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Can You Solve the Pretzel Mystery?

Here's the mystery: having one pretzel at bedtime resulted in better morning blood pressure. Could this be balancing the reader's need for sodium?

People prone to hypertension are often advised to cut as much salt from their diet as they possibly can. This step would reduce their sodium intake and presumably lower their risk of cardiovascular catastrophes. Many folks would interpret this as a prohibition on eating even a single potato chip or pretzel.

The Pretzel Mystery:

Q. I am battling high blood pressure. With effort, I have been able to keep my BP at an average of 125 to 135 over 82 to 87. My BP is higher in the morning than the afternoon, when it ranges from 120 to 125 over 77 to 82 range. At the doctor’s office, it was 160/95!

I have been following a low-sodium diet. But one day, I got a great deal on some pretzels and decided to indulge. I ate a pretzel before bedtime. I was surprised the next morning when my BP was 120/77.

The next night I did the same and the following morning it was 123/75. It seemed the salt was lowering my morning BP readings. So I skipped the pretzels a few nights, and my morning BP readings were higher again. I’ve decided to keep my usual daily diet as “low sodium” but have just one salty pretzel in the evening.

Controlling Blood Pressure with a Low-Sodium Diet:

A. Sodium is complicated. High salt diets are bad for health, but what about moderate sodium intake?

Some people are salt sensitive and benefit from a low sodium diet. For others, however, lowering salt intake too much may actually increase the risk for heart attack and stroke (Mente et al, The Lancet, July 30, 2016).

Excessively low sodium levels might trigger a stress reaction within the body. Some people who eat a very low sodium diet react with higher plasma renin, a natural compound that can raise blood pressure (Baudrand et al, Journal of Clinical Endocrinology and Metabolism, Nov. 2016). This could be counterproductive for blood pressure control.

Some European cardiologists disagree with the very stringent sodium restriction recommended by the American Heart Association (Mancia et al, European Heart Journal, Jan. 20, 2017).  It is clear that too much sodium is unhealthy, but it is possible that too little sodium is also undesirable. Perhaps your evening pretzel balances your intake.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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