March 29, 2009
Most Americans Need To Cut Down On Sodium

Most Americans should eat no more than 1500 mg of salt per day. That is two thirds of a teaspoon - not very much. But the average consumption is more than twice that amount.

Most Americans consume more than double the amount of their daily recommended level of sodium. A new study by the Centers for Disease Control and Prevention shows that more than 2 out of 3 adults are in population groups that should consume no more than 1,500 milligrams (mg) per day of sodium. During 2005-2006 the estimated average intake of sodium for persons in the United States age 2 years and older was 3,436 mg per day.

A diet high in sodium increases the risk of having higher blood pressure, a major cause for heart disease and stroke. These diseases are the first and third leading causes of death in the United States.

“It’s important for people to eat less salt. People who adopt a heart healthy eating pattern that includes a diet low in sodium and rich in potassium and calcium can improve their blood pressure,” said Darwin R. Labarthe, M.D., Ph.D., director of the CDC’s Division for Heart Disease and Stroke Prevention. “Reducing sodium intake can prevent or delay increases in blood pressure for everyone.’’

Easiest way to reduce salt consumption is to cut back on processed foods. At this McDonald's site choose "Sandwiches" from the right side combo box pop-down. You'll see that a cheeseburger contains 750 mg of sodium and a Quarter Pounder with Cheese contains 1190 mg of sodium. Note how cheese adds 230 mg of sodium to the hamburger and 460 mg to the Quarter Pounder.

Another way to look at sodium in the diet is in ratio to calories. A straight McDonald's hamburger has only 300 calories but 520 mg sodium. So if you ate 7 of them to get 2100 calories for a day you'd blow out your sodium budget with 3700 mg of sodium. But people don't eat most of their meals at fast food places. Processed foods eaten at home are a big problem too.

So how are people getting all that sodium at home? If you ate 2100 calories of Pepperidge Farm Double Chocolate Milano Distinctive Cookies you'd get only 1050 mg of sodium. Thinking about those cookies as a health food now? That's one of the advantages of reading this blog. I come up with things like this. Well, those Double Chocolate Milanos are way better than Nabisco Oreos on sodium If you ate 2100 calories of Oreos you'd get 2494 mg of sodium. Way more. I would have expected Nabisco Fig Newtons to be closer to a health food. But no. 2100 calories of Fig Newtons would give you 2625 mg of sodium. Most of the cookies I looked at deliver almost 1 mg sodium per calorie or even worse. But the Health Valley Chocolate Chip Oatmeal Cookies had the same 2:1 ratio of calories to sodium as the Pepperidge Farm Double Chocolate Milano Distinctive Cookies. So those are your two health foods for today. Shop accordingly.

Do you fit any of the risk categories below? Cut your sodum. If you aren't middle-aged remember you'll have to cut back eventually. Start looking for low sodium cookies for that day.

This study is the first to use national data to show that 69.2 percent of the adult population belongs to a specific group that should aim to consume no more than 1,500 mg of sodium per day.  This group includes persons with high blood pressure, blacks, or middle-aged and older adults (more than 40 years old).  The 2005 Dietary Guidelines for Americans recommend that adults in general should consume less than 2,300 mg (approximately one teaspoon of salt) of sodium per day. 

Of course, you could eat lots of fruits and vegetables, stop using salt (or switch to Lite Salt), rarely use ketchup, avoid fast food places, stop eating salty processed meats, and avoid high sodium salad dressings. But barring all that you could replace the bad foods with lower sodium cookies.

Share |      Randall Parker, 2009 March 29 10:43 AM  Aging Diet Heart Studies

Jake said at March 29, 2009 12:28 PM:

Another bogus study from the government. If these "experts" instead devoted their time to ending Vitamin D deficiency in the US, they would see a dramatic drop in blood pressure rather than the trivial drop achieved with salt reduction.

Recent excerpts from Junk Food Science

"Cochrane recently released a systematic review of the clinical trial evidence on reduced dietary salt for the prevention of cardiovascular disease, as well as the effects of low-salt diets on blood pressure and mortality. After 1 to 5 years of follow-up, those who’d received low-salt diets and intensive behavioral interventions, saw their systolic blood pressures reduced by a mere 1.1 mmHg, and diastolic blood pressures by 0.6 mmHg, even while successfully lowering salt intakes as confirmed by urinary 24-hour sodium excretions by 35.5 mmol."

"According to Dr. David Klurfeld, Ph.D., professor and chairman of the Department of Nutrition and Food Science at Wayne State University, editor-in-chief of the Journal of the American College of Nutrition, “the better controlled studies fail to show a significant benefit on blood pressure for large groups with sodium restriction.”

"Following the NHANES participants for nine more years through year 2000, the Albert Einstein researchers were unable to show among the general population that those eating the lowest salt diets had lower risks for developing cardiovascular disease or high blood pressure or dying prematurely. In fact, heart disease, high blood pressure and deaths were inversely related to salt intakes: the higher the sodium, the lower the risks; the lower the dietary salt, the higher the risks."

Wayne Conrad said at March 29, 2009 1:17 PM:

Something in the back of my memory says that salt does not cause hypertension in everyone. What I do not recall is (1) if I got that from a decent study, or just some junk science, and (2) what fraction of the population it claimed was sensitive to salt.

Randall Parker said at March 29, 2009 1:25 PM:

Wayne Conrad,

Genetic variants control the extent to which you are vulnerable to high blood pressure from high salt. It would be valuable to know one's own genetic profile for salt and blood pressure risk.


Your study is ignoring long term effects. Those effects can't all be undone simply by cutting salt once the higher blood pressure has developed.

Jake said at March 29, 2009 4:41 PM:

More from Junk Food science article:

"In fact, while there have been more than 17,000 studies published on salt and blood pressure since 1966, even following populations for decades, none has shown notable health benefits for the general population with low-sodium diets. According to Dr. David Klurfeld, Ph.D., professor and chairman of the Department of Nutrition and Food Science at Wayne State University, editor-in-chief of the Journal of the American College of Nutrition, “the better controlled studies fail to show a significant benefit on blood pressure for large groups with sodium restriction.”

My point is that the government is ready to spend billions on anti-salt campaign and it will benefit very few people. The money would be better spent on a campaign to stop Vitamin D deficiency among the 70% of Americans who have that deficiency. The Life Extension Foundation estimates that Vitamin D deficiency cause 275,000 excess deaths a year in the US from cancer, heart disease, and diabetes.

Each individual should sharply reduce salt consumption for a week to determine if they are one of the rare individuals that are salt sensitive. If their blood pressure drops significantly, then go on a restricted salt diet and taste bland food for the rest of your life. If your blood pressure does not significantly drop, then forget the anti-salt propaganda.

I love salt and my blood pressure is 112/70. I will add that when I cured my Vitamin D deficiency my systolic dropped 14 points and my diastolic dropped by 10 points.

steveSC said at March 29, 2009 6:06 PM:

I agree with Jake, another bogus study. No clinical evidence, just a belief that lowering salt is good, followed by an arbitrary goal and finding that, lo and behold, a lot of Americans don't meet that goal.

This is another in the long string of 'public health' pronouncements by the government where they find a small group of people who (may) benefit from an intervention, then the powers that be try to get everyone to follow along because it would be 'too confusing' to admit that only a small group would benefit. In this case, it is also confused by racial issues, since the people who are most likely to benefit from salt restriction are descendants of slaves who were transported across the Atlantic, a trip that selected genetically for people who could conserve salt.

A similar issue has created the cholesterol fear mongering. The primary study that 'proved' that lowering cholesterol is good for you appears to have had a sample that was 50% or more composed of people with a genetic problem, familiar hypercholesterolemia. Yes, it is good for those people to reduce cholesterol, but there is very little evidence that 'normal' people also benefit much.

Brett Bellmore said at March 30, 2009 3:57 AM:

I eat all the salt I want, and I've had low blood pressure all my life. Back in college, the doctors used to joke that I was technically in shock, my blood pressure was so low. As a matter of fact, I really appreciate my blood pressure climbing as I've gotten older, the pretty sparkles when I stand up suddenly have become a thing of the past. I'm fifty, and it's 105/60 on a rough day.

I really resent all the pressure to eat low salt foods. Unless you've got high blood pressure or a problem with edema, there's no reason at all you should restrict your salt intake.

bbartlog said at March 30, 2009 2:35 PM:

I tend to side with junkfoodscience on this one. And I would especially caution against looking *only* at blood pressure or even only at deaths from stroke or COPHD when doing the analysis. You want all-cause mortality. Low sodium can kill you in a number of not so obvious ways.

That said, there was an interesting study not that long ago that suggested that the ratio of sodium to potassium was a lot more important than the absolute level of sodium (in terms of heart disease risk). So I would suggest that, rather than worry about sodium, you should make sure you get enough potassium in your diet. Outside of sugar, people should worry a lot more about nutrients they might be missing than about the possible bad effects of things that are tasty. Unfortunately, the study of diet as an enumeration of taboo foods to be avoided is much more appealing to the puritanical American psyche...

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