Are You Overeating Salt?
On average, Americans overeat salt — more than a teaspoon and a half a day. Most often, it doesn't come out of a shaker. It is hidden in the foods you eat. But is it terrible for your heart to overeat, or is that just a concern for people with certain risk factors?
What’s the difference between salt and sodium?
Sodium is a component of table salt (sodium chloride). One teaspoon of salt, 40 percent sodium, and 60 percent chlorine, has about 2,300 milligrams of sodium, the upper recommended limit. If you restrict sodium to 1,500 milligrams a day, that’s only two-thirds of a teaspoon of salt. Sodium is also a significant component of other food ingredients (preservatives) such as MSG (monosodium glutamate), baking soda (sodium bicarbonate), disodium phosphate, sodium benzoate, sodium propionate, sodium sulfite, and sodium nitrite/nitrate.
Salt is essential for life. The sodium in salt helps transmit nerve impulses and contract muscle fibers. It also works with potassium to balance fluid levels in the body. But you need only a tiny amount of salt to do this — less than one-tenth of a teaspoon per day. The average American gets nearly 20 times that much.
Is salt pretty bad for your heart?
In general, most researches link lower sodium intake with lower blood pressure and a lower risk of cardiovascular disease. Sodium has a definite effect on blood pressure. The result is more robust in people with high blood pressure (hypertension), a sustained blood pressure reading of 120/80 or higher.
How does salt elevate blood pressure?
When you overeat salt, your body holds onto the water to dilute it. This extra water increases your blood volume, which means your heart works harder because it's pushing more liquid through your blood vessels. More strenuous pumping by the heart puts more force on the blood vessels. Over time, this increased force can raise blood pressure and damage blood vessels, making them stiffer, which increases the risk of stroke, heart attack, and heart failure.
Do people respond differently to salt?
Research has found that certain people appear genetically more salt (sodium) -sensitive than others. These salt-sensitive people typically see more significant drops in their blood pressure when they eat less salt. Other people may not see the same benefit. However, most people benefit from being aware of salt in their diet and limit their use.
Who is salt-sensitive?
About 60% of individuals with high blood pressure are salt-sensitive. In comparison, only 25% of people with normal blood pressure; however, they may develop high blood pressure later, since salt sensitivity increases with age and weight gain. These estimates come from studies of people who underwent formal testing for salt sensitivity. This arduous and costly process involves carefully increasing the sodium in the diet while monitoring blood pressure and continuously measuring how much sodium leaves the body in the urine. New research shows that salt intake raises blood pressure because it makes it harder for the cardiovascular system to juggle blood pressure regulation and body temperature simultaneously. The American Heart Association considers salt sensitivity to be nearly as strong a cardiovascular risk factor as chronic high blood pressure. Lowering high blood pressure reduces the risk of heart disease and stroke.
About 33% of people with high blood pressure appear to be salt-resistant. Their blood pressure doesn’t respond as vigorously to a reduction in sodium intake. Currently, it is not practical for providers to try to determine whether a patient is salt-sensitive or not.
Salt sensitivity survival advantage?
Millions of years ago, when our distant ancestors roamed around Africa, salt was scarce in their diets. The human body depends on sodium to maintain average blood volume, transmit nerve impulses, contract muscle fibers, and other vital functions. An ability to hold on to this nutrient was a survival advantage. And as humans evolved, infections causing sodium loss by diarrhea and vomiting were among the most severe threats to surviving into adulthood. This well founded theory may explain why humans have gene variants (Thrifty gene) that make them sensitive to salt.
Thrifty gene hypothesis explains why certain groups of people are more predisposed to a variety of diseases. Thrifty genes enable individuals to collect and process food efficiently, hold on to calories and sodium, and provide for periods of food shortage (feast and famine). The modern-day environment is full of salty, high-calorie foods. So these variants potentially contribute to high blood pressure and obesity — two leading contributors to heart disease. Why haven't these variants been "washed out" of the gene pool, since they no longer help us survive in this modern world? The diseases caused by these thrifty genes usually kill people in adulthood after they have procreated. So these gene variants persist in the human gene pool.
How much salt is too much?
If you don’t have any health issues: take 2,300 milligrams (mg) per day or less. It is approximately one teaspoon of salt.
If you have high blood pressure or cardiovascular disease: take 1,500 mg or less of sodium each day. It is ⅔ teaspoon of salt.
An average person consumes about 3,600 mg a day. So, this would mean cutting out about a third of the salt for most people.
Why do processed foods contain so much salt?
Traditionally, salt has been used to preserve food. These days salt is used to enhance flavor. Paradoxically, salt can make foods taste sweeter by blocking the bitterness of individual ingredients. It’s possible to reduce sodium without adversely affecting quality and taste. Many food companies have been lowering the salt co’ salt content due to increasing pressure in recent years.
Will cutting salt make food unappetizing?
You won’t miss the salt for long. Though we have an innate liking for salt, individual preferences are learned mainly and can be unlearned. It takes several weeks for your taste buds to adapt to a lower sodium level, but what once tasted just right will eventually feel too salty—and you will begin to notice flavors that were previously masked by the salt. A low-sodium diet tastes best when filled with fresh foods, like fruits and vegetables, that are naturally low in sodium but rich in flavor and reduced-sodium processed foods.
Does rinsing canned foods lower the sodium?
Yes, some. A half-cup of canned beans has about 350 to 500 milligrams of sodium. You can reduce this by about one-third if you drain and rinse the beans first. That still leaves most of the sodium, however. Alternatively, look for low-salt/sodium (and wash those too) or no-salt-added versions. Or prepare dry beans, which have negligible sodium, by soaking and cooking them. You can also rinse canned tuna and canned vegetables.
How can you reduce sodium in your diet?
Crackers, snacks, and canned food typically contain a lot of sodium. Avoid the ‘low fat’ or ‘low calorie’ version of food as it may contain a lot more sodium than the ‘regular’ version.
Try to ensure that each serving of food has less than 100 mg of sodium.
Substitute the salt for spices and other flavor enhancers.
Black pepper, cinnamon, turmeric, fresh basil, chili peppers, lemon juice, herbs, garlic, ginger, citrus, vinegar, and wine. They will excite your palate with a lot less sodium.
Use healthy fats to flavor food.
Roasted nuts and avocados to olive, canola, soybean, oils — can add a rich flavor to foods, minus the salt.
Roast, steam, sear and sauté, and roast.
Roasting brings out the natural sweetness of many vegetables and the taste of fish and chicken. If you steam some dishes, perk them up with a finishing drizzle of flavorful oil and a squeeze of citrus. Searing or sautéing foods in a pan build flavor.
Get your whole grains from sources other than bread.
Even whole-grain bread, though a healthier choice than white, can contain much sodium. Bread contains quite a bit of salt — not just for flavor but also for ensuring that the dough rises properly. You can skip that extra salt when you look for whole grains outside of baking. For example, instead of toast with breakfast, cook up steel-cut oats, farro, or other intact whole grains with fresh or dried fruit.
Shop for raw ingredients with maximum natural flavor, thereby avoiding the need to add as much (if any) sodium. Shop for peak-of-season produce from farmers' markets and your local supermarket.
Most of the salt that Americans consume comes from prepared and processed foods. Making your meals, rather than purchasing premade items, can give you more control over how much salt is in your diet. Opt to season food with herbs or spices instead of salt.
References:
https://www.cdc.gov/heartdisease/sodium.htm
Published 8/15/20
Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone re-balancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP, for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients. Their mission is to share simple, effective, and proven strategies that lead to meaningful, sustainable, and long-lasting well-being.
