Lower NaCl to Improve Health

News Review from Harvard Medical School - Lower-Salt Diet Would Have Major Impact

If all Americans cut their salt intake by less than half a teaspoon a day, we could save up to $24 billion in health costs every year. Researchers from Johns Hopkins University built a computer model to test the idea. Experts recommend less than 5.8 g of salt per day. Women eat about 7.3 g per day, and men 10.4 g. Most salt in the diet comes from processed foods, such as lunchmeat, canned food and sauces. The study was published January 20 in the New England Journal of Medicine. HealthDay News wrote about it the same day.

According to recent studies, most Americans eat roughly two teaspoons of salt a day: Men take in 10.4 grams, and women consume 7.3 grams.

If we reduced our average salt intake by 3g per day (this would translate to 1,200 milligrams of sodium per day), how much would this help the collective health of Americans? The study's calculations are startling. During the first decade after the change, a computer simulation predicts 54,000 to 99,000 fewer heart attacks per year, 32,000 to 66,000 fewer strokes per year, and 44,000 to 92,000 fewer deaths per year from any cause. Roughly 1 in 4 people who need medicine to treat high blood pressure would be able to go off the medicine.

These are not insignificant numbers. And while a lower-salt/low-sodium diet correlating to a healther body is not news, higher emphasis needs to be made from sources such as the Food and Drug Administration (FDA) to regulate the amount of sodium allowed into our food supply. And I'm not just talking about the table salt you sprinkle on top of your fries.

With a society hell-bent on convenience and speed of service, rather than quality, we have succumbed to a life of processed foods which are higher in sodium.

A randomized study published three years ago demonstrated that if you have pre-hypertension (mildly elevated blood pressure, but not enough to need treatment), reducing salt intake to about three-fourths of what you had been eating could lower your risk for heart and stroke events by 25%. “Events” include heart attacks, strokes, a need for an angioplasty procedure or bypass surgery, strokes and premature death.

Here are tips for reducing salt in your diet.

1. The most effective way to lower your salt is to cook your own food, starting with basic ingredients. Find new ways to flavor your food. Try out other spices, cinnamon, or herbs. Try them in very small amounts, or in foods you might not have considered, such as salad dressings. Use natural acids for flavor, such as lemon juice, lime juice, vinegars, tomatoes and yogurt.

2. Reduce your “portion size” for condiments. You don’t have to abandon barbeque sauce, ketchup, teriyaki sauce or soy sauce, if these are tastes that you love, but these are among the most high-salt sauces you can find. You probably will enjoy your food just as much if you squirt or dip into half your usual amount.

3. Buy fresh or frozen vegetables, or canned vegetables with no salt added.

4. Use fresh poultry, fish, and lean meat. Avoid salted canned tuna or processed meats, such as ham.

5. Keep herbs, spices, and salt-free seasoning blends in your kitchen and at your table.

6. Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes.

7. Cut back on frozen dinners, packaged mixes, canned soups or broths, salad dressings, and foods packed in “brine” (pickles, sauerkraut).

8. Rinse canned foods, such as tuna, to remove some sodium.

9. When available, buy low-sodium, reduced-sodium, or no-salt-added versions of foods.

10. Choose breakfast cereals that are lower in sodium.

11. Snack on fruits and vegetables, instead of chips.

12. A few salt-free salt substitutes exist, including Spike and Mrs. Dash. Salt substitutes marketed as "lite salt” replace about half the sodium chloride found in regular salt with potassium chloride. Lite salt still adds a substantial amount of salt into your diet. Plus, it can’t be used in cooking, because potassium chloride that is heated to high temperatures develops a bitter taste.

None of these tips should come as much of a surprise, it should be common knowledge that these steps are those that should be taken to lower the sodium content of your diet.

The real steps come from the individuals who choose to make such changes to improve the quality of their lives.

It is when the typically lazy American attitude gets in the way of real change that the government has to step in and mandate change from the food production level.

Several countries—Japan, the United Kingdom, Finland and Portugal—have imposed salt-related regulations that limit the salt content in processed foods. In some cases, they limit salt content in restaurants. In the United Kingdom, government efforts to lower population salt intake have resulted in a 10% reduction in dietary salt intake over the first 4 years of the program. Snack-food sales have been essentially unchanged, but the salt content of available snack foods is lower.

Imagine if salt in the diet was reduced gradually from now until 2019. Let's say we only get a third of the way towards our goal—we reduce salt intake by an average of 1 g per day. Just this modest success would save us somewhere between $19 billion and $32 billion in health care costs over the course of the next 10 years. If we were truly able to reach the more challenging goal (3 g less salt per day on average), we could save between $57 billion and $97 billion in health care dollars.