Sodium: How low to go?

Cutting back on salt too much might harm certain people.

Published: August 2013

Most Americans consume too much sodium: 3,400 milligrams a day, on average, equivalent to about 1 1/2 teaspoons of salt. They should reduce that to about 2,300 mg, says Marvin M. Lipman, M.D., chief medical adviser for Consumer Reports. Cutting back on sodium can help lower your blood pressure, a marker for cardiovascular disease.

But going too light on sodium might actually harm certain people, according to the Institute of Medicine, a group that advises the nation in health matters. In a review published in May that focused on research about how sodium consumption affects health, an IOM committee pointed out that many of those studies had shortcomings. Still, the findings raise important questions.

Lowering your sodium intake may reduce your risk of heart disease through means other than your blood pressure, according to the institute's president, Harvey Fineberg, M.D., Ph.D. Available evidence is inconsistent, and more research is needed to clarify links between sodium intake levels of 1,500 mg to 2,300 mg and health outcomes. But the research reviewed fails to support recommendations that people should reduce their sodium intake to 1,500 mg daily, a level that's reached by less than 1 percent of Americans. The IOM couldn't determine a "healthy" range for sodium because of a lack of consistency in the studies it analyzed.

Read more of our advice on food, vitamins and other dietary supplements.

The new studies support earlier findings that reducing sodium from high to moderate levels improves health, says Brian L. Strom, M.D., M.P.H., chairman of the committee and executive vice dean of the medical school at the University of Pennsylvania. "But they also suggest that lowering sodium intake too much may actually increase a person's risk of some health problems," he says, including heart disease and stroke.

The review found no support for federal recommendations to slash sodium intake to 1,500 mg a day for people who are particularly sensitive to a rise in blood pressure because of salt.

Consumer Reports says: Most people—especially those over 50, African-Americans, and those with a family history of hypertension—should reduce sodium consumption to about 2,300 mg daily, Lipman says. Those under a doctor's care for chronic kidney disease, congestive heart failure, diabetes, or hypertension should follow individualized advice on sodium restriction.  

How to slash salt

Here are a few ways you can reduce the sodium in your diet, according to the U.S. Dietary Guidelines for Americans.

• Read the Nutrition Facts labels on food when grocery shopping.

• Consume more fresh fruit and vegetables, which are naturally low in sodium.

• Prepare more food yourself using less salt. When eating at restaurants, ask for lower-sodium options, if available.

• Eat less pizza, bread, and other processed food.

•Track what you eat. (In Consumer Report's recent diet Ratings MyFitnessPal, a free smart-phone app and website, got one of the top satisfaction scores.)

Editor's Note: This article appeared in the September 2013 issue of Consumer Reports on Health.

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