Reducing Sodium

Consuming less salt and sodium can significantly lower your risk of a heart attack

It's no wonder that Americans unintentionally consume more salt than they should. Salt is in almost everything, from bran muffins to salami to movie popcorn. And it's also in those little packets next to the ketchup and in that shaker in the middle of the table.

Why do we toss salt into so much of what we eat? Partly out of habit, partly because it makes food tastier, and also because our bodies require a small amount of sodium (the critical ingredient in salt) to regulate blood pressure and muscle and nerve function.

But as with many good things in life, too much salt can be bad for your health. Excess sodium causes the body to retain fluid, which can raise blood pressure to potentially dangerous levels and up your chances of a heart attack or stroke. The good news: There is strong evidence that reducing sodium intake even a little bit can significantly reduce that risk.

Getting Serious About Consuming Less Salt

The time has come to get serious about cutting back on salt. Recent research indicates that reducing salt intake may be as important to heart health as quitting smoking, maintaining a healthy weight, or controlling high cholesterol.

A study published in the January 2010 issue of The New England Journal of Medicine (NEJM) estimated that slashing salt intake by 3 g a day—that's around half a teaspoon—could significantly lower your risk of having a first heart attack. Even reducing salt intake by as little as 1 g per day—about one fifth of a teaspoon—could have benefits as well.

Based on a sophisticated computer-simulation model, the researchers estimated that a 3-g reduction in salt intake might prevent as many as 99,000 heart attacks a year as well as up to 120,000 cases of coronary heart disease, 66,000 strokes, and 92,000 deaths. The corresponding numbers for a 1-g reduction are substantial, too, with up to 35,000 fewer heart attacks a year and 40,000, 23,000, and 32,000 fewer cases of coronary heart disease, strokes, and deaths, respectively.

How Much Is Too Much Salt?

Most people are not even aware of how much salt they consume, as almost 75% of it comes from processed and prepared foods, including canned goods, cold cuts, and condiments as well as breads and cereals. Only about 10% comes from the salt we add during cooking or at the table; the rest is found naturally in food.

The American Heart Association estimates that adults consume, on average, 9 to 12 g of salt per day (or 3,600 to 4,800 mg of sodium). However, the recommended daily amount is no more than 5.8 g of salt (2,300 mg sodium); for blacks and people over age 40 who are more susceptible to hypertension and for those who already have hypertension, less than 3.8 g of salt (1,500 mg sodium) is ideal.

How To Lower Your Sodium Intake

Lowering salt intake has become a national goal. In 2010, a group of cities, states, and health organizations, formed to help food manufacturers and restaurants voluntarily reduce the amount of salt in their products. Their goal: to reduce salt intake by 20% over the next five years to potentially save tens of thousands of lives a year.

For now, though, controlling your salt intake is in your hands.

Learn To Spot Excess Sodium on Nutrition Labels

Since most of the salt we eat comes from packaged and processed foods, it's important to read the Nutrition Facts label so you can choose products with less sodium. This label lists not only the number of milligrams of sodium per serving but also the percent Daily Value (% DV)—how much sodium a serving of the food contributes to the daily limit.

Keep in mind: A serving is often smaller than what people typically eat in a single sitting, and the % DV is based on a daily limit of 2,400 mg of sodium and will be an underestimate of the % DV if your goal is less than 1,500 mg.

Foods like jarred spaghetti sauces, canned vegetables, luncheon meats, soups, pickles, olives, and condiments tend to have the highest sodium contents, but there's variation among brands. Canned soups, for instance, can contain from 280 to 980 mg of sodium per serving depending on the brand. Frozen pizza ranges from 375 to 780 mg per slice. Higher-sodium varieties don't always taste saltier, so check the label. Also, non-salty-tasting foods like breads, breakfast cereals, and cakes can be high in sodium, too.

Some products market themselves as low or no sodium and are your best bets when you do opt for ready-made foods. Here's how those terms translate into actual amounts of sodium:

Sodium-free —less than 5 mg per serving

Very low-sodium —35 mg or less per serving

Low-sodium —140 mg or less per serving

Reduced sodium —usual sodium level reduced by 25%

Unsalted, no salt added, or without added salt—made without the salt that's normally used but still contains naturally occurring salt.

Use Less Salt at Home

Here are a few strategies for lowering your salt intake at home:

Substitute spices, herbs, and salt-free blends for salt in cooking and at the dinner table. For example, a dash of curry powder, oregano, basil, or celery seed will add flavor without sodium. A squeeze of fresh lemon or lime juice perks up fish and vegetables.

Opt for fresh fruits, vegetables, and meats over packaged, instant, or processed foods.

Rinse canned foods (such as beans or vegetables) to wash off some of the sodium.

Try ½ teaspoon (tsp) of salt in recipes that call for 1 tsp.

Reach for the pepper mill instead of the salt shaker.

Talk to your doctor before using a salt substitute. These products contain potassium chloride, which can be dangerous for people with kidney disease or those taking certain medications for high blood pressure or heart failure.

Salt in Restaurant Foods

To watch your salt intake when dining out, follow this advice:

Avoid fast-food and Asian restaurants; both are likely to serve foods with a high salt content.

Stay away from soups, sauces, and salad dressings. Ask for oil and vinegar to dress your salad or lemon to squeeze on your fish or vegetables.

Ask your server if they have a no-salt menu or if food can be prepared without salt.

Many chain restaurants provide nutritional information when asked. They also often post this information on their website.

Slowly Transition to a Low Sodium Diet

Cut down on salt gradually over a few weeks to make the transition easier. Research shows that a preference for salt can be unlearned and that it takes about six weeks to get accustomed to a lower-salt diet. The payoff —a healthier heart—is well worth it.

Foods With Too Much Sodium

Food / Average sodium content (mg)
Table salt, 1 tsp / 2,325
BK Big Fish sandwich / 1,540
Whopper with cheese / 1,450
Baking soda, 1 tsp / 1,260
Fast-food biscuit with egg & sausage / 1,210
Big Mac / 1,040
Anchovies, canned, 1 oz / 1,040
Pasta sauce, canned, 1 cup / 1,025
Beef broth/bouillon, 1 packet / 1,020
Soy sauce, 1 Tbsp / 900
Pretzels, 2 oz / 820
Salami, 2 oz / 820
Cottage cheese, 1 cup / 800
Sauerkraut, ½ cup / 780
Ham, 2 slices (2 oz) / 740
Herring, pickled, 3 oz / 740
Fast-food cheeseburger w/ condiments / 700
Smoked salmon, 3 oz / 670
Tomato juice, 1 cup / 650
Chicken McNuggets, six / 600
Pickle, 2 oz / 570
Bacon, 3 strips / 550
Beef/pork hot dog / 500

_{Source: U.S. Department of Agriculture.}