More Bad News on Dietary Sodium

A day does not go by on the radio or in the office that I am sitting with a patient discussing the health hazards of dietary salt (a.k.a. sodium).  I believe that this is one of the greatest threats to our health, in addition to excessive intake of calories and obesity. This past week in the New England Journal of Medicine, Dr. Lawrence J. Appel commented on a new study looking to reduce dietary sodium.

Health care reform is front and center on the U.S. political agenda. Actively debated are fundamental changes to the health care delivery system, which largely focuses on the diagnosis and treatment of existing disease. Prevention of disease, commonly accomplished through public health interventions, appears to be an afterthought, perhaps because the benefits are mistakenly perceived as small and the cost savings delayed.

In this issue of the Journal,Bibbins-Domingo and colleagues1 document a public health intervention designed to reduce dietary salt intake that can have huge benefits. In brief, the authors project that a national effort to reduce daily salt intake by 3 g (1200 mg of sodium) could reduce the annual number of new cases of coronary heart disease (CHD) by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction by 54,000 to 99,000 and reduce the annual number of deaths from any cause by 44,000 to 92,000. This intervention could also save 194,000 to 392,000 quality-adjusted life-years and $10 billion to $24 billion in health care costs annually. Even if the intervention reduced salt intake by just 1 g per day, the benefits would still be substantial and would warrant implementation.

While I agree with these recommendation, most people have no clue how to reduce sodium in their diet. Most believe the salt they consume comes in the way of a salt shaker. Wrong answer. Only 7% of our salt intake comes from adding it to the food on the table. Most is inserted i n the manufacturing process of prepared foods we are all addicted to. Changing these habits, through education of the public, and a re-tooling of how food is manufactured, will be the only way to tackle the issue.

My challenge to my patients, listeners on the radio, and all of you, is to read labels on the food you buy at the stores. Look at the sodium content, as well as the serving size. In general, you need to keep your daily intake to 2000 mg per day. This is critical especially if you have liver, heart, or kidney disease.

Avoid eating out at all costs. I find it impossible to locate food on a restaurant menu that is low in sodium. Learn to enjoy garlic instead.

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