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Most Americans consume far too much salt even if they add none to their foods. Experts discuss why salt is such a health problem and what the federal government is doing to push food processors toward reducing salt content in our diets.

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  • Dr. Bill Farquhar, Professor of Kinesiology and Applied Physiology, University of Delaware
  • Dr. Karen DeSalvo, Acting Assistant Secretary for Health, US Department of Health and Human Services
  • Dr. Robert Califf, Commissioner, US Food and Drug Administration

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16-30 Salt Bomb

Nancy Benson: You always hear people say “stay away from eating too much salt”. But that’s hard to do when our favorite foods like pizza, sandwiches, and snacks are filled with it.

Bill Farquhar: For the most part, even if you don’t ever salt your food, when you’re eating a typical American diet, chances are you’re getting too much sodium.

Benson: That’s Dr. Bill Farquhar, professor of kinesiology and applied physiology at the University of Delaware.

Farquhar: The average American consumes over 32 or 33 hundred milligrams per day and much of that comes from the highly processed foods that we eat. Most organizations recommend somewhere between 15 hundred and 23 hundred milligrams of sodium per day. It’s estimated that over, you know, 70 percent of the sodium we get is in processed food and I think it’s in how the foods are prepared. If you look at pizza, has a lot of sodium and cold cuts have a lot of sodium in them. So a lot of the things that we routinely eat just contain a lot of sodium. Eating in restaurants, they tend to have dishes that have more sodium then if we were preparing foods at home. I think people eat out a lot. Survey after survey shows that Americans consume well over 33 hundred milligrams of sodium per day.

Benson: The U.S. food and drug administration recommends a maximum daily intake of 2,300 milligrams of sodium. So obviously, we have a ways to go. To help get us there, the FDA has recently set both short and long term goals for the food industry to lower sodium content in processed and prepared foods. Dr. Karen DeSalvo, acting assistant secretary for health at the U.S. department of Health and Human Services, says less salt in foods should be a good thing for most people.

DeSalvo: The draft voluntary targets issued by the FDA today are intended to help the American public gradually reduce sodium intake to 23 hundred milligrams per day, a level recommended by leading experts and the overwhelming body of scientific evidence. This action is important because it gives every American consumer more control over their diet and their sodium intake. On average, Americans consume almost 50 percent more sodium than what most experts recommend.

Benson: However, Dr. Robert Califf, commissioner of the FDA, says the gradual approach is important.

Califf: Sodium has important functions in many foods such as taste, texture and microbial safety. And it can’t simply be removed without careful consideration of these factors. Not only is this approach more precise than a “one size fits all” strategy, but it also recognizes the fact that different foods have different potential for sodium reduction. As a result, each category has different draft voluntary targets. The FDA has established draft voluntary reduction targets for the majority of processed, packaged and prepared foods. By evaluating these foods in the nearly 150 categories, from bakery products to soups. The draft voluntary targets in the categories are based on our analysis of a current range of sodium and food categories, scientific research and discussion with industry experts. The FDA is confident that the draft short-term targets, which seek to decrease sodium intake to about 3,000 milligrams per day, are readily achievable. In fact, many foods such as top selling pretzel products have already made the short-term target.

Benson: Farquhar agrees. For the health of the nation, those targets are important.

Farquhar: I tend to think that most people link high sodium to blood pressure and blood pressure alone. And that’s been out there for many, many years now that high sodium can contribute to hypertension and increased blood pressure. I think probably far fewer people realize that high sodium can also cause other problems as well even if blood pressure does not go up. So I think not many people are informed about the adverse affects of sodium. For example, blood vessel function. There are different ways to assess blood vessel function in people, one important aspect of that is assessing endothelia function. Endothelia cells are the cells that line the inner most layer of the blood vessels. And there’s been evidence showing that high salt impairs endothelia function. And the reason that’ s important is that impaired endothelia function is a precursor to atherosclerosis, which is the main disease process underlying cardiovascular disease. So high salt can impair endothelia function and over time that can contribute to cardiovascular disease, even if blood pressure stays normal.

Benson: But not everybody is the same. Farquhar says depending on who you are, you may be more or less sensitive to salt.

Farquhar: The responses can vary tremendously. I mean, if you look at or examine hypertensive adults, for example, African American hypertensives, the majority of those adults tend to be salt sensitive. That is if they increase a lot of salt, their blood pressure will go up or if they take salt away, blood pressure will go down. But young healthy adults with normal blood pressure really not many of them are salt sensitive. Probably fewer than one out of four normotensive young adults are salt sensitive. So it really varies tremendously based on the population that studied. And on the low end I would say one out of four salt sensitive, that’s the young normotensive, and on the other end, older adults, hypertensive adults, African Americans, perhaps three out of four may be salt sensitive.

Benson: Most doctors would probably say that everyone should know their blood pressure. It might be that you are one of the rare people who isn’t affected by salt.

Farquhar: It is important to know that blood pressure response has varied tremendously person to person. And in fact, that’s led to this whole idea of salt sensitive blood pressure that is some people are sensitive to salt and some people are not. In terms of what are the mechanisms linking high salt to blood pressure, I mean, it’s really not knowing precisely. I mean, for one, high salt can expand the fluid in your body, exercise your fluid volume. And that can cause an increase in blood pressure. And that’s probably one of the main reasons how high salt can increase blood pressure. But there are other ways that can cause increases in blood pressure as well. I mean, the kidneys are involved, particularly regarding fluid balance. The blood vessels may be involved in that as well that is increasing blood pressure. The output of a heart’s involved in increasing blood pressure. So I think there are a lot of organs that can contribute to increases in blood pressure when one consumes a lot of salt.

Benson: New York City now requires restaurants to label dishes with more than 2,300 milligrams of salt. The warning label looks like a saltshaker placed next to high salt menu items. Farquhar says the intention is to discourage customers from making unhealthy choices.

Farquhar: It is hard to say if that will change individual behavior. I think it is important though for people to know if they’re consuming a meal that has over 2,300 milligrams of sodium. And I don’t know if one individual basis of that will steer or nudge individuals to healthier dishes, but I hope it will.

Benson: The good news is all this doesn’t mean you have to completely cut pizza out of your diet. Farquhar says just eat high sodium foods in moderation

Farquhar: I think on an individual basis, it’s very difficult to get sodium down into the range of 15 hundred to 23 hundred milligrams per day. Clearly, you have to make an effort to do that. You can’t eat pizza, but right, if you’re eating pizza every day or cold cuts every day, I mean your sodium intake is going to be quite high. I think you can still eat some of those items but just in moderation. The thought there is not that one high sodium meal permanently damages the blood vessels, the thought is if you’re eating high sodium every day and every day you have to declines in endothelia production, then over time that will lead to cardiovascular disease. It’s not thought that we know one high sodium meal will permanently damage the blood vessel, it’s just thought that it had more of an accumulative type of an affect.

Benson: So the next time you think to add more salt to your meal, Farquhar says think again; there’s probably more than enough.

You can find out more about all our guests on our website, radiohealthjournal.net.

Our writer this week is Heather Muno.

Our production director is Sean Waldron.

I’m Nancy Benson.


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