Salt And Gout – The Controversial Issues

Try to ask those patients with hypertension, what strikes a chord when they heard the word salt? They will certainly relate it to the cause of their sufferings.

To the majority, salt features terrible notoriety for their health condition. Despite the recommendations from public health advocates to reduce the consumption of salt in the diet, new research might suggest the opposite.

Juraschek et al. amazed other scientists with their findings which revealed that a high-salt intake could reduce gout triggers.

The controversial issues relating salt and gout suddenly emerged due to their findings which contradicts with health recommendations that urged people to cut back on sodium in attempts to lower risks associated with cardiovascular disease.

Although gout has been studied for many years, there are still lots of hidden answers. The lack of research conducted concerning salt and gout raises doubts about the latest findings.

This has prompted other researchers to carry out more relevant research.

With a strong relationship found between diet and gout occurrences, gout patients started to look back into their diet.

Gout may impact individuals from varying socioeconomic status, yet the dietary recommendations transverse all demographics with the common goal of preventing complications.

This article will focus on salt and gout, the effect of different salt levels in the body, their controversial issues, and other alternatives to reduce gout triggers.

Effects of Different Level of Salt in The Body

Salt is a common ingredient in our foods. Yet, little research has been done relating to salt and gout. What is salt exactly?

As part of the five essential tastes, salt has properties that release food molecules into the air, giving the food an aroma. Numerous origins create different types of salt with distinctive colors, textures, uses, and even flavors!

Mainly made from sodium chloride and other chemical compounds, salt is found throughout seawater and various rock formations.

Salt is a naturally occurring mineral found everywhere within the world, from the ponds of France to the caves of Pakistan.

Why Salt is Important?

Salt commonly features at the table or in the kitchen as table salt, rock salt, sea salt, or kosher salt.

Salt is essential not only for its flavor-enhancing and as food preservation but also to the human body for the brain to send vital electrical signals throughout the body.

Salt contains 40% sodium. Sodium is essential to maintain certain bodily functions. The body utilizes sodium to maintain fluid levels.

The sodium from salt binds water and maintains intracellular and extracellular fluids in the correct balance. A balance of fluid and sodium is vital for the well-being of the heart, liver, and kidneys.

It regulates blood fluids and prevents low blood pressure.

Fluctuations In Salt Level

Excessive consumption of salt is harmful, but insufficient intake may likewise have serious consequences. The brain activity will be affected in the case of a low sodium level.

A person with a low sodium level may feel sluggish and lethargic, experience muscle twitches, followed by seizures, a loss of consciousness, coma, and death.

This may happen faster if sodium levels drop quickly. Such symptoms can be severe in older people.

There is no doubt that high-salt consumption develops a warning signal to human’s health.

Excess sodium intake has been linked to medical issues, such as osteoporosis, kidney disease, and hypertension, which can lead to cardiovascular disease and stroke.

A study conducted by Dr. John P. Forman proved that salt consumption is directly connected to uric acid levels. Serum uric acid (SUA) and urine albumin excretion (UAE) levels tend to rise over time.

As the body cannot eliminate uric acid, it binds itself with the sodium chloride to form new crystals that are deposited directly within the bones and joints, causing different kinds of rheumatism such as arthritis, gout, and kidney and gall bladder stones.

In that study, he also cautioned that individuals with high salt intake were at a higher risk of hypertension if they had higher levels of SUA and UAE.

Hypertension is a key to the buildup of plaque in the arteries, leading to a greater risk of stroke and heart disease.

Does Higher Intake of Salt Reduce Gout Triggers?

In a study that surprised other researchers, Juraschek et al. concluded that SUA levels could be reduced by increasing the intake of salt (sodium).

They initially hypothesized that low salt intake would reduce the SUA level, which is a causal pathway for gout.

In their study, 103 adults diagnosed with pre- or stage 1 hypertension were randomly fed with either a Dietary Approach To Stop Hypertension (DASH) diet or a control diet (a common American diet).

They were then randomly given meals with different salt concentrations for 30 days: low (60 mmol/day), medium (120 mmol/day), and high (180 mmol/day).

The high salt level reflected a typical salt intake of an American adult consuming 2600 kcal of food/day.

Nevertheless, their findings opposed their first hypothesis. Regardless of diet, medium salt intake significantly reduced uric acid levels compared to low salt intake (DASH: -0.35 mg/dL. Control: -0.33 mg/dL).

Similarly, high salt intake significantly reduced uric acid levels (DASH: -0.33 mg/dL. Control: -0.53 mg/dL). Overall, when combined across both diets, compared to low salt intake, medium salt intake lowered the SUA by -0.34 mg/dL while high salt intake lowered SUA by -0.43 mg/dL.

There was no significant difference between high versus medium-salt intake across both diets (-0.09 mg/dL).

Supporting Additional Research

Acknowledging that there are debatable issues that arise between salt intake and uric acid, Juraschek et al. confirm that previous physiologic studies have suggested similar findings.

A study conducted on 27 men found increasing sodium intake from 20 mmol/d to 200 mmol/d decreased uric acid levels 1 mg/dL.

The mechanism of the association remains unclear, but the researchers theorize that the inverse relationship between sodium intake and uric acid could reflect the influence of the renin-angiotensin system, “as uric acid is inversely related to renal blood flow and vascular resistance.”

Their findings were supported by a study from Todd et al. whereby a moderate (150 mmol/day) and high (200–250 mmol/day) sodium diet, as compared with a low sodium diet (60 mmol/day), caused a statistically significant reduction in the SUA concentration.

A mini-review of the relationship between dietary sodium intake and SUA concentration conducted by Lei Lei and Wang demonstrates the equivalent.

In short-term dietary sodium intervention studies, including a recent further analysis of a previously published trial, high dietary sodium intake (200 mmol/day), compared with a low sodium diet (20–60 mmol/day), resulted in a significant reduction in SUA, being approximately 20–60 μmol/L.

Consuming Higher Sodium Not Recommended

Despite their findings, Juraschek et al. discourage the idea of consuming high-salt intake in the diet as a way to lower uric acid and managing gout.

Rather, they suggest that clinicians should be aware of potential dietary causes of gout flares. Gout is what you eat. Avoiding foods that could trigger gout attacks is the best way to be safe than feeling pain.

Salt – Which One to Prefer?

Frankly, we cannot avoid consuming salt. Salt is regarded as a compulsory ingredient for food preparation. But, we can choose our salt wisely, knowing which salt is preferable with the correct recommendations.

Which Salt to Prefer?

There are different types of salts, differentiate by its flavor, color, texture, and convenience. Trace minerals found in salt can affect both the color and taste of the salt.

Likewise, the size of the grain influences how the salty flavor hits your tongue. The larger grain size of salt can have a stronger flavor and last longer on your tongue.

However, there should not be any major taste difference between plain refined salt and the other gourmet salts.

Heretofore, no studies have compared the health effects of various sorts of salt. Most salts are similar, comprising of sodium chloride and trace amounts of minerals.

The main benefit of choosing less processed salts especially for gout patients is that you avoid additives and anti-caking agents that are found in regular table salt.

After all, salt is salt — its main purpose is to add flavor, but it is not a health remedy.

The Best Recommendations for Salt Intake?

Despite the current findings by Juraschek et al., other health issues sensitive to salt intakes – kidney disease, diabetes, hypertension, and kidney stones – point to the importance of a low sodium diet.

The average American eats more than 3,400 milligrams of sodium every day, mostly from processed foods.

All we need is about 500 mg of sodium daily, although the American Heart Association and the World Health Organization prescribe not surpassing a daily sodium intake of 1,500 mg a day or just over half a teaspoon of table salt.

People with hypertension, diabetes or cardiovascular diseases should be aware of this.

It is not easy to measure the amount of salt we are consuming, as the presence of salt is hidden in many foods.

It is therefore important to check the nutritional information on processed food to find out the salt, or sodium, content.

The U.S. Food and Drug Administration (FDA) warns people to be aware of low-salt claims on packaging. A serving with 1,400 mg or less of sodium per serving, it’s salt and sodium content is classified as “low.”

A food with a high-sodium content contains more than 20% of the recommended daily intake or more than 480 mg per serving.

If food is a salt- or sodium-free, it can contain up to 5 mg of sodium per serving. Terms such as “light” or “reduced” sodium mean there is less salt than the regular product per serving.

Doctors recommend avoiding foods with high salt content, and, if possible, selecting those with “no salt added.”

Other Alternatives for Gout Remedy

In addition to low sodium diet recommendations, gout patients ought to consume a well-balanced diet known as DASH diet as suggested by Juraschek et al. based on their findings.

The DASH diet emphasizes on fruits, vegetables, and low-fat dairy foods, and reducing the amount of saturated fat, total fat, and cholesterol while boosting consumption of whole grains, lean meats, fish, nuts and beans.

In short, this diet restricts many of the foods and nutrients that trigger a gout attack.

Consuming protein primarily from egg whites, nuts, peanut butter, and low fat cottage cheese is not connected with an increased incidence of gout.

Another alternative especially for an alcoholic person suffering from gout, is to stop the consumption of alcohol which could worsen gout flare-ups.

Finally, many gout sufferers treat the pain and inflammation of a gout attack with Epsom salt.

It is a naturally occurring pure mineral compound of magnesium and sulfate which can be absorbed through the skin.

According to those who have experimented with Epsom salt, the method is very beneficial as it increases the secretion of uric acid through the skin.


Gout costs the health care system in America around $7.7 billion. Alteration in the diet concerning gout whereas at the same time controlling hypertension and cholesterol levels could make a significant contrast to millions of lives.

We are discussing the connection between salt and gout in this article. Salt may be bad for you, but the reality could be different.

The relationship between salt and gout is still arguable as little research has been done and not much evidence that can support the benefits of increasing the intake of sodium in the diet.

Its positive effects on reducing gout triggers are mostly anecdotal at this point, and more research is required.

Yes, I know some of you cannot eat certain foods if they are not salted but again, choose a salt that you like and use it in moderation.

There are slight nutritional differences among them, but they are not different enough to make a dramatic or long-term effect on your overall health.


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