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James DiNicolantonio

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DiNicolantonio with Joseph Mercola
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Our body has a superpower to excrete excess sodium but not excess sugar. If you get too much sodium, no harm no foul. If you get too much sugar that leads to diabetes, obesity, heart disease and cancer. Don’t fear salt. Fear sugar.
—James DiNicolantonio in 2021[1]

James DiNicolantonio is an American cardiovascular research scientist, anti-sugar campaigner and cholesterol denialist. He is best known for his view that salt has been unfairly demonized by the medical community and that eating more of it will save lives.

As well as recommending an increased consumption of salt, DiNicolantonio is a low-carb advocate and fan of the ketogenic diet.[2][3] In 2018, he co-authored, with alternative medicine guru Joseph Mercola, the food woo book Superfuel, published by Hay House.[3][4]

The Salt Fix[edit]

Not only have we gotten it wrong, we've gotten it exactly backwards: eating more salt can help protect you from a host of ailments, including internal starvation, insulin resistance, diabetes, and even heart disease. (The real culprit? Another white crystal—sugar.)
—James DiNicolantonio[5]

Similar to other low-carbers such as Gary Taubes, DiNicolantonio blames sugar for causing most chronic conditions.[6] His health advice is to eat more salt and less sugar. His views on salt consumption are in opposition to conventional medical advice. The American Heart Association recommends that people cut down on salt consumption because of the risk of high blood pressure, as "the science behind sodium reduction is clear. Significant evidence links excess sodium intake with high blood pressure, which increases the risk of heart attack, stroke and heart failure."[7] Health authorities who cite research from evidence-based medicine recommend that people eat no more than 6g (about a teaspoon) of salt each day.[8][9][10][11]

DiNicolantonio is certainly correct in pointing out that sodium is an essential nutrient for the body, and that there are health risks from salt under-consumption.[12] However, he takes the salt consumption thing to an irrational extreme, claiming that there is no link between salt consumption and the risk of high blood pressure. Instead, sugar is the real culprit.[6][13] His advice to eat more salt has been condemned by medical experts as potentially dangerous.[14] The claims in his book, The Salt Fix, were criticized by health authorities, including Public Health England (PHE).[14] DiNicolantonio recommends that people eat 7.5g to 15g of salt a day. He says that this is a "normal" salt intake.[14] Louis Levy, head of nutrition science at PHE, stated that "Diet is now the leading cause of ill health. By advocating a high-salt diet this book is putting the health of many at risk and it undermines internationally-recognised evidence that shows a diet high in salt is linked to high blood pressure, a known risk for heart disease."[14]

DiNicolantonio's book has been endorsed by various low-carb cranks including Marika Sboros and the Weston A. Price Foundation.[15][16]

Cholesterol denialism[edit]

DiNicolantonio is a cholesterol denialist who argues against the scientific consensus. He claims that high blood cholesterol levels do not increase the risk of cardiovascular disease.[17] He promotes a diet high in saturated fat and blames sugar and carbohydrates for causing high cholesterol and obesity.[17][18]

DiNicolantonio has been accused of misrepresenting scientific evidence on saturated fat and its relationship to cardiovascular disease.[17] His 2014 editorial for the journal Open Heart was criticized by Tom Sanders, Emeritus Professor of Nutrition and Dietetics:

This article rubbishes the relationship with saturated fat and CVD, misrepresents the scientific evidence and then goes on to put the blame on sugar. It is beyond reasonable doubt that elevated LDL (low density lipoprotein) cholesterol is a major determinant of risk factor for cardiovascular disease. The saturated fatty acids palmitic, myristic and lauric acids raise LDL cholesterol in increasing order in meta-analysis human experimental studies.[18]

Bruce Griffin, Professor of Nutritional Metabolism noted that "to suggest that the theory relating saturated fat to increased total cholesterol is flawed, is nonsense, and contradicts 50 years of evidence-based medicine."[17]


  • The Salt Fix: Why the Experts Got It All Wrong--and How Eating More Might Save Your Life (2017) ISBN 978-0451496966
  • Superfuel: Ketogenic Keys to Unlock the Secrets of Good Fats, Bad Fats, and Great Health (with Joseph Mercola, 2018) ISBN 978-1401956356
  • The Longevity Solution: Rediscovering Centuries-Old Secrets to a Healthy, Long Life (with Jason Fung, 2019) ISBN 978-1628603798

See also[edit]