How much salt is safe?

Newswise — An increasing body of evidence indicates that we should reduce the amount of salt in our diet. The American Medical Association (AMA), the American Heart Association (AHA), the American Dietetic Association (ADA), and the National Institutes of Health have begun a campaign to cut the salt intake of Americans by one-half. The AMA is even pushing the Food and Drug Administration to withdraw salt’s designation as “safe,” according to UCLA's Healthy Years.

“The consequences of too much salt are hypertension, or high blood pressure, which increases the risk of a stroke or heart attack,” says Amy Schnabel, MS, RD, Clinical Nutrition Manager at the UCLA Medical Center. Ninety percent of Americans will develop hypertension unless they take steps to prevent it. Two studies reported in the April 19, 2007 issue of the British Medical Journal showed that people who cut back on the amount of salt in their diets by 25-35 percent could reduce their risk of cardiovascular disease by as much as 25 percent and lower their mortality rates by 20 percent.

Where’s the salt?
Identifying products that are high in salt is a good place to start. (For the record, table salt is sodium chloride and is 40 percent sodium by weight.) One problem in finding salt content is that excessive amounts are present in many products generally considered to be healthy. Just one cup of canned soup can contain more than 50 percent of the FDA recommended allowance of 2,400 mg a day, equivalent to one teaspoon (The Institute of Medicine recommends even less—1,500 mg per day). A serving of lasagna at a restaurant can put you over your sodium allowance in one meal.

“The biggest misconception about sodium intake is that many people think that, by removing the salt shaker from the dinner table, they aren't eating salt,” adds Schnabel. “What they may not know is that as much as 80 percent of dietary sodium comes from eating out and from packaged and processed foods. The average American consumes 4,000 to 6,000 milligrams of salt per day. It is used for taste, to preserve foods, and provide texture. About 12 percent of the sodium in our diets comes from adding salt and sodium-containing condiments to what we cook and eat. Even some drugs (antacids, for example) have high amount of sodium.

How Much is Too Much?
We need salt to maintain a balance of body fluids, to transmit nerve signals, and for muscles to function properly. But we don’t need as much as most people are getting. Here are some examples of foods and their sodium content:
2 large scrambled eggs = 342 mg
1 slice luncheon meat = 350 mg
½ cup canned green beans = 177 mg
4-inch oatbran bagel = 451 mg
1-ounce pretzel = 486
½ cup vanilla ice cream = 53 mg

How Much is Not Enough?
With age and the presence of chronic illnesses, the body may not process sodium the way it once did; for some people, that can result in hyponatremia—low blood sodium. Other contributing factors are pain medications, antidepressants, and diuretics, as well as an underactive thyroid, heart or kidney failure, cirrhosis, dehydration, and Addison’s disease. The symptoms of hyponatremia include nausea, headaches, confusion, lethargy, and loss of consciousness. The only way it can be diagnosed is by a blood test, so you must see a doctor to get an accurate diagnosis. If low blood sodium is found, you may be advised to temporarily reduce fluid intake, but the condition will ultimately be treated by determining and correcting the underlying problem.

How to Cut Back
There is no shortage of advice out there on how to reduce salt intake. The AHA says to start by choosing fresh, frozen, or canned foods that don’t have added salts. Do the same for nuts, seeds, dried beans, peas, and lentils. Limit salty snacks. (If salt is in the top four ingredients listed on the label, it’s too salty.) Avoid adding salt and canned vegetables to homemade dishes. Select fat-free or low-fat milk, low-sodium cheese, and low-fat yogurt. When eating out, ask for dishes prepared without salt. Use spices and herbs instead of salt to enhance taste. At home, put down the saltshaker and step away.

If you are younger, don’t have high blood pressure, and are generally healthy, eat reasonably, enjoy your meals, and don’t worry too much (yet) about salt intake. But if you are older or African-American, or if you have either hypertension or diabetes, take the low-sodium (1,500-2,400 mg) approach to what you eat. Eating salty foods is more habit than nutritional necessity, and habits can be changed—at any age.

What You Can Do
Identify foods that have a high sodium content.
Limit daily sodium intake to between 1,500 and 2,400 milligrams.
Ask for unsalted dishes when eating out.
Season your food at home with herbs and spices rather than salt.
Remove salt from recipes when possible.
Don’t put the saltshaker on your dining table.