This won't be the first time you have read that excessive salt intake is linked to certain health problems. However, most discussions of this topic explain how to cut down, but aren't very clear about why. If you're an average American, you are probably consuming about twice the recommended amount daily, and about ten times what your body needs for basic health. So, this topic might be important for you. Why? Read on.

Sodium Basics
By salt, we commonly mean table salt--sodium chloride. The health implications we'll be discussing here relate to the sodium component. The body needs only around 500 milligrams (abbreviated mg) of sodium daily, which can generally be achieved with a diet completely free of table salt or salty-tasting foods. Most experts recommend that for general good health, we all limit intake to 2400 mg per day, but the average intake for Americans is about double that. Sodium intake is linked to the development of hypertension through mechanisms that are still widely debated. Some people seem to be particularly "sodium-sensitive," but it is difficult to distinguish these from people who are not. High sodium intake has also been linked to a higher risk of stroke.

Another important reason to be concerned about sodium is its importance in fluid-retaining states like heart failure and kidney disease. Why should sodium have anything to do with fluid build-up? Because, as they teach you in medical school, where salt goes water goes. The sodium concentration of body fluid is tightly controlled at 0.9 percent. When we ingest excess sodium, the body compensates by retaining fluid in order to maintain the concentration at this level. That's why people with disorders causing fluid overload should restrict sodium, sometimes to as little as 1000 mg per day. It's also part of the reason that sodium intake can increase blood pressure. But restricting sodium is easier said than done.

Restricting Sodium May Not Be Easy
Table salt is certainly the commonest source of sodium. A level teaspoon contains about 2000 mg. Avoiding the addition of salt during cooking or at the table is therefore the first step. But by itself, that won't be enough.

To successfully keep sodium intake down, one must avoid many processed and prepared foods. Canned vegetables and soups are big culprits. Anything that tastes overtly salty or is cured in salt should also be avoided. Restaurant food, especially fast food, is notoriously high in sodium. In contrast, fresh vegetables, fruits, meat and fish generally have very little.

To get a "flavor" for the sodium content of various foods, here are a few examples. (On this list, one serving is defined as three and a half ounces):

• Cooked bacon, 1021 mg.
• Canadian bacon, 2500 mg.
• Fresh green beans, 4 mg
• Canned green beans, 236 mg.
• Roast beef, 60 mg.
• Corned beef, 1740 mg.
• Canned beef stew, 400 mg.
• Cottage cheese, 406 mg.
• Pizza, 702 mg.
• Pickles, 1428 mg.
• Canned soup, 350 to 450 mg.

In the past, of course, salting was an important means of preserving food. But, why is salt so prevalent in the foods we eat today? For one thing, salt improves flavor. Also, salted foods like soups seem thicker and less watery. Surprisingly, salt also increases the sweetness of foods like cookies and cakes. Salt also helps reduce the dryness of crackers, pretzels and similar foods. Despite all of this, you can still learn to shake the salt habit.

Tips for Getting the Low Sodium Habit
People adapt to the taste of salt. At first, food may not taste good after you start to cut down on sodium, but after a while you will find that the food you used to eat tastes too salty. Here some tips that can help you get the low sodium habit:

• Avoid seasonings that are high in sodium or have salt as part of their name such as soy sauce, garlic salt, onion salt and celery salt.
• Add flavor to food with herbs, spices and condiments such as lemon, vinegar, garlic, onion powder, pepper, dill, dry mustard, curry powder, basil, oregano and mint.
• At restaurants, ask about the salt content of foods. Some chefs will omit salt when asked. (If they won't, at least they'll begin to notice that their customers care about this issue.)
• Read food labels. As a general rule of thumb, avoid foods with more than 140 mg of sodium per serving. Foods labeled as "low sodium" have less than this amount per serving.
• Compare labels on similar products and choose the lower sodium brand.
• Finally, consider using salt substitutes, but ask you doctor first. The reason is that many such products are very high in potassium, which can be a problem for certain people.

March 2005