Karen Schroeder Kassel, MS, RD, MEd
Sodium intake may be an important factor in the development of
high blood pressure, which is a major risk factor for
heart attack and stroke. The risk of getting high blood pressure increases with age.
There is a good percentage of the general public who can be described as salt sensitive. This means that their blood pressures are likely to increase when they eat a high-sodium diet, and conversely, their blood pressures may be lowered by limiting dietary sodium.
Salt sensitivity is difficult to accurately diagnose. Therefore, appropriate sodium recommendations are a subject of debate among nutrition experts. Many believe that all people should limit their sodium intakes to either treat or prevent hypertension, regardless of their present blood pressure level. The latest US dietary guidelines (2015) suggest that ideally no more than 2,300 mg/day of sodium be consumed. People with high blood pressure, people older than 50 years, African Americans, people with diabetes, and people with kidney disease should limit sodium intake to 1,500 mg/day.
A major study in this area is DASH—Dietary Approaches to Stop Hypertension. This study found that a diet rich in fruits, vegetables, and low-fat dairy products, and low in saturated fat, cholesterol, and saturated fat—now called the
DASH diet—helped lower blood pressure.
The second phase of the study found further reductions in blood pressure when the DASH diet was combined with a sodium intake of no more than 2,400 mg/day.
The combination of DASH diet and a sodium intake of no more than 1,600 mg/day was as effective in controlling blood pressure as medication regimen involving a single antihypertensive drug. For some people with mild hypertension, diet alone may be an effective means of blood pressure control when the diet includes adequate calcium and potassium along with sodium restriction.
Sodium is found in many foods. Some are obvious, but others may surprise you.
Sodium chloride, better known as table salt, is the major source of dietary sodium.
Only a small amount of sodium comes from salt added during cooking or at the table. Fast foods and commercially processed foods—canned, frozen, and instant—add a significant amount of sodium to the typical American diet. These include:
Sodium occurs naturally in:
All food products contain a Nutrition Facts label, which states a food's sodium content. The following terms are also used on food packaging:
Here are some tips to help you lower your sodium intake:
Making dietary changes takes time. Start slowly and find what works best for you. When you find the right combination, you will be able to decrease the amount of salt you consume.
American Heart Association
National Heart, Lung, and Blood Institute
Dietitians of Canada
About sodium (salt). American Heart Association website. Available at: http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/About-Sodium-Salt_UCM_463416_Article.jsp#.WLmnik2QzIU. Updated August 26, 2016. Accessed March 3, 2017.
DASH diet. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T170319/DASH-diet. Updated April 29, 2016. Accessed March 3, 2017.
Dietary guidelines for Americans 2015-2020. Office of Disease Prevention and Health Promotion website. Available at: https://health.gov/dietaryguidelines/2015/guidelines. Updated December 2015. Accessed March 3, 2017.
Hypertension. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115345/Hypertension. Updated February 7, 2017. Accessed March 3, 2017.
Salt. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/salt/index.htm. Updated December 28, 2016. Accessed March 3, 2017.
Sodium and salt. American Heart Association website. Available at: http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/HealthyDietGoals/Sodium-Salt-or-Sodium-Chloride_UCM_303290_Article.jsp#.WLmoqk2QzIU. Updated October 3, 2016. Accessed March 3, 2017.
Last reviewed March 2017 by Michael Woods, MD, FAAP
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