My Aunt Susie sent me a link to a very good article entitled, “High Sodium in Unexpected Places,” published 12/5/08 in the New York Times. The author describes how some foods are high in sodium even though they might not taste salty (e.g. sweets, breakfast foods, and many low-fat foods). I liked the article – read it if you have time.
After reading the article, I got to thinking about salt (sodium chloride). Since many adults in my immediate and extended family have hypertension, I have always been aware of my sodium intake. However, since I do not have hypertension, I am not assiduous about checking food labels for sodium content. My approach, given the luxury of healthy blood pressure, is to simply limit intake of foods or ingredients known to be “heavy hitters” in sodium content: fast food, pre-prepared convenience food, salt (and sea salt), canned soup, soy sauce, salad dressings, MSG, and lunch meats. I do periodically spot check my food intake by counting milligrams (mg) of sodium, but I do not do this daily.
How much is enough and how much is too much?
The Institute of Medicine publishes the Dietary Reference Intakes (DRIs) for essential vitamins, minerals, water, and macronutrients (protein, fat, and carbohydrate). Sodium has two levels of intake: “Adequate Intake (AI)” and the “Tolerable Upper Intake Level (UL)." Take a look below for these levels – I collapsed some of the age groups since the values were the same. Note that 1 teaspoon of table salt provides about 2300 mg of sodium – that is the Tolerable Upper Intake Level for people aged 14 years and older!
Age Group Adequate Intake (AI) Tolerable Upper Intake Level (UL)
14 – 50 years 1500 mg (1.5 grams) 2300 mg (2.3 grams)
51 – 70 years 1300 mg (1.3 grams) 2300 mg (2.3 grams)
> 70 years 1200 mg (1.2 grams) 2300 mg (2.3 grams)
With prolonged exercise, as well as anything that causes heavy sweating, an individual’s need for sodium could be quite a bit higher than the UL. Please seek help from a physician or ask to be referred to a dietitian if you have questions about hydration and electrolyte replacement during heavy and prolonged exercise.
On the other end of the spectrum, people with hypertension, heart failure, and kidney disease often need less sodium to better manage their disease. Your physician might have recommended a modified sodium diet or lower salt diet – it is important that you follow your doctor’s recommendation. If you need more help with your diet, then please ask your doctor to refer you to a dietitian Dietitians are trained to provide Medical Nutrition Therapy.
Where are we at now?
Barring excessive sweating or disease, most of us will fine with an intake somewhere between 1200 mg – 2300 mg of sodium. The bad news is that we are a nation of fast food and convenience food eaters and our intake of sodium is typically double the Tolerable Upper Intake Level of 2300 mg sodium. According to the Institute of Medicine, about 77% of our sodium intake comes from salt added during the processing of food. It is helpful that the Food & Drug Administration (FDA) has labeling laws for packaged food so that we can identify lower sodium versions. Unfortunately, we are pretty much on our own when it comes to dining out. Do look online for information – many restaurant chains voluntarily provide nutrition information on their website. You can also use web-based nutrition sources or books such as Calorie King, USDA Nutrient Database, and Nutrition Data. My favorite book reference is Calorie King – the author updates it yearly.
Cutting down on sodium
Removing the salt shaker is a great first step but it is not enough to control sodium intake. If you dine out or purchase a lot of processed foods, then you might want to start looking at the sodium content of your packaged food – the Nutrition Facts label contains this information. Sodium can add up fast. Here are some educational flyers on how to decrease sodium consumption: University of Georgia Cooperative Extension, and University of Maine Cooperative Extension.
I also like the American Heart Association’s list of seasonings to use instead of salt for specific foods.
Sodium goals for meals and snacks
I use a rough guideline for sodium intake for each meal and snack. Since I like to eat 3 meals and 3 snacks a day, I limit my main meals to about 600 mg sodium and each snack to about 150 mg sodium. That gives me a total of about 2250 mg sodium per day. If you only eat 3 meals per day and no snacks, you could go up to about 750 mg sodium per meal.
Adequate intake of potassium and magnesium
Numerous studies have shown that the DASH Eating Plan is effective at reducing blood pressure by promoting adequate intake of potassium and magnesium in addition to limiting sodium. This is one of my favorite eating plans since it also encourages intake of a variety of healthful foods, has sample menus, encourages weight loss, and has lists of foods high in sodium as well as lists of foods high in potassium. My only “tweak” to this plan would be to include more servings of the healthy fats (monounsaturated fats) such olive oil, nuts, and fish. Please ask your doctor if the DASH Eating Plan is appropriate for you if you already have high blood pressure (hypertension).
Something to consider
Changing dietary habits can be hard, especially if you love salty food. Try to take it one step at a time. The largest sodium meals are typically the fast food and Asian restaurant foods. If you dine out a lot, then your first goal could be to start cutting down on how many meals you eat out. For example, if you eat fast food 5 meals a week, then your first goal could be to cut down from 5 to 3 fast food meals per week. Replace those 2 meals with a homemade meal – leftovers or sandwiches made without processed meat. You could also look for healthier, lower sodium frozen meals – my favorite brand is Amy’s (nice vegetarian selections). Eventually, wean yourself off fast food.
Ask for “No MSG” (monosodium glutamate).
Limit soy sauce: 1 tablespoon contains about 1000 mg sodium
Limit even Light soy sauce: 1 tablespoon contains 530 mg sodium
Have anything to share about salt and sodium? Do you like the DASH Eating Plan? Please share your comments.