Don't Pass the Salt – CUT the Salt!

With all the talk this past year about healthcare reform and its costs, there is one simple dietary step that could reduce healthcare costs by up to $18 billion and prevent 100,000 deaths per year: Cutting back our salt intake.

With all the talk this past year about healthcare reform and its costs, there is one simple dietary step that could reduce healthcare costs by up to $18 billion and prevent 100,000 deaths per year: Cutting back our salt intake.

It isn’t really a surprise that Americans consume far too much salt. The government’s Dietary Guidelines recommend that healthy adults consume no more than 2,300 mg of sodium a day, but the daily average is at least 3,400 mg. Lower amounts (1,500 mg) are recommended for groups that are at higher risk such as adults over 50 years old, African-Americans, and those with high blood pressure.

If Americans reduced their average intake of sodium even to the recommended 2,300 mg, it could save the nation as much as $18 billion annually in health care costs, eliminate 11 million cases of high blood pressure, prevent 100,000 deaths, and improve the quality of life for millions of people, according to a new study.

The research was conducted by RAND Corporation, the nation's largest independent health policy research program.

The figures were based on information about Americans' blood pressure levels, use of antihypertensive medications and sodium intake. Nearly 30 percent of the nation's population has hypertension, with a treatment cost of $55 billion."One of the reasons that hypertension is so pervasive is that sodium consumption is so high," according to a lead researcher.

But cutting back isn’t as simple as hiding the salt shaker. Almost 80 percent of our daily sodium intake comes from processed foods rather than from salt added during cooking at home or at the dinner table.

High sodium processed foods include boxed (i.e. macaroni and cheese, crackers), frozen (pizzas, TV dinners), canned (soups, sauces, dressings, and even vegetables), deli (hot dogs, processed meats, potato/pasta salad, cheese), bakery (cheesecake, white bread and pastries) and bagged (chips, pretzels and snacks).

Restaurant food also tends to be very high in sodium, with some dishes containing nearly twice the amount of sodium you should consume in a day. Fast food and major national chains are most often mentioned as the biggest offenders, but even school lunches average more than 1,000 mg each.

But increased awareness of the problem may be forcing some changes. The food industry began its own effort to incrementally reduce sodium in processed foods over the last year, and some restaurants now offer low-sodium or ‘heart-healthy” options.

In addition, a recent report by the independent, nonprofit organization Institute of Medicine (IOM) urges the U.S. Food and Drug Administration (FDA) it should look to control the levels of sodium permitted in packaged and restaurant food as soon as possible. The IOM predicts this change will prevent hypertension, heart disease, and stroke.

Whether or not these changes take place soon or much later, there are a number of things you can do to control your sodium intake right now:

1. Keep the 2,300 mg (or 1,500 mg if you are in one of the higher risk groups mentioned above) number in mind as you look at labels and try to keep your total daily intake under that amount.

2. Eat whole, natural foods such as fruits, vegetables and whole grains.

3. Prepare foods from scratch at home whenever possible; make extra servings and freeze for later use to maximize your efforts.

4. Substitute herbs and spices for salt when cooking. In addition to new and enhanced flavors, many herbs such as curcumin/turmeric and ginger provide health benefits as well. Also, replace white flour with whole wheat flour when baking.

5. If you buy prepared foods, look for low-sodium options, but still look at the actual amount of sodium per serving on the label (some “low-sodium” products just meant they have less than the outrageously high regular versions). Use tricks such as rinsing canned vegetables, draining some of the liquid off soup and replacing it with water, or rubbing visible salt off pretzels and crackers.

6. When dining out, ask about low-sodium options, or check the web sites, menus or pamphlets that many chain restaurants and fast-food places now provide with nutritional information.

7. Be especially aware of the worst sodium offenders, but also watch out for it in unexpected places, like canned vegetables/beans, salad toppings, and desserts.

Dr. Reginald B. Cherry ( is a member of the American Medical Association, Texas Medical Association, Harris County Medical Society, and the American College of Preventive Medicine. Dr. Cherry has authored numerous articles on Preventive Medicine, emphasizing nutrition and exercise. He also speaks extensively on these topics nationwide and conducts numerous seminars for various groups and organizations. Currently, his weekly television program reaches 80 million homes.