Don’t Pass the Salt Shaker Please!
By Theresa Conejo, RN, cardiovascular nurse at Nazareth Hospital, Mercy-Health System in Philadelphia. She is also a You're the Cure Volunteer Advocate for the American Heart/Stroke Association. Her passion is helping children and adults learn the importance of healthy eating and an active lifestyle.
As nurses, we know eating too much salt leads to high blood pressure and puts us at risk for heart disease and stroke. Most Americans consume too much sodium in the form of processed and restaurant food. It's easy to understand why. Sodium can be sneaky. It slithers into soups and sandwiches and cozies up to cold cuts and cured meats. It plants itself in your favorite pizza and poultry and burrows into breads and rolls. Sodium is an essential nutrient, but you don't need much in your diet. It adds up fast! Take bread, for example. One piece can have up to 230 mg of sodium, while a serving of turkey cold cuts can contain as much as 1,050 mg!
The consumer's confusion occurs with the variance on the daily requirement by organizations. The CDC recommended amount is no more than 2,300 mg a day. (The CDC also recommends that people over age 51, those who have high blood pressure, diabetes or chronic kidney disease stick to no more than 1,500 mg a day.) The WHO (World Health Organization) recommends 2,000 mg or less and the American Heart/Stroke Association recommends 1,500 mg per day.
Regardless of what rule you follow, most people consume about 3,400 mg of sodium a day - far too much than needed.
Why should sodium be on your radar? About one in three Americans has hypertension and a high-sodium diet may be to blame. In some people, sodium increases blood pressure because it holds excess fluid in the body, creating an added burden on the heart. Too much sodium also increases risk for stroke, heart failure, osteoporosis, stomach cancer and kidney disease.
How much sodium a day should we eat and what's the easiest way to track it? Thanks to a growing number of iPhone and smartphone apps, our patients can make healthier choices at home or on the go.
Sodium One sodium counter tracks your daily sodium budget providing a running count of how much sodium has been consumed and how much more you can eat while staying within the CDC recommended amount of no more than 2,300 mg a day. This app provides the sodium content in restaurant and supermarket foods as well and will also create a custom food menu.
Pretty Yellow Dog, a free app, keeps lists of your favorite foods and a running total of the amount of salt consumed. This app is compatible with an iPhone and iPad.
Fooducate an app that is growing in popularity, will allow you to scan the bar code of an item and find it's nutritional content.
iSodium 3.5 is one of 9 iNutrient apps based on the USDA National Nutrient Database.
Whether you patients are trying to lower blood pressure or live a healthier lifestyle, they should learn to read between the lines. When buying prepared and packaged foods, read the Nutrition Facts label.
Here are sodium-related terms you may find on food packages:
Sodium-free: Less than 5 mg of sodium per serving;
Very low sodium: 35 mg or less per serving;
Low sodium: 140 milligrams or less per serving;
Reduced (or less) sodium: Usual sodium level is reduced by 25% percent per serving;
Light (for sodium-reduced products): If the food is "low calorie," "low fat" and sodium is reduced by at least 50% percent per serving;
Light in sodium: If sodium is reduced by at least 50% per serving.
Food labels cannot claim a product is "healthy" if it exceeds 480 mg of sodium per reference amount, according to the U.S. Food and Drug Administration and U.S. Department of Agriculture. "Meal" products must not exceed 600 mg of sodium per labeled serving size.
You can also read the ingredient list to learn more about the source of the sodium. Watch for the words "soda" (referring to sodium bicarbonate, also known as baking soda) and "sodium" (including sodium nitrate, sodium citrate, monosodium glutamate [MSG] and sodium benzoate). Once you start to recognize these terms, you'll see why there's so much sodium in some foods - even those that don't taste very salty.
For more information on sodium and food sources visit www.cdc.gov/salt or take the Sodium Challenge at www.heart.org/sodium.