How to decrease your sodium intake? Discover practical tips and effective strategies to reduce sodium consumption and improve your overall health. Get the facts you need to make informed choices.

Understanding the Importance of Sodium Reduction

Sodium is an essential mineral that plays a crucial role in maintaining fluid balance and supporting various bodily functions. However, the average American consumes far more sodium than the recommended daily limit, which can have detrimental effects on health, particularly on cardiovascular health.

Excessive sodium intake has been linked to an increased risk of high blood pressure, heart disease, stroke, and other serious medical conditions. Reducing your sodium intake can help lower your blood pressure, improve heart health, and reduce your risk of these chronic health problems.

Smart Shopping Strategies for Lower Sodium

When grocery shopping, be mindful of the sodium content in the foods you purchase. Carefully read nutrition labels and compare products to find the option with the lowest sodium per serving. Avoid pre-packaged and processed foods, which tend to be high in sodium.

Opt for fresh or frozen poultry that has not been injected with sodium-based solutions. Be wary of condiments, sauces, and other seasoning items, as they can be significant sources of sodium. Look for reduced-sodium or low-sodium versions of these products.

When it comes to canned goods, choose those labeled “no salt added” or “low sodium.” Rinse canned beans and vegetables to further reduce their sodium content.

Flavorful Cooking Techniques to Reduce Sodium

Instead of relying on salt to add flavor, explore alternative seasonings and cooking methods. Herbs, spices, garlic, onions, and citrus juices can all enhance the natural flavors of your dishes without the need for excessive sodium.

Cooking techniques such as grilling, roasting, and sautéing can help bring out the natural flavors of your ingredients, reducing the need for added salt. Experiment with different spice blends and marinades to add depth and complexity to your meals.

Navigating Sodium-Conscious Dining Out

When dining out, be proactive in communicating your preference for lower-sodium dishes. Ask your server to prepare your meal without added salt, and request that sauces, dressings, and other condiments be served on the side.

Be mindful of menu items that are typically high in sodium, such as those that are pickled, brined, cured, or smoked. Instead, opt for steamed, baked, grilled, or roasted options, which tend to be lower in sodium.

If the restaurant provides nutrition information, review the sodium content of menu items before ordering and choose accordingly. Additionally, consider sharing a meal or requesting a smaller portion to further reduce your sodium intake.

Adjusting Your Taste Buds to Lower Sodium

Reducing your sodium intake can take some time, as your taste buds may be accustomed to the high levels of salt in many processed and prepared foods. However, studies have shown that over time, people who follow a lower-sodium diet begin to prefer it and find their previously enjoyed foods to be too salty.

Be patient with yourself and gradually decrease your sodium intake. Experiment with different flavors and cooking techniques to find a balance that satisfies your palate while promoting better health.

Understanding Salt Substitutes and Potassium Intake

Salt substitutes can be a useful tool in reducing sodium intake, but they require careful consideration. Many salt substitutes replace sodium with potassium, which can be problematic for individuals with certain medical conditions, such as kidney disease, or those taking specific medications.

Before using a salt substitute, it’s important to consult with your healthcare provider to ensure it’s safe and appropriate for your specific health needs. They can provide guidance on the appropriate sodium and potassium intake levels for your individual situation.

Putting It All Together: A Comprehensive Approach to Sodium Reduction

Reducing your sodium intake is a multi-faceted endeavor that requires a combination of strategies. By being mindful of your purchasing and dining choices, exploring flavorful cooking techniques, and gradually adjusting your taste preferences, you can effectively lower your sodium intake and improve your overall health.

Remember, small steps can lead to significant improvements. Implement these strategies gradually, and celebrate your progress along the way. Your health and well-being are worth the effort.

How to Reduce Sodium | American Heart Association

You might be getting more sodium than you need, even if you never pick up the salt shaker.

That’s because more than 70 percent of the sodium we eat comes from packaged and restaurant foods.  That can make it hard to control how much sodium you eat, because it’s added to your food before you buy it.

I know that too much sodium hurts my health. What can I do to cut back?

At the store/while shopping for food:

• Choose packaged and prepared foods carefully. Compare labels and choose the product with the lowest amount of sodium (per serving) you can find in your store. You might be surprised that different brands of the same food can have different sodium levels.
• Pick fresh and frozen poultry that hasn’t been injected with a sodium solution. Check the fine print on the packaging for terms like “broth,” “saline” or “sodium solution. ” Sodium levels in unseasoned fresh meats are around 100 milligrams (mg) or less per 4-ounce serving.
• Select condiments with care. For example, soy sauce, bottled salad dressings, dips, ketchup, jarred salsas, capers, mustard, pickles, olives and relish can be sky-high in sodium. Look for a reduced- or lower-sodium version.
• Opt for canned vegetables labeled “no salt added” and frozen vegetables without salty sauces. When they’re added to a casserole, soup or other mixed dish, there are so many other ingredients involved that you won’t miss the salt.
• Look for products with the American Heart Association’s Heart-Check mark to find foods that can be part of an overall healthy dietary pattern.

While the Heart-Check mark doesn’t necessarily mean that a product is “low-sodium,” it does mean that the food meets AHA’s sodium criteria to earn the Heart-Check mark.

You can eat foods with varying amounts of sodium and still achieve a balanced and heart-healthy diet. Learn more about the Heart-Check Food Certification Program.

When preparing food:

• Use onions, garlic, herbs, spices, citrus juices and vinegars in place of some or all of the salt to add flavor. Our recipes and tips can help!
• Drain and rinse canned beans (like chickpeas, kidney beans, etc.) and vegetables. You’ll cut the sodium by up to 40 percent.
• Combine lower-sodium versions of food with regular versions. If you don’t like the taste of lower-sodium foods right now, try combining them in equal parts with a regular version of the same food. You’ll get less salt and probably won’t notice much difference in taste. This works especially well for broths, soups and tomato-based pasta sauces.
• Cook pasta, rice and hot cereal without salt. You’re likely going to add other flavorful ingredients, so you won’t miss the salt.
• Cook by grilling, braising, roasting, searing and sautéing to bring out natural flavors. This will reduce the need to add salt.
• Incorporate foods with potassium like sweet potatoes, potatoes, greens, tomatoes and lower-sodium tomato sauce, white beans, kidney beans, nonfat yogurt, oranges, bananas and cantaloupe. Potassium helps counter the effects of sodium and may help lower your blood pressure.

At restaurants:

• Tell them how you like it. Ask for your dish to be made without extra salt.
• Taste your food before adding salt. If you think it needs a boost of flavor, add freshly ground black pepper or a squeeze of fresh lemon or lime and test it again before adding salt. Lemon and pepper are especially good on fish, chicken and vegetables.
• Watch out for these food words: pickled, brined, barbecued, cured, smoked, broth, au jus, soy sauce, miso or teriyaki sauce. These tend to be high in sodium. Foods that are steamed, baked, grilled, poached or roasted may have less sodium.
• Control portion sizes. When you cut calories, you usually cut the sodium too. Ask if smaller portions are available, share the meal with a friend or ask for a to-go box when you order and place half the meal in the box to eat later.

Ask about the sodium content of the menu items. Chain restaurants with 20 or more locations must provide nutrition information, including sodium content, to customers upon request.

Is my food going to taste bland with less salt?

With less salt, you can taste your food’s natural flavor, especially when you use cooking techniques and flavorful ingredients (see tips above) to enhance it.

Over time, your taste buds can adjust to liking less salt. Studies show that when people follow a lower-sodium diet, they start to prefer it, and that the foods they used to enjoy taste too salty.  Try it and see for yourself!

What about salt substitutes?

There are many salt substitutes, and a few of them replace some or all of the sodium with potassium. Most people can use them, but certain medical conditions (like kidney disease) and medications have implications on your potassium intake. Talk with your healthcare professional about whether a salt substitute is right for you.

Take Action: How to Reduce Your Sodium Intake | The Nutrition Source

Start early

High blood pressure can start developing in childhood, and becoming conditioned to high-salt tastes early in life can make it more difficult to cut back later. Childhood is an important time to focus on preventing the development of high blood pressure, but cutting back on salt and sodium can have a significant impact for people of all ages.

Cut back on prepared foods

About 70% of the sodium Americans eat comes from processed, prepared foods such as crackers, cheese, and canned foods, and restaurant meals. [1]

Even processed foods that don’t taste “salty”—like breakfast cereal—can have surprisingly high sodium levels. Additionally, foods consumed numerous times a day, such as bread, can add up to higher sodium intake even though an individual serving is not high in sodium.

According to the Centers for Disease Control and Prevention, top sources of sodium in the American diet include breads and rolls, cold cuts and cured meats, pizza, fresh and processed chicken, soups, sandwiches, cheese, egg dishes, and packaged savory snacks. Prepared sauces, salad dressings, and gravies also tend to be high in sodium.

Choosing foods with lower sodium doesn’t mean losing flavor. Human taste buds aren’t sensitive enough to notice a minor reduction in salt of about 30%, and for many types of foods, salt reductions of up to 30% won’t taste noticeably different. This means that home cooks, professional chefs, and the food industry can make significant sodium reductions with minimal impact on flavor.

Eat smaller portions of salty foods

There’s no need to completely eliminate favorite high-sodium foods or traditional cultural cuisines such as soy sauce (China), salted pickles and fish (Japan), or salty cheese and olives (Greece, Italy). Instead, it’s best to enjoy such foods in smaller amounts.

Discover reduced or no-sodium alternatives

Salt substitutes, including herbs and spices, and citrus like lemon can provide more flavor with less sodium. For example, citrus and sodium activate the same taste sensors so that less sodium can be used when they are combined. Explore your supermarket for low-sodium versions of traditional high-salt products, or experiment with new alternatives.

The Food and Drug Administration requires a “low-sodium” labeled food to contain less than 140 mg per serving. However, in foods where salt is a key component, such as soy sauce or cold cuts, the best a manufacturer can do is reduce the amount. In this case, the label can say “less sodium” or “lower sodium” although it may still be a high-sodium food. For example, one tablespoon of “less-sodium” soy sauce contains about 550 mg, as compared with 1,000 mg in the regular version. One serving of “lower-sodium” deli turkey breast contains about 380 mg—not much different from 450 mg in regular deli-sliced turkey.

Sodium-free substitutes contain 100% potassium chloride, while “lite” salts replace up to half of the table salt with potassium chloride. Potassium chloride (also called potassium salt) tastes much like sodium chloride, but it has a bitter aftertaste when heated so it is not recommended for cooking. However, check with your doctor before trying a potassium salt, because extra potassium can be dangerous for people who have trouble eliminating excess amounts or who are taking medications that can increase potassium levels in the bloodstream. This includes people with diabetes or kidney disease, those who have had a blocked urinary flow, or those taking a potassium-sparing diuretic, an ACE inhibitor, or an angiotensin-receptor blocker.

Cook your own meals

Instead of eating processed foods and restaurant meals, focus on cooking with fresh ingredients. Cooking with fresh unprocessed ingredients allows you to control the amount of salt (if any) you decide to add to your meals.

To get started, explore our recipes, including these tasty, low-sodium options:

Roasting cauliflower and other vegetables create a sweet, caramelized flavor. This recipe uses a variety of spices and fresh lemon juice to create intense, craveable flavors.

Get the recipe

A light, refreshing, beautiful salad that can be served as a side dish or dessert. The dressing for this salad also works well on salads made with mild-flavored baby greens, like baby spinach.

Get the recipe

For additional ideas, download Tasting Success with Cutting Salt: Twenty-Five Science-Based Strategies & Culinary Insights developed by the Department of Nutrition and The Culinary Institute of America. With the shared vision that healthy eating and lifestyles are fully compatible with delicious, flavorful food and cooking, the guide combines nutrition science and public health with culinary insight to promote sodium reduction strategies.

Related

References

1. Centers for Disease Control and Prevention. Sodium and Food Sources. https://www.cdc.gov/salt/food.htm Accessed 3/18/2019

Terms of Use

The contents of this website are for educational purposes and are not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The Nutrition Source does not recommend or endorse any products.

Eat Less Sodium: Quick tips – MyHealthfinder

Nine out of 10 Americans eat more sodium (salt) than they need. Eating too much sodium can lead to high blood pressure. High blood pressure can raise your risk of having a heart attack or stroke.

The good news is that cutting down on sodium can help lower your blood pressure or keep it at a healthy level.

To eat less sodium, you don’t have to make lots of changes at once. Use these tips to help lower the amount of sodium in your diet.

Know your sodium limit.

Ask your doctor how much sodium is okay for you. The general guidance is:

• Healthy adults and teens age 14 and older need to limit their sodium intake to no more than 2,300 mg a day.
• For people with high blood pressure – and people with blood pressure that’s between normal and high – limiting sodium to 1,500 mg a day may be helpful.
• Children under age 14 need no more than 1,500 to 2,200 mg a day of sodium, depending on how old they are.

Shop for low-sodium foods.

Most of the sodium we eat doesn’t come from our salt shakers. Sodium is in almost all the processed and prepared foods we buy – even foods that don’t taste salty, like bread or tortillas.

When you are shopping, limit these items that are high in sodium:

• Processed meats, poultry, and seafood – like deli meats, sausages, and sardines
• Sauces, dressings, and condiments
• Instant foods, like flavored rice or noodles.

Use this shopping list to find lower-sodium foods when you are at the grocery store.

Check the label.

Use the Nutrition Facts label to check the amount of sodium in foods and compare different options.

• Try to choose products with 5% Daily Value (DV) or less. A sodium content of 20% DV or more is high.
• Look for foods labeled “low sodium,” “reduced sodium,” or “no salt added.” But keep in mind that some low-sodium foods don’t have those labels. Check the Nutrition Facts label to be sure!

Make healthy shifts.

Swap out foods that are higher in sodium for healthier options. You can:

• Snack on unsalted nuts instead of salted pretzels or chips.
• Choose skinless chicken and turkey, lean meats, or seafood instead of deli meats or sausages.
• Go for vegetables that are fresh, frozen, or canned. Pick frozen vegetables without sauce and canned vegetables with the least amount of sodium.

Cook more at home.

Making your own meals is a great way to eat less sodium, because you are in control of what goes into your food.

• If you use canned foods, rinse them before eating or cooking with them. This will wash away some of the salt.
• Use condiments and spreads that are unsalted or lower in sodium. If you use regular spreads, use less.
• Don’t add salt to the water when you cook pasta or rice.
• Try different herbs and spices to flavor your food, like ginger or garlic, instead of salt.
• Take the salt shaker off your table.

Get less salt when you eat out.

• Ask if there are any lower-sodium dishes on the menu.
• When you order, ask that salt not be added to your food.
• Get dressings and sauces on the side so you can add only as much as you need.

Add more potassium to your diet.

Replace high-sodium foods with high-potassium foods. Eating foods with potassium can help lower your blood pressure. Good sources of potassium include potatoes, cantaloupe, bananas, beans, milk, and yogurt.

Strategies to Reduce Dietary Sodium Intake

Opinion

Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure, one of the most important modifiable determinants of cardiovascular disease (CVD). In the United States, almost 80% of sodium in the diet comes from packaged and restaurant foods. Given the current food environment, educational efforts such as clinician counseling are useful, but a comprehensive public health approach is necessary to achieve meaningful reductions in sodium intake. A successful approach includes several key strategies, which together will both promote positive decisions by individuals and change the context in which they make those decisions. The strategies include: (1) public education, (2) individual dietary counseling, (3) food labeling, (4) coordinated, voluntary industry sodium reduction, (5) government and private sector food procurement policies, and (6) FDA regulations, as recommended by the Institute of Medicine, to modify sodium’s generally regarded as safe (GRAS) status. Population-wide reduction in sodium intake has the potential to substantially reduce the public burden of preventable CVD and reduce health care costs.

Keywords: Salt, Sodium, Blood Pressure, Hypertension, Cardiovascular Disease, Policy

Introduction

Sodium in the Food Supply

Sodium is a major component of our food supply. The primary source is salt (sodium chloride), which provides ~ 90% of dietary sodium. Other contributors include sodium bicarbonate (i.e., baking soda) and mono-sodium glutamate (i.e., MSG). Many people enjoy the taste of salt. It also can deepen other flavors, [1] making it popular with both home and restaurant cooks. The taste for salt, however, is malleable and decreases as people are exposed to a lower sodium diet. [2] More importantly, salt is a major component of processed foods, and companies use it because it’s cheap, hides bitterness, and maintains texture. [1] Because of its ubiquity in the food supply, even motivated consumers find it difficult to reduce their salt intake. In fact, an estimated 80% of sodium intake in the United States (US) comes from restaurant and packaged food, while only 11% comes from discretionary sources, i.e. added by individuals during meals or while cooking. [3]

Actual sodium intake greatly exceeds recommendations. According to the 2010 US Dietary Guidelines for Americans, adults should consume no more than 2,300 mg per day. For people over age 50, those with hypertension or chronic kidney disease, and Black Americans, the recommendation is to consume no more than 1,500 mg. [4] The American Heart Association recommends that the 1,500 mg daily upper limit be applied to everyone. [5] Recent estimates from 24-hour dietary recalls, collected as part of the National Health and Nutrition Examination Survey (NHANES), indicate that average sodium intake in the US is ~3,600 mg/day. [1] Measures of intake from 24-hour urine collection studies in clinic settings and in adults find similar intake levels. [6, 7]

Scientific Rationale for Sodium Reduction

Blood Pressure (BP)-related diseases (i. e., coronary heart disease, stroke, and end-stage renal disease (ESRD)) are leading causes of morbidity and mortality throughout the world. [8] The relationship of BP with these outcomes has been characterized as strong, consistent, continuous, independent and etiologically relevant. [9] Importantly, the risk of BP-related diseases increases progressively throughout the range of BP, including both hypertensive and non-hypertensive ranges. [10] It has been estimated that 47% of coronary heart disease events and 54% of strokes can be attributed to elevated BP. [8] A cardinal feature of the elevated BP epidemic is the age-related rise in BP, in both children and adults.

Excess sodium intake has an important, if not predominant, role in the pathogenesis of elevated BP. [11, 12] Other lifestyle factors that raise BP include excess weight, insufficient potassium intake, high alcohol consumption, suboptimal dietary pattern, and physical inactivity. [13] Supportive evidence on the adverse effects of excess sodium intake on BP comes from animal studies, migration studies, ecologic studies, longitudinal observational studies, clinical trials, and meta-analyses of trials. The best available evidence strongly supports a direct relationship between sodium intake and elevated BP – on average, as sodium intake increases, so does BP. [14]

By lowering BP, sodium reduction should substantially reduce cardiovascular disease. Recently, several studies have estimated the public health benefits and cost savings attributable to the BP effects of a reduced sodium intake. In one study, reduction of dietary salt intake by 3g per day is projected to save 194,000 to 392,000 quality-adjusted life-years and $10 to $24 billion in health care costs annually, while reducing the annual number of deaths by 44,000 to 92,000. [15] Few trials have directly assessed the effects of sodium reduction on hard clinical outcomes. In the largest and longest of these trials, Cook and colleagues documented that persons assigned to a reduced sodium intervention had a 25 – 30% reduced risk of cardiovascular disease events. [16]

Importantly, excess sodium intake has adverse effects, apart from its effects on BP. [17] A large body of evidence indicates that sodium increases LV mass and alters vascular structure and function. [18] Furthermore, excess sodium intake appears to increase the risk of gastric cancer, chronic kidney disease, [19] kidney stones, and osteoporosis. [14] The latter two relationships reflect the well-documented, direct relationship of sodium intake with urinary calcium excretion – as sodium intake increases, so does calciuria. [20]

Still, the evidence base does have limitations. First, the assessment of sodium intake has methodological challenges. [21] Both systematic and random errors in the measurement of dietary sodium intake are commonplace. The gold standard remains urinary excretion of sodium from 24-hour collections, but even these estimates can be inaccurate because of collections problems, most commonly under-collection. Furthermore, because of large day-to-day and within-person variation, repeat measurements on multiple days are needed to obtain precise measurements. Such methodological issues have led to inconsistent and occasionally paradoxical findings. [22, 23] However, the best available evidence strongly supports population-wide sodium reduction as a means to prevent cardiovascular disease and stroke. [24]

Strategies to Reduce Sodium Intake

In this paper, we summarize strategies to lower sodium intake in the general population (see ). While all of these strategies have the potential to be effective on their own, a multi-factorial effort that includes several component strategies will have the greatest impact.

Table 1

Summary of six principle sodium reduction strategies, along with their projected impact and speed of implementation

Salt Reduction Strategy	Public Health Impact*	Speed of Implementation
1. Public Education	+	Fast
2. Dietary Counseling	+	Fast
3. Food Labeling	+	Slow
4. Coordinated Voluntary Industry Efforts	++	Medium
5. Food Procurement Policies	++	Medium
6. FDA Regulation of GRAS Status of Sodium	+++	Slow

Strategy 1: Public Education

A long-standing public health strategy to reduce sodium intake is to conduct public education campaigns. Since the 1970’s, when the National Heart, Lung and Blood Institute began sponsoring the National Blood Pressure Education Campaign, there have been major efforts to educate the public about sodium reduction. [1] Campaigns raised awareness of the connection between sodium and high blood pressure with consumer knowledge of the sodium hypertension relationship rising from 12% in 1979 to 48% in 1984. However, these gains have been hard to sustain; by 2002, awareness declined to 39%. [1]More problematic, the percentage of consumers actively trying to reduce sodium never increased beyond 33%. This may be because Americans do not have a good understanding of their own sodium intake. Thus, despite increased awareness, sodium consumption has not decreased and might even have increased since the 1970s. [1]

Education campaigns are most effective when conducted in conjunction with broader sodium policies and programs, as done in the United Kingdom (UK) and Finland. In Finland, mass media education campaigns were coupled with voluntary efforts by industry and warning labels on high salt packaged foods, all leading to an average sodium reduction of 1,200 mg/day. [25]In 2004, the UK government launched an extensive education campaign focusing on the sodium content of packaged food to complement a major voluntary sodium reduction initiative by the government. As a result, the number of consumers reducing sodium intake increased by a third and the number checking labels for sodium doubled. [26]

A similar trend can be seen in the more recent public education campaigns in the US, which have been coupled with broader policy work. The New York City Department of Health’s 2010 ads in the subway system highlighted the high levels of salt in packaged food and urged consumers to compare labels. [27] In Massachusetts in 2011, ads on television and in the transit system provided consumers advice on how to reduce sodium from packaged and restaurant foods. [28] Both New York City and Massachusetts are members of the National Salt Reduction Initiative, a voluntary coalition that aims to reduce the sodium content of packaged and restaurant foods by 25%. [29]

Public education is one of the easiest strategies to implement; it does not require regulatory or legislative action, it’s relatively inexpensive, and is generally uncontroversial. However, given the ubiquitous and high levels of sodium in the food supply, achieving sodium reduction will require lower levels of sodium in packaged and restaurant food. Hence, even though consumer education is a valuable tool to raise consumer awareness and support for more comprehensive initiatives, education alone is unlikely to reduce sodium consumption.

Strategy 2: Dietary Counseling

Individual dietary counseling, whether by physicians or other healthcare providers, is another important strategy for reducing sodium intake. Data show that sodium reduction is achievable through intensive dietary sodium counseling. [30, 31] A caveat is that advice alone will not allow patients to meet sodium and other lifestyle recommendations. [32] However, as demonstrated for smoking cessation [33] and weight control [34], physicians play an important role in the reinforcement and maintenance of behavior change. The physician-patient encounter offers a valuable opportunity for physicians to promote lifestyle changes, of which sodium reduction should be a major goal. A brief supportive message on the benefits of sodium reduction, even without extensive counseling, should be beneficial. Physician effectiveness in this role can be enhanced through their increased knowledge, skills, and a positive attitude towards sodium reduction and other lifestyle modification.

To efficiently and effectively influence patients’ efforts towards dietary salt reduction, physicians should be aware of ongoing public health initiatives. There are national efforts spearheaded by the federal government and professional organizations, as well as local public health campaigns that target sodium reduction. Additionally, there have been stories about sodium in the popular media, including a feature article in the November 2010 issue of Vogue magazine where sodium was highlighted on the highly coveted cover of the magazine. [35] Not all media stories support sodium reduction, so it is important to reinforce that despite occasional stories to the contrary, an overwhelming body of evidence supports population-wide sodium reduction.

Features of an effective counseling session with patients include: assessment of their readiness for change; discussion of the importance of reduced sodium intake for health; discussion of the overall concept of diet quality, e.g. DASH diet, with tips for successful adoption; assessment of patient barriers to adherence with suggestions for better adherence; goal setting; and distribution of written material (See ). [36] Although clinic visits often do not allow time to cover of all elements of an effective counseling session, a good first step is for the physician to protect time in the session to discuss diet and barriers to dietary modification.

Table 2

Approaches to provider-patient conversations about lowering sodium intake

Dietary counseling is especially important for medically high-risk patients, and referrals should be made to a registered dietitian or certified health educator. Medicare and other insurance groups provide medical coverage (reimbursement) for dietary counseling in certain patients (e.g. patients with chronic kidney disease and diabetes). Although the impact of the clinician might be limited given the difficulty in changing patient behavior in the current food supply, clinician support is still critical to create demand for the public health approach.

Strategy 3: Food Labeling

Food labeling can help motivated consumers choose lower sodium products. Some types of labeling can even prompt reformulation so that products are lower in sodium. However, as discussed below, the current US labeling system (i.e., the Nutrition Facts Panel) is poorly designed to convey information about sodium.

Nutrition Facts Panels in the US are highly complex and not very effective in motivating dietary behavior change. These labels have been mandatory since the National Labeling and Education Act was enacted in 1990. [1] Sodium information on labels is provided in a technical format (milligrams per serving and percent daily value of sodium), located on the back of packaged food, written in fine print, and surrounded by other nutrition and ingredient information.

Consumers often find these labels confusing, especially consumers with low literacy or numeracy. [37] Encouraging the use of labels to reduce intake is a common goal of recent sodium reduction campaigns. However, studies indicate that their usage overall and the usage of sodium information in particular has been declining. [38]Furthermore, people who report using Nutrition Facts Panels did not decrease sodium intake. [39]

Front of pack (FOP) labels that interpret nutrition information, as used in Finland and the UK, are more effective. In Finland, high salt warning labels were successful as part of a larger sodium reduction initiative. Packaged foods with sodium levels over a specified threshold determined by the type of food were labeled as a high-salt product. As a result, many companies discontinued high-salt products and introduced products that qualified for the low-salt label. Daily sodium intake in Finland has been reduced by ~1250 mg since 1979. [40]A voluntary FOP labeling system is used in the UK that targets salt and a few other nutrients of concern. A traffic light symbol indicates levels of fat, saturated fat, sugars and salt with green (low), amber (medium) and red (high) color-coding for each nutrient. [41] Although seemingly simple, some studies have questioned the effectiveness of this system in motivating healthier consumer purchases. [42]

In the US, there is increased interest in FOP labels. Reacting to the proliferation of labels designed by industry, the FDA recently solicited comments, information, and data. [43] Concurrently, the US Congress commissioned the Institute of Medicine (IOM) to examine FOP labels. In their 2011 report, they concluded that despite the lack of conclusive evidence, FOP labels would encourage healthier choices than the current Nutrition Facts Panel and would be easier to understand. Specifically, they recommended the creation of a FDA-mandated system that lists calories and then rates products from zero to three stars, based on levels of sodium, saturated fat, trans fat and added sugars.[43] However, even the development of a voluntary system by the FDA has been opposed by the packaged food industry, which has been working to create their own labeling system called Nutrition Keys. [44]

In summary, food labels help consumers choose packaged foods with lower sodium, but the labeling system can be improved. Labels that are prominently placed and consistent have the potential to influence consumer decisions. Additionally, labeling that indicates high levels of sodium can encourage manufacturers to reduce sodium voluntarily. Without reductions in the overall sodium levels in packaged food, even the best labeling system will not be sufficient to reduce sodium intake.

Strategy 4: Coordinated voluntary reductions

In the US, calls for voluntary industry action related to sodium reduction have been historically unsuccessful. [1]The Center for Science in the Public Interest found an average decrease in sodium content of packaged foods of only 5% from 1983 to 2004, with levels increasing after 1994. [45]However, evidence indicates that coordinated voluntary action that holds companies accountable for their pledges and is backed by authoritative bodies can be more successful. [26, 46]

Lowering the sodium content of packaged and restaurant foods is possible without limiting consumer choice and acceptance. In addition to adapting over time to a lower salt taste; [2, 47] when given lower sodium food and a salt shaker, people only add back a portion of the sodium removed. [48]

One recent and successful example of this approach is the UK Salt Campaign, an initiative of the UK Food Standards Agency (FSA) (now part of the Responsibility Deal overseen by the UK Department of Health [49]). A key aspect of this initiative was category-specific salt reduction targets for 2010 and 2012, set with assistance from industry. The FSA received and announced over ninety formal, public commitments from across the food industry. The government monitors these commitments through the creation of a processed food database, company reports, and periodic measurements of population sodium intake through 24-hour urine collection. To date, many companies have met 2010 targets and the UK saw an approximate 10% drop in sodium intake from 2000/1 to 2008. [26]

This model of coordinated voluntary sodium reductions has been adapted for the United States by the National Salt Reduction Initiative (NSRI), led by New York City. The NSRI consists of 75 signatories, including cities, states and national health organizations. [29] Itaims to reduce sodium intake by 20% and sodium in packaged and restaurant foods by 25% by 2014. [1]To do this, the NSRI set 2012 and 2014 voluntary sodium reduction targets for 62 packaged food and 25 restaurant food categories. To date, 28 packaged food and restaurant companies, many of them large national players such as Kraft, Target and Subway, have committed to the targets. [46]As in the UK, monitoring and evaluation are key elements of the initiative. Committed companies are asked to report nutrition information in target years. The NSRI has also created national packaged and restaurant food databases to independently monitor sodium content. [1]To evaluate the impact of the initiative, the NSRI will measure the change in population sodium intake in New York City through population-based 24-hour urinary sodium studies in 2010 and 2014. [50]

This type of voluntary action has a number of advantages. It’s significantly less controversial than regulation, both to food companies and the public. In addition, having specific sodium reduction targets and an independent database for monitoring, makes it is possible to hold industry accountable for their commitments. Critically, it targets packaged and restaurant food sodium content, rather than consumer behavior. Finally, it is a nuanced system which both reduces intake over time, allowing tastes to adjust, and distinguishes between different types of food, maintaining consumer choice and variety.

The drawback, however, is that a voluntary initiative cannot require the industry to participate and therefore sodium reductions may be limited to the number of companies involved. Commitments, though publicized and monitored, are not binding. Finally, though less controversial than regulation, even voluntary initiatives face strong opposition. In the US, industry backed groups such as Center for Consumer Freedom [51] and the Salt Institute have fought against the NSRI. [52, 53]

Strategy 5: Procurement Policies

Reduction of sodium intake can also be achieved if sodium standards are included in government procurement policies, as well as those of private and non-profit institutions. The US government annually purchases or provides funds to purchase large amounts of food, including more than $800 million to feed US Military personnel and 1.9 billion pounds of food as part of the National School Lunch Program. [1]Similarly, state and local governments buy food for schools, correctional institutions, senior centers, child-care centers, and other institutions. [1] Including specific sodium standards in the requirements for purchased food can provide additional support to coordinated voluntary reductions by creating measurable demand for lower sodium products and thus a financial incentive to reduce sodium.

Procurement policies with specific sodium standards are a relatively new phenomenon but have already been implemented by a number of government entities, including New York City, Massachusetts, and the Department of Health and Human Services (HHS). New York City’s standards, passed by Mayoral Executive Order in 2008, apply to more than 260 million meals and snacks purchased and served by New York City Agencies and their contractors. [54]The standards require purchased food items to have less than 480 mg sodium, with lower limits for specific food categories such as bread, canned fish, meat and cereal. They also have sodium limits for meals served. [55]The Massachusetts State Agency Food Standards, also passed by executive order, are very similar to those enacted in New York City. [56]The HHS food standards apply to all HHS concessions, conferences, and vending machines and require that all individual items served should have no more than 480 mg sodium and meals no more than 900 mg sodium. Lower standards apply to specific food items. [57]The Centers for Disease Control and Prevention (CDC) encourages local and state health departments to enact similar guidelines. [57]

Procurement policies increase demand for healthy, low sodium food, making it worthwhile for the food industry to produce and market these items. They also ensure that people who depend on the government for food are getting a balanced, low sodium diet. However, despite the reach of these policies, they impact only a fraction of the American food supply, and thus are not a stand-alone solution.

Strategy 6: Regulation of sodium levels in food

The CDC commissioned the IOM to study strategies to reduce sodium intake in the population. In 2010, the IOM recommended that the Food and Drug Administration (FDA) regulate the salt content of both restaurant and packaged food to reduce sodium intake. Salt in the United States is currently classified as GRAS, or Generally Recognized as Safe, a status given to food additives where there is “reasonable certainty of no harm”. Food products made with additives without GRAS status need FDA approval prior to marketing. The GRAS status of salt was set in 1958, when the FDA began regulating food additives and before much was known about the adverse health effects of sodium. Since 1979, and most recently in 2007, there have been proposals to revoke salt’s GRAS status since excess levels have been shown to be unsafe. The IOM specifically recommended that the FDA modify, rather than revoke, its GRAS status and extend it GRAS to restaurant food. [1]

A modified GRAS status would define levels of salt above which foods would not qualify for GRAS. Separate thresholds would apply to different categories of food and would depend on the need for salt in that food. Over time, as consumer palates adjust, the limits would be lowered in a stepwise fashion. Steps and final levels of GRAS for all categories of food would be defined at the outset, but evaluated and modified if necessary at pre-specified intervals.Foods with salt above the GRAS threshold could still be sold, but only after petitioning the FDA. [1]

Modifying the GRAS status of salt is likely the most effective strategy to reduce sodium intake in a long-term, sustainable way. Similar to the coordinated voluntary reduction strategies, it preserves choice and diversity in the marketplace by distinguishing between different types of food. Because the changes to GRAS will be regulatory, industry will have to participate and will be unable to rollback gains. Finally, GRAS is already under the purview of the FDA and does not require new legislation.

Despite numerous advantages to this approach, it is unclear if the FDA will implement the IOM recommendations. Any changes to the regulatory environment are likely to be strongly resisted by the food industry. Since a modification of GRAS would affect an enormous swath of the industry, the opposition might be considerable. If FDA does implement this recommendation, it would likely take years to draft and get approval, making it important to have interim strategies, such as the NSRI and food procurement policies, in place.

Conclusion

A public health approach will be needed for meaningful reductions in sodium intake. The levels of sodium in packaged and restaurant food are currently too high for individual action to be sufficient. Together, the strategies outlined above form a comprehensive stepwise sodium reduction approach. The most effective single strategy, however, is federal regulation. Currently, the FDA and the USDA are considering action on salt. [58] Unfortunately, regulatory actions are difficult to implement.

As the medical and public health communities advocate for regulatory and other strategies to reduce sodium intake, the support of clinicians is critical. In order to ensure that patients reduce their blood pressure and thus their risk of cardiovascular disease, clinicians need to support both the individual efforts of their patients and the additional public health approaches described herein.

Sodium: How to tame your salt habit

Sodium: How to tame your salt habit

Find out how much sodium you really need, what high-sodium foods to avoid, and ways to prepare and serve foods without adding sodium.

By Mayo Clinic Staff

If you’re like most people in the U.S., you’re getting far more sodium than is recommended. And that could lead to serious health problems.

Consider that 1 teaspoon of table salt, which is a combination of sodium and chloride, has 2,325 milligrams (mg) of sodium. That’s slightly more than the daily limit of 2,300 mg recommended by health experts.

The average American gets closer to 3,400 mg of sodium a day. 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 function properly. Sodium plays a role in:

• The balance of fluids in your 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 eliminate enough sodium, it builds up in the blood. Sodium attracts and holds water, so the blood volume increases. The heart must work harder to pump blood, and that increases pressure in the arteries. Over time this can increase 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 retain sodium more easily, which leads to fluid retention and increased blood pressure.

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 doctor or dietitian.

What foods have sodium?

Most of the sodium in the typical American diet comes from processed or prepared foods. These include bread, pizza, cold cuts and bacon, cheese, soups, fast food, and 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 (15 milliliters) 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. While these foods don’t have an abundance of sodium, eating them does add to your overall body sodium content. For example, 1 cup (237 milliliters) of low-fat milk has about 100 mg of sodium.

How do I cut back on sodium?

Almost all Americans can benefit from eating less sodium. Here are ways you can cut back:

• 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 or meat that hasn’t been injected with a sodium-containing solution. Look on the label or ask your butcher.
• Choose low-sodium products. If you buy processed foods, choose ones that are labeled low sodium. Better yet, 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. One entree may be at or above your daily limit.
• Remove salt from recipes whenever possible. You can leave out the salt in many recipes, including 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 herbs, spices and other flavorings. Use fresh or dried herbs, spices, and zest and juice from citrus fruit to jazz up your meals.
• 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 (10-centimeter) oat bran bagel has about 600 mg of sodium, and even a slice of whole-wheat bread contains about 150 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 (also called sodium bicarbonate)
• Baking powder
• Disodium phosphate
• Sodium alginate
• Sodium citrate
• Sodium nitrite

Try to avoid products with more than 200 mg of sodium per serving. And be sure you know how many servings are in a package — that information is also on the Nutrition Facts 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. For example, a can of chicken noodle soup that claims to have 25% less sodium still has a whopping 524 mg in 1 cup. It’s only lower in sodium compared with regular chicken noodle soup, which has more than 790 mg of sodium in a cup.

Here’s a rundown on common sodium claims and what they really 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% less sodium than the regular version.
• Lite or light in sodium. The sodium content has been reduced by at least 50% 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 because some of the ingredients may be high in sodium.

Use salt substitutes wisely

Salt substitute is made by replacing some or all the sodium with potassium, magnesium or another mineral. To achieve 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 or who take medicines that cause potassium retention, such as ones used to treat high blood pressure and congestive heart failure.

Go low and take it slow

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. Consider using salt-free seasonings to help with the transition.

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 salt daily — at the table and in cooking. Then throw away the saltshaker. 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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Show references

1. DASH eating plan. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan. Accessed May 6, 2021.
2. How much sodium should I eat per day? American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day. Accessed May 11, 2019.
3. Sheps SG, ed. Watch the salt. In: Mayo Clinic 5 Steps to Controlling High Blood Pressure. 2nd ed. Mayo Clinic; 2015. Revised 2018.
4. How to reduce sodium. Centers for Disease Control and Prevention. https://www.cdc.gov/salt/reduce_sodium_tips.htm. Accessed May 19, 2021.
5. Appel LJ. Salt intake, salt restriction, and primary (essential) hypertension. https://www.uptodate.com/contents/search. Accessed May 19, 2021.
6. 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed May 19, 2021.
7. Sodium and food sources. Centers for Disease Control and Prevention. https://www.cdc.gov/salt/food.htm. Accessed May 11, 2019.
8. Eat less sodium: Quick tips. U.S. Department of Health and Human Services. https://health.gov/myhealthfinder/topics/health-conditions/heart-health/eat-less-sodium-quick-tips. Accessed June 24, 2021.
9. Sodium in your diet: Use the Nutrition Facts label and reduce your intake. U.S. Food and Drug Administration. http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm315393.htm. Accessed May 19, 2021.
10. The role of potassium and sodium in your diet. Centers for Disease Control and Prevention. https://www.cdc.gov/salt/potassium.htm. Accessed May 19, 2021.
11. FoodData Central. U.S. Department of Agriculture, Agricultural Research Service. https://fdc.nal.usda.gov. Accessed May 4, 2021.
12. Get the scoop on sodium and salt. American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/sodium-and-salt. Accessed May 11, 2019.
13. Eating right for chronic kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition. Accessed May 19, 2021.
14. Shaking the salt habit to lower high blood pressure. American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure. Accessed May 19, 2021.
15. Zeratsky KA (expert opinion). Mayo Clinic. June 24, 2021.

See more In-depth

.

Guidelines and Health Benefits of a Low-Sodium Diet

• Reduce your salt intake by limiting smoked, cured, instant, and processed foods.
• Usually home-cooked meals have less sodium than frozen or pre-made meals.
• Adults should consume no more than 2,300 milligrams of sodium per day.
• Visit Insider’s Health Reference library for more advice. 

Your body needs sodium because it keeps your muscles and nerves running normally. Yet, 90% of adults in the US eat too much sodium, which can raise the risk of high blood pressure, stroke, and other dangerous conditions. 

If you are concerned that you have too much sodium in your diet, below are three tips on how you can reduce your sodium intake naturally.

How much sodium per day

The American Heart Association recommends that adults take in no more than 2,300 milligrams per day, which is roughly the amount of sodium in 1 teaspoon of salt.

On average, people in the US consume 3,400 mg of sodium per day, about 50% more than the recommended amount.

The amount of sodium you need per day varies based on age:

Most adults need 2,300 mg of sodium per day.

Yuqing Liu/Insider

1. Track your diet

“Try some of the diet-tracking apps or write down your foods, amounts, and sodium levels to get an idea of your daily consumption,” says Julie Garden-Robinson, PhD, a registered dietitian and professor at North Dakota State University.

Quick tip: Some free diet-tracking apps you can try include MyFitnessPal, Shopwell, and MyNetDiary.

If you don’t have access to the nutrition facts of your meal, you can avoid excess sodium by the acronym SCIP:

• Smoked
• Cured
• Instant
• Processed

Foods prepared using these processes tend to be high in sodium. For example, a cup of smoked salmon has 1,066 mg of sodium, whereas plain raw salmon only has 117 mg. 

So, when in doubt, skip the SCIP foods. 

2. Opt for “low in sodium” or “reduced sodium” products

There are plenty of low-sodium and sodium-free options out there, like low-sodium soy sauce and unsalted nuts.

But labels can be slightly confusing since there are so many options including low-sodium, reduced sodium, and very-low sodium. And each label refers to a different amount of sodium. 

For example, low sodium means the product has 140 mg of sodium, or less, per serving whereas sodium-free foods contain 5 mg of sodium per serving. Here’s a table to help you navigate various low-sodium labels:

If you aren’t sure whether a food is high in sodium, read nutrition labels and note the milligrams of sodium per serving and the percent daily value.

3. Limit processed foods 

There’s more sodium in processed or pre-prepared foods than you may think. 

“We may think that salting food at the table is the issue; however, processed foods make up the bulk of sodium we consume,” says Julie Garden-Robinson, PhD, a registered dietitian and professor at North Dakota State University.

Deli meats, frozen dinners, and some restaurant-prepared foods can carry a lot of hidden sodium. For example, two thick-cut slices of turkey can have up to 1,200 mg of sodium, more than half of your daily limit. And a frozen beef burrito can have around 816 mg of sodium, more than a third of your daily limit.

Important: A healthy alternative that can help you lower your sodium intake is to prepare your meals yourself with fresh, unsalted, or low-sodium ingredients. This gives you the most control over how much sodium is in your food. 

So instead of buying that frozen burrito, consider replacing it with a freshly-made burrito consisting of:

• Store-bought tortillas (or you can make them easily at home for an even lower-sodium option)
• Meat or beans of choice that you prepare using spices like cumin and cayenne that can give you plenty of flavor without loading up on salt. (Avoid refried beans as they’re more processed and contain a higher sodium content than straight canned beans.)
• Add some lightly-sauteed peppers and onions.
• Top it with some homemade guacamole and pico de gallo for a boost of fresh flavors. 
• Opt for sour cream over shredded cheese, since it usually has less sodium. Also try substituting Greek yogurt for sour cream for an extra protein boost and less fat.

High sodium intake can lead to health risks 

Limiting your sodium intake is important, as this can help lower your risk for serious medical conditions, including:

“When we eat too much sodium, our body retains more water to maintain the proper fluid balance,” Garden-Robinson says.

This increased water retention can result in swelling of your abdomen, arms, or legs, which can be painful and make it harder to walk.

Water retention can also decrease your blood circulation and cause stiffness in your arteries, which are both risk factors for blood clots and

heart disease

.

A 2014 report looked at over 100 studies in 66 countries found that the average sodium intake was 4,000 mg a day — 1,700 mg over the recommended daily intake.

The researchers analyzed health data and estimated that reducing sodium intake to recommended levels would prevent about 10% of deaths related to cardiovascular disease. 

Insider’s takeaway 

Many Americans are getting too much sodium through their diet, which can have serious, long-term health consequences.

Related

6 easy ways to start eating healthy, according to dietitians

However, there are strategies you can use to lower your sodium intake and stay healthy.

If you are worried that you may be getting too much sodium, try tracking your diet and contact your doctor or a nutritionist for an evaluation.

F.D.A. Issues New Salt Guidelines

Nutritionists and public health experts commended the F.D.A. for taking on the problem of excess sodium, saying the effort would help sharpen the public’s focus on the dangers of overindulgence and create pressure on food companies to reduce their reliance on salt as a cheap flavor booster. But many said that voluntary measures were unlikely to move the needle very much. Some experts have suggested mandatory reductions, though they acknowledge that the food industry’s formidable lobbying power makes such measures unlikely at the federal level.

“This is a good start because there hasn’t been much guidance on sodium reduction from the F.D.A. in many years, but I would have preferred stronger guidance that is closer to mandatory,” said Dr. Larry Appel, director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Voluntary measures just kick the can down the road.”

The food industry’s reaction to the new recommendations was somewhat muted. The National Restaurant Association and the Consumer Brands Association, which represents packaged food companies, declined to comment on the new guidelines; multinational food companies like PepsiCo, Nestlé and McDonald’s declined to comment or did not immediately respond to emailed requests for comment.

The Sustainable Food Policy Alliance, a lobbying group created by the U.S. divisions of Nestlé, Danone, Mars and Unilever, applauded the new guidelines. “These targets present another opportunity for the food industry to support healthy eating by continuing to improve the nutrition profile of products,” it said in a statement.

The perils of excess sodium consumption are well documented, and public health experts have long urged federal regulators to take a more aggressive approach to reduce sodium levels in processed and prepared foods. The call to action first gained prominence at a White House conference on nutrition in 1969, followed a year later by an F.D.A. advisory committee report, which warned that salt was unhealthy at the levels then being consumed by most Americans.

In the decades since, salt consumption has remained well above recommended levels and the results have been catastrophic for public health, even more so for communities of color. On Wednesday, Xavier Becerra, the health and human services secretary and the first Latino to head the agency, sought to frame the new guidance as a way to tackle the health disparities that have become even more apparent during the coronavirus pandemic and its disproportionate toll on Black and Hispanic people.

Referring to an aunt and an uncle whose premature deaths, he said, were linked to high blood pressure, he pointed out that low-income Americans whose diets are heavy in sodium-laden processed food are especially vulnerable.

90,000 What happens to the body if you give up salt? The doctor answers

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What happens to the body if you give up salt? The doctor answers

What happens to the body if you give up salt? The doctor answers – RIA Novosti Sport, 02.02.2021

What will happen to the body if you give up salt? The doctor answers

Is it true that salt is white death? How will the body change if you stop adding it to food? RIA Novosti deals with these and other issues together with Alina… RIA Novosti Sport, 02.02.2021

2021-02-02T07: 00

2021-02-02T07: 00

2021-02-02T07: 00

health

food

health

salt

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MOSCOW, 2 Feb – RIA Novosti, Anna Chernogolovina.Is it true that salt is white death? How will the body change if you stop adding it to food? In these and other issues, RIA Novosti understands together with Alina Almaskhanova, an endocrinologist-nutritionist at the Medsi CDC at Solyanka. Salt and edema Russians consume salt twice as much as needed – 11 grams per day, Rospotrebnadzor reports. Excess salt (i.e. sodium) means fluid retention, edema, and increased blood pressure. Each extra gram of sodium is an average of 200 milliliters of water that the body stores.”High blood pressure negatively affects the kidneys,” says Alina Almaskhanova. “Problems with the kidneys further increase blood pressure, and the risks of a vascular catastrophe – heart attack, stroke, are higher. diseases, kidney problems “. How much you need per day The norm of salt is one teaspoon per day, that is, five to six grams of sodium. If we exceed it twice, health problems arise. “Children only need two to three grams of sodium per day – that’s half a teaspoon.Older people, as a rule, have arterial hypertension, so two or three grams will also be enough “, – explains the specialist. Rospotrebnadzor declares that 80 percent of the salt we consume is “hidden salt.” So, in 100 grams of cooked sausage, on average, 2-2.5 grams of salt, in raw sausage – already 3.5 grams …”There is especially a lot of salt in fast food, semi-finished products, smoked meats, where salt serves as a flavor enhancer, as well as in pickles and pickled vegetables. To reduce its amount, you can remove mayonnaise, ketchup and other ready-made sauces, soups on bouillon cubes from the diet” endocrinologist. Salt for health However, you cannot give up salt. Sodium is essential for the normal functioning of the nervous and muscular systems. “Sodium deficiency is as unhealthy as too much sodium. In this case, water and potassium are excreted intensively – this increases the burden on the kidneys.A headache appears, weakness, nausea occurs, digestion is disturbed, blood pressure drops, and the head is regularly dizzy. All this means that the quality of life is decreasing “, – Alina Almaskhanova explains. Three days without salt is beneficial. Three days or a week without salt will not change negatively. Moreover, if you have consumed an excessive amount of salt before, you will notice a positive effect: excess fluid will go away, weight and swelling will decrease.Long-term exclusion of salt, for a period of more than two to three months, can lead to negative symptoms.When exactly they happen depends on the characteristics of your body. The body’s compensatory systems are able to maintain sodium in the blood at a certain level for a long time.

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food, health, salt

MOSCOW, February 2 – RIA Novosti, Anna Chernogolovina. Is it true that salt is the white death? How will the body change if you stop adding it to food? In these and other issues, RIA Novosti understands together with Alina Almaskhanova, an endocrinologist-nutritionist at the Medsi CDC on Solyanka.

Salt and edema

Russians consume salt twice as much as needed – 11 grams per day, Rospotrebnadzor reports.Excess salt (i.e. sodium) means fluid retention, edema, and increased blood pressure. Each extra gram of sodium is an average of 200 milliliters of water that the body stores.

“High blood pressure negatively affects the kidneys,” says Alina Almaskhanova. “Problems with the kidneys further increase blood pressure, and the risks of vascular catastrophe – heart attack, stroke are higher. risks of heart disease, kidney problems. “

January 29, 3:15 PM Who is it dangerous to eat astringent persimmon? The endocrinologist answers

How much is needed per day

The norm of salt is one teaspoon per day, that is, five to six grams of sodium. If we exceed it twice, health problems arise. “Children only need two or three grams of sodium per day – this is half a teaspoon. Older people usually have arterial hypertension, so two or three grams will also be enough,” the specialist explains.

The most salty foods

It is necessary to take into account not only the salt that we add to homemade food, but also the “hidden” salt contained in store products. Rospotrebnadzor states that 80 percent of the salt we consume is “hidden salt”. So, in 100 grams of boiled sausage, sausages, on average, 2-2.5 grams of salt, in raw smoked sausage – already 3.5 grams.

“There is especially a lot of salt in fast food, semi-finished products, smoked meats, where salt serves as a flavor enhancer, as well as in pickles and pickled vegetables.To reduce its amount, you can remove mayonnaise, ketchup and other ready-made sauces, soups on bouillon cubes from the diet, “the endocrinologist advises. salt is impossible. Sodium is necessary for the normal functioning of the nervous and muscular systems.

“Sodium deficiency is as unhealthy as its excess. In this case, water and potassium are intensively excreted – this increases the load on the kidneys.A headache appears, weakness, nausea occurs, digestion is disturbed, blood pressure drops, and the head is regularly dizzy. All this means that the quality of life is decreasing, “Alina Almaskhanova explains.

Three days without salt will benefit

There will be no negative changes in three days or a week without salt. salt, you will notice a positive effect: excess fluid will go away, weight and swelling will decrease.

Prolonged exclusion of salt, for a period of more than two to three months, can lead to negative symptoms.When exactly they happen depends on the characteristics of your body. The body’s compensatory systems are able to maintain sodium in the blood at a certain level for a long time.

January 28, 15:05 ZODDietologist told about the dangers of coconut oil

Why it is necessary to eat – SPb GBUZ “City Polyclinic No. 112”

Why is it necessary to eat

Apple – prevents the development of atherosclerosis, protects against cancer, lowers blood cholesterol levels.Contains fiber and vitamin C, fruit acids.

Banana – stimulates the work of the heart and blood vessels, removes excess fluid from the body, helps with constipation. Contains B vitamins, potassium, magnesium.

Kiwi – improves vision, participates in metabolism. Contains vitamin C, magnesium.

Plum – lowers blood pressure and strengthens blood vessels, helps with constipation.Contains organic acids, vitamins A and E.

Peach – stimulates the formation of hemoglobin, removes toxins from the body. Contains carotene (provitamin A), phosphorus, iron, essential oils.

Orange – strengthens the immune system, reduces the risk of cancer, thins the blood. Contains vitamins A and C, magnesium and calcium.

Sugar – friend or foe.

Refined sugar (unlike natural sources of carbohydrates – fruits, berries, vegetables, cereals, bread, dairy products) are very quickly absorbed into the bloodstream.With its excessive use, the organs and systems responsible for its “processing” are not able to cope with its surplus, as a result, their functions are disrupted, metabolism worsens. Excessive consumption of sugar leads to an excess of energy reserves in a person, and as a result to the deposition of fat. The formula is simple: every 25 grams of excess sugar contributes to the formation of 10 grams of fat.

A healthy adult living in a temperate climate needs about 50 grams of sugar a day, including those found in confectionery and beverages.With significant physical exertion, an increase in sugar up to 100 g.

In middle and old age, the amount of sugar can even be reduced.

For some diseases, sugar consumption should be avoided altogether or severely limited. For example, diabetes, obesity, diathesis in children.

We must remember that a person can easily do without sugar at all. The large amount of carbohydrates found in other foods more than compensate for its lack.

Why eat it

Salt.

Table salt (NaCl) is one of the most essential substances for a person.It is the only mineral that we eat in its natural form. It has long been valued worth its weight in gold, and has often been the cause of wars and salt riots. In ancient Rome, earnings were often paid not with money but with salt, in fact, from here the word “soldier” came from. Sodium and chlorine ions are part of the internal environment of the body, where their concentration is strictly specified. Sodium is the main regulator of extracellular fluid volume. Participant in the transmission of muscle and nerve impulses, he plays an important role in the prevention and treatment of hypertension and heart failure.

Sodium – Its intake into the body is especially important because of its value on the one hand and its harmfulness for people with high blood pressure on the other. It needs only no more than 5 grams. per day, and 1 teaspoon of top-of-the-line salt contains 2,000 mg of sodium. You also need to remember that sodium is contained in soda, which is actively used in all baked goods, and monosodium glutamate, which is part of preservatives. Instant products contain excess sodium and therefore are just as harmful to use, instant medications also contain sodium and their use should be prohibited in case of hypertension.Sweeteners contain baking soda. Patients should be taught to choose foods that are low in sodium. With significant physical exertion or in hot weather, sodium consumption increases, while its content in food can be increased. Excess sodium intake retains much more water in the body than it needs to satisfy physiological reactions. Which in turn immediately affects the work of the heart, blood vessels, kidneys.

A salt-free diet in its pure form is generally impossible, since sodium is contained in small quantities in all products prepared industrially.We are talking about limiting the salting of food when cooking at home and about the exclusion of “salty” foods.

Indicators of salt deficiency – weakness, low blood pressure, a tendency to infectious diseases. The other side of the matter is that when consuming salted food, the body tries to reduce its concentration in the blood by dilution, retaining fluid in the bloodstream and in the tissues of the body. Thirst appears and the person begins to drink a lot. The organs that are most susceptible to fluid deposition begin to swell.This applies in particular to intervertebral discs, the strength of which is highly dependent on their saturation with water. With unstable saturation, they either swell or dry out, which leads to their premature destruction and osteochondrosis. It turns out that it is impossible to completely abandon the salting of food completely. But to moderate salt intake in order to stabilize the water balance is worth it. If you add salt to food not during cooking, but immediately before eating, then salting does not occur to the entire depth, but only along the surface, which significantly reduces salt consumption.

Salt contains not only salted and canned foods, but also sauces, ketchups, spices.

Balanced nutrition – what is it.

Oysters are preferred from seafood. Avoid – salted nuts, cashews, coconut,

Moderate – pistachios and brazil nuts.

It is known that in the body there is a certain relationship between various types of metabolic processes, therefore, with a prolonged lack of one of the nutrients, the need for a number of others changes:

• A lot of carbohydrates – lack of vit B ₁ ;
• A lot of carbohydrates, reduced protein consumption;
• A lot of meat in the diet – lack of vit B ₆ ;
• Lack of protein in the diet – lack of sex hormones, lack of calcium and vitamin D;
• Low in fat and carbohydrates – lack of protein;
• Low dietary calcium (400 mg for men and 500 mg for women) alters the ratio of potassium to sodium in the blood and increases blood pressure accordingly.
• Lack of protein in the diet – lack of niacin.
• If there is enough vitamin C and B ₁ – then the content of copper, manganese, zinc in the blood is normalized.
• Vitamin E deficiency leads to a decrease in the level of copper in most tissues and manganese in muscles, while it increases in the liver.

The use of large doses of vitamins A, D, C, B has a significant effect on metabolic disorders of copper, manganese and zinc

In addition, they retain fluid in the body: mushrooms, vegetables and other products rich in extractive substances, as well as sweets and products prepared with the use of malt.

Liquid is intensively removed: cottage cheese, tea, raspberries, parsley, dill, fennel.

Excessive enthusiasm for products of this or that group is equally harmful to the body.

Water demand is higher in the morning and gradually decreases in the evening.

It is recommended to drink 250-300 ml of green tea in the morning in order to flush out night waste from the body, saturate the body with fluid and have a mild tonic effect on it. During the day, it is recommended to consume water, diluted juices and sugar-free compotes.

In cloudy weather, when the body tends to retain fluid, it is recommended to drink tea, with its tendency to diuretic effect.

Why eat it

Potatoes . In our country, potatoes are very common as the main vegetable in our diet. 100 g of potatoes contains 20 g of carbohydrates, 2 g of protein (in terms of its composition, potato protein is the most complete of all proteins of plant origin).He in our diet becomes the most essential supplier of Vit S. There are special potato diets, which are used for medicinal purposes for certain diseases, such as chronic renal failure. The low protein content and high potassium deposition allows a high therapeutic effect to be achieved. When boiling peeled potatoes, potassium salts are released into the broth. Potatoes are used in patients with hypertension, CVS, especially with the presence of edema. Raw potato juice is used in the treatment of peptic ulcer disease, hypertension as a remedy that reduces muscle spasm and inhibits gastric acid secretion.Quite high in it the content of B vitamins, especially PP, folic acid. The calorie content of potatoes is 89 kcal per 100 g of product, therefore, with a tendency to obesity, it is better to reduce its amount in the diet.

90,000 Which of the 5 types of table salt is the most harmless?

Its basic properties do not change from the type of salt.
Photo: pexels.com

Sodium is beneficial to health in moderation and is found in all types of salt.

The salt is available in a variety of colors and textures. Some of its types are considered more useful than ordinary table salt, as they are less processed and contain more trace elements.

Salt supports the optimal functioning of the body.Both sodium and chlorine are important elements that support cellular balance, circulation, and blood sugar levels. Without enough sodium, the brain cannot function properly.

5 types of salt you can choose from:

1. Cookware. Refined table salt contains about 97–99% sodium chloride. Iodine is often added to it for benefit. If you are trying to reduce your sodium intake, it is important to ensure your iodine intake on foods such as eggs, dairy products, fish, and seaweed.

2. Kosher . Coarse, flaky salt. Compared to refined table salt, pure kosher salt usually contains no additives such as iodine. The size of the crystals of kosher salt is ideal for removing moisture, including blood, from meat in accordance with traditional Jewish law. One teaspoon of kosher salt contains less sodium than the same amount of table salt. But that’s because kosher salt has a larger grain size.

3. Marine. Produced by evaporation of seawater. May contain traces of minerals such as iron, potassium, and zinc, but they do not provide additional health benefits when consuming normal amounts of salt.

4. Himalayan (pink salt). Sourced in Pakistan, traces of rust (iron oxide) give it a pink color. Himalayan salt has been credited with benefits due to its mineral properties, but there is no scientific evidence for this.

5. Salt with spices. It is a salt mixed with herbs. To reduce the amount of sodium in your diet, it is best to use herbs alone.

Despite some differences, specialty salts contain the same amount of sodium by weight as regular table salt, so they do not have significant health benefits. But at least you have a choice.

How to reduce salt intake to normal?

Many people do not even think about the fact that in their daily diet there is more salt than the body needs.At first, they do not complain about health, since the body easily copes with the removal of excess salt from the body. But over time, taste sensations can become dull, and there are some changes in the body, and then people start gradually salting the food. When the body can not cope with the withdrawal of excess salt, gradually begins to rise blood pressure.

Why does blood pressure increase?

Because excess salt attracts water, and since this salt is contained in the blood, the volume of blood increases.With an increase in blood volume, the pressure on the walls of blood vessels also increases. If the excess salt intake is regular, then the elevated pressure remains regular. Thus, hypertension can occur.

How to normalize salt intake?

Of course, you can reduce salt intake to normal. According to the recommendations of the World Health Organization (WHO), the norm is 5g of salt per day for an adult. That is, if in Ukraine the average salt intake is 15g or more per person, it is necessary to reduce salt intake by 2-3 times.

There is another way – it is a replacement in the diet of ordinary salt, salt with a reduced content of sodium, the main component of salt that attracts water, Potassium.

So the Finns began to do, starting in 1972.

Today, salt with reduced sodium content and potassium supplement is sold in all major European and global retail chains.

How much potassium does the body need?

According to the WHO recommendation, potassium intake per adult should be at least 3.5 g per day (3.5 g is contained in about 600-700g of green). According to studies, in Europe, the average consumption of potassium is about 3 g per day per person. That is observed potassium deficiency In nutrition.

Potassium also contributes to the removal of excess sodium from the body.

Potassium is a useful substitute for sodium.

Therefore, if it is impossible to extract salt, which is contained in the finished products and exceeds the norm several times, then when cooking food, you can use salt with a reduced sodium content with the addition of potassium.

In Ukraine, this salt is produced under the trademark SOLENA. SOLENA is a salt in which 30% of sodium is replaced by potassium.

Using SOLENA instead of regular salt will reduce sodium intake and reduce potassium deficiency in the diet.

Salt SOLENA is used for healthy eating. It allows you to maintain normal body water-salt balance.

Also such salt recommend using in a salt diet, the Ukrainian Association of Cardiologists and the Ukrainian Association of Nutritionists.

Reduce the intake of sodium salt to normal and reduce potassium deficiency in the diet will help salt SOLENA low in sodium (70% sodium salt, 30% potassium salt) . Click to see where to buy salt SOLENA.

90,000 Healthy Diet Guidelines – Eat Less Salt

30 September 2016

What is sodium?

Sodium is a mineral that is regularly added to food for flavor and preservation purposes.It is a critical mineral for the human body: it is essential for the proper functioning of the nervous and cardiovascular systems. However, most people consume too much sodium.
Consuming too much sodium can increase your risk of high blood pressure (hypertension) and heart (cardiovascular) disease. These risks increase with age. Reducing the amount of sodium in the diet can reduce the risk of hypertension and cardiovascular disease.

Guide to healthy eating

It is recommended to limit sodium intake to less than 2300 mg per day. For persons with prehypertension and hypertension, an even greater reduction in sodium intake is recommended – to a level of 1500 mg per day. Reducing dietary sodium can help lower blood pressure, even if the target intake of 1,500 mg per day is not always met. For reference, half a teaspoon of table salt contains about 1200 mg of sodium.

Sources of sodium in food

Although excess sodium in food comes from extra salt, most of the excess sodium comes from processed and ready-to-eat foods.The figure below lists the most common meals served in restaurants and fast food outlets, as well as processed foods and shelf-stable foods high in sodium on offer in stores.

Follow recommendations

• Prepare your own food. Restaurant meals tend to contain more sodium than homemade foods. As a general approach to reducing sodium intake, try to cook and eat more often at home.
• Explore new fragrances. The more often a person eats salty food, the more he begins to like it. You can habituate yourself to less salty foods – try alternative supplements like fresh herbs or garlic.
• Compare and make a difference. Look for products in the store that are low in sodium and offer alternatives to saltier ones. Check the food label; if it says more than 150 mg sodium per serving, look for a lower sodium option.This also applies to canned foods such as soups, beans and vegetables, as well as processed meats such as bacon.
• Reduce the amount of bread, chips and crackers you eat. Although they may not taste too salty, store-bought breads, chips and crackers, as well as prepared sandwiches and pizzas, add significant amounts of sodium to the diet. Some breads contain 230 mg of sodium per serving – 10% of the RDI in just 1 slice. Check nutritional labels for breads with less than 150 mg sodium per slice, and remember to remember portion sizes to avoid overeating.
• Buy groceries around the perimeter of the store. The foods that have the highest amounts of added sodium are usually displayed in the interior aisles of the grocery store. Choose to shop around the perimeter of the store, which usually contains the healthiest foods – in particular, vegetables and fruits.

Nephrological care (Consultative polyclinic No. 1)

Nephrological department GBUZ TO OKB No. 1

News from medical unit # 1.World Salt Awareness Week

Every year, World Salt Awareness Week is celebrated throughout the second week of March. The goal of the event is to reduce the consumption of salt in the diet of people around the world in order to improve the health of the world’s population.

Salt is the main element of our nutritional needs. Salt is made from sodium and chlorine, two micronutrients that are essential for the body to function properly – maintaining water balance, kidney and nerve function.However, excessive consumption of it is hazardous to health.

The recommended daily intake of salt is less than 5 g (1 teaspoon without top).

Salt in excess is dangerous to the body!

• excess salt, retaining fluid in the body, causes the formation of edema;

• thirst caused by the intake of salty food increases fluid intake, leads to an increase in blood pressure, which can lead to stroke in 62% of cases;

• due to the blocking of cell membranes with sodium from table salt, the metabolism in the cells of the body is inhibited, which makes it difficult to access oxygen, nutrients, necessary drugs for normal life;

• table salt is a flavor enhancer, therefore stimulates appetite and promotes obesity;

• there is evidence of the relationship between excessive consumption of salty food with the development of cataracts, urolithiasis.

How not to oversalt?

• do not salt the food during cooking, but add salt at the end of cooking or individually on a plate;

• use herbs and spices to improve the taste;

• remove the salt shaker from the table so as not to oversalt mechanically;

• limit or exclude the use of pickles and marinades;

• use as little as possible technologically processed foods containing “hidden” salt: canned food, semi-finished products, cheeses, sausages, chips, snacks, crackers.

Several studies show that reducing your salt intake now will improve your long-term health. Blood pressure rises with prolonged salt intake, so even a slight decrease in it is of great importance.

Potassium, sodium, chlorine in serum

Sodium, potassium and chlorine are the main electrolytes of the body.

Electrolytes are mineral compounds that are capable of conducting electrical charges.Being in tissues and blood in the form of salt solutions, they help to move nutrients into cells and remove metabolic products from cells, maintain their water balance and the required level of acidity.

Synonyms Russian

Serum electrolytes.

Synonyms English

Electrolyte Panel, Sodium, Potassium, Chloride, CMP, BMP.

Research method

Ion selective electrodes.

Units

Mmol / L (millimol per liter).

What kind of biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Eliminate alcohol from the diet within 24 hours before the study.
• Do not eat for 12 hours before testing.
• Do not smoke within 30 minutes prior to examination.

General information about the study

Electrolytes are mineral compounds with an electrical charge.They are found in the tissues of the body and in the blood in the form of salt solutions. Electrolytes promote the movement of nutrients into the cells of the body and the removal of metabolic products from them, maintaining the water balance of cells and stabilizing acidity (pH).

The main electrolytes in the human body are sodium (Na +), potassium (K +) and chlorine (Cl-).

Most of sodium is found in intercellular fluids. Potassium is found mainly inside cells, but a small but vital amount is present in the plasma, the liquid part of the blood.

Keeping potassium levels in check is very important. Even small changes can affect the heart rate and the heart’s ability to contract. Chlorides migrate through the membrane either inward or outward of the cell and thereby maintain its electroneutrality. Chloride levels usually correspond to sodium levels.

Sodium, potassium and chlorides enter the body along with food, while the kidneys are involved in removing them from the body. The balance of these chemical elements is an important indicator of human health, in particular how the kidneys and heart function.

Combined measurement of sodium, potassium and chloride levels allows you to determine the anion “window” – the difference in the content of anions and cations in the blood. Its abnormal value is not a specific indicator, however, it suggests the presence of toxic substances (oxalates, glycolates, aspirin) in the body or the likelihood of metabolic abnormalities caused by starvation or diabetes mellitus.

Since electrolyte and acid-base imbalances are associated with a wide range of acute and chronic diseases, electrolyte testing can be prescribed for both already hospitalized patients and those who have just gone to emergency departments.

What is the research used for?

• As part of a general medical examination or as an independent study when testing for metabolites.
• For electrolyte screening and acid-base imbalance studies.
• To monitor the effectiveness of the treatment of imbalances affecting the functioning of certain organs.

When is the study scheduled?

• When diagnosing a disease with symptoms such as edema, nausea, weakness, blurred consciousness, cardiac arrhythmia.
• When examining patients suffering from acute and chronic diseases.
• If it is necessary to monitor the effectiveness of the treatment of hypertension, heart failure, liver and kidney diseases.
• If the level of one of the electrolytes, for example sodium or potassium, is low, then a second test is prescribed to monitor the dynamics of the imbalance until the normal level of this electrolyte is restored.

What do the results mean?

Reference values ​​

Potassium, sodium and chlorine levels depend on dietary intake, body water content and the amount of electrolytes excreted by the kidneys.In addition, it is influenced by natriuretic proteins that promote the excretion of sodium by the kidneys, as well as the hormone aldosterone, which maintains a constant sodium concentration and increases the body’s loss of potassium.

Among all electrolytes, the most important indicators for humans are the levels of potassium and sodium. When the kidneys are dysfunctional, the body can sometimes retain excess fluid to dilute sodium and chloride in such a way that their concentration drops below normal.

With severe loss of fluid, the concentration of potassium, sodium and chloride can increase sharply. Certain forms of heart disease, muscle problems, nervous system problems, and diabetes also cause abnormal levels of one or more electrolytes.

In order to determine the cause of electrolyte disturbance and prescribe the correct treatment, it is important to find out which electrolyte balance is disturbed. If these abnormalities are not treated, the patient is at risk of dizziness, seizures, irregular heartbeat, and even death.

What can influence the result?

• Depending on which electrolyte balance is disturbed, as well as on the duration of this disturbance, treatment will consist in changing the diet – switching to a lower salt intake, in increasing the amount of fluids drunk to dilute the concentration of electrolytes, or in taking diuretics. After the start of treatment, it is sometimes necessary to conduct a regular analysis to find out how successful the therapy is and to make sure that there is no recurrence of the imbalance.
• Certain chemicals and medicines, such as anabolic steroids, corticosteroids, laxatives, cough medicines, and oral contraceptives, can cause sodium levels to rise. Others, such as diuretics, carbamazepine, and tricyclic antidepressants, sometimes cause it to decrease.
• Substances that affect blood sodium levels also alter chloride levels.
• Swallowing large amounts of baking soda or a very large dose of antacids can also decrease chloride levels.