   |  | | Are you getting too much of it? | By Mike Magee, MD
The average American consumes two to three times as much salt as she or he should on a daily basis, and only 15% of that comes from the salt shaker. About 10% occurs naturally in foods, and a whopping 75% is put there by the food industry.1 A can of soup or a visit to a restaurant generally means hidden salt. Excessive salt intake leads to high blood pressure, and high blood pressure, which leads to cardiovascular disease, is both silent and deadly.
We need about 1/2 a gram of salt a day for normal function.2,3 On average, Americans consume about 4 grams and many probably don’t even realize it.2 The food industry adds salt to everything from breakfast cereals to cheeses. Why? Because we consumers have developed a taste for it. We tend to buy foods that are high in sodium and shun those that are not. Other reasons on top of this include the fact that salt is a relatively inexpensive additive, it has some preservative qualities, it adds texture to the food, and it covers up a few bad tastes that are byproducts of food processing itself.4 Packaged foods pack a wallop of salt: one gram in some cans of soup, and two grams in some frozen TV dinners.4,5
Understanding the connection between sodium, high blood pressure, and cardiovascular disease is key. To put it simply, high blood pressure causes cardiovascular disease, and cardiovascular disease leads to heart attack or stroke. How? High blood pressure is, in part, the result of too much blood volume in our circulatory systems. When sodium levels are high, the concentrated mineral draws in more water and expands blood volume. That volume must be pumped through the blood channels, putting extra stress on the heart. The volume itself creates expansion pressure on the vessels, stressing weak points, which can occasionally rupture. If this occurs in a blood vessel in the brain, a stroke is the result.5
Who’s at risk? Approximately 30% of the U.S. population has high blood pressure, which is a reading of 140 over 90 or greater. And high blood pressure causes about half of the deaths from cardiovascular disease worldwide.1,6 Age and race can increase risk. Nearly 70% of Americans over age 80 have high blood pressure, compared to only 10% between ages 30 and 39. African Americans are 40% more likely than whites to suffer from high blood pressure, they’re 50% more likely to die of heart disease, and 80% more likely to die from a stroke. That’s why it’s recommended that seniors and African Americans of all ages consume no more than 1.5 grams of sodium a day, compared to the 2.3 grams a day recommended for the rest of the population. In fact, adhering to these recommended amounts over the next 10 years would save approximately 150,000 lives per year.2
To give credit where credit is due, some food manufacturers are trying, and we, the consumers, are not exactly cooperating. For example, ConAgra’s versions of low sodium Healthy Choice chicken noodle soup and low sodium Hamburger Helper went down in defeat. No buyers. But there is some good news on this front – the products from which the company has more quietly reduced sodium are doing well, including Kids Cuisine, Chef Boyardee, and Banquet frozen dinners.4
So what can we do to take more control of our own sodium intake? First, read the labels. Total intake per day of sodium should not exceed 2.3 grams, except for African Americans and the elderly, who should only consume 1.5 grams a day. Any food with a half a gram or more in a portion is probably worth avoiding. Second, watch the restaurants. A single meal often contains 4 grams of sodium. And think twice about that free bread on the table – it’s one of the worst offenders.2 Third, remove the salt shaker from your table at home. Why add insult to injury? Fourth, accept a little pain. Studies show we like the taste of salt and weaning ourselves off it will be noticeable at first. But studies also show that adjusting to the change happens quickly and cravings disappear rapidly. Making the small sacrifice is well worth it. Cutting your sodium intake in half can drop your blood pressure 5 points, and that decreases your risk of death from heart disease by 9% and from stroke by 14%.2
References
1. He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003; 42:1093-1099.
2. Havas S, Rocella EJ., Lenfant C. Reducing the public health burden from elevated blood pressure levels in the United States by lowering intake of dietary sodium. American Journal of Public Health. 2004; 94:19-22.
3. National Research Council, Committee on Dietary Allowances. Recommended Dietary Allowances. National Academies Press; 10th edition. Nov. 1989.
4. Warner M. The War Over Salt. The New York Times. 13 Sept. 2006.
5. AMA calls for measures to reduce sodium intake in U.S. diet. American Medical Association. 13 June 2006.
6. AMA Recommends Salt Warning Labels. CBS News. 14 June 2006.
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