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Beware of the Salt Shockers

Dozens of foods can drive your sodium consumption way past recommended levels.

From the WebMD Archives

You know salty snacks like chips, pretzels, and crackers are loaded with sodium. But do you realize most of the salt you consume comes from the foods you're picking at the grocery store? It's not just the salt shaker, says Rosemary Yurczyk, MS, RD, CDE, dietitian and diabetes educator at the University of California Davis Medical Center in Sacramento.

Government guidelines recommend that people consume less than 2,300 milligrams of sodium per day -- about one teaspoon of salt. So if you eat three meals a day, you'll want to stay within 800 milligrams of sodium per meal, Yurczyk says.

Trouble is, it's so easy to go overboard, even if you just want to add some extra flavor to your poultry or a little sauce over the pasta. Check out the sodium stats, reported by the U.S. Department of Agriculture:

  • Dehydrated onion soup mix (1 packet): 3,132 milligrams
  • Seasoned bread crumbs (1 cup): 2,111 milligrams
  • Spaghetti sauce (1 cup): 1,203 milligrams

But what if you just want a cup of soup, or you often microwave a frozen meal for lunch or dinner? What if you simply must have that favorite canned veggie side dish your grandma always served? Check your numbers:

  • Canned chicken noodle soup (1 cup): 1,106 milligrams
  • Frozen turkey and gravy (5 ounces): 787 milligrams
  • Canned cream-style corn (1 cup): 730 milligrams

Surprised? It doesn't end there.

Be careful with the flavorings you add to the goodies on the barbecue grill and under the broiler. Perhaps you'd like to drink something fruity and refreshing? What about that one little sandwich for lunch or the fact you're known to pack a little more punch on your pizza? Are there any sodium shockers there?

  • Teriyaki sauce (1 tablespoon): 690 milligrams
  • Vegetable juice cocktail (1 cup): 653 milligrams
  • Beef or pork salami (2 slices): 604 milligrams
  • Canned jalapeno peppers (1/4 cup, solids and liquids): 434 milligrams

Nutrition labels can help you to judge whether you're looking at a low-sodium food. According to Yurczyk, here's the breakdown:

  • Low-sodium food: less than 140 milligrams per serving
  • Moderate-sodium food: less than 400 milligrams per serving
  • High-sodium food: more than 400 milligrams per serving

Continued

For example, seedless raisins, at 16 milligrams of sodium per cup, are low-sodium. A piece of angel food cake, at 210 milligrams, is moderate.

Looking at labels can help you find the sodium in your grocery items. But realize that the sodium listing is for just one serving size, not the whole container, Yurczyk cautions. "If you eat two servings, you'll have to double the amount of sodium."

Labels can guide you in making better choices within food categories, too, such as breads and pastries. For instance, a croissant contains 424 milligrams of salt, compared with only 148 milligrams for one slice of whole-wheat bread.

Dangers Dining Out

Restaurant dining poses another hazard. If you frequent fast-food restaurants -- where sodium abounds in sauces, fries, lunch meats, and even salad dressings -- ask for a nutrition fact sheet, Yurczyk suggests. That way, you'll get the skinny on how much sodium is really in that biscuit with egg and sausage: 1,141 milligrams. Or that 6-inch submarine sandwich with cold cuts: 1,651 milligrams. "It's a bit scary how much sodium is in fast-food meals," she says.

Other types of restaurants aren't likely to have nutrition fact sheets. But Yurczyk says you can still make sodium-sensible choices.

What gets the thumbs down from Yurczyk? "Soup -- in restaurants, it's not likely to be low-sodium; appetizers with cheese and prosciutto and processed meats; a casserole with cheese and sausage."

And the thumbs up? "If you order fish, steamed vegetables, and a salad on the side, it's not going to be a high-sodium meal."

The Great Sodium Debate

Hillel Cohen, DrPH, a researcher at the Albert Einstein College of Medicine in New York, fired the latest salvo in the great sodium debate. His study shows that people who reported eating limited salt were actually 37% more likely to die of cardiovascular causes, such as stroke and heart disease, than people who ate larger amounts of salt. Cohen is an associate professor of epidemiology and population health.

The medical establishment has revered the low-sodium diet for so long that it's hard to get doctors to question it, he says. Cohen doesn't bother to follow the conventional wisdom himself. "I actually don't pay attention to sodium."

Continued

He says his study, which was published in the March American Journal of Medicine, doesn't mean that everyone should abandon the low-sodium diet right away. He does say, though, that researchers need to ask if the current recommendations are truly useful for everyone -- and whether a low-sodium diet might even have negative effects on health.

Not so fast, says Jeffrey Cutler, MD, a scientific advisor at the National Heart, Lung, and Blood Institute who has studied high blood pressure.

"There's an immense body of evidence that links salt to high blood pressure," Cutler says. High blood pressure is a known risk factor for cardiovascular disease. What's more, people who eat a salt-laden diet don't just have high blood pressure to worry about. They may also be courting osteoporosis, kidney stones, and -- as seen in some Asian countries -- even stomach cancer, he says.

"When you look at all the evidence, the balance is still for the low-sodium diet," Cutler says.

Are there any other tips for staying within the 2,300 milligram-limit per day? Try these:

  • Take the salt shaker off the table.
  • Don't add salt to dishes as you're cooking. Instead, try herbs and sodium-free spices.
  • Use fresh or frozen foods instead of canned foods. If you buy canned products, look for low-sodium or unsalted ones.
  • When you eat out, ask that your meal be prepared without sodium sources, such as salt, soy sauce, and monosodium glutamate.
  • Keep a daily record of how much sodium you eat and drink.

And last, when you shake the sodium habit, don't start complaining too early that your unsalted oatmeal tastes like glue, Yurczyk says. "Salt is an acquired taste. It takes three weeks to get over it and then you get used to the natural taste of food."

WebMD Feature Reviewed by Louise Chang, MD

Sources

SOURCES: Hillel Cohen, DrPH, associate professor of epidemiology and population health, Albert Einstein College of Medicine. Jeffrey Cutler, MD, scientific advisor to the director of the division of epidemiology and clinical applications, National Heart, Lung and Blood Institute. Rosemary Yurczyk, MS, RD, CDE, University of California Davis Medical Center. USDA National Nutrient Database for Standard Reference, release 18. Cohen, H., American Journal of Medicine, March 2006; vol 119(3): pp 275.e7-275.e14.

© 2006 WebMD, Inc. All rights reserved.

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