Health Information Library

By Mayo Clinic Staff

Are you getting more sodium than health experts suggest is wise? If so, it could lead to serious health problems.

Sodium is a mineral. You can find it naturally in food, such as shellfish or milk. Manufacturers also may add sodium to processed food, such as processed meats and snack foods. Sodium also is used to flavor food in condiments, such as soy sauce. Table salt, pink salt, sea salt and other salts used in cooking have sodium.

The World Health Organization suggests a limit of 2,000 milligrams of sodium a day. Most of the sodium you eat is hidden in prepared foods. And for that reason, many people worldwide take in more sodium than their bodies need.

A diet high in sodium increases the risk of high blood pressure and related conditions.

See where all that sodium comes from and learn how you can cut back.

The body needs some sodium to work well. Sodium plays a role in:

• The balance of fluids in the body.
• The way nerves and muscles work.

The kidneys balance the amount of sodium in the body. When sodium is low, the kidneys hold on to it. When sodium is high, the kidneys release some in urine.

If the kidneys can't remove enough sodium, it builds up in the blood. Sodium attracts and holds water, so the blood volume rises. The heart must work harder to pump blood, and that increases pressure in the arteries. Over time, this can raise the risk of heart disease, stroke and kidney disease.

Some people may be more sensitive than others to dietary sodium. This means their blood pressure is more likely to rise from sodium they eat. Also, people with kidney disease may become more sensitive to dietary sodium.

Eating less sodium is linked to lower blood pressure. And lowering your blood pressure can help prevent conditions such as heart attacks and stroke.

Most people eat too much sodium. In the United States, people take in on average 3,300 milligrams of sodium a day — well beyond the recommended daily intake. The American Heart Association recommends a goal of 1,500 milligrams of sodium a day for the best health outcomes.

Most of the sodium people eat comes from prepared and packaged foods. These include:

• Prepared meats such as hotdogs, bacon and cold cuts.
• Pickled and canned foods.
• Snack foods and desserts.
• Pizza.
• Cheese.
• Bread, tortillas and pasta.
• Prepared dinners, frozen dinners and restaurant meals.

Many recipes call for salt, and many people also salt their food at the table. Condiments that are often added to food, such as ketchup and soy sauce, also have sodium. One tablespoon of soy sauce, for example, can have more than 800 milligrams of sodium.

Most foods naturally have sodium. These include all vegetables and dairy products, meat, and seafood. These foods don't have a lot of sodium. But eating them does add to the overall amount of sodium in your body. For example, 1 cup of low-fat milk has about 100 milligrams of sodium.

Almost everyone can find a way to eat less sodium. Some ways you can cut back are:

• Eat more fresh foods. Most fresh fruits and vegetables are naturally low in sodium. Also, fresh meat is lower in sodium than are lunchmeat, bacon, hot dogs, sausage and ham. Buy fresh or frozen chicken, turkey, fish, or meat without added sodium.
• Choose low-sodium products. If you buy processed foods, such as broth or ready-to-cook dishes, choose ones that are labeled low sodium. Buy plain, whole-grain rice and noodles instead of pre-seasoned, packaged rice and noodles.
• Eat at home. Restaurant foods and meals often are high in sodium. A single entree may have enough sodium to reach or go above your daily limit.
• Remove salt from recipes whenever possible. You can leave out the salt in many recipes. Those include casseroles, soups, stews and other main dishes that you cook. Look for cookbooks that focus on lowering risks of high blood pressure and heart disease.
• Replace salt with other flavorings. Use fresh or dried herbs, spices, and zest and juice from citrus fruit to make your meals tasty.
• Limit the use of condiments. Soy sauce, salad dressings, sauces, dips, ketchup, mustard and relish all have sodium.

Taste alone may not tell you which foods are high in sodium. For example, you may not think a bagel tastes salty. But a large multigrain bagel may have as much as 600 milligrams of sodium. And that's before you put anything on it. Even a slice of whole-wheat bread has about 150 milligrams of sodium. So a sandwich could have at least 300 milligrams of sodium even before adding cheese, vegetables or meats.

So how can you tell which foods are high in sodium? Read food labels. The Nutrition Facts label found on most packaged and processed foods lists the amount of sodium in each serving. It also lists whether the ingredients include salt or items that have sodium, such as:

• Monosodium glutamate (MSG).
• Baking soda, also called sodium bicarbonate.
• Baking powder.
• Disodium phosphate.
• Sodium alginate.
• Sodium citrate.
• Sodium nitrite or nitrate.

Try to stay away from products with more than 200 milligrams of sodium a serving. And be sure you know how many servings are in a package. That information also is on the nutrition label.

The supermarket is full of foods labeled reduced sodium or light in sodium. But don't assume that means they're low in sodium. It just means the products have less sodium than do the regular versions of the products.

Here's what common sodium claims in the United States really mean:

• Sodium-free or salt-free. Each serving in this product has less than 5 milligrams of sodium.
• Very low sodium. Each serving has 35 milligrams of sodium or less.
• Low sodium. Each serving has 140 milligrams of sodium or less.
• Reduced or less sodium. The product has at least 25% less sodium than does the regular version.
• Lite or light in sodium. The sodium content has been reduced by at least 50% from the regular version. But some foods with these labels may still be high in sodium.
• Unsalted or no salt added. No salt is added during processing of a food. But some foods with these labels might not be sodium-free. That's because some of the ingredients may naturally have sodium.

A salt substitute is made by replacing some or all of the sodium with potassium, magnesium or another mineral. These table salt substitutes help lower the amount of sodium you get, and potassium and magnesium help lower blood pressure. But they need to be used carefully. You can use too much if you are trying to get the same salty taste as you would from table salt.

The potassium in some salt substitutes may be a problem for some people. Too much potassium can be harmful for people with kidney problems. It also can be bad for those who take medicines that cause the body to hold on to potassium. These include medicines used to treat high blood pressure and congestive heart failure.

The key is to slowly cut back on foods that are high in sodium, such as prepared and processed products. And that doesn't mean you have to stop eating your favorite foods. For example, you could use fresh, lower sodium ingredients to make your own pizza instead of ordering in. Or you could cook and freeze homemade beef and veggie stew rather than buy the canned version.

When you go grocery shopping, read nutrition labels to find out how much sodium a product has. You can look for reduced- or low-sodium versions of any prepared foods you buy often.

Slowly cut back on table salt too. Try salt-free seasonings to help make the change. After a few weeks of this, you might not miss the saltshaker. Start using no more than 1/4 teaspoon of salt daily at the table and in cooking.

As you eat less sodium and salt, your craving for it might fade. And that could help you enjoy the taste of the food itself, with heart-healthy benefits.