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Beware of the Salt Shockers

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

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."

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."

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