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We all have heard about the detrimental effects of sodium intake in regards to high blood pressure and associated co-morbidities like cardio-vascular diseases. But let’s start by first learning about beneficial and more friendly facts about sodium. Sodium is an important mineral in our body that plays an essential role in managing the fluid/volume status in our body and is essential for proper functioning of our muscles. To make it simpler; every time you flex a muscle or your heart beats, sodium plays an important role in that process by sending signals across from nerves to your muscle in order to achieve the purpose of contraction. 

That being said, we all know “excess of anything is bad”, Sodium is no exception to the rule.   

It is very well documented that excess Sodium consumption has direct co-relation with elevated blood pressure in normotensive (Not Hypertensive Individuals) and Hypertensive Individuals. This consequently results in higher risk of cardio-vascular events and leads to disease like Coronary Artery Disease, Congestive heart failure, Chronic Kidney disease, Stroke, Proteinuria. In addition, excess sodium also direct relation to increased risk of kidney stones and osteoporosis, by increasing urinary calcium secretion.  

Recommended Sodium Intake:

  • Most guidelines recommend around 1500-2300 mg/day. General Rule of Thumb is to keep your 24-hour sodium intake < 2000 mg/day or < 2 gm/day.

 As per CDC Website: About 90% of Americans consume too much sodium and average daily sodium intake for Americans is > 3400 mg per day.   

Following a sodium restricted diet is the first and foremost step any patient with newly diagnosed Hypertension should follow regardless if they have Pre-Hypertensionor Hypertension and if they need medications or not. In addition, watching sodium intake is particularly beneficial for patients with diseases like congestive heart failure and chronic kidney disease since salt restriction prevents fluid overload and consequently recurrent hospital admission.   

Unfortunately, most of the sodium we consume comes from processed/restaurant foods. So, learning how to read labels is very important. This information can be easily found on websites, example being choosemyplate.gov. In addition, you can seek help from other resources i.e. Dieticians. Also, most national food chain restaurants have to post their nutritional facts online and can be easily accessed by searching for “restaurant name nutritional facts”  

Once you start reading labels, you may be surprised to see the salt content of the foods, even though they may not necessarily taste salty and in fact may be sweet.   

Examples of common foods and their sodium content

  • Morton Iodized Salt ¼ tsp: 590 mg
  • Milk 1 Cup: 105 mg
  • 1 Oreo Cookie: 45 mg
  • Honey Bunches of Oats Cereal ¾ Cup: 135 mg
  • Big Mac (Alone, No French Fries): 960 mg
  • Medium French Fries: 190 mg
  • 1 Slice of large cheese pizza: 710 mg
  • 1 Soda Can: 45 mg

Q&A

Q: Doc, it is easier said than done. 
A: That is true. But remember that if you cannot get down to 2 gm per day of sodium intake then consuming 3 gm per day is still better than 4 gm per day.   

Q: I was told I have hyponatremia (Low Serum Sodium), should I be consuming more Sodium or Salt. 
A: Not True. It all depends on what is causing Hyponatremia. If your low serum sodium is because of conditions like Cirrhosis or Congestive Heart Failure, then excess salt consumption will be deleterious.   

Q: Is Sea Salt better than Table Salt. 
A: False, Sodium content in Sea Salt and Table Salt is about same. Remember, learn to read the label.   

Q: I do take Blood Pressure meds, that should treat my hypertension, so why do I need to follow salt restricted diet. 
A: It has been proven, in order to get maximum benefit of anti-hypertensive medications, salt restriction is important and necessary.   

Q: Does salt restriction help lose weight? 
A: Salt Restriction may not directly help you lose body fat but it may help you lose weight by shedding excess fluid retention and by following healthier diets like DASH Diet (Rationale being choosing low salt food options will help make you healthier dietary options which will help you lose weight).   

REFERENCE:

Reviewed by:  Arvind Garg, MD Springfield, IL, USA

Nephrology, Cardiology, Diet and Nutrition


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