Sack the Salt, Experts Say

From the WebMD Archives

May 17, 2000 (New York) -- Put down the salt shaker and forget super-sizing the french fries. Cutting back on salt, say high blood pressure experts, can not only bring high blood pressure under control but it may reduce the risk of heart attack and stroke.

Results of a federally sponsored study, which involved more than 400 people aged 22 or older and looked at the effect of salt intake on blood pressure, suggests that most Americans are consuming more than twice as much salt as they should, and that's a problem, the experts say.

Salt, according to a team led by a Harvard researcher, appears to be a major factor in blood pressure. Frank Sacks, MD, who presented the study results at a press conference sponsored by the American Society of Hypertension, says that reducing daily salt intake to just 1,500 mg, instead of the 3,300 mg consumed by most Americans, can reduce blood pressure without the use of blood pressure medications. He says that cutting back on salt had the same positive results regardless of age, sex, or race.

And for those who want to maximize the health impact of salt reduction, the best approach is to combine it with a diet that emphasizes whole fruits and vegetables instead of processed foods, he says. In the study, persons with high blood pressure found that the combination of healthy diet and salt restriction significantly lowered their blood pressure, Sacks says.

Systolic pressure -- the first or higher number when blood pressure readings are given -- came down more than 11 points, and diastolic -- the second number -- came down an average of seven points. Even persons who didn't have high blood pressure lowered their blood pressure by restricting salt, Sacks says. He also says that cutting back on salt can lower blood pressure even if one doesn't switch to the healthy diet he recommends.

Currently, the government recommends a daily salt, or sodium, intake of 2,400 mg. That is too high, say Sacks and fellow researchers William Vollmer, PhD, and Eva Obarzanek, PhD. And while the recommendation is high, reality is worse. Sacks tells WebMD that most Americans actually take in about 3,300 mg of salt a day.

The reason for the high salt consumption, says Obarzanek, a nutritionist at the National Heart, Lung, and Blood Institute, is processed foods. Manufacturers, she says, load in the sodium in the belief that it makes the foods tastier. "A half cup of prepared spaghetti sauce contains more than 600 mg of sodium," she adds.

Vollmer, who works as a researcher at Kaiser Permanente Center for Health Research in Portland, Oregon, agrees and says some foods should be erased from shopping lists. "Pickles are especially bad because the sodium content varies so much," he tells WebMD. Fast-food restaurants pose particular challenges, says Vollmer, who adds "I used to work at one of those places ... avoid the french fries in all cases." For those who can't avoid a quick trip to the drive through window, Obarzanek suggests taking a "hold the pickle, hold the ketchup, add more tomatoes, and don't salt the burger," approach.

Fast-food quips aside, Sacks says the study has serious public health implications. Restricting salt and switching to a healthy diet could "result in a 20% reduction in the prevalence of heart attacks and 35% reduction in strokes," he says. Those reductions would be seen in people with and without high blood pressure, he says.

It is possible, Sacks says, that "a person taking blood pressure medications may be able to reduce their reliance on medications by switching to this diet," he says. For example, a person taking two drugs to control blood pressure might be able to discontinue one of the medications, Sacks says.

Vollmer tells WebMD that the take-home message is "to eat fewer processed foods." He says, however, that it's best to take a realistic approach. He suggests, for example, that whole foods be prepared without salt during the cooking process and that salt should be added when the foods are served. He says that the researchers found that cooking with salt doesn't improve taste but does leave harmful amounts of salt behind. "We found that adding the salt after preparation can satisfy the 'taste for salt,' but uses less salt to do so," Vollmer says. He says that people may initially find food less tasty, but after a few days when the body becomes used to less last, most people will begin to complain about the salty taste when served foods seasoned the "normal" way.

Obarzanek says that the study findings suggest that "obviously, salted foods, such as potato chips, have no place in a healthy diet. We need to teach people to read labels to find out sodium content, and we need to get the food industry on board to make more low-sodium foods available," she says.

Vital Information:

  • Studies show most people eat 3,300 mg of salt daily. The U.S. government recommends Americans limit salt intake to 2,400 mg a day. But researchers say keeping salt consumption to 1,500 mg a day can reduce blood pressure and possibly allow patients to stop blood pressure medication.
  • The researchers say cutting back on salt helps your health regardless of your age, sex, or race. For maximum results, researchers urge people to combine low-salt diet with a lot of fruit and vegetables and avoid processed foods, which tend to be loaded with salt.
  • The changes in lifestyle could translate into significant reductions in heart attacks and strokes -- both in people who have high blood pressure and those who don't.