By: Austin Perlmutter, MD, Medical Student, Miller School of Medicine
If you’re like the average American, you’re a bit of a salt addict. More technically, you’re consuming excessive dietary sodium. For most of us, this isn’t too concerning, and this mindset is reflected in our data. We know the average human needs around 500 mg of sodium each day for basic body functions, but Americans consume on average 7 times this number each day. Don’t get me wrong, salt is crucial for the body’s proper function. But, at the excessive levels we’re consuming, salt leads to serious complications like high blood pressure, heart attack and stroke.
In 1975, researchers wanted to determine the effects of our high-salt diet on health. To accomplish this goal, they decided to venture into the rainforest of northern Brazil. Here, they studied the Yanomamo tribe, a group of persons with minimal exposure to the outside world, and coincidentally, a “life-long extreme restriction of dietary sodium.” The fascinating data showed that in this population, blood pressure stabilized after the second decade of life, and did “not systematically increase during subsequent years of life.” If we know that only 11% of males and 7% of females in their 20’s are hypertensive, but that 67% of men and 79% of women will be hypertensive after age 75, then the impact of preventing age-related changes in blood pressure is tremendous.
At a population level, statisticians predict that our overconsumption of sodium will lead to 500,000 extra deaths over the next 10 years. This means that our extra bag of pretzels may have effects far beyond inducing cravings for a glass of water. Despite suggestions that low salt diets are dangerous, well conducted research continues to show health benefits of lowered salt intake.
Beyond just sodium, the ratio of sodium to potassium in the diet predicts death. A large study published in the Journal of the American Medical Association found “higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality.” Keep this in mind, because the imbalance between sodium and potassium is generally considered to be the main problem in this disease process.
Our diet tends to be very rich in sodium and low in potassium, and therefore most of us have an excess of sodium and a deficit of potassium. Our cells should be filled with potassium, and when they can’t get enough, they suck up sodium from the blood. High sodium inside cells then leads to changes in vascular physiology associated with hypertension. In addition, the lack of potassium promotes glucose intolerance, another factor highly associated with development of hypertension and vascular complications. Obviously we need some salt, but our balance is way off.
To sum it up, we’re eating too much sodium and too little potassium. On a practical level, most of us simply aren’t aware of how much sodium or potassium we’re eating, and are rather desensitized to the excessive salt added to most of our foods. Luckily, we can stop this damaging process, and potentially reverse some of the harm our salt-rich diets have already inflicted. We need to eat more potassium and less salt, but of course, this may present a challenge if we don’t know how. Here are the keys to your success:
- Start reading nutrition facts: The nutrition facts label requires sodium content for the enclosed food product. It’s probably reasonable to shoot for 1500mg of total daily salt intake, so snacks and meals with high sodium should be used sparingly within that limit
- Avoid foods with high hidden salt content
- Processed meats, snack foods, soups and sauces are rich in sodium content. Unless you know how much salt is in a product, be very wary.
- Restaurants tend to use lots of salt to improve flavor of foods, and people tend to severely underestimate the salt content of restaurant food. Sauces and dishes mixed with meat are among the worst culprits.
- It’s in the grain foods! Breads and rolls are the top source of American dietary sodium!
- Know your own foods. If you prepare your own food, you’re in a great position to monitor your sodium intake. Obviously, adding salt with a shaker either during preparation or after serving a meal is a contributor to total sodium intake. However, be aware of the ingredients you use and how much sodium each of them may contribute to the final product. Real foods tend to be much lower in sodium than their processed alternatives. This means that use of unadulterated vegetables, meats, nuts and grains grants you a far lower sodium intake than buying prepared versions.
- Up your potassium intake.
- Potassium may be a crucial piece in preventing the side effects of high dietary sodium. Less than 2% of Americans actually get their daily recommended value of potassium, even though we know a potassium deficit may increase risk for disease.
- Vegetables like kale, chard, spinach, collard greens, lima beans, Brussels sprouts, zucchini and broccoli are very healthful overall, and contain high levels of potassium.
- For protein, meats including beef, poultry, fish and lamb are other good sources of dietary potassium, as are nuts like pistachios and almonds (remember, unsalted).
- Fruits such as cantaloupe and banana are high in potassium, but sugar content may negate the health benefits. Avocado is technically a fruit, is high in potassium, and is a much more healthful alternative.
- If you have kidney problems or are taking prescription medications, make sure to speak with your physician prior to initiating a higher potassium diet