Another salt offensive was launched in June, this time by the American Medical Association. In the mounting campaign against salt, the association called for sodium to be slashed by 50 per cent in processed foods, fast-food products and restaurant meals over the next decade. And it's a concern that is echoed by leading health experts in Canada, too.
Salt is under attack because it's the single biggest contributor of sodium to the diet, accounting for 90 per cent of our intake. Salt's chemical name is sodium chloride. By weight, salt is composed of 40 per cent sodium and 60 per cent chloride. (One teaspoon of table salt contains 2,300 milligrams of sodium.)
Consuming too much sodium increases the likelihood of developing high blood pressure, a risk factor for heart attack, stroke and kidney disease. A high sodium diet may also increase the risk of forming kidney stones and trigger gastroesophageal reflux symptoms. (Gastroesophageal reflux is a disease in which stomach acid flows back into the esophagus, causing it to be irritated and inflamed.)
According to dietary surveys, Canadian men are consuming as much as 3,800 milligrams of sodium a day, and women get up to 2,500 milligrams -- more than double the amount that's required for health.
These numbers actually underestimate sodium intakes because they do not include salt added at the table.
Salt isn't the only vehicle for sodium in our diet. Other compounds that add sodium to foods include monosodium glutamate, baking soda (sodium bicarbonate), baking powder, sodium benzoate, sodium nitrite and sodium propionate. Manufacturers add sodium to foods to enhance flavour, add texture, give colour and prevent spoilage.
Sodium ingredients other than sodium chloride may have a lesser impact on blood pressure since many contain less sodium. Sodium bicarbonate, for example, contains 27 per cent, MSG has 13 per cent and baking powder 10 per cent.
The impact of sodium on your health depends on how much you consume -- regardless of the source. We do need some sodium for health, but it's an amount considerably less than we're consuming.
In the body, sodium is needed to regulate fluid balance and blood pressure and it keeps muscles and nerves working properly.
People under 50 need 1,500 milligrams of sodium a day, people aged 50 to 70 need 1,300 milligrams, and older individuals need 1,200 milligrams. (With age, the body becomes more sensitive to the blood-pressure-raising effects of sodium.) Endurance athletes, such as marathoners, need more sodium to replace sweat losses that occur during prolonged exercise.
The daily upper limit of sodium for adults is 2,300 milligrams of sodium. People who are sodium sensitive -- roughly 35 per cent of Canadians -- should limit their daily intake to less than 2,300 milligrams. In salt-sensitive individuals, excess sodium can boost blood pressure. People who are prone to salt sensitivity include older adults, blacks, and those who have a parent, sibling or child with high blood pressure.
It's easy to spot the grains of salt in your saltshaker, but most of the sodium we ingest each day (77 per cent) is hidden away in processed and restaurant foods -- only 6 per cent is added while eating. That's why the American Medical Association is urging the U.S. government to develop regulations to limit sodium in packaged and restaurant foods.
Some of the worst sodium culprits include soups, canned vegetables, frozen dinners, processed meats and snack foods. Salt mines at restaurants include breakfasts, Chinese entrees and deli sandwiches.
When watching your sodium intake, it's the total amount you consume that is most important, not necessarily the content in any one food. Use the following strategies to help you lower your sodium intake:
Read nutrition labels: Mandatory nutrition labelling means that it's relatively easy to compare and identify packaged foods that are lower in sodium. The Nutrition Facts table lists the amount of sodium (in milligrams) per serving of the food. To quickly determine whether a food has a little or a lot of sodium, read the percentage cent daily value that is set at 2,400 milligrams. Foods low in sodium will have a daily value of 5 per cent or less; that means they will contain no more 120 milligrams of sodium a serving (e.g. 0.05 x 2,400 = 120).
It's okay to include a high-sodium food in your diet as long as you balance it with foods naturally low in sodium such as fresh fruits and vegetables.
Adjust recipes: Remove or reduce the salt called for in recipes when possible.
In most casseroles, stews and main dishes you can omit the salt. In baked goods it's usually safe to reduce salt by half without affecting quality and taste. If you buy packaged mixes for rice, pasta or soups, use only half the seasoning packet and boost flavour by adding fresh or dried herbs. Make your own salad dressings and sauces without added salt.
When using canned foods like vegetables, lentils and legumes, rinse under running water before cooking to reduce sodium content.
Don't shake the salt: Flavour foods without sodium by using garlic, ginger, lemon juice, lime juice, salsa, onion, vinegar and herbs. Many condiments including Worcestershire sauce, soy sauce (1,000 milligrams of sodium per tablespoon!), hot sauce, ketchup and mustard also contain sodium -- so use them sparingly.
Limit processed foods: Limit your intake of processed meats such as bologna, ham, sausage, hot dogs, bacon, and deli meats. Rely less on convenience foods such as canned soups and frozen dinners. When possible, choose lower sodium products. If you can't find them in your supermarket, ask your grocer to stock them.
Be assertive when dining out: Request that salt not be added and order sauces and dressings on the side so you can control the amount you use. If eating at a family-style or fast-food restaurant, check the company's website before you go. In February of 2005, the Canadian Restaurant and Foodservices Association announced that more than 24 large chains such as Pickle Barrel, Kelsey's, Jack Astor's, East Side Mario's and White Spot voluntarily agreed to make nutrition information, including sodium, available to consumers by the end of 2005. If this information isn't posted on-line, ask at the restaurant.
Check your medicine cabinet: Some medications including certain antacids, laxatives and non-steroidal anti-inflammatories contain large amounts of sodium. If you're unsure, read the ingredient list or ask your pharmacist. (Never stop taking your medication without checking with your doctor.)
Leslie Beck, a Toronto-based dietitian at the Medcan Clinic, is on CTV's Canada AM every Wednesday.