Dr. Carl S. Goldstein is the co-author, with Olivia Thomas and Christina Badaracco, of the new book Mix It Up: The Culinary Medicine Cookbook for Big Flavor: No Salt Needed. He is a nephrologist and is a clinical professor of medicine at Rutgers University School of Medicine in New Jersey.
Q: What inspired you and your co-authors to write Mix It Up?
A: I have labored for decades to escort patients to a no-salt diet based on a healthy balanced nutrient platform to benefit a number of medical conditions. I realized that telling patients not to eat salt was analogous to my mother telling me to be creative. Generally good counsel but no structure or direction.
I discovered Olivia Thomas through her participation in a Columbia University course on culture and nutrition. Her role was in video presentations of practical kitchen application of the nutritional principles discussed in the preceding lecture.
She was great! Charismatic, demonstrations enriched with hints on both food and kitchen safety. The problem I had was that every recipe had salt. For a program on culinary nutrition, that did not resonate with me.
I reached out to share my thoughts on her great presentation confounded by the liability of salt in each meal. We exchanged a series of e-mails and ultimately agreed to write a no-salt book predicated, in part, on her (and consulting partner Christina Badaracco) earlier Mix It Up cookbooks for general health and weight management.
The division of labor was their reformulation of earlier recipes to be no salt and the creation of many new no-salt recipes. I was the concept guy and author of the front matter setting forth the use case for no salt as centrally important to human health.
Q: The book’s subtitle is “No Salt Needed” – do you think most people use too much salt in their recipes?
A: Absolutely!! The science is that the human body requires about 500 mg of sodium daily; the average American eats between 3,500 mg and 11,000 mg. High sodium content is a significant part of the malignancy of ultra-processed foods.
We know that stroke rates around the world are highest in areas with the highest per-capita sodium intake (Spain, Portugal and Japan). We also know that a 30 percent reduction in sodium intake has a more significant effect on cardiovascular risk reduction that cigarette cessation.
Salt is that big a factor. Salt is addictive and Big Food has weaponized this the way Big Tobacco weaponized nicotine.
Culture is a big factor, too. In the 19th century the only way to keep food from spoiling was by salting it. That was so important that Roman soldiers were paid in salt (the word salary is from the same Latin root as salt). But with the advent of the ice box and refrigeration, food preservation no longer required salt.
When descendants of people from those earlier times seek to replicate meals made by their grandparents and ancestors, they remember the flavor effect of the added salt. Grandma had to use salt but grandchildren do not. Separating culture from diet composition is a sentinel event to a salt-free cuisine.
Q: Do you have any particular favorites among the recipes in this book?
A: I have a lot of favorites! We provide an array of exchange tables for protein source and seasoning. Many dishes can be made vegetarian or vegan and can be easily customized to personal tastes.
There are no-salt recipes to make pickles, several salt-free pesto recipes, a variety of chili and meatball (can be beanball) recipes. Some great salt-free dessert ideas, too.
Q: What do you hope readers take away from the book?
A: My goal is to show the panorama of what a no-salt diet is. Highly seasoned, big flavor, no salt.
Many patients hold the prejudice that no-salt foods taste like cardboard and the objective of this book is to counter that misconception. I hope readers see the spectrum of no-salt possibilities and embrace both the salt-free benefits and the underlying healthy meal structures in the book.
Q: What are you working on now?
A: I am trying to develop a Culinary Medicine curriculum for the residents at my hospital, Overlook Medical Center. All of my share of the profits from the book from every distribution channel is being donated to the Overlook Hospital Foundation, hopefully to cultivate an endowment sufficient to get this didactic program started.
Q: Anything else we should know?
A: I don’t think it is possible to overestimate the role that nutrition plays in human health.
I am discouraged by the content on the Food Channel and similar commercial food networks. The amount of sodium in these offerings is often stunning and legitimizes the use of some very unhealthy foods (salt is on top of my list followed closely by things such as Chicharron and the profane ubiquitous use of bacon).
I think salt literacy is generally low, obfuscated in part by Big Food which does not want you to know how much salt is in ultra-processed foods (or you wouldn’t buy or eat them).
Understanding the dangers of a high-salt diet (hypertension, heart failure, kidney stones, osteoporosis, stomach cancer), I hope, favorably influences dietary salt reduction among readers and improves overall nutritional content of meals and general health.
--Interview with Deborah Kalb











