Sneaky Sodium: It’s Lurking Everywhere!

Hopefully you all had an enjoyable and relaxing Thanksgiving holiday. And hopefully you didn’t overindulge too much, but if you did, you’re getting back on track. If you ate a “traditional” Thanksgiving meal (plus leftovers), which usually includes turkey, gravy, stuffing, and the rest of the fixings, chances are you got more than your fair share of sodium.

OK, you may argue, but it’s one day out of the year! Well, not really. What many people don’t realize is that sodium stealthily hides itself in so many of the foods we eat every day, and not just in the usual suspects, like canned foods. Sodium is everywhere!


Why care about sodium?
Sodium is a mineral that we all need to help regulate fluid volume and blood pressure. Our muscles and nerves depend on sodium, too, to function properly. But as with everything in life, some is good, but too much can be harmful. Too much sodium in the diet can cause the body to hang on to fluid.

This can be a serious problem for people with high blood pressure[1], congestive heart failure, or kidney disease. People with diabetes are more likely to have these conditions than people without diabetes. Also, some people are “salt sensitive,” meaning that when they consume a high amount of sodium, their blood pressure increases in response to the sodium. You can’t tell if someone is salt sensitive just by looking at them.

How much sodium do we need? And what’s too much sodium?
The latest edition of the Dietary Guidelines for Americans was released in 2010. The recommendation is to limit daily sodium intake to no more than 2300 milligrams (mg). However, if you are age 51 or older, are African-American, or have diabetes, hypertension (high blood pressure), or kidney disease (a little more than half of the US population, by the way), you should aim for just 1500 mg per day.

In case you’re wondering, the average daily sodium intake is about 3300 mg, but many people take in close to twice that amount. Obviously, most of us are probably taking in way more sodium than we need.

Where is the sodium coming from? You might be surprised.
When you think of the word “sodium,” you probably think of “salt.” They’re not quite the same thing, though. Table salt is 40% sodium and 60% chloride. A teaspoon of salt contains about 2300 mg of sodium, so there’s your daily intake right there. Sea salt, by the way, which is made by evaporating seawater, really isn’t lower in sodium than table salt, although some people claim that they use less of it. It’s still a source of sodium, though.

Most of our sodium intake doesn’t come from the saltshaker, however. Instead, the majority of our sodium comes from foods we buy in the grocery store. Recently, the Centers for Disease Control (CDC) looked at data from the National Health and Nutrition Examination Survey (NHANES) on 7,227 Americans ages two and up.

The CDC team found that more than 75% of the sodium that we consume is added to the foods that we buy or to foods that we purchase in restaurants. Only about 5% of our sodium intake is added by us during cooking or with the saltshaker. Food manufacturers and restaurant owners love sodium because it helps to preserve food and, of course, adds flavor. To be fair, though, food companies are making an effort to cut back on the amount that they use.

Here are the top 10 “heavy hitter” foods that are laden with sodium, based on the CDC’s research:

• Bread and rolls: They contribute 7.4% of the sodium in our diets. Some breads contribute more than 200 mg per slice. Read the label for sodium and don’t assume that “healthy” breads are low in sodium.

• Cold cuts and cured meats: This isn’t so surprising, but deli meats like turkey, ham, bologna, bacon, and hot dogs contribute 5.1% of our sodium intake. Look for lower sodium versions.

• Pizza: Contributing 4.9%, pizza’s ingredients — cheese, sauce, the crust and meat toppings — are not exactly low in sodium. Making your own is the best bet.

• Fresh and processed poultry: 4.5%, thanks to chicken nuggets, fried chicken, and chicken plumped up with salt solution.

• Soups: 4.3%. Making your own is easy.

• Sandwiches and burgers: Big Macs, chicken sandwiches, and the like contribute 4%.

• Cheese: 3.8%. Use it sparingly!

• Pasta mixed dishes: Frozen pasta entrees and restaurant pasta meals contribute 3.3%.

• Meat mixed dishes: Meatloaf, chicken pot pie, and so on — 3.2%

• Salty snacks: Chips, pretzels, tortilla chips, crackers — 3.1%

Making our own food with fresh ingredients (and not a lot of salt) is the best way to slash sodium. But the reality is that we all use at least some convenience foods. Compare food labels between brands and whenever possible, choose the no-salt-added, low-sodium, or reduced-sodium versions. Cook with herbs, pepper, and other spices. And taste your food before you salt it. You really can retrain your taste buds to prefer less salt!

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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