Kathy D. McManus, MS, RD
Brigham and Women’s Hospital
ost people know that eating too much salt can contribute to high blood pressure (hypertension), but high sodium intake has been linked with other serious conditions as well. Even in someone who does not have hypertension, excessive sodium intake increases risk for congestive heart failure (inadequate pumping action of the heart)... kidney disease... arteriosclerosis (hardening of the arteries)... and stroke.
It also has been linked to osteoporosis. High sodium intake may increase the excretion of calcium, which over time reduces calcium in the bones, leading to a deficiency that often results in osteoporosis.
New finding: A high-sodium diet could trigger an ulcer or even increase the risk of cancer. In a lab study reported at the May 2007 meeting of the American Society for Microbiology in Toronto, researchers found that salt increased the virulence of the Helicobacter pylori bacterium. This bacterium causes the vast majority of ulcers and greatly increases a person's risk of gastric cancer and a certain form of lymphoma.
HOW MUCH IS TOO MUCH?
The US Department of Agriculture (USDA) recommends that adults consume no more than 2,400 milligrams (mg) of sodium a day. That's the amount of sodium found in approximately one level teaspoon of salt. On average, according to the Center for Science in the Public Interest, Americans consume about 4,000 mg of sodium daily.
As we get older, especially after we pass 45 years of age, our risk for high blood pressure rises, and so we should be even more vigilant about our salt intake. The USDA recommends that people middle-aged and older consume no more than 1,500 mg of sodium a day.
Others who should be extra careful of their salt intake are African Americans, who, as a group, are more prone to high blood pressure, as well as people with a genetic predisposition to the condition (usually indicated by having a close family member, such as a parent or sibling, who has high blood pressure).
Avoid processed foods. More than 75% of the typical American's daily sodium comes from processed foods, to which salt is added as an inexpensive flavor enhancer and preservative.
Instead, opt for...
Fresh or frozen fish, vegetables and fruits, rather than canned. If you do use canned goods, such as beans, drain and rinse them to remove most of the salt.
Homemade soups. Eight ounces of canned tomato soup can have nearly 1,000 mg of sodium, almost a full day's allowance if you're middle-aged or older.
Fresh or dried herbs and spices for flavoring, such as oregano, rosemary, onion powder, curry powder and cumin. Or try a dash or two of a salt-free spice blend. Caution: Salt substitutes containing potassium chloride can be harmful for those with impaired kidney function or those who are taking certain medications, such as ACE inhibitors or potassium-sparing diuretics. Check with your doctor.
Review your medications. Sodium is found in many over-the-counter medications, including antacids. Examples: Alka-Seltzer (567 mg per tablet) and Bromo Seltzer (959 mg per packet). Cough syrups and laxatives can be high in sodium, too.
Eat a potassium-rich diet. Potassium from food blunts the effect of salt on blood pressure. Vegetables (especially leafy greens and potatoes), bananas, citrus fruits and beans are particularly rich in potassium.
Be extra careful when dining out. Americans eat at least 30% of their meals outside their homes, and most restaurants use lots of salt.
If your food is being prepared to order, ask the server to ask the cook not to add salt.
Avoid entrées and side dishes with cream, cheese or seasoned sauces, which often are highly salted. Ask for the items plain or with the sauces on the side.