MORE ABOUT SODIUM: SNEAKY WAYS IT ENTERS OUR DIETS

Studies uniformly show that cutting down on sodium (the primary component of table salt) in your diet can lower blood pressure — reducing your risk of stroke, heart failure and other health problems.

Although the exact numbers are still controversial, experts say most people should consume less than 2,300 mg of sodium each day. That’s about the contents found in 1 1/2  teaspoon of table salt. People with certain medical conditions should consume even less.

However, the average American consumes at least 3,400 mg of sodium per day – or 48 percent or more than the recommended daily limit. So why is this? We have already demonstrated how huge amounts of sodium are unwittingly consumed when we dine in restaurants. But even at home we are subject to “sneaky” forms of sodium intake.

For instance, one slice of white bread can contain as much as 230 mg. of sodium,

In the effort to seek a “healthier” form of salt, some believe that sea salt is the answer. No, it is not, for, although this latter form of salt is different in taste and texture, it contains the same amount of sodium than ordinary salt.

Avoiding the salt shaker is a useful start, but unfortunately, a major part of the sodium in American diets – almost 80 percent – comes from processed and packaged foods. These foods can be high in sodium even if they don’t taste salty.

The processed foods to which I am referring include the following:

  • Frozen meals
  • Canned or pickled foods
  • Snack foods
  • Deli meat
  • Cheese
  • Condiments, sauces and dressings
  • Breads
  • Cereals
  • Soda (including diet soda)

Checking labels is the only way to know how much sodium is in your food. If you buy packaged or processed foods, first choose foods that are labeled “sodium-free” or “very low sodium,” but then check the actual numbers on the labels. Also, remember that the amount of sodium listed on the ingredient label references a particular serving size. If you eat more than the listed serving size, you’ll consume more sodium.

Let’s look at some ways to shop and cook low sodium:

We begin by assessing how much sodium is in popular foods.

The Centers for Disease Control has a list of six popular foods with high sodium content dubbed the “Salty Six.”

  1. Breads and rolls – each piece can have up to 230 mg of sodium
  2. Pizza – one slice can have up to 760 mg of sodium
  3. Cold cuts and cured meats – Two slices of bologna have 578 mg of sodium
  4. Poultry – especially chicken nuggets. Just 3 ounces have nearly 600 mg of sodium
  5. Canned soups – one cup of canned chicken noodle soup can have up to 940 mg of sodium
  6. Sandwiches – consider the bread, cured meats, processed cheese and condiments, and sandwiches can easily surpass 1,500 mg of sodium

Diet for High Blood Pressure

If you have high blood pressure, the DASH diet (Dietary Approaches to Stop Hypertension) is a low-sodium intervention that I have presented in a previous post (5/2/13). Most of the foods in that diet are also low in fat. The diet calls for four to five servings of fruit, four to five servings of vegetables, and two to three servings of low-fat dairy. It’s also rich in whole grains, fish, poultry, beans, seeds, and nuts – while also limiting sugar and red meats.

Train your taste buds

At first, foods may not taste as good without sodium. But you will adjust over time. Natural substitutes that taste great include lemon, ginger, curry, dried herbs (such as bay leaves, basil and rosemary), onion, garlic and dry mustard. You might also use salt substitutes, which are usually rich in beneficial potassium, but check with your doctor first, especially if you are taking any medications.

 

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HIDDEN KILLER IN RESTAURANT AND PROCESSED FOODS: SALT

                            

   As I have noted previously, the sodium we eat, mainly in the form of salt (sodium chloride), is a major cause of high blood pressure (hypertension)—a serious threat to health, usually accounting for premature death from cardiovascular disease. Salt, which is the main source of sodium, contains about 40% of this element. Hypertension affects almost 75 million American adults, rising to a lifetime probability for individuals with advancing age to as high as 90%. Although blood pressure can be controlled with medication, as many as 50% of individuals still remain above desirable levels despite such treatment. Even in those whose blood pressure is controlled with medication, their risk of developing heart disease and stroke remains higher than for those who have a normal blood pressure level naturally.

    With this background, the need for prevention and control of blood pressure is an urgent priority in this—and most other—nations. Although major lifestyle factors (avoiding obesity, regular exercise, moderation of alcohol intake, and diet rich in fruits, vegetables and low fat dairy products) are important in reducing this risk, all the major health organizations have recognized sodium as the preeminent culprit and have recommended that each individual should control the amount of sodium he/she consumes, limiting it no more than 2,300 milligrams daily, and for high risk groups such as those with hypertension, diabetes, or chronic kidney disease, no more that 1,500 mg/day. Unfortunately, the current per capita sodium consumption of American adults is about 3,800 mg/day (not including what is added from the salt shaker). No more than 1% of the population consumes as little as 1,500 mg/day. Although the media have expressed recent doubts about possible risks of consuming too little sodium, these doubts have been debunked by careful analysis.§

      According to one estimate, at least 150,000 premature deaths per year could be prevented in the U.S. alone if the sodium content of packaged and restaurant foods were reduced by 50%.  This is especially meaningful since approximately 33% of calories are obtained from food purchased from restaurants and other sources outside of the home, constituting major and hidden sources of sodium. Overall, approximately 80% of the sodium consumed by Americans has been added by food manufacturers and restaurants. Are these latter companies doing anything to reduce this risk? The answer at present is very little, for one large survey# disclosed only minimal and inconsistent changes in the sodium content of their products—already far too high—between the years 2005 and 2011. To their credit, however, several major companies§ have issued statements committing to lowering sodium levels in some products over the next several years. Especially noteworthy is that Walmart, the nation’s largest supermarket chain, has called on its suppliers to lower sodium levels in their products by 25% by the year 2015. Nevertheless, even if these efforts are implemented, they would not nearly address the necessary reduction in sodium content. Thus short of a major public health initiative involving the government, we are unlikely to see sufficient voluntary changes in our food supply within the next several years.

    So, given insufficient outside support, what can the individual do about this health danger? Urging the food industry voluntarily to label all ingredients contained in processed and restaurant foods would be a step in the right direction, but most are unlikely to do so unless they are forced. A public initiative directed at governmental leaders might also bring about some desired results in this direction. But, at present, limiting sodium intake is a matter of personal choice, and I can help by offering some information about the contents of various processed and restaurant foods, as of the year 2011:

 SUMMARY OF SODIUM LEVELS PER 100 GM (ABOUT 3 OZ) IN MULTIPLE FOOD SUBCATEGORIES, IN DESCENDING ORDER.

PROCESSED FOODS (per 100 gm)        SODIUM

  Food                                                       Milligrams 

Bacon (smoked)                                             1,803

Salad Dressing, Caesar                                  1,079

Barbecue Sauce, Original and honey                989

Hot Dogs                                                            927

Turkey Breast, sliced, Deli                                 878

Macaroni and Cheese                                        831

Pork Sausage                                                     822

Cheese, Cheddar, sliced                                    645

Salsa, medium                                                   611

Pizza, Pepperoni                                               560

Potato Chips and Crisps                                    547

Pizza, Cheese                                                    521

Bread, White                                                      500

Bread, Whole Wheat                                         493

Sauce, Spaghetti, tomato, marinara                407

Soup, Tomato                                                    286

Tuna Fish, white, albacore, canned in water    261

Soup, Vegetable                                                243

Pork, Fresh or Frozen                                      186

Tomatoes, Canned, Diced                                174

Chicken, Fresh or Frozen                                   77

RESTAURANT FOODS

 Sausage Biscuits, breakfast                               895

Chicken strips or tenders                                   736

Cheeseburgers, all sizes                                    568

Pizza, cheese, hand-tossed style                      541

Grilled chicken sandwiches                                525

French fries, medium                                         503

Hamburgers, all sizes                                        428

   This is obviously only a partial list of various foods. Moreover, adding any additional salt with the shaker amplifies the problem—so don’t do it!

    So at this time, all I can do is to wish each and every one of you good luck in your food choices. Also remember to have your blood pressure checked at regular intervals, at least yearly, inasmuch as high blood pressure usually develops in the absence of warning symptoms or signs that might alert you to possible impending disaster!


§ Nutrition Action Healthletter, July/August 2013.

# Jacobson M.F. and McCarter R. Changes in sodium levels in processed and restaurant foods, 2005 to 2011. JAMA Internal Medicine. 173;20134:1285-91.

§ Campbell’s Soup, ConAgra Foods, Domino’s Pizza, General Mills, Hormel Foods Corp., McDonald’s, Smithfield Hams, Sodexo, Inc., Subway, and Walmart.

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