More salt or less – what to do?
June 1, 2015
Does less salt in your diet actually help your heart health?
Most of us would likely answer yes to that question. But a better, more nuanced answer is that it depends on you, your lifestyle, and your blood pressure.
According to the CDC, the average American consumes around 3,500 mg of sodium per day. That’s not just the salt we use to flavor our food. Most people should not add salt to their food because more than enough sodium already exists in the foods we eat.
CDC data says 77 percent of the sodium we eat comes from restaurant meals and processed foods - bread, meat, packaged snacks, and other “convenience foods” that have been canned, cooked, frozen, dehydrated, or milled for a longer shelf life.
The amount of sodium in staple foods is more than most people think:
- 1 slice of white bread has 80 to 230 mg
- 3 oz. of sliced deli or pre-packaged turkey breast has 450 to 1,050 mg
- 1 fast food cheeseburger has 710 to 1,690 mg
- 4 oz. of fresh boneless, skinless chicken breast has 40 to 330 mg
These numbers are alarming. But a 2014 observational study called the Prospective Urban Rural Epidemiology (PURE) study questions the benefit of reducing daily sodium below 3,000 mg (slightly more than one-half teaspoon). The study, which included more than 100,000 people in 17 countries, found that people who consume between 3,000 and 7,000 mg of sodium per day were at the lowest risk of death from cardiovascular disease. The risk of death was higher when people consumed less than 3,000 mg or more than 7,000 mg of sodium per day.
No, that is not a misprint. However, comparing results from an observational study like the PURE investigation to the results from randomized control trials is like comparing apples to oranges. Observational studies report on observed patterns, whereas randomized control trials measure cause and effect. Both types of research can be useful, but they measure very different outcomes.
Here at UT Southwestern, we agree with the new national guidelines that recommend we consume no more than 2,400 mg of sodium per day. That’s slightly less than one-half teaspoon. The guidelines further state that six out of 10 adults should reduce salt intake to 1,500 mg per day (about one-fourth teaspoon) to reduce hypertension – high blood pressure – and improve their health.
What to do
Most experts agree that a great starting point is to encourage people with pre-hypertension (blood pressure of 120-139/80-89) or hypertension (blood pressure greater than 140/90) to lower their sodium intake by approximately 1,000 mg per day from their baseline sodium level. Your sodium level can be easily determined with a phone app or website that tracks your sodium intake.
It’s easier than ever to cut back on salt, given that 62 packaged foods and 25 restaurant food categories now have lower-sodium versions. Traditionally high-sodium foods – canned beans, ketchup, and taco and chili seasoning – are now available in low-sodium or no-sodium-added versions. Make a point to read the nutrition labels on all the foods you buy because once sodium is added to a food, you can’t remove it. The amount of sodium already in your food may determine what spices and seasonings you use to avoid adding more sodium to your family’s meal.
More important than reducing sodium in your diet is developing an overall healthy lifestyle. The most comprehensive approach to lowering blood pressure and reducing cardiovascular risk includes:
- Reducing calories to promote weight loss, if you’re overweight
- Eating more fruits and vegetables as emphasized in the DASH (Dietary Approaches to Stopping Hypertension) diet
- Exercising moderately 30 to 40 minutes, three to four times a week
- Lowering sodium intake to an appropriate value
In summary, while the most appropriate level of sodium is dependent on the individual, an overall healthy lifestyle pattern is beneficial to all of us!
Definitions to help you
Term Used on Label: What it Means:
- Salt/Sodium Free: Less than 5 mg per serving
- Very Low Sodium: 35 mg or less of sodium per serving
- Low Sodium: 140 mg or less of sodium per serving
- Reduced Sodium: At least 25 percent less sodium than the original product
- Light in Sodium or Lightly Salted: At least 50 percent less sodium than the regular product
- No Salt Added or Unsalted: No salt is added during processing, but the product is not
Use the Percent Daily Value (%DV) to compare products:
- 5%DV (120 mg) or less of sodium per serving is low
- 20%DV (480 mg) or more of sodium per serving is high