The Sodium Wars Are Heating Up

February 21, 2012 in Health, Nutrition by Joyce Bunderson

I’ve just returned from a lovely, warm, relaxing week cruising in the Caribbean. You’d think that I’d be a calm as the new-fallen snow that greeted me upon my return to the mountain west. But alas, The American Heart Association (AHA); The Salt Association and the food processors are in combat. From my perspective, some of the food processors/Salt Association arguments are disingenuous; and that causes my eyes to roll and exasperated sighs to escape me, in addition to dissipating my restful week.

First, let me say, that the argument that people really don’t care is such lousy logic. The food processors argue that people are more concerned about calories, fat and fiber, than they are about salt. I think that health educators need to help the public (and the food processors for that matter) realize that nutrition is a fairly complex field – being concerned about one issue does not solve them all. Frankly, I believe that the public understands this but the food processors, are grasping at straws, trying to protect their present level of sodium use, saying the public doesn’t care anyway.

Why we need to care

Let’s not forget why we are striving to reduce sodium in our diet. Heart disease and stroke are an epidemic in the United States today. The number of heart attacks and strokes that occur in the United States is 2,000,000 per year. A substantial number of studies have found that on average, as dietary salt intake rises, so does blood pressure.

The prevalence of high blood pressure in the U.S. continues to rise. An estimated nine in ten Americans will develop high blood pressure during their lifetime. Individuals with high blood pressure are at increased risk for stroke, heart failure, kidney failure, stomach cancer, and osteoporosis. Sadly these risks extend to children and adolescents as well. Children are at risk of developing heart disease and elevated blood pressure at an earlier age, because an estimated 97% of them currently consume too much sodium.

Million Hearts

Government and organizations are uniting in the national "Million Hearts™" initiative to prevent a million heart attacks and strokes over the next 5 years. Reducing sodium in the population is a major part of this initiative. Controlling sodium intake is one of the risk factors that we can impact – with a little commitment and effort we can make a difference.

Issue of taste

Another of the food processor’s arguments is that people are used to the high sodium and they will not like the taste of products made with less sodium. Let’s remember the receptors in our mouth do adapt to the lower sodium; and mercifully, it happens fairly rapidly. On December 23, 2011, Mary Ireland wrote about an interesting observation of her taste for salt and her mother’s – remarkable how two people most often separated over the years end up with such divergent preferences for salt. I know personally, that being in the habit of lower salt consumption, has made me sensitive to highly salty foods.

Voluntary sodium reduction by food processors

In short, it’s not going at all well. Campbell’s for example has added back the salt to their soup. The food industry has not stepped up to the plate – sodium seems to be staying put. So organizations like the AHA are suggesting that a mandatory nationwide standard will be necessary. The AHA has made extensive suggestions and explained the importance of the issue in a nineteen-page comment to the FDA. Included in their comment is their statement that they “strongly disagree’ with the Salt Association’s statements. I especially enjoyed reading how the AHA hired independent evaluators to look at the research that the Salt Association used to say it was potentially unhealthy to reduce salt.

Processed foods and sodium

The latest argument by the food processors is that much of our food supply is processed in one way or another and that’s most often a good thing. They’re trying to sell us on calling the cleaning of fruits and vegetables as processing – thereby making fresh fruits and vegetable processed. Maybe we should use the term highly processed – maybe that would help with ending this new argument that most of our food is processed.

Caroline Scott-Thomas says that we should “stop demonizing processed foods and focus on sodium instead.” This would be difficult for me, because highly processed foods not only have a sodium problem, but also in addition, they so often lack the nutrients necessary for optimally nourishing health.

In general, I think that the public knows that Cheetos, Ritz Crackers, Skittles, Doritos, Kraft Mac and Cheese, and Froot Loops, for example, are more processed that an apple that is rinsed off and coated with a little wax. It’s a little more challenging to see that a can of Campbell’s Chicken Noodle Soup is different than budget friendly homemade chicken noodle soup; but one place to start is with the Nutrition Facts label. Let’s be clear about processed foods; food processors often use additional sodium to extend shelf life and as a cheap way to add flavor. Let’s not try to dissuade the public from ‘demonizing’ highly processed foods; they are very frequently high is calories and sodium, and very low in nutrients. Look at the long lists of ingredients that are used to try to formulate something that resembles food. (Check out the link in this paragraph.)

How processed is processed?

There’s a nice little chart showing a few sodium comparisons published by Colorado State University Extension. What I like about the chart is that it helps illustrate what happens, as related to sodium, with processing. Some of my favorite examples are: apple; corn, cucumber; pork; potato, tomato, steak; and tuna. Note: There is also a nice list of herbs and spices to use instead of some or all of the salt. In addition to the herbs and spices, you may want to consider balsamic vinegar reductions – great way to impart flavor to foods without adding salt and/or lemon juice.

Because 77 percent of the sodium in the average American diet comes from salt added to processed or restaurant foods, it’s difficult to just be careful at home and still reduce your salt intake. Keep your eye on the Nutrition Facts Label on food packages and you’ll be able to know how much sodium is in packaged foods.

The American Heart Association shares helpful advice:

“As a guideline, to include a “sodium free or salt free” claim on the label, a product cannot exceed 5 milligrams of sodium per serving.  A product with a “low sodium” claim must not exceed 140 mg per serving.  A “no salt added or unsalted” claim on the label does not mean the food is “sodium free.”  Compare the sodium content between various products and choose the one with the lowest amount of sodium.”

Which foods are contributing the most sodium?

The Centers for Disease Control and Prevention (CDC) published the top ten sources of sodium in the diet:

  1. Breads and rolls
  2. Cold cuts and cured meats
  3. Pizza
  4. Poultry
  5. Soups
  6. Sandwiches
  7. Cheese
  8. Pasta dishes
  9. Meat dishes
  10. Snacks

Sometimes we wouldn’t even guess that a food has added sodium. For example, it turns out that much of the raw chicken and pork bought from grocery stores has been injected with a sodium solution. Knowing that, we may decide to adjust our recipes. If it calls for added sodium, we can add less or even none; because it’s already in the meat.

Are you surprised about bread and rolls being at the top of the list? Bread is not such a high sodium food, especially compared with the foods on the list, but the problem is that often bread is served at several meals a day. As a nation, we eat lots of bread (just think about all the buns, muffins, in burgers, and breakfast sandwiches). Go back to that Colorado State Extension list and look at a slice of bread (114mg) compared with a cup of tomato soup (932mg) or chicken soup (1,107mg) for example. Tufts University suggests that buying the right brand can cut sodium from the high of 230 mg to 80 mg per serving.

My greatest hope is that we can remain diligent and realize that decreasing sodium in our diet is a worthy goal; because of its link to the number one killer of Americans – stroke and cardiovascular heart disease.