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Adobe Reader | Salt & SodiumAbout Sodium and Health
 Key points  
			
				
					Your body needs a small amount of sodium to 
								work properly, but too much sodium is bad for 
								your health.While sodium has many forms, most sodium we 
								consume is from salt.Most Americans consume too much sodium.Most sodium comes from processed and 
								restaurant foods.Eating too much sodium can increase blood 
								pressure and the risk of heart disease and 
								stroke.Most sodium in our diets comes from packaged 
								and restaurant food, not the salt shaker.You can reduce sodium intake by following 
								the tips below at the grocery store, at home, 
								and in restaurants.Sodium and potassium are electrolytes that 
								help your body maintain fluid and blood volume.Consuming too much sodium and too little 
								potassium can raise your blood pressure.High blood pressure increases your risk of 
								heart disease and stroke.   
 Health risks  
			
				Eating too much sodium can increase your blood pressure and 
					your risk for heart disease and stroke. Together, heart 
					disease and stroke kill more Americans each year than any 
					other cause. DeficiencyA deficiency of sodium in the U.S. is rare because it is so 
					commonly added to a wide variety of foods and occurs 
					naturally in some foods. Hyponatremia is the term used to 
					describe abnormally low amounts of sodium in the blood. This 
					occurs mainly in older adults, particularly those living in 
					long-term care facilities or hospitals who take medications 
					or have health conditions that deplete the body of sodium, 
					leading to hyponatremia. Excess vomiting, diarrhea, and 
					sweating can also cause hyponatremia if salt is lost in 
					these fluids that are expelled from the body. Sometimes too 
					much fluid abnormally collecting in the body can lead to 
					hyponatremia, which might stem from diseases such as heart 
					failure or liver cirrhosis. In rare cases, simply drinking 
					too much fluid can lead to hyponatremia if the kidneys can’t 
					excrete the excess water. Symptoms of hyponatremia can 
					include: nausea, vomiting, headaches, altered mental 
					state/confusion, lethargy, seizures, coma.   
 Types of Salt  
			
				Finely ground salts are dense, so they tend to contain more sodium than 
		coarser salts. Note that sodium content can vary widely among brands, so 
		check the Nutrition Facts label for exact amounts. 
		
			
				
					| Type | Approximate amount of sodium (1 teaspoon)
 |  
					| Iodized table salt, fine | 2,300 mg |  
					| Kosher salt, coarse | 1,920 mg |  
					| Kosher salt, fine, Diamond Crystal®† | 1,120 mg |  
					| Sea salt, fine | 2,120 mg |  
					| Sea salt, coarse | 1,560 mg |  
					| Pink (Himalayan) salt | 2,200 mg |  
					| Black salt | 1,150-2,200 mg |  
					| Fleur de sel | 1,560-2,320 mg |  
					| Potassium salt (salt substitute) | 0 mg (contains 2,760-3,180 mg potassium) |  
			
				† The inclusion of brand-names on this 
		list is for reference only and does not constitute an endorsement. The 
		Nutrition Source does not endorse specific brands.    
 Sodium in everyday foods adds up  
			
				Most people eat too much sodiumYour body needs a small amount of sodium to work properly, 
					but too much sodium is bad for your health. Americans 
					consume more than 3,300 milligrams (mg) of sodium per day, 
					on average. This is well above the federal recommendation of 
					less than 2,300 mg of sodium daily for teens and adults as 
					part of a healthy eating pattern. Sodium is found in foods from almost all food categories. 
					Some of the top sources of sodium for U.S. adults and 
					children ages 1 and older include: 
					Sandwiches.Rice, pasta, and other grain-based dishes.Starchy and non-starchy vegetables.Meat, poultry, and seafood dishes.Pizza.Soups.Chips, crackers, and savory snacks.Desserts and sweet snacks.Condiments and gravies.Cold cuts and cured meats.Breads and tortillas. Source: Dietary 
					Guidelines for Americans, 2020-2025   
 Sodium or salt?  
			
				Salt and sodium are not the same. Salt is sodium chloride 
					which is table salt. Sodium chloride is 40% sodium and 60% 
					chloride. One teaspoon of table salt contains about 2,400 mg 
					of sodium. Sodium is a mineral found in many ingredients in common 
					foods: 
					Monosodium glutamate (MSG).Sodium bicarbonate (baking soda).Sodium nitrate (a preservative).   
 Reducing Sodium Intake
			
				Why it's importantEating too much sodium can increase blood pressure and the 
					risk for heart disease and stroke. Together, heart disease 
					and stroke kill more Americans each year than any other 
					cause. Even foods that may not taste salty can be major sources of 
					sodium. Foods with only moderate amounts of sodium, such as 
					bread, can be major sources of sodium because they’re eaten 
					so frequently. ToxicityToo much sodium in the blood is called hypernatremia. This 
					acute condition can happen in older adults who are mentally 
					and physically impaired who do not eat or drink enough, or 
					who are sick with a high fever, vomiting, or infection that 
					causes severe dehydration. Excessive sweating or diuretic 
					medications that deplete the body of water are other causes. 
					When sodium accumulates in the blood, water is transferred 
					out of cells and into the blood to dilute it. This fluid 
					shift and a build-up of fluid in the brain can cause 
					seizures, coma, or even death. Extra fluid collecting in the 
					lungs can cause difficulty breathing. Other symptoms of 
					hypernatremia can include: nausea, vomiting, weakness, loss 
					of appetite, intense thirst, confusion, kidney damage. At the grocery store
					Tip:  Some grocery stores have a registered 
					dietitian who can help you find low-sodium products. If your 
					grocer doesn't have a registered dietitian, ask your doctor 
					for a referral. A registered dietitian can provide valuable 
					guidance on reducing your family's sodium intake and 
					managing blood pressure.Buy fresh, frozen, or canned vegetables with no salt or 
						sauce added.Choose packaged foods labeled "low sodium," "reduced 
						sodium," or "no salt added" when available.Compare the amount of sodium in different products by 
						reading Nutrition Facts labels. Check the amount of 
						sodium per serving and the number of servings per 
						container. Choose the options with the lowest amounts of 
						sodium.When possible, purchase fresh poultry, fish, pork, and 
						lean meat, rather than cured, salted, smoked, and other 
						processed meats.For fresh items, check to see whether saline or salt 
						solution has been added—if so, choose another brand.Ask your grocer if they have a low sodium shopping list 
						available. At home
					When cooking, replace or reduce the amount of salt you 
						use. Alternatives could be garlic, citrus juice, 
						salt-free seasonings, or spices.Prepare rice, pasta, beans, and meats from their most 
						basic forms (dry and fresh) when possible.Eat more fruits and vegetables.Limit sauces, mixes, and instant products, including 
						flavored rice and ready-made pasta. At restaurants
					Ask for nutrition information before you order, and 
						select a lower sodium meal.Ask that no salt be added to your meal.Order vegetables with no salt added or fruit as a side 
						item.Split a meal with a friend or family member.Keep takeout and fast food to an occasional treat.   
 Choose a heart-healthy diet  
			
				The Dietary 
Approaches to Stop Hypertension (DASH) eating plan is 
a simple, heart-healthy diet that can help prevent or lower high blood pressure. 
							 The DASH diet is low in sodium, cholesterol, and saturated and total fats. The 
diet is high in fruits and vegetables, fiber, potassium, and low-fat dairy 
products. Sodium and HealthIn most people, the kidneys have trouble keeping up with 
					excess sodium in the blood. As sodium accumulates, the body 
					holds onto water to dilute the sodium. This increases both 
					the amount of fluid surrounding cells and the volume of 
					blood in the bloodstream. Increased blood volume means more 
					work for the heart and more pressure on blood vessels. Over 
					time, the extra work and pressure can stiffen blood vessels, 
					leading to high blood pressure, heart attack, and stroke. It 
					can also lead to heart failure. There is some evidence that 
					too much salt can damage the heart, aorta, and kidneys 
					without increasing blood pressure, and that it may be bad 
					for bones, too. Learn more about the health risks and 
					disease related to salt and sodium: Cardiovascular diseaseAfter conducting a review on sodium research, the Institute 
					of Medicine concluded that reducing sodium intake lowers 
					blood pressure, but evidence of a decreased risk of 
					cardiovascular diseases (CVD) is inconclusive.  It is 
					clear, however, that high blood pressure is a leading cause 
					of CVD. It accounts for two-thirds of all strokes and half 
					of heart disease.  In China, high blood pressure is the 
					leading cause of preventable death, responsible for more 
					than one million deaths a year. There may be a genetic component to salt intake, as people 
					respond differently to lower sodium intakes. Those who 
					are “salt-sensitive” experience the greatest blood pressure 
					reductions after following a reduced sodium diet. Those who 
					are “salt-resistant” do not experience these changes even 
					with significant increases in sodium intake. Studies have 
					found that women more than men, people older than 50 years, 
					African-Americans, and those with a higher starting blood 
					pressure respond the greatest to reduced sodium intake. 
					[5,6] However, there is not enough evidence to make strong 
					conclusions about specific groups who may be salt-resistant; 
					the overall evidence supports a benefit of limiting sodium 
					intake for everyone, even though the optimal target amount 
					is not clear. Observational and clinical research has found that higher 
					sodium intakes are associated with cardiovascular diseases 
					and related deaths.  The following are key studies: 
					
					Intersalt: Researchers measured the amount 
						of sodium excreted over a 24-hour period (a good 
						stand-in for salt intake) among more than 10,000 adults 
						from 32 countries. The average was nearly 4,000 mg of 
						sodium a day. Yet the range was huge, from 200 mg a day 
						among the Yanomamo people of Brazil to 10,300 mg in 
						northern Japan. Populations with higher salt 
						consumption had higher average blood pressures and 
						greater increases of blood pressures with age. Four 
						groups of people—the four countries with salt intakes 
						less than 1,300 mg per day—had low average blood 
						pressures and little or no upward trend of blood 
						pressure with age.
						The authors conducted a re-review and update on the 
							Intersalt data. They found: 1) a stronger 
							association than their prior study with higher 
							sodium intakes and higher blood pressure, and 2) a 
							stronger association with higher sodium intakes and 
							higher blood pressure in middle age participants as 
							compared with younger adults.
					TOHP: The two Trials of Hypertension 
						Prevention (TOHP) were conducted from 1987-1995. 
						They tested the impact of lifestyle changes on blood 
						pressure, such as weight loss, stress management, 
						nutritional supplements, and consuming less sodium. In 
						each of the studies, small decreases in blood pressure 
						were seen with sodium reduction over 18-36 months. Years 
						after the trials had ended, the researchers surveyed the 
						participants and found that:
						After an average of 10-15 years, the TOHP 
							participants in the sodium-reduction groups were 25% 
							less likely to have had a heart attack or stroke, to 
							have needed a procedure to open or bypass a 
							cholesterol-clogged coronary artery, or to have died 
							of cardiovascular disease.The higher the ratio of potassium to sodium in a 
							participant’s diet, the lower the chances were of 
							developing cardiovascular trouble. This suggests 
							that a strategy that includes both increasing 
							potassium and lowering sodium may be the most 
							effective way to fight high blood pressure.
					TOHP Follow-up Study: A continuation of 
						the two previous TOHP trials in 2000 that looked 
						specifically at CVD or deaths from CVD.  When 
						participants with sodium intakes less than 2,300 mg 
						daily were compared with those who had intakes of 
						3,600-4,800 mg, there was a 32% lower risk of developing CVD. There was also a continuing decrease in CVD-related 
						events (stroke, heart attack) with decreasing sodium 
						intakes as low as 1,500 mg daily.
					DASH: The Dietary Approaches to Stop 
						Hypertension (DASH) trials, begun in 1994, were major 
						advances in blood pressure research, demonstrating the 
						links between diet and blood pressure. 
						
							In the first study, 459 participants were randomly 
							assigned to either 1) a standard American diet high 
							in red meat and sugars, and low in fiber, 2) a 
							similar diet that was richer in fruits and 
							vegetables, or 3) the “DASH 
							diet,” which emphasized fruits, vegetables and 
							low-fat dairy foods, and limited red meat, saturated 
							fats, and sweets. After eight weeks, the fruits and 
							vegetables diet and DASH diet reduced systolic (the 
							top number of a blood pressure reading) and 
							diastolic (the bottom number of a blood pressure 
							reading) blood pressure, with the DASH diet 
							producing a stronger effect.The second study found that lowering sodium in 
							either the DASH or standard American diet had an 
							even stronger impact on reducing blood pressure. The 
							DASH study contributed much of the scientific basis 
							for the Dietary Guidelines for Americans 2010, which 
							recommends reducing daily sodium to less than a 
							teaspoon.A meta-analysis of clinical trials found that a moderate 
						sodium reduction to about 4,000 mg a day for at least 
						one month caused significant reductions in blood 
						pressure in individuals with both normal and high blood 
						pressure. Further analysis showed that blood pressure 
						was reduced in both men and women and white and black 
						races, suggesting a benefit for the total population. Assessing people’s sodium intakes can be tricky, and the 
					most accurate method known is to measure 24-urine samples 
					over several days. This is the method Harvard researchers 
					used when pooling data from 10,709 generally healthy adults 
					from six prospective cohorts including the Nurses Health 
					Studies I and II, the Health Professionals Follow-up Study, 
					the Prevention of Renal and Vascular End-Stage Disease 
					study, and the Trials of Hypertension Prevention Follow-up 
					studies. They looked at both sodium and potassium 
					intakes in relation to cardiovascular disease (CVD) risk (as 
					noted by a heart attack, stroke, or procedure or surgery 
					needed to repair heart damage), and measured two or more 
					urine samples per participant. After controlling for CVD 
					risk factors, they found that a higher sodium intake was 
					associated with higher CVD risk. For every 1,000 mg increase 
					of urinary sodium per day, there was an 18% increased risk 
					of CVD. But for every 1,000 mg increase of potassium, there 
					was an 18% lower risk 
					of CVD. They also found that a higher sodium-to-potassium 
					ratio was associated with higher CVD risk, that is, eating a 
					higher proportion of salty foods to potassium-rich foods 
					such as fruits, vegetables, legumes, and low-fat dairy. Chronic kidney diseaseChronic kidney disease (CKD) shares risk factors with 
					cardiovascular disease, with high blood pressure being a 
					major risk factor for both. Salt sensitivity is reported to 
					be more prevalent in patients with CKD due to a reduced 
					ability to excrete sodium, which may lead to increased blood 
					pressure. Although there is evidence that links high sodium intake 
					with high blood pressure, there is not adequate evidence 
					that a low sodium restriction protects against or causes 
					better outcomes of CKD than a moderate sodium restriction. 
					One systematic review of patients diagnosed with CKD found 
					that high sodium intakes of greater than 4,600 mg a day were 
					associated with progression of CKD, but low sodium intakes 
					less than 2,300 mg a day had no significant effect when 
					compared with moderate sodium intakes of 2,300-4,600 mg a 
					day. Guidelines generally advise a moderate rather than low 
						sodium restriction to prevent the development and 
						progression of CKD. A daily sodium intake of less than 
						4,000 mg is recommended for overall management of CKD, 
						and less than 3,000 mg daily for CKD with symptoms of 
						fluid retention or proteinuria, a condition in which 
					excess protein is excreted in the urine. OsteoporosisThe amount of calcium that your body loses via urination 
						increases with the amount of salt you eat. If calcium is 
						in short supply in the blood, it can leach out of bones. 
						So a diet high in sodium could have an additional 
						unwanted effect—the bone-thinning disease known as 
						osteoporosis.  A study in post-menopausal women 
						showed that the loss of hip bone density over two years 
						was related to the 24-hour urinary sodium excretion at 
						the start of the study, and that the connection with 
						bone loss was as strong as that for calcium intake. Other studies have shown that reducing salt intake 
						causes a positive calcium balance, suggesting that 
						reducing salt intake could slow the loss of calcium from 
						bone that occurs with aging. CancerResearch shows that a higher intake of salt, sodium, or 
					salty foods is linked to an increase in stomach cancer. The 
					World Cancer Research Fund and American Institute for Cancer 
					Research concluded that salt, as well as salted and salty 
					foods, are a “probable cause of stomach cancer.”
					   
 Effects of Sodium and Potassium  
			
				Why it's importantSodium and potassium are electrolytes needed for your body 
					to function properly, including hydration, blood volume, and 
					the functioning of your nerves and muscles. We get 
					electrolytes from our food and drinks. Consuming too much sodium can raise your blood pressure. 
					Limiting sodium intake is especially important if you have 
					high blood pressure, also known as hypertension. Increasing potassium intake can help decrease your blood 
					pressure if you have high blood pressure. By lowering blood 
					pressure, increasing potassium intake can also reduce your 
					risk for heart disease and stroke. Terms to knowThough the words "salt" and "sodium" are often used 
					interchangeably, they do not mean the same thing. Salt is 
					also known by its chemical name, sodium chloride. Salt is a 
					crystal-like compound that is common in nature. Sodium is a 
					mineral, and it is a chemical element found in salt. Check the Package for Nutrient ClaimsYou can also check for nutrient claims on food and beverage 
					packages to quickly identify those that may contain less 
					sodium.  Here’s a guide to common claims and what they mean: 
			
				
					
						| What It Says | What It Means |  
						| Salt/Sodium-Free | Less than 5 mg of sodium per serving |  
						| Very Low Sodium | 35 mg of sodium or less per serving |  
						| Low Sodium | 140 mg of sodium or less per serving |  
						| Reduced Sodium | At least 25% less sodium than the regular product |  
						| Light in Sodium or Lightly Salted | At least 50% less sodium than the regular product |  
						| No-Salt-Added or Unsalted | No salt is added during processing – but these products 
						may not be salt/sodium-free unless stated |  
			
				Food sources of sodium and potassiumMost Americans eat too much sodium and too little potassium. Americans consume 
more than 3,400 milligrams (mg) of sodium each day, on average. This is well 
above the federal recommendation of 
less than 2,300 mg of sodium daily for teens and adults as part of a healthy 
eating pattern. Most sodium in our diets comes from packaged and restaurant 
					food. Foods with moderate amounts of sodium, such as bread, 
					can be major sources of sodium because they're eaten so 
					frequently. Most potassium we eat naturally occurs in vegetables, fruit, 
					seafood, and dairy products. Some good sources of potassium include 
					bananas, oranges, melons, potatoes, sweet potatoes, and 
					cooked spinach and broccoli. Foods High in SodiumMore than 40% of the sodium Americans get comes from the following 
		foods: 
					Bread and rollsPizzaSandwichesSmoked or cured meats (bacon, cold cuts, ham, frankfurters, sausage, 
			sardines, and anchovies)SoupsBurritos and tacosSavory snacks (chips, popcorn, pretzels, snack mixes, and crackers)ChickenCheese and cheese spreadsEggs and omelets Other sources high in sodium include: 
					Salted nutsCanned beans and vegetablesOlives, pickles, sauerkraut, and other pickled vegetablesCommercially prepared pasta and tomato sauces and salsaCondiments such as mustard, ketchup, BBQ sauce, and salad dressingsSoy sauce and other sauces   
 
		Health Risks
		  
			
				Consuming excessive amounts of sodium can be a risk factor for high 
		blood pressure in some people, which can lead to serious health 
		issues, such as heart disease and stroke. To avoid those risks, experts recommend most healthy adults take in no 
		more than 2,300 milligrams (mg) of sodium per day; 1,500 mg per day 
		is even better. For 
		some context, the Food and Drug Administration (FDA) estimates that the 
		average American consumes about 3,400 mg of sodium per day—much more 
		than is generally recommended. Since most diets are too high in sodium, it’s important to pay attention 
		to how much salt and added sodium are present in your food—especially in 
		processed foods like pizza, deli meats, soups, salad dressings, and 
		cheese. But as experts point out, you can’t always count on your taste 
		buds to sound the alarm. Keep in mind that foods high in sodium don’t 
		always taste salty, so watch out for sweet offenders like cereals and 
		pastries too.   
 One Final Note..  
			
				Roughly 90% of Americans ages 2 and older consume too much 
					sodium and don’t even realize it, which can be bad for your 
					health. It's a good idea to check with your healthcare 
					provider if you have any concerns about your sodium intake 
					and how it may be affecting your health. In the meantime, you can become aware of how much sodium 
					you’re consuming by actively seeking out lower-sodium foods, 
					checking the Nutrition Facts labels and ingredient lists on 
					packaged foods, and cooking at home more often—just try to 
					keep the salt shaker use to a minimum.  The FDA has been working with the food industry to gradually 
					reduce sodium levels in food in the short and long term. 
					While there’s no quick fix, federal regulators are aiming 
					for a broad reduction in the next several years.      |