Most people with cardiovascular disease consume excessive amounts of sodium
Last reviewed: 07.06.2024
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Many people consume more than the recommended daily amount of sodium, especially those who most need to reduce their sodium intake for heart health.
A new study finds that people with cardiovascular disease consume more than twice the recommended 1,500 milligrams (mg) of sodium each day.
The average amount of sodium consumed daily was 3,096 mg, with 89% of study participants consuming more than the recommended amount.
The results will be presented April 6-8 at the American College of Cardiology Annual Scientific Session . The results have not yet been published in a peer-reviewed journal.
People with cardiovascular disease should reduce their sodium intake
The American Heart Association (AHA) recommends that adults who are not at risk for cardiovascular disease consume no more than 2,300 mg of sodium per day. This is roughly equivalent to a teaspoon of table salt.
The average person with cardiovascular disease in the present study exceeded this level by nearly 1,000 mg.
The study used data from 3,170 participants in the Centers for Disease Control's NHANEST Trusted Source study. This sample included men and women over the age of 20 who had been diagnosed with cardiovascular disease.
Most of this group were 65 years of age or older, white, and had less than a high school education. The men, who made up just over half of the subjects (56.4%), were overweight and consumed an average of 1,862 calories per day.
While excessive sodium intake is often thought to be the result of fewer food choices, the study turns that hypothesis upside down.
The group with the highest sodium intake was people with higher incomes and higher education.
What happens to the heart if you consume too much sodium?
The chemical name for table salt is sodium chloride. Sodium is a natural mineral that is essential for human health in small amounts.
"Sodium helps balance water in the body," explained cardiologist Jane Morgan, M.D., clinical director of Piedmont Healthcare Corporation in Atlanta, Georgia. "It even supports proper muscle and nerve function." (Dr. Morgan was not involved in the study.)
"There's a saying in medicine, 'Where sodium goes, water follows,'" he said.
"This is why salt increases the volume of blood in the body. The result is an increase in blood pressure. Increased blood pressure makes your heart work harder, which ultimately puts you at risk for cardiovascular disease," Dr. Morgan said.
Dr. Morgan noted that excess sodium has long been linked to thickening of the arteries and atherosclerosis.
Does the average person consume too much salt?
"The persistent overconsumption of sodium among all socioeconomic strata suggests that sodium intake may be influenced by factors beyond simple access to resources," said Michelle Rutenstein, a dietitian. Rutenstein was not involved in the study.
Rutenstein suggested that this could mean "widespread availability and marketing of convenient processed foods high in sodium, cultural dietary habits that prioritize salty foods, and limited awareness or education about the health risks associated with excessive sodium intake."
Morgan agreed, going even further:
"This is a great indication of the prevalence of the Western diet and the craving for salt and 'flavor'. It is also a reflection of the ease and availability of sodium in many grocery products, even when buying 'healthy' foods."
Dr. Morgan added that packaging and labeling is not easy for the average consumer to understand.
She said the Food and Drug Administration (FDA), for example, could "create a standardized food rating system that everyone understands where those food choices fall on the health spectrum. Then the consumer can really make an informed decision."
How can I reduce my sodium intake from food?
Tracking your salt intake is the first step to reducing your sodium intake, but it can be difficult to know how much sodium you're actually consuming.
In many food products, sodium is not only used to impart a salty flavor. It can be used in baking, thickening, preserving meats, retaining moisture, and as a preservative. Many foods high in sodium don't seem salty at all.
"Without careful scrutiny of food labels and adherence to sodium levels, people may unintentionally consume excessive amounts of sodium," Rutenstein said.
"People may not be aware of the sodium content of their food even before they consider using a salt shaker," Rutenstein added. "For example, a typical restaurant meal can contain more than 2,000 mg of sodium, which is more than the recommended amount for people with cardiovascular disease."
Rutenstein recommended the following tips for reducing sodium intake:
"To consume less sodium with food, focus on cooking at home, using fresh ingredients, choosing low-sodium options, using herbs and spices for flavor, reading labels and being mindful of hidden sodium in processed foods. When dining out, people can make lower-sodium and heart-healthier choices by asking for sauces and dressings as garnishes, choosing grilled or steamed dishes instead of fried, and asking for food to be prepared without added salt."
"These simple changes can go a long way toward reducing your overall sodium intake while [you] still enjoy a delicious meal," Rutenstein noted.
Dr. Morgan suggested four simple principles to keep in mind:
- Choose fresh produce.
- Limit side dishes, including salad dressings: barbecue, soy, teriyaki, ketchup, etc.
- When cooking, replace salt with other herbs and spices.
- If you crave salty foods, try fresh fruit, dark chocolate or almonds instead.
Common salt substitutes
Rutenstein suggested a number of ways to replace salt in food while retaining its flavor, such as adding small amounts of lemon or grapefruit juice to recipes.
"The sharp taste of citrus can trick taste buds into perceiving more saltiness than there actually is, allowing dishes to remain flavorful with reduced sodium," she said.
Rutenstein also advocated for spiciness, adding chili peppers or hot sauce to dishes depending on your taste preferences.
You can also replace the table salt shaker with garlic powder (not garlic salt, which has sodium in it), oregano, or any other favorite powder.
"Dijon mustard, whole-grain mustard or dry mustard powder can add spice and depth to dressings, marinades and sauces. Adding mustard to vinaigrettes, sandwich spreads or rubs adds a savory flavor without relying on sodium," suggested Rutenstein.