Salt: The New Public Enemy?

Your doctor says to lower your sodium intake, so you got rid of your salt shaker and cut back on the salami and pickles at lunch.  But did you check the labels on your favorite frozen dinners, American cheese, and low-fat soup you keep in the cupboard for a rainy day?  Or check the sodium content for your favorite chain restaurant meal online?  More than 75% of your sodium intake is from these types of processed foods and you may be consuming more sodium than you think.  Here are some of the biggest culprits: fast food; restaurant food; canned foods like beans, soups, stews, fish, and veggies; cheese; bread; instant soups, gravies and packaged seasoned rice dishes; smoked, cured, or processed meats; and condiments like ketchup, Asian sauces, olives and pickles.

One teaspoon of salt contains 2300 milligrams (mg) of sodium – the maximum daily recommended intake for healthy individuals by the Centers for Disease Control and Prevention (CDC).  However, 70% of the population has one or more cardiovascular risk factors, like high blood pressure, are older than 40 years old, or are African American.  If that’s you, the CDC recommends only 1500mg of sodium per day.  The average American consumes closer to 3400mg of sodium daily and public health officials are combing for ways to cut back and save lives in the process.

In the United Kingdom, the government has imposed tighter regulations on added salt in processed foods, working with manufacturers to improve the quality of their products.  In 5 years, sodium intake was down by nearly 10%.  In the last few months, the FDA has been discussing public health strategies suggested by the Institute of Medicine and experts from Stanford University and the Department of Veterans Affairs.  Ideas include collaborative policies similar to the work taking place in the U.K., and even a salt tax, but none have been finalized.  These experts suggest that collaborating with manufacturers to reduce sodium consumption by 9.5% could protect Americans against 510,000 strokes and 480,000 heart attacks over the lifetime of adults currently over age 40, while saving over $32 billion in medical costs.  Adding a tax to further reduce intake by 6% could save an additional $22 billion.  In this economic rut, what’s not to like about that?

The truth of the matter is that this kind of speculation is just that: speculation.  While the policymakers wrangle with research on the development of salty taste in humans and the level of consumer awareness about sodium and its link to heart disease, the healthiest thing we as individuals can do is to focus on simple strategies for reducing our sodium intake, one meal at a time.  As a Registered Dietitian, here are my suggestions for doing so, based on NIH recommendations:

  • Prepare most of your meals at home from fresh, whole, and varied ingredients like vegetables, whole grains, dry beans, fresh fish or poultry, low-fat dairy and eggs.
  • Fill half of your plate with fresh, frozen, or canned fruits and vegetables that say “no salt added” on the packaging.  Fruits and vegetables contain large amounts of potassium which has been shown to reduce cardiovascular disease risk, by lowering blood pressure, especially when these foods replace sodium-rich foods in the diet. (However, if you have kidney disease, you may need to avoid foods high in sodium and potassium in the diet; talk to your doctor.)
  • Use fresh meat, fish, poultry, and eggsinstead of processed or canned varieties.  For example, you could roast your own chicken in the oven to use in sandwiches instead of buying pre-sliced deli meats.
  • Experiment with herbs and spices – if you must add salt to your food, add it before cooking, as it has time to marinate with other flavors to impart a more flavorful result than adding it at the end of cooking.
  • Read food labels and choose no-salt-added, or low- and reduced-sodium items.  If a product contains more than 10% of the Daily Value (or more than 240mg) think twice before making your purchase.
  • Avoid condiments high in sodium or at least use them sparingly.
  • Choose mozzarella, swiss, ricotta, goat cheeses over other cheese varieties – but still read the food label to be sure.
  • Rinse canned and jarred foods, like tuna and capers, to wash away some of the excess sodium.
  • Aim for meals containing fewer than 500mg of sodium.  More than that could put you over your limit for the day.  Food naturally contains a small amount of sodium and if you’re a “snacker”, be sure to factor snacks between meals into your total as well.

For more in-depth information about hypertension and a healthy eating plan, check out the DASH Diet (Dietary Approaches to Stop Hypertension Diet).  Also, be sure to talk to your healthcare provider (an MD or Registered Dietitian) about your cardiovascular risk factors before embarking on a drastic diet change.


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