Salt Shakedown

by Charles Platkin, PhD

One of the main reasons we’ve been alerted to limit our sodium intake is that too much sodium in the diet has been linked to an increase in blood pressure (aka hypertension), which increases the risk of strokes, heart failure and kidney damage. When your blood pressure is too high, your heart is working harder, and your blood vessels and body organs are exposed to additional force and stress. Currently a third of all Americans have high blood pressure — which often presents no symptoms.

There has been some debate over the issue of “salt sensitivity,” that is, whether everyone’s blood pressure is affected by salt — and whether people need to be concerned about salt consumption if they are not salt sensitive and don’t have high blood pressure. However, David L. Katz, M.D., M.P.H., professor of public health at Yale University School of Medicine and author of “The Way to Eat” (Sourcebooks, 2002) points out that “to say only some people are sodium sensitive is a bit like saying only some people are ‘calorie sensitive.’ In fact, we are all calorie sensitive, with our individual responses representing variations on the theme.”

Additionally, there is virtually no way to simply test an entire population to see if they are salt sensitive, “so we really don’t know exactly who is salt sensitive and who isn’t,” explains Eva Obarzanek, Ph.D., R.D., M.P.H., a research nutritionist at the National Heart, Lung, and Blood Institute.

But an extremely small minority believes the correlation is overblown. “There are no studies to specifically show that reducing salt will improve your health outcomes,” says Dick Hanneman, President of the Salt Institute. And no one is saying salt is all bad. “It’s just that we consume too much. Following a lower sodium diet would be helpful in decreasing the risk of high blood pressure, not only in those who have high blood pressure but also in the general population,” advises Myron H. Weinberger, M.D., professor of medicine at Indiana University Medical Center and director of the Hypertension Research Center.

If you think you can limit your salt intake just by putting a piece of tape over your saltshaker, you’re mistaken. In fact, only about 10 to 20 percent of our sodium intake comes from the saltshaker. The rest comes from the foods we eat every day. It’s in processed foods, snack foods, junk foods and restaurant foods — foods typically high in fat (saturated and trans), calories and cholesterol. While salt started out as a preservative, “Now, it’s primarily used as a method of flavoring, making us thirsty and adding weight to foods inexpensively,” says Marion Nestle, Ph.D., M.P.H., professor of nutrition at New York University.

Currently Americans consume between 4,000 to 6,000 mg sodium per day. So what can you do besides taping up the saltshaker?

The DASH-Sodium study found the lowest blood pressure levels among those who kept their sodium intake at 1,500 mg a day or less while also following the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet works by increasing your intake of fruits and vegetables and reducing your intake of processed foods (including junk food) — which naturally reduces your sodium intake.

“One reason (aside from an aging population) for the recent rise in blood pressure could be an increase in our reliance on processed and fast-food, although there is no specific research that supports this,” explains Obarzanek.

Even though salt, or sodium chloride, is only about 40 percent sodium, and only 10 to 20 percent of our sodium intake comes from the saltshaker — we still need to cut down. Try lemon juice, vinegar or various blends of salt-free herbs and spices such as fresh garlic, black pepper, ginger and parsley. Use low-sodium broths and flavored vinegars to enhance the taste of the foods you prepare. And there are also some great salt substitutes, including Mrs. Dash, which is excellent, or AlsoSalt.

Avoid condiments that are high in sodium. Did you know that one tablespoon of soy sauce contains nearly 1,000 mg of sodium? A tablespoon of ketchup is considerably lower — around 200 mg — but that’s still high. Other offenders include barbecue sauce, soup mixes and tenderizers.

Many snack foods, including low-fat ones, are on the high end of the sodium spectrum. Eat less of these salty foods, which include salted crackers, popcorn, pretzels, chips, nuts, seeds and pickles. For example, take a look at Cheetos Cheese Puffs — 370 mg of sodium per ounce. Choose unsalted versions when possible, or stick to fresh snacks like fruits and vegetables.

Sodium is used as a preservative in many canned foods, including soups, tuna, vegetables and vegetable juices. To reduce your sodium intake, choose fresh or frozen instead of canned foods. You can also opt for low-sodium versions of canned products. If you decide to use canned foods, at least rinse them with water (except the soup products) before cooking to reduce sodium content.

  • Campbell’s Condensed Chicken Noodle Soup (1/2 cup): 890 mg sodium
  • Del Monte Fresh Cut Green Beans (1/2 cup): 390 mg sodium

Sodium is also used as a preservative in cured foods like deli meats, franks and bacon. Take a look at one Ball Park beef frank, which has 620 mg, or three slices of Hebrew National Soft Salami, which have 420 mg. Pepperoni can have as much as 500 mg per ounce. And even 2 ounces of sliced turkey can have more than 400 mg.

To cut down, use fresh meats and poultry or buy low-sodium versions of these cured meats.

Potassium, another mineral essential to good health, works in concert with sodium to regulate blood pressure. Studies have shown that people who consume more potassium through foods have lower blood pressures than those who consume less. Rich sources of potassium include most fruits, especially bananas, raisins, watermelon and oranges, as well as wheat germ, potatoes, spinach, and zucchini.

Don’t go out and buy a potassium supplement though! You don’t want to throw your electrolyte balance out of whack. Too much potassium can be dangerous — even deadly.

The more processed a food, the higher the sodium. This includes frozen dinners, packaged dinner mixes, instant hot cereals, flavored rice and pasta mixes, cake mixes and processed cheese spread — or even breakfast cereals (e.g., Rice Krispies contains 320 mg in 1 1/4 cup).

The high sodium content is yet another reason to limit your intake of fast food. Even Subway’s low-fat sandwiches have 700 to 1,300 mg of sodium each (except the Veggie Delite, which still racks up 510 mg). One of the biggest sodium offenders is Chinese food — an order of General Tso’s Chicken can contain more than 3,000 mg of sodium!

  • McDonald’s Big Mac: 1,050 mg of sodium
  • KFC Original Recipe Chicken Breast: 1,150 mg of sodium
  • Pizza Hut’s Supreme Stuffed Crust Pizza (1 slice): 1,170 mg of sodium

I was surprised to find out that something as healthy as V8 juice has more than 600 mg of sodium per serving. So read the Nutrition Facts panel on the package for sodium content and percentage of daily value. And don’t believe a food has very little sodium just because the package reads “Lower in Sodium!” The question to ask is, “Lower than what?” Sodium content has to be listed on all food labels by law. To be labeled low sodium, foods must have fewer than 140 mg per serving. Those with 35 mg or less earn the label very low sodium, and foods with 0.5 mg or less are considered sodium free.

Try not to exceed 2,300 mg of sodium per day. Buy “healthy” versions of salt-laden foods like soups, pasta sauces and lunch meats. The word “healthy” can’t appear on the label if the food contains more than 480 mg of sodium per serving.

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