Nutrition and healthy eating

Are you getting more sodium than health experts suggest is wise? If so, it could lead to serious health problems.

Sodium is a mineral. You can find it naturally in food, such as celery or milk. Manufacturers may also add sodium to processed food, such as bread. Sodium also is used to flavor food in condiments, such as soy sauce. When sodium is combined with another mineral called chloride, the two make table salt.

The daily limit set by nutrition experts in the U.S. is 2,300 milligrams (mg) a day for people ages 14 and older. The World Health Organization suggests a limit of 2,000 mg of sodium a day. Most of the sodium you eat is hidden in prepared foods. And for that reason, many people worldwide take in more sodium than their bodies need. This can put them at higher risk of a long-term illness such as high blood pressure, also called hypertension.

See where all that sodium comes from and learn how you can cut back.

What happens to sodium in the body?

The body needs some sodium to work well. Sodium plays a role in:

• The balance of fluids in the body.
• The way nerves and muscles work.

The kidneys balance the amount of sodium in the body. When sodium is low, the kidneys hold on to it. When sodium is high, the kidneys release some in urine.

If the kidneys can't remove enough sodium, it builds up in the blood. Sodium attracts and holds water, so the blood volume rises. The heart must work harder to pump blood, and that increases pressure in the arteries. Over time, this can raise the risk of heart disease, stroke and kidney disease.

Some people are more sensitive to the effects of sodium than are others. That means they hold onto sodium more easily. As a result, more fluid stays in the body and blood pressure rises.

Higher sodium, higher risks

By and large, eating less sodium is linked to lower blood pressure. That could help prevent dangerous problems such as heart attack and stroke.

How much sodium is too much?

Keep in mind that less is better, especially if you're sensitive to sodium. If you aren't sure how much sodium your diet should include, talk to your health care provider. Or you could meet with a dietitian, a health care provider who gives advice about diet and nutrition.

What foods have sodium?

Sodium often comes from processed or prepared foods. These include:

• Bread.
• Pizza.
• Cold cuts and bacon.
• Cheese.
• Soups.
• Fast food.
• Prepared dinners, such as pasta, meat and egg dishes.

Many recipes call for salt, and many people also salt their food at the table. Condiments also may contain sodium. One tablespoon of soy sauce, for example, has about 1,000 mg of sodium.

Some foods naturally contain sodium. These include all vegetables and dairy products, meat, and shellfish. These foods don't have a lot of sodium. But eating them does add to the overall amount of sodium in your body. For example, 1 cup of low-fat milk has about 100 mg of sodium.

How do I cut back on sodium?

Almost everyone can find a way to eat less sodium. Some ways you can cut back are:

• Eat more fresh foods. Most fresh fruits and vegetables are naturally low in sodium. Also, fresh meat is lower in sodium than are lunchmeat, bacon, hot dogs, sausage and ham. Buy fresh or frozen poultry, fish, or meat without added sodium.
• Choose low-sodium products. If you buy processed foods, such as broth or ready-to-cook dishes, choose ones that are labeled low sodium. Or buy plain, whole-grain rice and pasta instead of products that have added seasonings.
• Eat at home. Restaurant foods and meals are often high in sodium. A single entree may contain enough sodium to reach or go above your daily limit.
• Remove salt from recipes whenever possible. You can leave out the salt in many recipes. Those include casseroles, soups, stews and other main dishes that you cook. Look for cookbooks that focus on lowering risks of high blood pressure and heart disease.
• Replace salt with other flavorings. Use fresh or dried herbs, spices, and zest and juice from citrus fruit to make your meals tasty.
• Go easy on the condiments. Soy sauce, salad dressings, sauces, dips, ketchup, mustard and relish all contain sodium.

Check the label

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 oat bran bagel has about 600 mg of sodium. And that's before you put anything on it. Even a slice of whole-wheat bread contains about 150 mg of sodium. So a sandwich could have at least 300 mg of sodium even before adding vegetables or meats.

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 items that contain sodium, such as:

• Monosodium glutamate (MSG).
• Baking soda, also called sodium bicarbonate.
• Baking powder.
• Disodium phosphate.
• Sodium alginate.
• Sodium citrate.
• Sodium nitrite.

Try to stay away from products with more than 200 mg of sodium a serving. And be sure you know how many servings are in a package. That information also is on the nutrition label.

Learn the lingo

The supermarket is full of foods labeled reduced sodium or light in sodium. But don't assume that means they're low in sodium. It just means the products have less sodium than do the regular versions of the products.

Here's what common sodium claims in the United States really mean:

• Sodium-free or salt-free. Each serving in this product has less than 5 mg of sodium.
• Very low sodium. Each serving has 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% less sodium than does the regular version.
• Lite or light in sodium. The sodium content has been reduced by at least 50% from the regular version. But some foods with these labels may still be high in sodium.
• Unsalted or no salt added. No salt is added during processing of a food that usually contains salt. But some foods with these labels might not be sodium-free. That's because some of the ingredients still may contain sodium.

Use salt substitutes wisely

A salt substitute is made by replacing some or all the sodium with potassium, magnesium or another mineral. To get that familiar salty taste, you may use too much of the substitute and get too much sodium.

The potassium in some salt substitutes may be a problem for some people. Too much potassium can be harmful for people with kidney problems. It also can be bad for those who take medicines that cause the body to hold on to potassium. These include medicines used to treat high blood pressure and congestive heart failure.

Go low and take it slow

The key is to slowly cut back on foods that are high in sodium, such as prepared and processed products. And that doesn't mean you have to stop eating your favorite foods. For example, you could use fresh, lower sodium ingredients to make your own pizza instead of ordering in. Or you could cook and freeze homemade beef and veggie stew rather than buy the canned version.

When you go grocery shopping, read nutrition labels to find out how much sodium a product has. You can look for reduced- or low-sodium versions of any prepared foods you buy often.

Slowly cut back on table salt too. Try salt-free seasonings to help make the change. After a few weeks of this, you might not miss the saltshaker. Start using no more than 1/4 teaspoon of salt daily at the table and in cooking.

As you eat less sodium and salt, your craving for it might fade. And that could help you enjoy the taste of the food itself, with heart-healthy benefits.