The U.S. Dietary Guidelines recommend reducing sodium in your diet to less than 2,300 milligrams a day for the general population. And for people with prehypertension or hypertension, the guidelines advise that a further reduction to 1,500 milligrams a day can lead to greater reductions in blood pressure.
Because people are accustomed to eating processed and restaurant foods (which tend to be very high in sodium), it’s hard enough to get down to the 2,300 milligram a day limit (the amount in a teaspoon of salt), let alone to the lower limit. In fact, the average American consumes more than 4,000 milligrams of sodium a day, and many get closer to 6,000 milligrams—much more than the small amounts needed to maintain basic body functions, including the regulation of fluid balance and transmission of nerve impulses.
Why limit sodium? Many large observational studies have linked high-sodium diets to hypertension (high blood pressure), which increases the risk of heart attacks and stroke. These studies don’t prove that salt is the culprit—it may be something in salty foods or about high-sodium diets that increase blood pressure, or that such foods are low in nutrients (such as potassium) that are important for blood pressure control. And not everyone is “salt-sensitive”—that is, has blood pressure that is significantly affected by sodium intake. But reducing sodium does lower blood pressure, on average, as seen in studies on the DASH diet (see below).
Though there has been debate in recent years about whether very low levels of sodium are necessarily better, virtually all health experts agree that it’s still prudent to reduce sodium as much as possible.
Here is some information to help you make the transition to a lower-sodium lifestyle.
What’s the difference between salt and sodium?
Sodium is a component of table salt (sodium chloride). One teaspoon of salt, which is 40 percent sodium and 60 percent chlorine, has about 2,300 milligrams of sodium, the upper recommended limit. If you are restricting sodium to 1,500 milligrams a day, that’s only two-thirds of a teaspoon of salt. Besides salt, sodium is also a major component of other common food ingredients such as MSG (monosodium glutamate), baking soda (sodium bicarbonate), disodium phosphate, sodium benzoate, sodium propionate, sodium sulfite, and sodium nitrite/nitrate, among others. Many of these are used as preservatives.
Can’t I just hide my salt shaker?
That won’t help as much. About three-quarters of the sodium we consume comes from processed and restaurant foods, not the saltshaker. Salting food at the table and in cooking accounts for only about 10 percent of our sodium intake. Another 10 percent comes naturally from food. Canned foods, frozen meals, smoked and cured meats, prepared mixes, sauces, bouillon cubes, vegetable juice, and pickled foods tend to be particularly high in sodium. But even cottage cheese has more sodium than you may think—about 400 milligrams per half cup. Nearly all foods that have been processed in some way—from bread and cheese to ketchup and frozen waffles and even candy—contain added sodium. Even foods that don’t taste particularly salty can be high in sodium.
How salty is restaurant food?
Of course, it varies. But, as reported by the Center for Science in the Public Interest, a single meal at a chain restaurant can easily have more than a day’s worth of sodium, with some having more than 4,000 milligrams—high enough to bring on heart failure in susceptible people. Don’t assume that full-service restaurants are better. Overall, they serve up as much sodium (or even more) than fast-food restaurants, according to a study in the European Journal of Clinical Nutrition.
Tips to Reduce Sodium
Most Americans would benefit from reducing the amount of salt in our diet. But salt is in so many packaged foods, how do you know where to begin? Here are four ways to get started.
Why do processed foods contain so much salt?
Traditionally, salt has been used to preserve food. Today, though, manufacturers use salt to improve food qualities and enhance flavor. Paradoxically, salt can make foods taste sweeter by blocking the bitterness of certain ingredients. But if you check the sodium content of similar products, you will see a large range, which indicates that it’s possible to reduce sodium without adversely affecting quality and taste. In fact, a study a few years ago found that sodium levels within the same food brands varied widely by country, possibly because of different local manufacturing practices, not out of preferences or necessity. In recent years, many food companies have been lowering the salt content of their foods due to increasing pressure.
Won’t cutting down on salt make my food unappetizing?
You won’t miss the salt for long. Though humans have an innate liking for salt, individual preferences are largely learned—and thus can be unlearned. It takes several weeks for your taste buds to adapt to a lower sodium level, but what once tasted just right will eventually taste too salty—and you will begin to notice flavors that were previously masked by the salt. According to one survey, three out of four people who are on sodium-restricted diets say they “do not miss the salt.” Keep in mind that a low-sodium diet tastes best when it’s filled with fresh foods, like fruits and vegetables, that are naturally low in sodium but rich in flavor, as opposed to reduced-sodium processed foods.
Does rinsing canned foods, like beans, lower the sodium?
Yes, some. A half-cup of canned beans has about 350 to 500 milligrams of sodium. You can reduce this by about one-third if you drain and rinse the beans first. That still leaves most of the sodium, however. Alternatively, look for low-salt/sodium (and rinse those too) or no-salt-added versions. Or prepare dry beans, which have negligible sodium, by soaking and cooking them. You can also rinse canned tuna and canned vegetables.
Are bread and cereal high in sodium?
They typically contain only modest amounts per serving. But because we tend to eat these foods often and in large quantity, this can add up. A slice of bread has about 150 to 250 milligrams—a sandwich thus can have 500 milligrams of sodium before you even add the fillers. Many breakfast cereals have more than 200 milligrams in a standard serving, and you may eat more than a serving at a time. If you eat a lot of these foods, look for low-sodium or no-sodium versions.
Is it true that some raw poultry is high in sodium?
Yes, depending on how it’s processed. Raw chicken and turkey are often injected with saltwater to plump them up and make them juicier. A 4-ounce serving of “enhanced” chicken may have as much as 400 milligrams of sodium, compared to only 50 to 70 milligrams in untreated. Due to a loophole, salt-injected meat may still be called “natural,” so it’s important to always check the labels. There is no way to wash off the salt, as it has been mechanically forced into the flesh.
How do I know how much sodium a food has?
Check the nutrition facts panel. It lists the amount of sodium in milligrams per serving—the most direct way of knowing how much you’re getting. It also gives the “percent daily value” (% DV)—how much sodium a serving of the food contributes to the total daily limit. But because the daily value is set at 2,400 milligrams (not 1,500 milligrams), the % DV will be an underestimate for many people.
Salt in Packaged Foods
Some foods that pack a hefty dose of sodium don't even taste salty, as you'll see in this list. Use it to help you reduce your daily sodium load, which should be below 2,300 milligrams a day or 1,500 milligrams a day, depending on your age and ethnicity.
What else can I look for on food labels?
Look for foods that say “unsalted” or “no salt added.” “Low-sodium” foods contain less than 140 milligrams of sodium per serving; “very low-sodium” foods have 35 milligrams or less; “sodium-free” foods, less than 5 milligrams. “Reduced- sodium” foods have at least 25 percent less sodium than the original, but they may still be high in sodium. Reduced-sodium soy sauce, for instance, can still have close to 700 milligrams per tablespoon if the original had 900 milligrams.
Does sea salt have less sodium than regular salt?
Not by weight. Basically, salt is salt. There are small nuances in specialty salts, such as kosher and sea salt, but mostly in taste and texture, not chemical composition. Because sea salt has larger crystals, though, it takes up more volume, so a teaspoon has less sodium than a teaspoon of regular salt. You may thus use a little less than you would regular salt, but the difference is too small to have any beneficial effect on your blood pressure. No matter what salt you use, shake it lightly.
How else can I bring out flavor in food, if not with salt?
Swap the salt shaker for the pepper mill or herb/spice blends, such as Mrs. Dash, that contain no sodium (check the labels to make sure). Experiment with your own blends using various combinations of garlic powder, dried parsley, rosemary, tarragon, thyme, red pepper flakes, celery seed, dill, cumin, and curry powder, for example. A mix of cinnamon, ground cloves, ginger, allspice, and anise seed is good on poultry and vegetables. Or simply add lemon or lime juice or balsamic (or flavored) vinegar. Fresh herbs, of course, are also wonderful to use.
Are salt substitutes a good idea?
They can be helpful for many people, but they are not for everyone. It is essential that you talk to your doctor before using one. Most (such as Morton Salt Substitute, NoSalt, and Nu-Salt) consist of potassium chloride, which tastes somewhat like table salt, though more bitter. “Lite” or “low-sodium” salts (such as LoSalt and Morton Lite Salt) are blends of sodium and potassium chloride. Though many people could benefit from the extra potassium, you should not use salt substitutes if you have certain conditions (notably kidney disease) or if you take hypertension medications that increase potassium retention, including ACE inhibitors and potassium-sparing diuretics. If it’s okay for you to use them, but note that the lite and low-sodium products contain some sodium, so you must still use them sparingly.
Does my drinking water contain sodium?
Tap water from most public water systems contains little or no sodium. Noncarbonated bottled water and seltzer are very low in sodium or sodium-free, but club soda has about 50 milligrams per cup. Mineral water contains varying amounts, depending on its source—as much as 300 milligrams per cup. Water softeners add some sodium, and the “harder” the water is, the more sodium it takes to “soften” it. A quart of very hard water that’s been softened can have more than 300 milligrams of sodium. Though it costs more, a potassium-based softening system is an option.
Do medications contain sodium?
Many do, including antacids, laxatives, and cough medicines—usually in very small amounts, as an inactive ingredient. But some, like effervescent antacids/analgesics, have quite a lot. A dose (two tablets) of Alka-Seltzer has more than 1,100 milligrams of sodium, from sodium bicarbonate. Over-the-counter medications that contain sodium as an active ingredient must list the amount if it’s more than 5 milligrams a dose.
If I follow the DASH diet, do I still need to lower sodium?
The lower the sodium the better. Short for “Dietary Approaches to Stop Hypertension,” the DASH eating plan is rich in fruits and vegetables, whole grains, nuts, seeds, and dry beans, plus low-fat/nonfat dairy foods. These foods provide potassium, magnesium, calcium, and fiber, as well as other nutrients and phytochemicals that work together to have a blood pressure-lowering effect—in just a few weeks. Though DASH is naturally low in sodium (compared to a typical American diet), research shows that it lowers blood pressure even more when sodium is reduced from the standard 3,000 and 2,300 milligram plans to 1,500 milligrams a day. For more on DASH, see Your Guide to Lowering Blood Pressure from the National Heart, Lung, and Blood Institute.
Published July 31, 2015