Keeping sodium intake in check important for chronic conditions

Erin Brandl, MD Enlargephoto

Erin Brandl, MD

Chips and salsa; A smoked turkey sandwich; cheese and crackers; a slice (or two, or three) of pizza. Is your mouth watering as you read this list? If so, you’re typical in that — like most of us — you love your salt. According to the Centers for Disease Control (CDC), the average American consumes about 30 percent more sodium each day than their body needs to maintain optimal health.

The recommended sodium intake level for anyone over the age of two is 2,300 milligrams per day. “Most people consume much more than that without even realizing it,” said Cortez internal medicine specialist, Erin Brandl, MD. Too much sodium increases an individual’s risk for high blood pressure which can result in heart disease and stroke. “More than 800,000 people die every year from heart disease, strokes, and other cardiovascular diseases,” said Brandl.

Salt in and of itself isn’t bad, but too much of it can be unhealthy, particularly for individuals who have certain chronic conditions such as high blood pressure, heart disease, diabetes, or history of a stroke. “We need sodium in our diets,” said Brandl. “It helps every cell in the body function, and our bodies tightly regulate how much of the sodium we take in gets into the bloodstream.” The sodium we consume but don’t require to function is excreted in the urine, but if the kidneys can’t keep up we end up with fluid retention and swelling. Who hasn’t had the experience of overdoing it with a big, salty dinner and waking up the next morning with puffy eyes and hands? That’s evidence of too much sodium.

In our often hot and usually dry climate, even if you’re working or playing outdoors and sweating a lot, the recommended daily sodium intake of 2,300 milligrams still holds. “If you’re an elite athlete in training or going out for a hard, all-day hike in the heat, you probably do want to have a few salty snacks,” said Brandl, adding that in cases such as this other electrolytes are also warranted. But for the average active person, sticking to the 2,300 milligram limit is smart.

Research from the CDC indicates that about 90 percent of Americans take in an average of 3,300 milligrams of sodium per day, and very little of that is the result of tipping the salt shaker at the dinner table. About 65 percent of salt intake comes from food purchased in stores, and another 25 percent comes from food eaten in restaurants. Even seemingly healthy foods like whole grain breads contain hidden sodium because the element is found not only in regular table salt, but also in baking soda and baking powder. Luncheon meats, poultry, cheeses, and soup are also on the “top ten” list of foods high in sodium.

“It’s frustrating that manufacturers control how much sodium is in what we eat. The box of macaroni and cheese doesn’t come with a little packet of salt for us to use. The salt is already in the food,” said Brandl. This is why reading food labels is so important. “When you look at labels, pay close attention to what the package says is the serving size and how many servings are in the package,” said Brandl. “Better yet, reduce the amount of processed and packaged foods you eat, then opt for fresh food such as fruits and vegetables instead. They’re naturally low-sodium,” she said.

“Consuming too much sodium is of particular concern for people who have high blood pressure,” said Brandl. She encourages her patients to cut back on sodium by reminding them that less salt might mean fewer medications. “A patient can be on four or five blood pressure medications and be able to go down to two or three if they manage their sodium intake. If a patient is on a single blood pressure medication and limits sodium in the diet and loses weight, he or she may be able to come off of the medication completely,” added Brandl. Cutting back on sodium also helps the medications that patients do take for high blood pressure work more effectively.

If you’re one of the estimated 50 percent of people who need to carefully control their sodium levels (over the age of 51, African American, or managing high blood pressure, diabetes, or chronic kidney disease), there are relatively painless ways to reduce your salt intake. Here are a few to consider:

Gradually reduce the amount of salt you use to cook with and use at the dinner table. Your palate will likely adjust to lower sodium over time.

Always taste food before reaching for the salt shaker.

Flavor foods with herbs and spices and with no-sodium or low-sodium sauces.

Cut back on processed/packaged foods and when you do use them, read labels before you bring them home from the supermarket.

Look for foods that say “salt-free” or “low sodium” on the label (but study the label anyway).

Ask for low-sodium options when eating out.

Track the number of milligrams of sodium you take in every day and set a goal to reduce it to the recommend daily limit (or per your doctor’s instruction) by a certain future date.

Salt substitutes are an option, but Brandl warns that they’re not appropriate for everyone. “These substitutes are potassium based, so certain patients with chronic kidney disease should not use them,” she said. “I recommend that anyone considering using a salt substitute speak to their doctor about it first.”

Keeping sodium intake in check is good for the individual, and good for the health of society as a whole. “A 2010 study published in the New England Journal of Medicine concluded that even a modest reduction in salt intake would reduce the incidence of cardiovascular disease and dramatically cut down on healthcare costs,” said Brandl. “I think this should be a major focus when it comes to overall public health.”

Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez, Colorado. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal healthcare provider.

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