By Marika Sboros
Dr James DiNicolantonio, a US cardiovascular research scientist, is up next in Foodmed.net’s Vital Signs Q&A series of personality profiles. He shows why the US legal profession’s loss has been the health profession’s gain.
DiNicolantonio once wanted to be a lawyer but his parents steered him into the family tradition of pharmacy.
He is also a doctor of pharmacy at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, an associate editor of British Medical Journal’s (BMJ) Open Heart and a mythbuster of note.
He is perhaps best known these days as author of The Salt Fix. It’s a seminal book that dashes to death the low-salt myth. In it, he provides fascinating new understanding of salt’s essential role in our health and what happens when we aren’t getting enough salt. And why that has far-reaching, even heart-stopping, implications.
He shows that salt may be one solution to, rather than a cause of, the chronic disease crises facing the planet.
He is author or coauthor of more than 200 publications in medical literature. The New York Times, Time, Forbes, the BBC and Men’s Health, among others, have featured his research.
- What was your earliest ambition?
I originally wanted to be a lawyer. I always loved to study and argue and so it made perfect sense to me at the ripe age of 10 years old. My parents always said I would make a great lawyer but ultimately they pushed me towards pharmacy.
Pharmacy has been in my family since my great-grandfather graduated from the University at Buffalo as a pharmacist in the early 1930s. My mom and brother are both pharmacists. So, it made sense that I would chose that path too. I have always wanted to help people in some way and I figured this was a great career to do that.
- What made you specialise in cardiovascular research?
I developed my passion for the cardiovascular system in pharmacy school. I had a great mentor and professor in Dr. Nick Norgard. He taught our cardiology unit in pharmacy school and he really ignited my passion for cardiology. After I graduated, we became good colleagues. We even went on to publish a few papers together in the medical literature.
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- In a nutshell, how do you describe your work as Cardiovascular Research Scientist at Saint Luke’s Mid America Heart Institute?
My work is based on what I am passionate about. I try and research topics that are important to public health and my goal is to try and make a difference in people’s lives. If someone gets just one “aha” moment from my research and that helps improve their health then it was all worth it.
- What prompted you to write The Salt Fix?
When I was working as a community pharmacist, my patients kept telling me that their doctors had diagnosed them with high blood pressure and told them to remove all the salt from their diet. The problem was that after they did this they felt like crap. They were having muscle spasms, muscle cramps, heart palpitations, fatigue, dizziness, especially when standing from a seated position. I saw firsthand how the low-salt advice was wrecking the quality of life of my patients.
I told them to go back to their doctor and let them know how they were feeling. And many times the doctor would tell them to add some salt back to their diet. Or if they had low sodium levels in the blood they would even cut down the dose of their diuretic they had prescribed from high blood pressure or even completely eliminate it sometimes. Almost immediately, all their symptoms of salt deficiency would go away as soon as they integrated salt back into their diet. My experience was telling me that the low-salt advice was harmful to people. So, I knew I had to research it and write a book.
- How is the book doing?
It’s not a New York Times Best-seller but for my first book I am happy with how it is doing. What has been really great is all the emails and messages I have received from people. They were suffering from symptoms of salt deficiency but never knew what was wrong with them. They say how quickly their health improved after integrating salt back into their diet. That feedback is what really has made writing the book worth it.
- What do you say to cardiologists who say you’ve got it all wrong about salt? And that you’re giving people the wrong – and dangerous – message?
My message has never been to consume high amounts of salt. But many times, some cardiologists don’t fully understand my message. I am very against consciously restricting salt intake. And my main message is to use real salt to eat real food. I think once they understand my actual message, many cardiologists are much more receptive.
- Why’s there so much conflicting advice on diet and nutrition?
I think there’s so much nutritional controversy because the studies we have are flawed. It’s also because nutrition is a mix of an art and a science. That’s because people are different and what works for one person might not work for another.
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- What’s your view of the state of nutrition science these days?
There is also a lot of industry money at stake. This can bias the evidence and promote the wrong health messages to the public.
- Have you ever had a health scare?
Yes, but not in the way you would think. I was bench pressing by myself about six years ago in my home and I tore my pectoralis tendon pretty bad. I never had surgery to repair it. So, my ability to lift heavy weights with my chest is gone. That was a point in my life where I could no longer lift heavy weights and get away with eating a high-carbohydrate diet. After that happened, I really had to understand what a healthy diet is.
- Have you ever had a weight problem?
No, but soon after I lost my ability to lift heavy weights I did start having a little trouble keeping a flat stomach.
- How do you start your day?
I normally start my day early (5:30 AM) with a coffee and a little heavy cream. And normally I normally don’t eat anything until lunch at around 11 AM.
- What do you eat for the rest of the day?
My lunch is usually a burrito bowl at Chipotle with beans, peppers and onions, pork, chicken, salsa, corn, cheese, and lettuce. For dinner, it can vary from pork chops, pastured eggs, and spinach, to salmon and cooked and cooled potatoes. I generally have one small bowl of organic popcorn at night and maybe one or two dark chocolate squares with some almonds each day. I usually drink some mineral water each day too.
- How is that different from your diet of, say, 10 years ago?
My diet of 10 years ago never consisted of pastured eggs, just your regular store-bought eggs. My diet also completely lacked seafood and vegetables and was very high in refined carbohydrates and sugar. At college, I used to drink chocolate milk and Gatorade. But I got away with that because I was young and lifting heavy.
- How much salt do you eat these days?
I don’t actually measure my salt intake but I’m probably getting around two teaspoons per day. I normally only work out once or twice a week and will generally use 1/3rd to 1/2 teaspoonful of Redmond Real Salt before my workouts. And I salt my food to taste.
- Do you take supplements?
Yes. I drink high magnesium/calcium mineral water, hydrolyzed collagen protein, fish oil and a little vitamin D in the winter. I also make sure to get good sun exposure during the warmer weather without burning.
- What do you do to keep fit?
I generally do a full-body workout once or twice a week. I can’t lift very heavy with my chest but I still lift moderate-heavy weights and do body-weight exercises. And I also eat very clean and consume little to no processed food.
- What’s the least healthy thing you do these days?
Probably not doing much cardio. I go in spurts. For six months, I may not jog at all and then for six months I may jog every other day.
- What was a defining moment in your life?
One day in the pharmacy, a single mom who was a patient of mine told me she just suffered a stroke. And that if she had another one she wouldn’t be able to take care of her kids. I asked her three questions: Do you snore at night? Do you wake up in the middle of the night? And do you feel well rested in the morning? After she answered those questions, I told her that she might have sleep apnea.
A few weeks later, she came into the pharmacy and told me that her doctor said she had one of the worst cases of sleep apnea they had ever seen. She was so thankful for what I had done. Right then, I knew that I could make a real impact in people’s lives and it was the greatest feeling in the world. I wanted to keep doing that in my life.
- I was going to ask if you’ve had mentors in your life. You mentioned one, Nick Norgard, who got you inspired and passionate about cardiology. Any others?
Yes. Dmitri Vasin who is a nephrologist and one of the smartest doctors I know. And Marty Strauss, another doctor who really opened my eyes to the lack of evidence-based medicine. I am grateful for all of them.
- Ever read a book that had a significant impact?
There have been several, but by far and away Good Calories Bad Calories (by Gary Taubes) was the most impactful.
Click here to read: Taubes and the case against sugar
- What are you reading now?
Right now, I’m not reading any books but focusing on researching and writing a second book
- Do you have time for hobbies?
My #1 hobby is spending time with my wife and kids. They are my everything.
- What’s the best advice anyone ever gave you?
My dad always told me that if I worked hard I could accomplish anything. Those words have always stuck with me, even to today.
- What’s the craziest or most dangerous thing you’ve ever done?
I’ve had some pretty crazy moments when I was younger behind the wheel. I’ll just leave it at that.
- If you could edit your life, what would you change?
I wouldn’t change anything. Any mistakes I’ve made have lead me here and I’m pretty happy where I’m at.
- Any pet peeves?
When I ask for a sleeve on my coffee and I don’t get one and I end up burning my hands walking into work with my coffee.
- What’s your biggest fear?
Letting down the people that I love the most in this world.
- And your hopes and dreams?
I hope that my work makes a true difference in people’s lives. That’s my goal.