Salt: Shake it Down

Salt may not be the sexiest topic (unless maybe you're talking about the new Angelina Jolie flick), but since more than 90% of us consume too much of the stuff, it's time we acknowledged the issue and its effect on our health and well-being.

Excess salt, or sodium, is well-known to contribute to high blood pressure, an often silent killer that afflicts up to 60 million Americans, and is a major factor in heart attacks and strokes. The US Centers for Disease Control and Prevention estimate that by cutting salt consumption substantially, up to 120,000 heart attacks and 66,000 strokes could be prevented each year. Each year! That amounts to an enormous amount of misery, disability, and death that could be avoided with really simple changes in the way we eat.

Most of my patients will tell me that they rarely use the salt shaker-- and I believe them. The problem is that the vast majority of the salt we take in comes from processed foods and restaurant foods, while only about  10% comes from table salt. I will never forget a cooking demonstration I attended where I watched a local celebrity chef toss a fistful of salt on a hunk of meat before throwing it on the grill. What he said really struck me: "If I didn't use this much salt, you wouldn't want to pay for this steak." Why? Because we have allowed ourselves to become accustomed to the taste of salty foods, and now consider that taste to be normal.

While we get a lot of sodium from cooked meat, lunch meat and other animal products, surprisingly, we get even more from grain products, including breads and pasta dishes. People under age 40, without hypertension, should have no more than 2300 mg, or about one teaspoon daily. Those with high blood pressure and those over 40 will do better with less than 1500 mg daily. But most of us are getting more than twice the recommended amount of sodium.

If you eat out, a restaurant meal will typically provide 2300-4600 mg, or up to three times your daily limit. This is why the US Institute of Medicine recently asked the FDA to set new standards for the amount of salt that manufacturers and restaurants can add to their products. Of course, these businesses add salt because that is what we consumers have demanded, so the hope is that requiring progressive changes across the board will keep the playing field level.

Meanwhile, read labels when you buy frozen or canned food, and look for options with lower sodium. Even though an item is labeled "healthy," it may contain far more salt than it should. When you eat out, ask for sauces on the side, because that is often where the sodium lurks. Choose foods closer to nature, like fruits, vegetables, fresh fish and unprocessed whole grains. As a result, you may find that you are spending less on blood pressure pills. High blood pressure or not, you'll also retain less fluid, your shoes and rings will start to fit better, and your belt may even get a little looser.