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Sodium

The stealth additive, shaking the health hazard

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Sodium

Salt is added to almost all the processed food we eat. Cutting back on sodium also cuts your risk of cardiovascular disease, and that's good for your health.

It was only a matter of time before something replaced trans fat as the evil du jour. Trans fats clearly have no place in a healthy diet, and now that countless health-based associations have raised consumer awareness of the trans fat issue, they’re directing their focus to sodium.

What’s all the fuss about sodium? It’s the link between this simple chemical and cardiovascular disease.

New research in the February issue of the New England Journal of Medicine suggests that cutting sodium intake would reduce blood pressure and could eliminate a great deal of cardiovascular disease. The study also suggests it wouldn’t take much to have a real impact: as little as half a teaspoon less of salt (2 mL) each day, a reduction of 1,200 mg of sodium.

Sodium and hypertension

This new research comes at a good time because, according to Statistics Canada’s 2010 publication Health Reports, nearly one in five Canadian adults have high blood pressure—that’s about 4.6 million people between the ages of 20 and 79.

Yet another 2009 study in Applied Physiology, Nutrition and Metabolism reported that if Canadians reduced their sodium intake by roughly 1,840 mg per day, the prevalence of hypertension would decrease by 30 percent. In the case of adult men, this would put them closer to the recommended intake of 1,500 mg per day set out by the Canadian Hypertension Education Program (CHEP).

Researchers concluded this sodium reduction could prevent about 1 million cases of hypertension. That would mean roughly 11,500 fewer cases of cardiovascular disease each year in Canada and would save the health care system $430 million annually.

New sodium guidelines

CHEP has set out some fairly ambitious targets for daily sodium intake. It recommends that those between the ages of one and three limit their sodium intake to 1,000 mg, 1,200 mg for ages four to nine, 1,500 mg for ages nine to 50, and roughly 1,300 mg for those over 50. It seems ambitious because, according to the 2007 Canadian Community Health Survey, on average, adult men consume about 3,500 mg of sodium every day, and adult women consume about 2,600 mg. 

Keep in mind these survey results are based on telephone interviews. Using a method called 24-hour recall, dieticians ask their subjects to describe what they had to eat and drink in the previous 24 hours—an inherently limited process.

Where is the sodium coming from?

77% - convenience foods
12% - naturally occurring
6% - added at the table
5% - added during cooking

Research is full of examples in which subjects under-report the so-called bad foods and over-report the good. Bottom line? It’s likely that the average Canadian adult is consuming more sodium than reports indicate—a lot more.

Salt and convenience foods

People often note, “I don’t use salt in cooking or add it at the table!” If only it were that simple. The sobering reality is that salt added during cooking only makes up about 5 percent of our total intake. Essentially it’s the same for salt added at the table: a meagre 6 percent.  A further 12 percent of sodium in our diets is naturally occurring, meaning that it is a component of the whole food.

So where is all the sodium coming from? Convenience foods. Whether it’s prepackaged goods, prepared foods, canned ingredients, or takeout—the vast majority of our sodium comes from added salt and sodium-based ingredients. According to Health Canada, processed and prepared foods contribute nearly 80 percent of sodium found in the Canadian diet.

A 2008 Nielson survey found when Canadians pick up fast food, 30 percent of the time it’s lunch and 57 percent of the time it’s dinner. When asked how many days per week they consume takeout meals, 33 percent said at least once a week and another 24 percent reported one to two times.

Adding to the problem, sodium content varies greatly between similar products across brands. The odds are further stacked against the average consumer since restaurant foods are exempt from mandatory sodium labelling. Presently, any sodium reduction by manufacturers is completely voluntary. This makes it a real challenge for any of us to reduce our sodium intake.

Low-sodium strategies

Think of your sodium in terms of a budget: even your lower sodium choices throughout the day can add up. Try to follow as many of the following tips as possible instead of counting milligrams of sodium. You, your family, and anyone else who gives these tips a go will be well along the fast track to reaching the CHEP sodium intake recommendations.

  • Choose fresh, unprocessed foods whenever possible.
  • Season foods with fresh or dried herbs and spices, lemon juice, fresh garlic, or flavoured vinegars.
  • Wean yourself gradually from the amount of salt you use in cooking and at the table.
  • Look for lower-sodium versions of your favourite condiments.
  • Cook with naturally sodium-free oil or with salt-free butter.
  • Cut back on instant foods such as noodles and cereals.
  • Choose lower-sodium versions of prepared frozen foods.
  • Check the ingredients list for hidden sources of sodium.
  • Rinse canned foods, such as beans or tuna, under the tap for at least 60 seconds, which can remove up to 80 percent of sodium.
  • Choose foods with 10 percent daily value (DV) of sodium per serving. The percent DV of sodium on food labels is based on the upper limit of 2,400 mg.
  • Ask fast-food outlets about the sodium content in their foods. Some have pamphlets with nutritional information to help you choose low-sodium options.

Low-salt, kid-friendly snacking

Some of the top food sources of sodium include pizza, subs, hamburgers, hot dogs, soups, pasta sauces, canned pasta foods, potato chips and fries, cheese, and cereals—all popular with children.

A typical serving, such as two slices of pizza, a can of spaghetti, a small submarine, or two hot dogs, will exceed the recommended maximum daily amount of sodium.

Let’s face it: getting kids to avoid salty foods may be next to impossible. Reduce the amount of sodium by doing the following.

  • Ask for half the cheese when you order pizza. Limit serving to one slice and include some fruit, low-fat dairy, or vegetables on the side.
  • Skip the cheese when ordering a submarine.
  • Look for lower-sodium versions of prepared spaghetti and pasta sauces.
  • Make homemade fries. Slice 1 large potato or sweet potato, toss with 1 Tbsp (15 mL) extra-virgin olive oil. Bake at 375 F (190 C) for 20 minutes.
  • Resist adding salt when making hamburgers. Top with lettuce, cucumbers, sprouts, and tomatoes.
  • Choose lower-sodium condiments.
  • Snack on fresh foods such as unsalted nuts, seeds, fruit, and vegetables.
  • Choose salt-free peanut butter or other nut butters.
  • Involve children in food selection at the market and in cooking. They are more likely to buy into a lower-sodium meal if they’ve been included in the process. Allow them to choose a couple of fruits and vegetables.
  • Look for lower-sodium cold cereals.

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