One tricky part with fermented foods is that the salty ones appear to increase rates of colon and stomach cancer as I recall.
I read something years ago about how as the Japanese population adapted a more western diet, heaps of ailments came upon them as you’d expect, but their salt intake declined so dramatically that they stopped experiencing stroke and GI tract cancers nearly as much.
I think you’d need to pin down just how much salt was causing those issues though and then ask if the benefits of the salty fermented foods outweigh the current problem of having depleted gut microbiomes and atrocious diets.
So, I’m certainly not suggesting everyone avoid salty fermented foods. I eat (and make) a fair amount myself and as I alluded above, I suspect it’s better for me than eating food that is, on balance, worse for me.
There’s no perfect diet, but there are clearly worse diets. I try to avoid the latter.
Seems unlikely. A lot of the traditional West African diet is fermented and they have the lowest rates of colon cancer on Earth. Smoked foods and foods containing nitrates/nitrates are correlated with stomach and colon cancer, but not salty or fermented foods. Studies that show a correlation of salt intake with cancer are very possibly confusing intake of smoked meat or processed meat (also high in salt) with colon cancer. For example, when adjusting for processed meat, one study finds that salt is not correlated at all with colon cancer. [1]
Interesting, thanks for that. I hadn’t seen it yet. Though the rest still stands, and as mentioned in the paper, reducing sodium intake is still recommended for other health benefits. There is a wealth of other research showing that most people in North America should dramatically reduce their sodium intake.
> Reduction of processed meat intake may be an effective strategy for CRC prevention, while sodium reduction should still be recommended to achieve other health benefits.
Apart from that, I’m still seeing evidence of correlation with stomach cancer, even if not in the lower GI tract:
Given the connection to stomach cancer and cardiovascular disease, it does seem wise to be careful about salt intake.
Regarding west African diets, are they high in salted fermented foods or just fermented foods? It seems if the food is low in salt, it’s probably just fine
There is a wealth of other research showing that most people in North America should dramatically reduce their sodium intake.
The evidence for this seems much less conclusive than most people think: https://examine.com/nutrition/awful-nutrition-myths/#summary.... The tl;dr is that most of that salt comes from crappy food, and that’s what you want to fix - it’s not the salt as such.
It really is the salt though, and examine says as much:
> Some myths contain a grain of truth. Studies have associated excess salt with hypertension (high blood pressure),[54] kidney damage,[55] and an increased risk of cognitive decline.[56][5
The thing is, a lot of people have no idea that their salt intake is way too high. You’re right that the salt tends to come from processed foods, but the salt is still a problem.
I’m not trying to suggest the processed foods are not a problem, either. It’s a compounding problem, and it’s a massive one.
To be fair, that says "a grain of truth", and that's contained within a section entitled: "Myth 6: Salt is bad for you". The summary says:
But a drastic decrease in salt intake has not shown uniform benefit in clinical trials. Most people will benefit more from a diet of mostly unprocessed foods than from micromanaging their salt intake.
As an example, salt-sensitive hypertension is a condition which some people have, but most people don't. If you don't, then salt will generally not affect your blood pressure adversely (it will go up temporarily if you eat a whole Domino's pizza, but will quickly go down again).
There are some interesting points in this podcast and related resources/sources (not a fan of all of this site’s content, though Gregor is good at compiling research):
My take away from this and other sources is that we don’t have proper long-term, randomized, human trials to determine exactly what to say about this. At the same time, there are cases where a reduction is clearly helpful but no typical cases where an increase is beneficial.
I’m certainly not out to debate or disprove you here — I’d really like to eat more salt, but the evidence I come across doesn’t justify it. I’d rather be wrong, though.
Not quite. I’d seen information about fermentation-related carcinogens, but like the article says, I haven’t come across anything suggesting this is problematic unless you eat a lot of this stuff every day (like the people in China who were a part of the study mentioned in the article).
I linked to an article pointing to heavily salted, preserved foods being correlated with stomach cancer in a response to another comment. Though salted fermented foods fall into this category, so would things like jerky or salted olives for example. It isn’t clear to me what should be avoided necessarily, though it seems like decreasing sodium intake is a net positive regardless.
In any case, I think eating these foods is likely okay or even healthful so long as it doesn’t make up a large part of your diet.
I read something years ago about how as the Japanese population adapted a more western diet, heaps of ailments came upon them as you’d expect, but their salt intake declined so dramatically that they stopped experiencing stroke and GI tract cancers nearly as much.
I think you’d need to pin down just how much salt was causing those issues though and then ask if the benefits of the salty fermented foods outweigh the current problem of having depleted gut microbiomes and atrocious diets.
So, I’m certainly not suggesting everyone avoid salty fermented foods. I eat (and make) a fair amount myself and as I alluded above, I suspect it’s better for me than eating food that is, on balance, worse for me.
There’s no perfect diet, but there are clearly worse diets. I try to avoid the latter.