Doctor's Notes: New Dietary Guideline Take an “Assault on Salt”

Doctor's Notes: New Dietary Guideline Take an “Assault on Salt”

50% of the United States population needs to cut the amount of sodium they eat each day. That’s the message to you and the food industry as our federal government issues new dietary guidelines, which are the recommendations behind the popular food pyramid.

Other recommendations in the guidelines are similar to previous years - limit trans fats, reduce calorie intake from solid fats and added sugars, eat fewer refined grains and more whole grains, consume less than 300 mg per day of cholesterol. The guidelines also recommend eating less than 10 percent of calories from saturated fats - full-fat cheese and fatty meats.

For the first time, the Agriculture and Health and Human Services departments, which issue the guidelines every five years, are telling people who are 51 and older, all African-Americans and anyone suffering from hypertension, diabetes or chronic kidney disease to reduce daily sodium intake to little more than half a teaspoon.
That group includes about half of the population and those who are most at risk of having higher blood pressure due to sodium intake. For everyone else, the government continues to recommend about a teaspoon a day 2,300 milligrams, or about one-third less than the average person usually consumes.

“The assault on salt” is aimed strongly at the food industry, which is responsible for the majority of sodium most people consume. Most salt intake doesn't come from the shaker on the table; it's hidden in foods such as breads, chicken and pasta.

It has long been known that too much sodium increases the risk of high blood pressure, stroke and other problems. But cutting the salt won't be easy. You've been trying to eat less sodium — just a pinch of table salt on your baked potato and a dash on your scrambled eggs. But a pinch here and a dash there can quickly add up to unhealthy levels of sodium. Consider that just one teaspoon of table salt has 2,325 milligrams (mg) of sodium. And it's not just table salt you have to worry about. Many processed and prepared foods already contain lots of sodium. In fact, if you're like many people, you're getting far more sodium than is recommended, and that could lead to serious health problems. See how sodium sneaks into your diet and ways you can shake the habit.

The main sources of sodium in the average U.S. diet.

Sodium: Essential in small amounts
-Your body needs some sodium to function properly because it:
-Helps maintain the right balance of fluids in your body
-Helps transmit nerve impulses
-Influences the contraction and relaxation of muscles
-Your kidneys naturally balance the amount of sodium stored in your body for optimal health. When your sodium levels are low, your kidneys essentially hold on to the sodium. When sodium levels are high, your kidneys excrete the excess in urine.

But if for some reason your kidneys can't eliminate enough sodium, the sodium starts to accumulate in your blood. Because sodium attracts and holds water, your blood volume increases. Increased blood volume makes your heart work harder to move more blood through your blood vessels, which increases pressure in your arteries. Such diseases as congestive heart failure, cirrhosis and chronic kidney disease can make it hard for your kidneys to keep sodium levels balanced.

Some people's bodies are more sensitive to the effects of sodium than are others. If you're sodium sensitive, you retain sodium more easily, leading to fluid retention and increased blood pressure. The extra sodium can even lead to high blood pressure, which can lead to heart disease, stroke, kidney disease and congestive heart failure.

Sodium: How much do you need?
According to the 2011 Dietary Guidelines for:
-Individuals 51 and older
-All African Americans
-Anyone suffering from hypertension, diabetes or chronic kidney disease
-Don't exceed 1,150 mg of sodium a day (little more than ½ teaspoon… that’s down almost1/3 from 2005 Guidelines of 1,500 mg Note: Two slices of pepperoni pizza contain more than 1365 mg salt)

For everyone else, the recommendation is about 1 teaspoon a day - 2,300 milligrams, or about one-third less than the average person usually consumes.

NOTE: Keep in mind that these are upper limits, and less is usually best, especially if you're sensitive to the effects of sodium. If you aren't sure how much sodium your diet should include, talk to your doctor.

Also note that the new federal guidelines are an “assault on salt” and are aimed strongly at the food industry, which is responsible for the majority of sodium most of us consume. Most salt intake doesn't come from the shaker on the table; it's hidden in foods such as breads, chicken, frozen foods (especially prepared dinners) and pasta.

Sodium: Main dietary sources
To help keep your sodium consumption in check, you need to know where the sodium comes from. Here are the main sources of sodium in a typical diet:

Processed and prepared foods. The vast majority of dietary sodium comes from eating foods that are processed and prepared. These foods are typically high in salt, which is a combination of sodium and chloride, and in additives that contain sodium. While these ingredients have many practical uses — such as preservation and enhanced taste — they can greatly increase your sodium intake.
Natural sources. Some foods naturally contain sodium. These include celery and other vegetables, and dairy products such as milk, meat and shellfish. While they don't have an abundance of sodium, eating these foods does add to your overall sodium intake. For example, 1 cup (237 milliliters) of low-fat milk has about 107 mg of sodium.

In the kitchen and at the table. Many recipes call for salt, and many people also salt their food at the table. And many other condiments also contain sodium. One tablespoon (15 milliliters) of soy sauce, for example, has about 1,000 mg of sodium.

Sodium: Be a savvy shopper
Taste alone may not tell you which foods are high in sodium. For example, you may not think a bagel tastes salty, but a typical 4-inch (10-centimeter) oat-bran bagel has about 532 mg of sodium.
So how can you tell which foods are high in sodium? Read food labels. The Nutrition Facts label found on most packaged and processed foods lists the amount of sodium in each serving. It also lists whether the ingredients include salt or sodium-containing compounds, such as:
-Monosodium glutamate (MSG)
-Baking soda
-Baking powder
-Disodium phosphate
-Sodium alginate
-Sodium nitrate or nitrite
-Know your labels

Many food packages include sodium-related terms. Here's what they mean:
-Sodium-free or salt-free. Each serving in this product contains less than 5 mg of sodium.
-Very low sodium. Each serving contains 35 mg of sodium or less.
-Low sodium. Each serving contains 140 mg of sodium or less.
-Reduced or less sodium. The product contains at least 25 percent less sodium than the regular version.
-Lite or light in sodium. The sodium content has been reduced by at least 50 percent from the regular version.
-Unsalted or no salt added. No salt is added during processing of a food that normally contains salt. However, some foods with these labels may still be high in sodium.

But watch out — foods labeled "reduced sodium" or "light in sodium" may still contain a lot of salt. If the regular product starts out high in sodium, reducing it by 25 or 50 percent may make little difference. For example, regular canned chicken noodle soup contains about 1,100 mg of sodium per cup, while the reduced-sodium version may still have 820 mg per cup.

The bottom line? Avoid products with more than 200 mg of sodium per serving. And check the Nutrition Facts label closely for the serving size — and consider how many servings you actually eat.
Sodium: Tips to cut back

You may or may not be particularly sensitive to the effects of sodium. But most people can benefit from reducing sodium intake. On average, Americans eat about 3,600 mg of sodium a day — about double the goal for many.

Here are ways you can cut back on sodium in your diet:
-Eat more fresh foods and fewer processed foods. Most fresh fruits and vegetables are naturally low in sodium. Also, fresh meat is lower in sodium than are luncheon meat, bacon, hot dogs, sausage and ham. Buy fresh and frozen poultry or meat that hasn't been injected with a sodium-containing solution. Look on the label or ask your butcher.

Read nutrition labels closely and buy items labeled low in sodium.
Opt for low-sodium products. If you do buy processed foods, choose those that are labeled "low sodium."

Remove salt from recipes whenever possible. You can leave out the salt in many recipes, including casseroles, stews and other main dishes that you cook. Baked goods are generally an exception since leaving out the salt could affect the quality and taste. Use cookbooks that focus on lowering risks of high blood pressure and heart disease to help guide you to sparing the salt without spoiling taste or quality.

Limit use of sodium-laden condiments. Soy sauce, salad dressings, sauces, dips, ketchup, mustard and relish all contain sodium.
Ask that salt not be added to foods at restaurants

Use herbs, spices and other flavorings to enhance foods. Use fresh or dried herbs, spices, zest from citrus fruit, and fruit juices to jazz up your meals. And remember that sea salt has about the same amount of sodium as table salt.

Use salt substitutes wisely. Some salt substitutes or light salts contain a mixture of table salt and other compounds. To achieve that familiar salty taste, you may use too much of the substitute — and get too much sodium. Also, many salt substitutes contain potassium chloride. Although potassium can lessen some of the problems from excess sodium, too much potassium can be harmful if you have kidney problems or if you're taking medications for congestive heart failure or high blood pressure that cause potassium retention.

Sodium: Cut back gradually
Your taste for salt is acquired, so you can learn to enjoy less. Decrease your use of salt gradually and your taste buds will adjust (without this change it takes at least 300 - 400 mg of sodium in a dish to have it be salty enough to properly activate the salt taste buds. After a few weeks of cutting back on salt, you probably won't miss it, and some foods may even taste too salty. Start by using no more than 1/4 teaspoon of added salt daily, and then gradually reduce to no salt add-ons. As you use less salt, your preference for it diminishes, allowing you to enjoy the taste of the food itself, with heart-healthy benefits.

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