Yes, you should still watch your sodium. Here are tips on how to do it.
By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column
Too much salt in the diet is a bad thing -- or is it?
Most of us have long heard that it's best to go easy on the salt shaker. But a recent study has confused the issue somewhat.
In the study, published in the March 2006 American Journal of Medicine, people who reported eating limited salt were found to be 37% more likely to die of cardiovascular disease (conditions such as stroke and heart disease) than people who ate more salt. The researchers concluded that their findings raise questions, and that further studies are needed.
But, experts say, it's important to keep in mind that this is just one study, compared with scores of others that have found health benefits to avoiding a high-sodium diet.
According to the American Heart Association, 1,500 milligrams of sodium is the ideal daily goal for African-Americans, middle- and older-aged Americans, and people with high blood pressure. The rest should aim for less than 2,300 milligrams of sodium a day -- the equivalent of about 1 teaspoon of salt.
The Salt Connection
New research shows that a high-salt diet may have a negative effect on our bodies' levels of vitamin D -- a vitamin considered important to many aspects of health.
Older women who had high blood pressure caused by salt were found to have lower concentrations of a certain marker of vitamin D than women with normal blood pressure, Myrtle Thierry-Palmer, PhD, a biochemistry professor at Morehouse School of Medicine in Atlanta, tells WebMD.
There is also some evidence that a high-sodium intake increases calcium losses in the urine -- which is bad news for bone density. Too much sodium may also contribute to the development of kidney stones.
And what about heart disease? Research has shown a connection between high-salt intake and an increase in blood pressure in certain people who are considered "salt sensitive."
High blood pressure is a major risk factor for cardiovascular disease. That's important information for the nearly one in three American adults who have high blood pressure, according to the American Heart Association (AHA).
Studies have shown that cutting back on salt can lower blood pressure in people with and without high blood pressure, according to a statement from the AHA.
"Reduced salt intake can blunt the rise in blood pressure that occurs with age and reduce the risk of atherosclerotic cardiovascular disease events and congestive heart failure," according to the January 2006 statement.
Here's something baby boomers need to know: People tend to become more sensitive to sodium as they get older. Likewise, their blood pressure is more likely to drop when they cut back on salt in their later years.
Further, sodium may increase the risk for stroke even beyond its affect on blood pressure, according to research reported at the 2005 American Stroke Association International Conference.
The risk of stroke was higher in people who ate more sodium, regardless of their blood pressure, reported researchers. Their results also showed that people who took in more than 4,000 milligrams of sodium a day almost doubled their stroke risk compared with those getting 2,400 milligrams or less.
Are You Salt-Sensitive?
The reason salt-sensitive people's blood pressure responds strongly to salt intake is through sodium's effect on blood volume. When you eat more salt, your blood pressure tends to rise and when you eat less salt, your blood pressure lowers.
What portion of the population is salt-sensitive? Some researchers have estimated that about a quarter of the American population with normal blood pressure is salt-sensitive, while about half of the people with high blood pressure seem to be salt-sensitive. The black population has demonstrated a greater susceptibility to salt sensitivity than the white population, adds Thierry-Palmer.
5 Steps to Less Salt
1. Pass Up Processed Foods
The Food Standards Agency of the United Kingdom estimates that 75% of salt intake comes from processed food. Some food companies are developing products with less sodium, so keep an eye out for sodium listed on food labels. Only small amounts of sodium occur naturally in foods, eating mostly natural, whole foods will help keep levels of sodium down.
2. Cut Back on Condiments
Always dress your sandwiches and burgers yourself. This way, you can not only control the amounts of condiments used, you can choose those that are lower in calories, fat, and sodium, such as:
- Balsamic vinegar. 2 teaspoons has 14 calories, 0 grams fat, and 2 milligrams sodium
- Mustard. 1 teaspoon has 10 calories, 0 grams fat, and 100 milligrams sodium
- Pickle relish. 1 tablespoon has 21 calories, 0 grams fat, and 109 milligrams sodium
- Horseradish. 2 teaspoons has 4 calories, 0 grams fat, and 10 milligrams sodium
- Low-sodium light mayonnaise. 17 calories, 1.3 grams fat, and 27 milligrams sodium (the numbers may vary depending on brand).
- Lemon juice (from 1/2 lemon). 8 calories, 0 grams fat, and 1 milligram sodium
Feel free to load on all the lettuce, tomato, and onion your heart desires. Each adds 5 calories or less per serving, and is mostly sodium-free.
3. Beware of Dressings and Sauces
If you think a little bit of dressing or sauce won't add that much sodium to your meal, think again. Take a gander at some of the dressing offered at the Jack in the Box fast-food restaurant:
Creamy Southwest Dressing (71-gram serving): 1,060 milligrams sodium
Bacon Ranch Dressing (71-gram serving): 810 milligrams sodium
Asian Sesame Dressing (71-gram serving): 780 milligrams sodium
4. Opt for Alternatives
Purchase a battery-operated pepper grinder and your favorite flavor of salt-free herb and spice blend (like Mrs. Dash). Then keep them front and center on your kitchen table to help you break the habit of salting your food.
5. Forgo Fast Food
Eating at fast-food chains may be fast and cheap, but you pay the price in calories, fat, and sodium. Many fast-food items are big on sodium. The following items, at a few top chains, topped the sodium scale:
Jack in the Box
- Bacon Ultimate Cheeseburger: 2,040 milligrams sodium
- Chipotle Chicken Ciabatta with Grilled Chicken: 1,850 milligrams
- Bruschetta Chicken Ciabatta Sandwich: 1,810 milligrams
- Ciabatta Breakfast Sandwich: 1,770 milligrams
- Ultimate Breakfast Sandwich: 1,700 milligrams
- Bacon 'n' Cheese Ciabatta Burger: 1,670 milligrams
- Chipotle Chicken Ciabatta with Spicy Crispy Chicken: 1,650 milligrams
- Sausage, Egg, & Cheese Biscuit: 1,430 milligrams
- Homestyle Chicken Strips (3) with dipping sauce: 1,690-1,890 milligrams sodium, depending on sauce
- Frescata Club Sandwich: 1,610 milligrams
- Frescata Italiana Sandwich: 1,530 milligrams
- Roasted Turkey & Swiss Frescata Sandwich: 1,520 milligrams
- Big Bacon Classic Sandwich: 1,510 milligrams
- Deluxe Breakfast: 1,920 milligrams sodium
- Premium Crispy Chicken Club Sandwich: 1,830 milligrams
- Premium Crispy Chicken Ranch BLT Sandwich: 1,750 milligrams
- Premium Grilled Chicken Club Sandwich: 1,690 milligrams
- Big Breakfast: 1,470 milligrams
- Sausage, Egg, & Cheese McGriddle: 1,300 milligrams
Published October 2006.
SOURCES: "Healthy Lifestyle Could Significantly Reduce High Blood Pressure," American Stroke Association Journal Report, Jan. 24, 2006. American Heart Association scientific statement. Loria C.M. Journal of Nutrition 2001; vol 131: pp 536S-551S. Bihorac, A. American Journal of Hypertension, August 2000; vol 13: pp 864-872. Reusser, M.E. Journal of Nutrition, April 2006; vol 136: pp 1099-1102. Thierry-Palmer M. Journal of Nutrition, January 2003; vol 133: pp 187-190. Falkner, B. Hypertension, 1990; vol 15: pp 36-43. Weinberger, MH. Hypertension, 1986; vol 8 (Suppl II): II: pp 127-34. Hillel W. Cohen, DrPH. American Journal of Medicine, March 2006; vol 119 : pp 275.e7-275.e14. American Heart Association web site. Food Standards Agency web site. Jack in the Box web site. McDonald's web site. Wendy's web site. Food Processor nutritional analysis software, ESHA Research. WebMD Feature: "Beware of the Salt Shockers." Myrtle Thierry-Palmer, PhD, professor of biochemistry, Morehouse School of Medicine, Atlanta.
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