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The more we use these substances, the less dopamine we produce naturally in the brain, and the more habituated our brain cells become to the dopamine that is produced—the number of “dopamine receptors” declines. The result is a phenomenon known as dopamine down-regulation: we need more of the drug to get the same pleasurable response, while natural pleasures, such as sex and eating, please us less and less.
Salt sensitivity is an elusive and controversial concept, but it implies that only some of us are sensitive to the salt content of the diet. For those of us who are, our blood pressure goes up and down in response to how much salt we’re eating. Others can eat salt with impunity and their blood pressure remains relatively constant. That only some of us may be salt-sensitive is still considered by the public-health authorities reason enough to tell everyone to eat less salt.
On the one hand, as we’ve said, they’ve been willing to blame the victims, at least those who are overweight or obese, for eating too much and exercising too little, and the food industry for making too much food available and for manipulating the taste with sugar, salt, and fat to the point that we just can’t eat in the necessary moderation. They’ve also entertained the possibility that dietary fat and particularly saturated fat plays a uniquely causal role. But their tests of this dietary fat hypothesis have mostly failed to support it.
Is it that we’re all simply eating too much and exercising too little, which is the one simple answer that the nutritional establishment will embrace in the face of so much evidence to the contrary? Another simple answer, and a more likely one, is sugar.