Banning the Salt Shaker Has Little Effect on Heart Health

If you think tossing out the salt shaker can help you cut down on sodium and boost your heart health, think again. Most of the salt that Americans consume comes from processed foods and restaurant meals — and is not added at the table or in home-cooked dishes, a new study finds.

The findings, published online in the American Heart Association journal Circulation, indicate only 10 percent of salt in the diets of 450 Americans came from food prepared at home. About half of that was added at the table.

But restaurant meals and processed foods — such as crackers, breads, and soups — accounted for nearly three-quarters of the participants’ salt intake

“Telling patients to lay off the salt shaker isn’t enough,” says Dr. Lisa J. Harnack, lead author of the study and a professor at the University of Minnesota in Minneapolis.

“Rather, commercially processed and restaurant foods should be the primary focus when educating patients on strategies for lowering sodium in the diet. Food manufacturers and restaurants should be encouraged to lower the sodium content in their food products to support Americans in consuming a diet consistent with sodium intake recommendations.”

The average American adult consumes far more sodium each day than the recommended maximum of 2,300 milligrams, researchers say. Sodium is an important contributor to high blood pressure, one of the leading causes of heart attack and stroke.

To get a clear picture of Americans’ swooning love affair with salt, Harnack’s team recruited 150 participants ages 18-74 in each of these three cities:

• Birmingham, Ala.
• Minneapolis, Minn.
• Palo Alto, Calif.

Half the participants were male, and half were female. Equal percentages of the participants were:

• Non-Hispanic white
• Hispanic
• African-American
• Asian

Participants visited a clinic once at the beginning of the study and then kept records of daily food intake for four days, which they reported to researchers in four telephone interviews. They also provided samples of salt to replicate the amount they added to food at home.

Across age groups, the researchers found similar intakes of dietary sodium: an average of 3,501 mg per day (higher than recommended daily maximum of 2,300 mg — about a teaspoonful — for healthy adults). This average even more dramatically exceeds the 1,500 mg daily limit recommended for 70 percent of American adults based on their age, race or ethnicity, or existing high blood pressure.

In addition to restaurants and processed foods found in stores, the researchers found that the most common sources of dietary sodium were:

• Sodium naturally found in food (14.2 percent)
• Sodium added in home food preparation 5.6 percent)
• Sodium added to food at the table (4.9 percent)
• Sodium in home tap water, dietary supplements, and antacids accounted for less than 0.5 percent of total intake

Sodium can be difficult to avoid, especially when people eat a lot of processed food from grocery stores or restaurants. To address this serious health threat, the Institute of Medicine recommends gradually decreasing sodium levels in commercially processed foods.

According to the American Heart Association, restaurant and prepackaged food companies must be a part of the solution to reduce sodium and give Americans the healthy options they need and deserve. The AHA encourages packaged food companies and restaurants to reduce the sodium in their products to help make meaningful impact on the health of all Americans. The association has developed a sodium reduction campaign to help.

But there’s much consumers can do for themselves, Harnack says.

“If you’re aiming to limit your sodium intake to the recommended level of less than 2,300 milligrams per day, you’ll need to choose foods wisely when grocery shopping and dining out,” she notes.

“For packaged foods, the nutrition fact panel may be useful in identifying lower sodium products, and for menu items diners can request sodium content information. Also, if you frequently add salt to food at the table or in home food preparation, consider using less.”

A recent Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report shows that more than 89 percent of adults and 90 percent of children exceed the recommended limits for sodium, not including salt added to food at the table.

This includes more than 75 percent of these at-risk populations:

• Adults over age 50
• African-Americans
• People diagnosed with either hypertension or pre-hypertension

The authors observed excessive sodium intake in all demographic groups. But they found that such intake was more common in men than in women (98 percent versus 80 percent), and in white adults than in black adults (90 percent versus 85 percent).

They also found that Americans ages 19-50 had the highest sodium consumption as well as the highest calorie consumption.

More information about the risks of dietary sodium and ways to reduce it can be found on this CDC Website.