Getting to the Heart of a Healthful Diet: Sodium

Here's Why:

Sodium intake can raise blood pressure in people predisposed to having high blood pressure, and high blood pressure (or hypertension) is a major risk factor for heart [2] attacks.

About half of the people with hypertension [3] and 30% of the general public are described as "salt sensitive." This means that their blood pressures are likely to increase when they eat a high-sodium diet, and conversely, their blood pressures may be lowered by limiting dietary sodium.

Salt sensitivity is difficult to accurately diagnose. Therefore, appropriate sodium recommendations are a subject of great debate among nutrition [4] experts. Some believe that all people should limit their sodium intakes (2400 mg/day) to either treat or prevent hypertension [3] regardless of their present blood pressure level. Others, though, advise that only people with hypertension [3] or those who are believed to be salt sensitive need to limit sodium in their diets.

Nutrition researchers are still trying to tease out the exact role of sodium in hypertension [3]. A major study in this area is DASH—Dietary Approaches to Stop Hypertension. This study found that a diet rich in fruits, vegetables, and low-fat dairy products, and low in saturated fat, cholesterol [5], and saturated fat—now called the DASH diet—helped lower blood pressure. The second phase of the study found further reductions in blood pressure when the DASH diet was combined with a sodium intake of no more than 2400 mg/day.

Here's How:

Sodium is found in many foods. Some are obvious, but others may surprise you.

Major Food Sources

Table salt (sodium chloride; NaCl) is the major source of dietary sodium—about 1/3 to 1/2 of the sodium we consume is added during cooking or at the table.

Fast foods and commercially processed foods—canned, frozen, instant—also add a significant amount of sodium to the typical American diet. These include:

Beef broth
Ketchup
Commercial soups
French fries
Gravies
Olives
Pickles
Potato chips
Salted snack foods
Sandwich meats
Sauces
Sauerkraut
Tomato-based products

Sodium occurs naturally in:

Eggs
Fish
Meats
Milk products
Poultry
Shellfish
Soft water

Other sources of sodium in the diet:

Baking powder
Baking soda
Monosodium glutamate (MSG)
Sodium alginate
Sodium citrate
Sodium nitrate and nitrite
Sodium propionate
Sodium sulfite
Soy sauce

Reading Food Labels

All food products contain a Nutrition Facts label, which states a food's sodium content. The following terms are also used on food packaging:

Food label term	Meaning
Sodium free	Less than 5 mg/serving
Very low sodium	35 mg or less/serving
Low sodium	145 mg or less/serving
Reduced sodium	75% reduction in sodium content from original product
Unsalted, no salt added, without added salt	Processed without salt when salt normally would be used in processing

Tips For Lowering Your Sodium Intake

Gradually cut down on the amount of salt you use. Your taste buds will adjust to less salt.
Taste your food before you salt it; it may not need more salt.
Substitute flavorful ingredients for salt in cooking, such as garlic, oregano, lemon or lime juice, or other herbs, spices, and seasonings.
Select fresh or plain frozen vegetables and meats instead of those canned with salt.
Look for low sodium, reduced sodium, or no salt added versions of such foods as:
- Canned vegetables
- Vegetable juices
- Dried soup mixes
- Bouillon
- Condiments (ketchup, soy sauce)
- Snack foods (chips, nuts, pretzels)
- Crackers
- Bakery products
- Canned soups
- Butter and margarine
- Cheeses
- Canned tuna
- Processed meats
Cook rice, pasta, and hot cereals without salt or with less salt than the package calls for (try 1/8 teaspoon for two servings). Flavored rice, pasta, and cereal mixes generally already contain added salt.
Adjust your recipes [6] to gradually cut down on the amount of salt you use. If some of the ingredients already contain salt, such as canned soup, canned vegetables, or cheese, you do not need to add more salt.
Limit your use of condiments such as soy sauce, dill pickles, salad dressings, and packaged sauces.

RESOURCES

American Dietetic Association
www.eatright.org [7]

The Nutrition Source
Harvard School of Public Health
http://www.hsph.harvard.edu/nutritionsource/ [8]

CANADIAN RESOURCES:

Canadian Council on Food and Nutrition
www.ccfn.ca [9]

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca [10]

Last reviewed December 2006 by Jill D. Landis, MD [11]

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical [12] advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health [13] provider prior to starting any new treatment or with any questions you may have regarding a medical [12] condition.