Lowering Cholesterol by Lowering Salt

Some years ago I was fortunate to have spent a week interviewing Demetrio Sodi-Pallares, an internationally renowned cardiologist who had a very different approach to lowering cholesterol.

A woman whose heart had been damaged by rheumatic fever was referred to "Dr. Sodi," as we called him, for ongoing heart treatment. When the doctor first took a look at her lab results, he could hardly believe his eyes.

Total cholesterol came back at 800 mg/dl. As you probably know, 200 mg/dl is about the upper limit of healthy cholesterol.

Total cholesterol came back at 4500 mg/dl. A healthy level is generally 150 mg/dl or lower. And Dr. Sodi's patient also had extremely low levels of T4, the thyroid hormone.

At first, the doctor simply did not believe the lab. He sent blood samples to two other laboratories for verification, and the numbers came back nearly the same. One laboratory reported triglycerides were 4339 mg/dl, and the other, 4442. Since triglycerides at this concentration are almost visible in the blood, Dr. Sodi decided lipid lowering was urgent, but he was at a loss as to what to prescribe.

Then, acting on a hunch, the doctor gave his patient some very unusual instructions:
Eliminate salt from your diet. No canned soups, no pickles, no food made from mixes, no barbecue, only half a teaspoon of salt to be added to food in any one day. The doctor showed his patient a thimble. "This," he said, "is half a teaspoon of salt."

If this patient improved, it would be due to cutting out the salt, not cutting out the fat. Dr. Sodi wanted to save his patient, who was extremely poor and had no insurance, the expense of cholesterol- and triglyceride-lowering drugs, as well as their side effects. But he gave the diet only two weeks to work.

Two weeks later the patient returned to the doctor to have her blood drawn, and cholesterol and triglycerides were measured yet again.

The results were not perfect, but they were enormously improved. Triglycerides were now 800 mg/dl and total cholesterol was 240 mg/dl. That was interesting, but the doctor was concerned that results might have been a fluke. He told her, therefore, go back to your original low-fat, low-cholesterol diet, but eat all the salty foods you want.

The patient returned for a third visit in a month. Triglycerides were back up to 2224 mg/dl, and cholesterol had skyrocketed along with it. She was so fatigued she asked if she could not have a prescription for Synthroid.

But the doctor had a different idea. He asked her to go back to the very low sodium diet, but to eat all the eggs and unsalted butter she wanted. This brought triglycerides down to 600, which is still too high but an enormous improvement, and cholesterol to 240.

Dr. Sodi was working with impoverished patients who had no insurance, but results have also come from well-to-do Americans. When I mentioned this method in a radio interview, an 82-year-old man who had had two heart attacks and two angioplasties and who was taking Lasix, Norvasc, Tenormin, and Lescol called in and said he'd ask his doctor about trying the plan for a month (and you should make any dietary change working with you doctors, not against them).

Six weeks later he emailed, that he was no longer on Tenormin for high blood pressure or Lescol for high cholesterol, and "Had my routine check-up yesterday by my cardiologist and she was surprised and pleased with my progress. We have dropped two of my medications. Triglycerides are 80 down from 150, HDL 48 up from 40, and LDL 117 down from 147. How about that!"

When drugs don't work, and you can't find any more fats to eliminate, work with your doctor to follow a very low sodium diet. You may be equally happy with the results. a>