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How to avoid the health risks of too much salt

Stick to fresh foods, and fill your salt allotment from healthy sources like whole-grain breads.

too much salt label canned goods
Image: Michael Carroll Photography

As we reported in August 2016, the FDA is encouraging the food industry to cut back on added sodium in commercially processed and prepared food. It’s a good reminder for all of us that too much salt in the diet is risky for health. How much is too much? “It’s controversial, although I don’t think anyone is in favor of unlimited salt intake,” says Dr. Randall Zusman, a cardiologist with Harvard-affiliated Massachusetts General Hospital.

Salt risks

We need a certain amount of the sodium in salt for the health of all cells and organs, and to maintain a proper fluid balance in the body. Usually, when a person consumes too much sodium, the kidneys efficiently flush the excess sodium out of the body. But some people retain excess sodium. This increases the amount of body fluid and blood pressure, which makes the heart work harder. Persistent high blood pressure increases the risk of developing the artery-blocking plaques of atherosclerosis. For all these reasons, eating too much salt on a regular basis can increase the risk of a heart attack or a stroke. “Salt can also negate the effects of many medications to treat high blood pressure, such as diuretics and ACE inhibitors,” says Dr. Zusman.

How much is too much?

So what’s the controversy about? It centers on how much salt is safe for consumption, and it’s still being debated. The American Heart Association recommends a limit of 1,500 milligrams (mg) per day. The FDA recommends a limit of 2,300 mg of sodium per day. The U.S. Dietary guidelines used to recommend a limit of 1,500 mg per day for a wide swath of people (everyone 51 and older, all African Americans, and anyone with high blood pressure, kidney disease, or diabetes), but this year changed it to 1,500 mg per day only for people with high blood pressure, and 2,300 mg for everyone else.

Common sources of sodium

What’s not debated is that most of us in the United States are consuming too much sodium, an average of 3,400 mg per day (the amount in about 1½ teaspoons of salt). Where does it come from? Some comes from the saltshaker, and some occurs naturally in foods, such as milk, beets, and celery. “But the majority comes from processed foods, especially any-thing that’s smoked, processed, instant, or cured,” says Debbie Krivitsky, director of clinical nutrition at the Cardiovascular Disease Prevention Center at Massachusetts General Hospital.

Sodium is frequently added during manufacturing, to make food taste good or to act as a preservative or a binder to help yeast rise. There’s a lot of sodium in many TV dinners, such as the 1,250 mg of sodium in a serving of Stouffer’s Swedish meatballs and pasta. Sodium is also hiding in everything from bread to jarred pasta sauce to lunch meats and even breakfast cereals. For example, one cup of Post Grape-Nuts cereal has 540 mg of sodium. Half a cup of Prego traditional tomato sauce has 480 mg of sodium.

What you should do

It’s best to avoid processed food. Choose fresh, frozen (no sauce or seasoning), or no-salt-added canned vegetables, and opt for fresh poultry, seafood, and lean meat, rather than processed meat and poultry.

Krivitsky recommends limiting sodium to 500 or 600 mg per meal, and making sure it comes from healthy sources, like whole-grain breads and cereals.

How can you find out about sodium content? Start reading Nutrition Facts labels. You really can find low-sodium options. For example, one cup of Post Shredded Wheat has no sodium, and half a cup of Prego No Salt Added pasta sauce has just 40 mg of sodium.

Krivitsky also recommends ditching saltshakers and flavoring food instead with spices, such as cumin, rosemary, basil, ginger, or dill; flavored vinegars; and lime or lemon juice. “Low salt doesn’t mean less flavor,” points out Krivitsky. “It just means less salt.”

How about a salt substitute?

When you want to add something salty to food, a salt substitute may do the trick. Substitutes are made from potassium chloride, which is similar to table salt (sodium chloride).

Substitutes fall into two categories: low-sodium or “light” salt, which replaces up to half of the sodium chloride with potassium chloride, and no-sodium or “salt-free” salt, which contains only potassium chloride.

For some people, potassium chloride can leave a bitter aftertaste. People with certain types of heart or kidney disease, or taking certain potassium-retaining medicines, may be told to avoid potassium-based substitutes. For others, potassium chloride is advisable: it not only helps avoid excess sodium, but also helps lower blood pressure.

Posted by: Dr.Health

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