Find, and reduce, hidden sources of sodium in your diet

According to experts, if Americans reduced their sodium intake by 1,200 mg per day, it could prevent 92,000 deaths, 66,000 strokes, 99,000 heart attacks and 120,000 new cases of heart disease annually. Think of the healthcare savings: It’s estimated at anywhere from $10 to $24 billion per year.

Yes, these are astounding statistics, but reducing sodium intake is about far more than setting aside the salt shaker. In fact, the salt Americans shake onto their foods is relatively small compared to the sodium already added to the food before it gets to the table. “We only get about 10 percent of our sodium from the salt shaker,” said Nina Marinello, PhD, coordinator of Sports Nutrition for University at Albany Athletics.

One of the biggest misconceptions that Amy Laskey, clinical dietitian at Saratoga Hospital, finds is that people think that a low sodium diet can be achieved by not adding extra salt to food. “Not using the salt shaker does not constitute a low sodium diet,” she said. “The sodium is already in the food.” Our bodies do need sodium, but only about 200 mg a day, according to the American Heart Association. Current recommendations for sodium consumption are less than 2,300 mg per day, with experts advocating less than 1,500 mg per day for those middle-aged and older or for those who already have high blood pressure. As it stands now, women consume an average of 3,000 mg per day and men 4,000 mg.

Dining out danger

If you eat out, though, your sodium consumption is most likely much higher. Olive Garden’s Chicken parmigiana and spaghetti packs a whopping 3,380 mg, a bloomin’ onion with sauce at the Outback Steakhouse has 5,510 mg, and Chili’s Texas Cheese fired with jalapeno ranch dressing go even higher at 5,530 mg.

More info

You can learn more about how to lower sodium in your diet by visiting the American Heart Association website at www.heart.org.

Too much sodium in one’s diet can be the cause of a variety of health problems. Excess salt raises blood pressure, which the Institute of Medicine (IOM) of the National Academies says causes one in six deaths in the United States. Blood pressure tends to rise as we age, with roughly 90 percent of people developing hypertension at some point. “High” blood pressure is considered to be 140 over 90 and higher, but some experts are making the point that the “pre-hypertensive” stage of numbers higher than 120 over 80 also increase the risk of heart disease and stroke.

Studies indicate that cutting sodium consumption can lower the risk of heart attack, stroke and cardiovascular disease. Some studies have linked excessive sodium consumption to kidney damage and even osteoporosis.

“The majority of people I see have far too much sodium in their diets, but in my opinion, it’s not really their fault,” Laskey said.

The food industry has added sodium (as well as sugar and fat) to its foods to make them appealing to consumers, and the amount that they can add is currently not regulated by the Food and Drug Administration.

Salt is a “generally recognized as safe” (GRAS) ingredient according to the FDA. Growing advocacy around reducing the amount of sodium in the food supply has prompted the FDA to conduct research in this area and it is currently reviewing recommendations made by the IOM on how to reduce Americans’ sodium intake. IOM’s report, “Strategies to Reduce Sodium Intake in the United States,” released in April, suggests that sodium content be reduced step by step so that consumers can adjust to decreased sodium content.

Some food industry giants have voluntarily taken steps to decrease the sodium content of their products. Nestle has removed more than 15 million pounds of salt from its products and Unilever removed 9,100 tons. General Mills, Kraft, Sara Lee, ConAgra, and Campbell’s have also been lowering the sodium in many of their products.

But there’s still a long way to go.

Since the sodium is already in many of the foods that people pick up from grocery store shelves and freezers, reducing the amount of sodium in one’s diet takes some concentrated effort.

Life or death changes

Joseph LaFreniere of Albany is a success story. Last March, the 62-year-old had triple bypass surgery on his heart. When he was going through rehab in the hospital, a nutritionist came to meet with him. “You talk to the nutritionist, you have to do exercise, change what you eat,” LaFreniere said. “They tell everybody, and most people don’t take it to heart,” he said.

That was not the case with LaFreniere. He saw two choices: change his eating habits or risk an early death.

He admits that he “ate frivolously” before his surgery. “You think you’re invincible–everybody does,” he said.

All of that changed after his surgery. LaFreniere and his wife took the salt shaker off the table, and have made significant changes to their eating habits. “The biggest change is that when I go to the store and I pick up any product in the aisles, I look at the sodium content,” he said, noting that foods like canned soup, cheese and lunch meat have enormous amounts of sodium. Now, instead of a bowl of soup and a sandwich, he might eat a salad and a banana for lunch. “I try to stay away from canned food totally,” he said, noting that he and his wife are now eating more fresh vegetables and fruit.

He also noticed that fat free or lower fat versions of products may have more sodium than their regular counterparts. The added sodium is an effort by manufacturers to make up the taste lost when fat content is reduced or removed.

Food from scratch

Limiting the amount of processed foods one eats will reduce sodium intake. This means getting back into the kitchen and cooking from scratch and using more herbs for flavor than salt.

Cooking fresh does mean more time, LaFreniere said, but the couple feels like it is worth it. “We realize it’s more beneficial for us in the long run for your whole life, your quality of life,” LaFreniere said. Reducing his sodium intake has helped to reduce his blood pressure drastically.

If you do plan to eat out, there are some strategies for limiting sodium intake. Marinello suggests visiting the restaurant’s website ahead of time to find nutritional information. “Think it through before you go and avoid the obvious,” she said.

Special requests

When that information is not available, choose dishes as plain as possible, and make special requests, Laskey suggests. For example, if your meal comes with a side of vegetables, ask that they be prepared without salt. In addition, if you know you’re going to be eating out, focus on eating very low sodium foods the rest of the day, she said.

It took some adjustment to get used to a lower sodium diet, about four to six weeks, LaFreniere said. But now, his body lets him know if something has too much salt in it. “If I do get too much salt and I don’t pick up on it from my taste, later on, I’ll get a headache,” he said.

It can take longer, up to three months, to adjust to the flavor change of a lower sodium diet, Laskey said. “Sometimes that’s a long time for people to wait,” she said.

LaFreniere is glad about the changes he has made. “I’m 62, and I don’t think I look, it, and I have more energy,” he said. The dietary changes, which also included lowering cholesterol and fat intake, combined with regular exercise at St. Peter’s Cardiac Rehab Center, resulted in weight loss of 37.5 pounds.