This last weekend my husband and I ate out twice; the first night we went to an excellent Italian restaurant and had delicious pasta (mine in mushroom sauce, his with lobster and tomato sauce). The next night (obviously I didn’t cook) we had sushi and edamame – the former dipped in soy sauce and the latter sprinkled and boiled with salt. In retrospect, we ate way more sodium then we should have; as do 90 % of Americans.
I’ve previously written articles about the dangers of our overabundant salt consumption. But just to remind you about the sodium stats: The Dietary Guidelines for Americans, 2005 state that persons with hypertension, all middle-aged and older adults and all blacks should limit their intake of sodium to 1,500 mg/day. These specific groups include nearly 70% of the US adult population! The rest should be content with levels that are no higher than 2,300 mg/day.
(If we underwent a population-wide reduction in sodium to 1,500 mg a day, we could reduce the number of new cases of coronary heart disease by 60,00 to 120, 000 cases and stroke by 32,000 to 66,000!)
To estimate the proportion of adults whose sodium was within recommended limits, the CDC analyzed data from the National Health and Nutrition Examination Survey (NHAMES) for 2005-2006, the most recent data available. They found that only 5.5% of those who should be limited salt eaters followed the 1,500 mg/day guideline and when it came to those allowed more sodium, only 18.8% were less-than- 2,300g/day-compliant. I and my husband certainly didn’t meet any of these guidelines this past weekend!
Aside from the obvious (soy sauce and salted edamame), where does all that sodium intake come from? Well, here are some salty tidbits from an editorial note on the CDC report in this week’s Journal of the American Medical Association: In the United States, an estimated 77% of dietary sodium intake comes from processed and restaurant foods and only 10% comes from table salt (1/2 a teaspoon contains 1200 mg of sodium) and cooking. The foods with much of the excessive sodium that we consume also have the most calories, even though they may not taste salty. The authors state that “Grains contribute the largest amount of sodium and calories followed by meats.” This sodium laden grain category includes frozen meals, soups and breads. The meats with the most sodium consist of lunch meats, sausages and hot dogs. Even when the vegetable category was analyzed, it too was found to contain way too much sodium, probably because it included vegetable based soups, sauces, white potatoes (those salty French fries and potato chips), salads with dressing as well as canned vegetables. In the NHAMES study, a more detailed look at the sodium containing culprits found that yeast breads, chicken, mixed chicken dinners, pizza, pasta dishes and cold cuts topped the list.
Because the NHAMES data was obtained though self-reported intake, many scientists feel that the population’s sodium consumption was actually higher. (We tend to make our previous meals sound smaller and healthier than they were; I know that when I wrote about my food intake I omitted the chocolate and tapioca pudding that I ate). And the sodium from salt added at the table was not calculated in the NHAMES questionnaire…. and we all know people who salt everything, even before they have tasted it.
It’s apparent that we have to become better sodium consumers if we want to confront our number one cause of death. Since sodium intake largely comes from processed and restaurant foods, we have to start “deprocessing” and, if possible, (now I know I am entering dangerous culinary territory) cook for ourselves or at least know how our food is prepared and cooked. (I made this latter statement for all of you out there who rely on others to prepare the food you eat at home). Become a restaurant pest and ask what each dish is made from and how it’s prepared. Get your salad with dressing on the side and use very little. Sauces can also go on the side or be eliminated. Bread, french fries and pickles should not be an eating-out staple. Those quick take-out sandwiches with cold cuts (and/or the hotdogs) are not a terrific way to get your nutrients.
Oi …. so what’s left to eat? Well fruits are always fine, raw veggies are great and then “unsauced” and uncured fish, chicken (not plumped in salt water), meat, eggs (properly cooked and from non salmonella contaminated chickens) as well as dairy should all contain no or at least less sodium. Remember, whatever is pre-prepared and packaged to last long and taste sweet or salty, probably contains a lot of sodium. Read the label, it will tell you how many milligrams of sodium a portion contains. You might be surprised. Meanwhile, I’ll go take my blood pressure!