and they have this whole section in the store there of these little flavored salts.

There was a lime salt, then a chili salt, and all these things. It really struck me that as that really hot, humid area, they naturally craved saltier things, and so they had a whole section on it.

Now, I live in the Seattle area. We don’t get a lot of hot, humid, sweaty days, and so there’s not as much of that around here, but we definitely don’t have any salts. There’s a whole line of flavored salts, so they definitely have a taste for that and sell more of those products because of that.

Dr James: Yeah, they’re certainly ahead of the curve. I will say that the sports drinks, they’re not providing enough salt, and the reason is, is because who wants to drink something as salty as our own sweat? But regardless of all that, you’re still losing that amount of salt.

I think Gatorade and Powerade only have like 350 milligrams of sodium per liter, and we’re losing between about 850 to 1,250 milligrams of sodium. It’s like three to four times less in salt that you actually need, which is why most people need to add salt because it’s going to be … You don’t want to drink something that is as salty as your own sweat, so the way to do it is like you kind of said, more like a shot or just taking it, if it’s garlic salt, some people can handle a half a teaspoon straight up, but if you don’t add that extra salt, you’re not … It’s not even that you’re not replacing what’s lost.

When you dose yourself with salt … I can’t specifically give that as a health recommendation to anybody because we know what’s going on. When anyone recommends anything to anyone, they’re all of a sudden sued or they’re in front of a board of practitioners, but there are legitimate physiological facts of dosing yourself with salt. It is a huge vasodilator. It’s possible that even a half a teaspoon isn’t enough, and there’s all these potential benefits of increasing blood circulation and lowering your heart rate even further for exercise.

There was one study that show 2,300 milligrams of sodium per liter consumed did reduce dehydration. It reduced fluid loss. 2,300 milligrams of sodium is a full teaspoon of salt, and most people are going to lose about a liter of fluid per hour of exercise, so goes to show you that there are studies that have shown that adding a high amount of salt to a liter of fluid, which isn’t going to taste good, so I wouldn’t recommend doing that, you would want to integrate the salt on its own and then add the fluid, there’s real benefits to that.

Carole Freeman: Well, I just realized the shortcut that Gatorade or other sports drinks are doing is that they’ve got sugar in them, so they’ve given you the insulin response, and then your kidneys are going to retain more salt because of that. Sugar’s cheaper than salt so let’s just keep people more sugar. Plus, they think it taste better, so they’re going to buy more of it, so [crosstalk 00:57:03].

Dr James: Yeah, no, exactly. The real issues begin when your body, what ends up happening is when it’s so damaged … Can you still see me? I lost you for a second. Okay, there we go.

Carole Freeman: Oh, yeah. I can see you. Yeah.

Dr James: When we start losing our internal sea is when we start really getting some serious issues. When sugar starts damaging the intestine and starts damaging the kidneys and we can’t absorb salt anymore and we start spilling it out to kidneys, you can literally die within hours.

Carole Freeman: Oh, wow.

Dr James: It’s an … There are a lot of salt-wasting kidney diseases out there. I’m not going to list them all. I have a lot of them listed in the book but when you’ve consumed decades worth of sugar, now all of a sudden, you can’t hold on to your internal ocean, and you start spilling salt, and it’s a huge issue.

Carole Freeman: Wow. Wow. Yeah, so much good stuff here. In just wrapping this up, was there anything else that you were hoping I would ask you about or that you want to share now?

Dr James: No, honestly, we covered a lot. I’m pretty good. I think we did it justice.

Carole Freeman: Yeah. Good, good. It’s been a pleasure having you on here, and I just have one final question for you. I ask everybody on my interviews is, Meteor’s coming towards Earth today. You know it’s your very last day on the planet. What’s your last meal going to be?

Dr James: Oh my gosh. It honestly would probably just be a juicy steak with a ton of salt. I would lather that baby up with salt and just grill it real nice and …

What’s really interesting is that salt not only provides flavor but when you cook it, it provides a crust and it traps in a lot of-

Carole Freeman: Oh, yeah.

Dr James: … flavor and juices. What I do is when I cook pork chops, I’ll layer the sides of salt, like olive oil, good salt, pepper, get a nice sear, trap in the moisture, and then I’ll tilt the plate a little bit like this, and I’ll let all the salty juices form this nice salty soup, and then I’ll put a ton of spinach in it.

Salt allows you to eat healthy foods, bitter foods you never would’ve consumed, so I always like to say salt is our key, it’s our gateway, it’s a natural substance to not only eating healthy but to exercising more, and what’s better than that?

Carole Freeman: Yeah, that’s one of my favorite ways to make a prime rib is do a real thick salt crust on it. That’s great.

Yeah, well, James, thank you so much for being here and sharing this information. Hopefully we change some more lives with this information because it’s certainly a lot different than a lot of people have been doing for a long time, so I appreciate you being here. If you guys like this video, give us a thumbs up. Subscribe if you want to see more. That’s all for now. Bye everybody.