Take Individualized Approach When Reaching for the Salt Shaker

Dorian Martin Health Guide
  • My 80-plus-year-old father has heart issues. In the past decade, he’s started experiencing edema, which is when the body ends up retaining fluid. It normally affects the feet, ankles and legs (which is why the doctor prescribed compression stockings for Dad to wear). However, it also can affect the whole body and that’s what happened to Dad. He had to go into the hospital earlier this year to have excessive fluid removed through a catheter. The doctors ended up removing more than 20 pounds of fluid from him, including 1.5 liters of fluid from around his lungs.


    So why am I telling you this in a diet and exercise blog post?  It’s because in addition to being caused by heart failure, kidney disease, liver problems from cirrhosis, some medicines, issues with lymph nodes and sunburn, what you eat can cause edema – specifically through eating too much salt.  And too much salt can especially exacerbate health issues when someone has high blood pressure.

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    Therefore, I was really interested in a new international study just published in the New England Journal of Medicine that looks at use of salt. The study involved taking fasting urine samples taken from 101,945 people in 17 countries over an average of a three-year period. The researchers then used these samples to estimate 24-hour sodium and potassium excretion. They found that the average excretion of sodium was 4.93 grams per day while the average excretion of potassium was 2.12 grams per day.


    The researchers found that an estimated sodium intake between 3 grams (3000 milligrams) and 6 grams (6000 milligrams) per day was associated with a lower risk of death and cardiovascular events among people. The researchers’ analysis found that a higher estimated sodium excretion of 7 grams or more per day was associated with an increased risk of major cardiovascular events (heart attack or stroke) and death. Not surprisingly, the association between a high level of sodium excretion and the combination of major cardiovascular events and death was most pronounced among people who have hypertension (high blood pressure). The analysis also found that participants who consumed less than 3,000 milligrams of sodium daily had a 27-percent higher risk of a heart attack, stroke or death than those whose intake was between 3,000-6,000 milligrams. The researchers also found that potassium, which is found in fruits and vegetables, seems to lower blood pressure and cardiovascular risks.


    In comparison, the current guidelines put out by the U.S. government, the World Health Organization and the American Heart Association recommend between 1500 and 2300 milligrams or lower of dietary sodium intake daily.  Let’s put that into a different measurement. According to the American Heart Association, one teaspoon of salt equals 2300 milligrams of salt.


    So what should you do? Although I am not a medical doctor, I think it all comes down to moderation and also taking an individual approach. For instance, Dad has been on a low-salt diet due to his health issues for quite a while. While I don’t face the same challenges, I am in the habit of limiting the salt I use while cooking and he uses a salt substitute to season his food.  


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    However, there are still challenges to keeping the amount of dietary sodium in check. Take eating out, for example. When we periodically bring in dinner, Dad often selects items that are a lot more salty. For instance, one of his favorites is a chicken fingers basket from Cotton Patch. The restaurant’s website shows that that meal includes 3220 milligrams of sodium in the chicken fingers, 320 milligrams in the cream gravy, and 1897 milligrams in the French fries. That’s a total of 5,437 milligrams of sodium in one meal!


    So I’d encourage you to talk to your doctor during your next appointment to see guidance on the amount of sodium you should be eating based on your own health profile. Try to cook more often using whole foods (as opposed to boxed or preprepared foods), which will allow you to control sodium content. And definitely beware of sodium levels when you’re eating out!


    Primary Sources for this Sharepost:


    American Heart Association. (2014). About sodium (salt).


    Cotton Patch. (ND). Nutritional information.


    Marchione, M. (2014). Study questions need for most people to cut salt. Houston Chronicle.


    O’Donnell, M., et al. (2014). Sodium, potassium, and cardiovascular events. The New England Journal of Medicine.


    Winslow, R. (2014). Low-salt diets shown to pose health hazard. Wall Street Journal.


Published On: August 14, 2014