Salt has played a significant role in culture, diet and health
throughout human history. Salt has been used to add flavor to
foods, keep foods fresh, make icy roads and sidewalks safer and was even
a form of currency in Ancient Rome (the word salary comes from the
Latin word salarium – the money allowed to Roman soldiers for the
purchase of salt). However, you may be hearing more about it recently as
increasing concerns about how much salt we consume have prompted public
health efforts to reduce intakes.
What is sodium and why do we need it?
is an essential mineral that the body is unable to make, so it must be
supplied by the diet. Although the terms “sodium” and “salt” often are
used interchangeably, salt is composed of 40 percent sodium and 60
percent chloride; one teaspoon of salt contains about 2,300 milligrams
(mg) of sodium.
In the body, sodium is necessary for fluid regulation, nutrient
transport and blood pressure regulation; in food it is important for
preservation, texture, stability and flavor. For more information, check
out IFIC Review: Sodium in Food and Health.
Why is sodium an important issue?
sodium intake is associated with increased risk of high blood pressure, a
major risk factor for heart disease and stroke for those individuals
who are sensitive to sodium or are predisposed to hypertension. The U.S.
Department of Agriculture estimates that the average American consumes
3,400 mg of sodium a day, which exceeds current dietary guidance.
For example, even though the 2005 Dietary Guidelines for Americans
recommend that healthy Americans consume less than 2,300 mg.
Further, people who are hypertensive, middle-aged, elderly or African
American should not exceed 1,500 mg (the Centers for Disease Control and
Prevention estimated that 69.2 percent of U.S. adults fall within this
special population). The World Health Organization recommends a maximum
intake of 2,000 mg a day for adults.
It is critical to help consumers understand the importance of
managing sodium intake and guidance on how to do so. IFIC research shows
that most people are not personally concerned with their sodium intake,
but they think others should be. Additionally, they know neither how
much sodium they should have each day nor how much they typically
However, people are interested in learning more about sodium and
health, and it is important that they understand and incorporate all of
the dietary and lifestyle factors, that, when coupled with reducing
sodium intake, can help reduce the risk and treat hypertension.
According to the National Heart, Lung and Blood Institute JNC7 (The
Seventh Report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure) report, the most
effective strategies are weight reduction, adoption of the Dietary
Approaches to Stop Hypertension (DASH Diet) and engaging in regular
physical activity. The DASH eating plan is rich in potassium, magnesium
and calcium. Sodium reduction and moderation of alcohol consumption may
also play a key role in hypertension management.
Many stakeholders are exploring ways to reduce sodium
At the federal level, the Institute of Medicine convened an expert
committee examining strategies to reduce sodium intake, which is
expected to release recommendations by February 2010. In addition, the
Dietary Guidelines Advisory Committee, including a Subcommittee on
Sodium, Potassium and Water, is in the process of developing a report
based on scientific evidence-based reviews to inform the 2010 Dietary
Guidelines for Americans.
The Center for Science in the Public Interest has called for
increased government regulation of sodium in food products since the
1970s (the U.S. Food & Drug Administration currently regulates salt
as a “Generally Recognized As Safe” substance), and the New York City
Department of Health and Mental Hygiene is working with the food
industry to launch a voluntary sodium reduction initiative.
Internationally, the United Kingdom’s Food Standards Agency has been
encouraging voluntary reductions within food categories while running a
consumer education campaign. Health Canada is developing a similar
The food industry has voluntarily been reducing the amount of sodium
in its products incrementally and often without fanfare because
consumers tend to shy away from products advertised as low- or
reduced-sodium. Only 13 percent of consumers say they would choose a
product indicating “low-sodium” compared to other front-of-pack claims
or no claims, according to IFIC research.
A work in progress…
It is important to
keep in mind that achieving a balanced, healthful diet means more than
focusing on just one nutrient. The Dietary Guidelines recommend
including all five food groups and abundant amounts of fruits,
vegetables, whole grains and low-fat or fat-free dairy products while
maintaining flexibility and variety. For more information (and CPE
credit for dietitians), explore the IFIC Foundation learning module,
Helping Consumers Get the “Big Picture:” Practical Approaches to
Promoting a Healthful, Balanced Eating Pattern.
Be sure to read next month’s issue of Food Insight, which
will include tips for managing sodium intake.