Fork U with Dr. Terry Simpson

Salt: From the Roman Legion to Your Electrolyte Packet
You've probably heard that Roman soldiers were paid in salt—and that this is where we get the word salary. It's a great story. It's also almost certainly not true.
The Romans had money. We find Roman coins throughout the former empire, including around military forts such as those along Hadrian's Wall, and we have evidence that Roman soldiers were paid in money. What we do have is an ancient linguistic connection between the Latin sal, meaning salt, and salarium, which eventually gives us salary. Somewhere along the way, that became the much better story that a legionary went to the quartermaster and collected his wages at the imperial salt lick.
But the fact that the story sounds believable tells us something important: salt really was extraordinarily valuable.
Long before Rome, humans sought salt just as other animals do. Animals travel to mineral licks, and humans learned to exploit saline springs, coastal deposits, and eventually salt mines. Nobody needed to measure a serum sodium to discover salt. We had two very good reasons to want it: salt tastes good, and salt preserves food.
That second property changed civilization. Meat and fish could be salted and dried. Vegetables could be fermented. Milk could be transformed into cheese, concentrating its nutrition and allowing it to last far longer than fresh milk. Salt helped food survive winter, travel aboard ships, and provision armies. The Egyptians even used natron—a mixture of sodium salts rather than ordinary table salt—to dry and preserve their dead. Hence the mummy. Or occasionally, presumably, the daddy.
Once everyone wanted salt, governments discovered the next obvious thing to do: tax it. Salt became a source of state revenue in ancient China, traveled along trade routes in Rome, was burdened by the French gabelle, and eventually became the focus of Gandhi's famous Salt March against British rule in India.
Then something changed. We got very good at producing salt, and we invented refrigeration. One of the principal reasons humans had consumed large quantities of salt—preserving food—became much less important. Unfortunately, we didn't stop liking the taste. Modern food manufacturers discovered that salt was cheap, improved flavor and texture, and could be added to almost everything.
Today, the problem is rarely finding enough sodium. It's avoiding too much of it.
There was, however, one particularly clever moment when public health took advantage of our universal salt habit. Iodine deficiency once produced enormous numbers of goiters and, more importantly, could impair fetal and childhood brain development. In 1924, iodized salt appeared on grocery shelves in Michigan as part of the American effort to combat endemic iodine deficiency.
The idea was beautifully simple: everybody eats salt, so put iodine in the salt. Salt iodization became an extraordinarily effective way to prevent iodine-deficiency disorders, and it remains recommended by the World Health Organization.
Which makes today's fascination with expensive “mineral” salts particularly amusing. Celtic sea salt, Himalayan pink salt, and other specialty salts contain magnesium, calcium, and other minerals—but in trace amounts. If you like their taste or texture, wonderful. I have fancy salts in my kitchen too. That's cuisine, not cardiology.
If you want magnesium, eat some nuts.
And then buy Morton's.
We have performed a similar trick with hydration. There are people who genuinely need extra sodium: athletes exercising for hours, people working in extreme heat, and people experiencing substantial fluid losses. The development of sports drinks was a reasonable response to athletes losing both water and electrolytes during prolonged exercise.
Somehow, that became the idea that everyone needs mango-flavored electrolytes simply because they own a water bottle.
Most of us don't.
Sodium is essential, but essential doesn't mean unlimited. The WHO currently recommends adults consume less than 2,000 mg of sodium per day—about 5 grams of salt—and notes that average global sodium intake is more than twice that amount. Most dietary sodium isn't necessarily coming from the salt shaker. Processed meats, breads, sauces, prepared foods, restaurant meals, cheese, and other frequently consumed foods can contribute substantial amounts.
That doesn't mean your food needs to be bland. Cook vegetables. Eat legumes. Have fish. Use olive oil, herbs, spices, lemon, and vinegar—and use enough salt to make good food taste good. Just don't confuse seasoning your dinner with adding unnecessary sodium to an already sodium-rich diet.
Salt helped build civilizations. It preserved food, provisioned armies, generated taxes, helped make cheese possible, and eventually became a vehicle for preventing iodine deficiency. We spent thousands of years figuring out how to get enough of it.
Now we've become so good at it that we're paying extra to put more of it in our water.
Listen to this episode of FORK U for the story of salt, and head over to drsimpson.com for the deeper dive into sodium, blood pressure, vascular health, salt sensitivity, gastric cancer, electrolytes, and what the science actually says about how much salt we should be eating.

How a tiny seed changed the way we work, think, meet, and start the day

Bread gave civilization calories. Beans gave it protein. Olive oil gave it light. Coffee gave civilization somewhere to meet—and a reason to stay awake.
Coffee came late to Western civilization. The Greeks didn't have it. The Romans didn't have it. Even Galileo had to stay awake at night looking through his telescope without the help of an espresso machine. Historians no longer like the old idea of the “Dark Ages,” and for good reason. But I have my own definition: the Dark Ages were simply the time before Western civilization discovered coffee.

Coffee Started as a Fruit
First, coffee isn't really a bean. What we call the coffee bean is the seed of a fruit, often called a coffee cherry. Coffee plants originated in Africa, especially Ethiopia, where we get the wonderful legend of a goat herder named Kaldi. He supposedly noticed that his goats became unusually energetic after eating the red fruit from a coffee tree. The goats danced, Kaldi tried the fruit, and eventually the local monks discovered it helped them stay awake for evening prayers.
It's a great story, although there isn't much evidence that Kaldi actually existed. The history becomes more reliable by the 1400s, when we know people were drinking coffee in Yemen. From there, coffee traveled along trade routes through the Middle East and into the Ottoman Empire. Somewhere along the way, something important happened: coffee stopped being simply a drink and became a reason for people to gather.

Coffeehouses Woke People Up
By the 1500s, coffeehouses were appearing in the Ottoman world. People came to drink coffee, but they stayed to talk about business, politics, religion, news, and probably their neighbors. Coffee eventually moved west, and by the 1600s, coffeehouses were spreading across Europe. London's first coffeehouse is generally dated to 1652.
Some of these coffeehouses became known as “penny universities.” For the price of a cup of coffee, you could sit, listen, argue, and perhaps learn something. Coffee did not cause the Enlightenment, but it certainly provided a convenient place for people to discuss it. Unlike the tavern, the main drug being served made people more alert instead of less.

The Swedes Took Coffee Seriously
Then there were the Swedes. After losing to Russia in 1709, King Charles XII of Sweden spent several years in Ottoman territory. While there, he and his companions developed quite an affection for coffee. When the Swedes eventually returned home, that affection came with them, and coffee became deeply rooted in Swedish culture.
Today, the Swedes have fika, which is much more than a coffee break. You stop what you are doing, sit down, usually have something to eat, and most importantly, talk to another person. In other words, coffee provides an excuse to stop working long enough to remember that there are other human beings around you.
That sounds remarkably familiar to me.

Coffee in Rainy Alaska
I grew up in Ketchikan, Alaska, one of the wettest cities in America. Some years, the rainfall can approach 200 inches, and this isn't always the lovely rain that gently falls outside while you read a book beside the fireplace. In Ketchikan, the rain sometimes blows sideways.
Many women of my mother's generation had moved to Alaska because their husbands brought them there. Their families might be thousands of miles away, winter days were short, and sometimes it seemed as though the rain would never stop. This was before SSRIs, but there was always coffee.
My mother and her friends would gather at someone's house, sit around the kitchen table, drink coffee, and talk. Looking back as a physician, I think those gatherings served an important purpose. Not because coffee treats depression—it doesn't—but because friendship, conversation, and human connection matter. When the rain was blowing sideways, and you had had enough of your own house, you could always go to Betty's house for a cup of coffee.
Of course, there were standards. In our part of Alaska, coffee meant Hills Bros. If Betty served something else, everyone would still drink it gratefully, but it would certainly be discussed. Coffee could generate more conversation than differences in religion. In a town where you could still hear Norwegian spoken on the streets, coffee sometimes seemed like our national beverage. Admittedly, Ketchikan also had far more bars than churches, but that's another story.

We Still Meet Over Coffee
That social role of coffee never disappeared. In many parts of the world, you don't begin a business meeting with business. First comes coffee. You make introductions, ask about family, talk about where you are from, and get to know one another. Then you conduct business.
We Americans have made the process more efficient. We pick up a paper cup from the espresso bar, carry it into a conference room, open the laptop, and get right to work. We've kept the coffee, but perhaps we've lost a little of the ritual.
Still, coffee shops are thriving, while alcohol use, particularly among younger adults, has been declining. For generations in America, meeting someone often meant, “Let's get a drink.” Increasingly, that drink might be coffee. From a health standpoint, replacing some alcohol with coffee is probably a pretty good trade: a healthier drink and a brighter mind.
Even first dates now happen over coffee. Some people think a proper first date should involve dinner, but I'm not convinced. If I'm going to spend two hours discovering whether I like someone, wouldn't I rather find out after they've occupied a few of their adenosine receptors? Give them an espresso, and let's hear their interpretation of Hume.

What Coffee Does to Your Brain
Which brings us to caffeine. Caffeine doesn't actually give you energy. Instead, it blocks receptors for adenosine, a chemical involved in the feeling of sleep pressure. As you've been awake longer, adenosine signaling helps tell your brain that you're tired. Caffeine interferes with that message, which is why you feel more alert.
My first scientific encounter with caffeine wasn't coffee at all. In the organic chemistry laboratory at the University of Chicago, we isolated caffeine from tea by brewing what may have been the world's strongest cup. It looked completely undrinkable, which was fine because we weren't making afternoon tea; we were doing chemistry.
Years later, my friend Simon Majumdar introduced me to proper British builder's tea. Suddenly, I understood the British a little better. Builder's tea is one step removed from containing enough caffeine to keep you awake through one of my podcasts.

Do You Really Have to Wait 90 Minutes?
You may have heard the popular claim that you should wait 90 minutes after waking before drinking coffee because of cortisol. There is a little real physiology behind the claim. Caffeine can temporarily increase cortisol, and cortisol normally changes around the time we wake up.
However, that doesn't prove the 90-minute rule. People who regularly consume caffeine develop substantial tolerance to some of its cortisol effects, and we don't have clinical trials showing that people who wait exactly 90 minutes have better health, better sleep, or better alertness.
This is an important lesson that goes well beyond coffee. A biological mechanism is not automatically a medical rule. If waiting 90 minutes makes you feel better, then wait. If you've been drinking coffee shortly after waking for thirty years, sleep well, and enjoy your morning cup, there isn't good evidence that you need to stand beside the coffee maker holding a stopwatch.

Coffee Is More Than Caffeine
For years, medicine tended to think about coffee mainly in terms of caffeine. Caffeine stimulates us and can temporarily increase blood pressure, so it seemed reasonable to worry that coffee might be bad for the heart. Then researchers began looking at what actually happened to people who drank coffee over many years, and the story became much more interesting.
Coffee contains hundreds of compounds, including chlorogenic acids, which are polyphenols. It also contains other compounds created or changed during roasting. In other words, coffee isn't simply caffeine dissolved in brown water.
Large observational studies have found that moderate coffee consumption is associated with lower rates of several health problems, including type 2 diabetes and cardiovascular disease. Some of the most consistent findings involve the liver, where coffee drinking has been associated with lower risks of chronic liver disease, cirrhosis, and liver cancer.
Interestingly, some health associations also appear in people who drink decaffeinated coffee. That tells us caffeine cannot be the entire story. Of course, these studies don't prove that coffee prevents disease, and coffee isn't medicine. But they certainly make the old idea that coffee must be bad for us much harder to defend.

How You Make Coffee Matters
Even the way we brew coffee changes what ends up in the cup. Coffee contains compounds called cafestol and kahweol, and cafestol can raise LDL cholesterol. Boiled and unfiltered coffee retains more of these compounds, while a paper filter removes many of them.
That makes a simple invention from 1908 surprisingly important. A German woman named Melitta Bentz wanted a cleaner cup of coffee without grounds and began experimenting with paper filtration. More than a century later, we

For years, beans have suffered from an image problem.
They've been called "the poor man's meat," joked about for causing gas, and often relegated to the side of the plate. Yet for thousands of years, beans, lentils, chickpeas, and peas—collectively known as pulses—were among the most important foods on Earth.
If bread supplied the calories that built cities, beans supplied much of the protein that sustained them.
Long before protein powders and high-protein snack bars, civilizations from Rome to India relied on pulses as an everyday source of nourishment. The Roman laborer's bowl of puls—a hearty porridge often enriched with legumes—was far more representative of daily life than the lavish banquets of emperors. Across the Mediterranean, dishes like pasta e fagioli reflected a simple truth: grains and legumes together formed a remarkably nutritious meal.
Modern science has largely caught up with what history already knew.
Beans are rich in protein, but they're also packed with dietary fiber, resistant starch, folate, magnesium, potassium, and a remarkable collection of plant compounds that support both heart and metabolic health. Their fiber nourishes the trillions of bacteria living in our colon, producing short-chain fatty acids that help maintain the health of the intestinal lining and may reduce inflammation throughout the body.
Perhaps most remarkable is that cultures around the world independently discovered the same dietary pattern. Italy has beans and pasta. India has dal with flatbread. Latin America combines beans with rice or corn. The Middle East gave us hummus. These weren't accidents. They were elegant nutritional solutions developed centuries before anyone knew what an amino acid was.
Beans also improve the soil they grow in. Through a partnership with nitrogen-fixing bacteria living on their roots, legumes enrich the earth for future crops. Few foods nourish both the people who eat them and the land that produces them.
Today, beans are enjoying a well-deserved renaissance. Heritage producers such as Rancho Gordo have reminded us that beans have flavor, texture, and personality. They're no longer just pantry staples—they're ingredients worthy of the center of the plate.
In this week's Fork U podcast, we'll explore how one humble family of plants helped build civilizations, why modern nutrition keeps rediscovering their value, and why the "poor man's meat" may actually be one of the richest foods in human history.
Sometimes the greatest superfoods aren't new discoveries.
Sometimes they've been quietly simmering in the pot all along.

Olive Oil: The Original Superfood

Before electricity lit our homes, olive oil did.
For thousands of years, olive oil was far more than something people poured over bread. It fueled lamps, preserved food, moisturized skin, and was used in religious ceremonies. Long before it became a staple of the Mediterranean diet, it helped build civilization.
Today, we think of olive oil as healthy. The fascinating part is that people believed it was medicinal long before they understood cholesterol, inflammation, or blood pressure. Sometimes medicine begins with observation. The science simply catches up later.

More Than Just Fat
When people hear "olive oil," they often think of fat. That's true, but not all fats behave the same way.
Olive oil is rich in monounsaturated fat, the primary fat found in the Mediterranean diet. Rather than worrying about the chemistry, it is more useful to think about what happens inside the body.
The real benefit comes from what olive oil replaces.
Instead of cooking with butter or shortening, people sauté vegetables with olive oil. Olive oil is better than creamy dressings, and it is part of a delicious vinaigrette. And my favorite is, instead of spreading butter on bread, dipping it in olive oil.
Those small substitutions can add up over time.

The Science Is Impressive
One of the first studies to grab the attention of cardiologists came from Lyon, France. Researchers enrolled people who had already suffered a heart attack and asked one group to adopt a Mediterranean-style diet rich in olive oil.
The results surprised almost everyone.
Those following the Mediterranean diet had dramatically fewer second heart attacks than those eating their usual diet. It was one of the studies that helped transform olive oil from a traditional food into a modern medical recommendation.
Since then, researchers have followed hundreds of thousands of people around the world. Again and again, the same pattern appears. People who regularly consume olive oil tend to have lower rates of heart disease, lower rates of type 2 diabetes, and even lower mortality.
Even better, randomized clinical trials such as the PREDIMED study showed that people at high cardiovascular risk reduced their chances of major cardiovascular events by following a Mediterranean diet supplemented with extra-virgin olive oil.

Why Does It Work?
Scientists think olive oil helps in several ways.
When olive oil replaces butter and other saturated fats, LDL cholesterol usually falls. The natural polyphenols found in extra-virgin olive oil also appear to reduce inflammation and help blood vessels relax by improving nitric oxide production. In addition, studies suggest olive oil improves insulin sensitivity and helps protect LDL cholesterol from becoming oxidized, an important step in the formation of artery plaque.
No single mechanism explains everything.
Instead, several small benefits appear to work together.
That is often how nutrition works.

Not All Olive Oils Are the Same
If you ask people where the best olive oil comes from, be prepared for a lively discussion.
Some prefer the buttery oils from Liguria in Italy. Others enjoy the peppery oils of Lebanon, Greece, or Spain. I have favorites from Arizona, where I lived for years, and from California, where I live now.
California also has some of the highest purity standards for olive oil in the world. While olive oil fraud has occurred in some parts of the world, California producers have built a reputation for careful quality control. That gives me confidence in what I'm pouring into my pan.

A Small Change Worth Making
Nutrition rarely comes down to one magical food.
Instead, it comes from making better choices more often.
Adding olive oil to your kitchen is one of those simple changes that is easy to enjoy. It makes vegetables taste better, encourages home cooking, and replaces less healthy fats without making meals feel restrictive.
Sometimes the healthiest habits are also the most delicious.
Olive oil first transformed civilization by lighting the night.
Today, it may help illuminate a healthier future—one meal at a time.

Cheese: Humanity's Greatest Delicious Accident
What if one of the world's favorite foods happened by accident?
That's probably how cheese began.
Nobody knows exactly who made the first cheese. Maybe it was a shepherd carrying milk in a bag made from a sheep's stomach. The milk warmed in the sun, natural rennet in the stomach lining began to separate the curds from the whey, and suddenly milk had become something entirely different.
Instead of throwing it away, someone tasted it.
Transforming Cheese
Cheese is another example of one of humanity's greatest skills: transforming food. We didn't simply discover food—we learned how to make it safer, preserve it longer, and often make it taste even better.
Then, over thousands of years, every culture added its own touch.
The English gave us Cheddar. The French perfected Brie and Roquefort. Italy created Parmigiano Reggiano. Greece gave us Feta. Norway even created brown cheese by slowly caramelizing whey into a sweet, nutty delight.
Each cheese tells the story of the people who made it.
Then there's the science.
For years, cheese was criticized because it contains saturated fat. However, modern nutrition research has taught us that cheese is far more complicated than a single nutrient. Cheese contains protein, calcium, beneficial bacteria from fermentation, and a unique food structure that scientists now call the dairy matrix. Interestingly, studies have found that eating cheese is generally neutral—and in many cases modestly protective—when it comes to heart disease.
One of my favorite ironies involves Parmesan.
People often warn about MSG while happily grating Parmesan over their pasta. Yet Parmesan is naturally rich in free glutamate, the compound responsible for the delicious savory flavor we call umami. Nature discovered that trick long before chemistry gave it a name.
Like bread, soup, and cooking itself, cheese reminds us that humans became successful because we learned to transform food instead of wasting it.
The next time you enjoy a piece of good cheese, remember you're tasting one of humanity's oldest scientific experiments.
This week on FORK U, we'll explore the fascinating history of cheese, how it shaped civilization, why it's healthier than many people think, and why your charcuterie board has a much longer history than Instagram.
And on my Substack later this week, we'll dive even deeper into the science behind cheese, fermentation, heart health, the Mediterranean diet, and why nutrition is always more interesting than social media makes it seem.