By- Dr. Joan Marie Pellegrini

Americans consume about twice the amount of salt that is recommended in our diets. This is approximately a doubling of the amount we consumed forty years ago. We cannot live without salt. Salt contains sodium which is vital to many cellular functions. However, eating more salt than we need can lead to high blood pressure (hypertension). Hypertension is known as the silent killer because there are rarely any symptoms. Also, we do not check our blood pressure except when we visit a doctor. Over time, hypertension can cause heart disease, stroke, and kidney failure among other problems. It is estimated that even a small reduction in our salt intake will dramatically reduce our risk of these diseases.

The New York City Department of Health and Mental Hygiene is coordinating a national effort to prevent stroke and heart attack by reducing the amount of salt in packaged and restaurant foods. Only about 10% of our daily salt intake comes from our salt shaker. About 80% comes in processed foods. The American Heart Association and the American Medical Association are also fully supportive of this national effort and have guidelines for salt reduction. The good news is that many large national companies have signed on to the initiative and have pledged to reduce the amount of salt in their products.

What should you do to decrease your salt intake? Most of us can name the obvious offenders: potato chips, salted nuts, soy sauce, etc. Unfortunately, there are hidden sources in the foods we buy. A quick visit to the sodium chart from the USDA will show you that one slice of wheat bread from a national chain may contain almost 10% of your daily allowance. That means that the most important thing we can do is look at labels in the grocery store. Buy the brand of food that has the least amount of salt if you can. There are some items that will have a lot of salt no matter what brand you buy: canned soup or dry soup comes instantly to mind. In general, you should aim for a maximum of 2000 mg of sodium a day. If you are eating out, you will not be able to know which food has the lower salt content unless you ask the chef or wait staff. Even then, they may not know. This is why the national initiative would like restaurants to list sodium content on their menus and also to reduce sodium in their offerings.

Even though sodium is ubiquitous and hidden in our foods, the good news is that even a small reduction in our intake will give us benefit. The other good news is that there is a national initiative for food manufacturers to decrease the amount of salt in their products and to provide labels to help us know how much salt we are consuming.

References:
http://www.time.com/time/health/article/0,8599,1884864,00.html
Time Magazine printed this article in March 2009 and it is an easy read. It also has the link for the Sodium chart from the USDA.

http://www.nyc.gov/html/doh/html/cardio/cardio-salt-initiative.shtml
This site has links for Institute of Medicine report on public health priorities to control hypertension. It also has the link for the journal article that is heavily referenced in the Time Magazine article (Bibbins-Domingo K, et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease in NEJM 1010; 362.)

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