by Carole Jackson, Bottom Line Health
If you live in the US, the odds are nine to one that you ingest too much sodium, according to new research from the Centers for Disease Control and Prevention (CDC). That doesnât mean just a bit too much — for many, the excessive salt intake is enough to kick off high blood pressure, heart disease, stroke and/or kidney disease. In fact, dialing sodium intake back to the right amount could save 120,000 Americans from heart disease and 66,000 from strokes each year, researchers said.
However, the story behind the story is that consuming this “right” amount of salt will never be possible for people who donât know exactly where all their dietary sodium lurks — and the hiding places are likely to surprise you.
According to the CDC report, the food group where most Americans are getting the highest amount of sodium is grains! This includes bread (even the healthy whole-grain kind), pasta and pizza crust (the tomato sauce and cheese add yet more sodium). Second-highest is meats — not only the lunch meat and sausage youâd expect, the report also specifically cited prepared chicken dinners and other prepared and packaged meats. And third is “processed vegetables” including vegetable-based soups and sauces and canned vegetables, not to mention the unsurprising potato products such as chips and fries.
Early Morning Peril?
According to Mark Houston, MD, head of the Hypertension Institute in Nashville and associate clinical professor of Medicine at Vanderbilt University School of Medicine, the sodium-loaded surprises donât stop there. Dr. Houston said that he was taken aback to see that the report barely mentioned other foods that contain sodium in plentiful amounts, including the all-American classic (and seemingly healthful) breakfast of milk (107 mg in one cup of low-fat milk) and cereal (200 mg in one cup of cornflakes). Most people donât realize these contain any sodium at all!
We canât just take a pass on sodium. We need it to help our nerves function properly, to aid nutrient absorption and for maintaining the right balance of water and minerals in our bodies. But, said Dr. Houston, most healthy adults require only 500 mg to 1,000 mg of sodium/day, and no one should ingest more than 2,300 mg. Some people should go lower still, setting 1,500 mg/day as the upper limit. This includes…
People with high blood pressure, diabetes or kidney disease.
African-Americans, who are genetically predisposed to high blood pressure.
People over age 50, who also are considered at higher risk for hypertension.
People who are “salt sensitive,” which describes about one-third of the adult population. Such individuals are extraordinarily reactive and will experience a rise in blood pressure after eating just a small amount of sodium.
Since you canât rely on your taste buds to identify foods and beverages high in sodium, Dr. Houston made the following recommendations:
Read every label. You may be surprised to learn that one slice of whole-wheat bread typically contains about 100 mg of sodium and one ounce of cheddar cheese contains 180 mg. There are 390 mg of sodium in a half-cup serving of canned sweet peas, 709 mg in two ounces of turkey breast lunch meat and 780 mg in one cup of canned vegetable beef soup. Other surprisingly high sources of sodium: Four large black olives contain 150 mg of sodium… a one-ounce dill pickle has 260 mg… and two teaspoons of yellow mustard contain 115 mg.
Be mindful when adding salt. You may not realize that one-half teaspoon of salt (about whatâs used in a pan of homemade lasagna or a batch of chocolate chip cookies) contains about 1,160 mg of sodium. A quick dash of salt (such as what youâd sprinkle on grilled fish or corn on the cob) contains 290 mg of sodium. Be aware that for the average American, about 70% of daily sodium intake is in prepared, packaged or processed foods, and the remaining 30% comes from the saltshaker.
Perk up your food without sodium. If you eat foods that are inherently more flavorful, youâll be less likely to want to add salt. Try making salads with arugula, for example — it has a more intense flavor than more commonly used lettuces such as romaine or iceberg. Another idea: Add cilantro or ginger (both of which also have nutritional value) to salads and other dishes. Fresh lemon juice, peppermint, basil and vinegar are other zesty sources of flavor that add taste but contain virtually no sodium.
Eat lots of fresh fruits and vegetables — meat and poultry, too. These are naturally very low in sodium.
Dr. Houston has one more piece of advice for those of us trying to reduce salt intake — go slow. He suggests cutting back gradually, by about 150 mg/day to 250 mg/day to reach your goal of 2,000 mg/day unless you are in a high-risk group, in which case it should be 1,500 mg/day. Not only will this help you feel less deprived, youâll also learn to appreciate the true flavors of foods that had been masked by salt and other unhealthful condiments. Such an approach also helps your body adjust to and properly balance sodium concentrations. This is good advice that should not be taken with a grain of salt!
Mark Houston, MD, is the director of the Hypertension Institute in Nashville and an associate clinical professor of medicine at Vanderbilt University School of Medicine. He is the author of What Your Doctor May Not Tell You About Hypertension (Grand Central).