Sodium: To salt or not to salt?

Why Sodium?

What is Sodium? Essential mineral in small amounts Electrolyte Table salt – Sodium and Chloride (NaCl)

Function in Body Helps maintain balance of fluids Helps transmit nerve impulses Influences contraction and relaxation of muscles

Function in Food Preservatives Inhibits growth of food- borne pathogens Modify flavor Binds ingredients Enhances color Stabilizer

2005 Dietary Guidelines 2,300 mg – Healthy Adult 1,500 mg – High blood pressure, kidney disease or diabetes Average American consumes 3,500 mg daily

High Sodium Foods Frozen Meals Tomato Sauce Soups Condiments Canned Foods Prepared Mixes

Sodium equivalents ¼ teaspoon salt = 600 mg ½ teaspoon salt = 1,200 mg ¾ teaspoon salt = 1,800 mg 1 teaspoon salt = 2,300 mg 1 teaspoon baking soda = 1,000 mg

Food Labels Sodium Free <5 mg/serving Very Low <35 mg/serving Low Sodium <140 mg/serving Reduced Sodium – Usual sodium level is reduced by 25% “healthy” <480 mg/serving “meal type” <600 mg/serving

Fat Free Healthier? Regular RitzReduced Fat 135 mg/16 g 160 mg/15 g

Campbell’s Soup RegularLow Sodium 890 mg/can 140 mg/can

Sea Salt Grains obtained from the natural evaporation of seawater Undergoes little or no refining technique which allows it to retain natural traces of other minerals Contains same amount of sodium as table salt

Potassium chloride Used as a salt substitute Provides the salty flavor and helps extend shelf-life Known to posses a bitter or metallic aftertaste Health risks involved with high intakes

High Sodium Diet Example Breakfast ¾ cup Cheerios – 159 mg 1 cup milk – 107 mg Breakfast bar – 105 mg Lunch Turkey sandwich 2 slices bread – 205 mg 2 oz turkey – 680 mg 1 slice American cheese – 250 mg 1 Tbsp Mayo – 70 mg Chips – 120 mg 16 oz coke – 60 mg Dinner 2 cup Cheeseburger Macaroni Hamburger Helper – 1620 mg Total= 3376 mg (146% over recommended)

Low Sodium Diet Example Breakfast ½ cup Oatmeal – 0 mg Banana – 0 mg 1 cup Cranberry juice – 35 mg Lunch 1 cup pasta – 183 mg ½ cup marinara sauce – 525 mg Apple – 0 mg Dinner Chicken breast – 64 mg 2/3 cup brown rice – 10 mg 1 cup asparagus – 5 mg Total = 812 mg

Sodium Intake and Disease Let’s look at which diseases may be related to high sodium intake.

Sodium health links High blood pressure Heart Disease Stroke

High blood pressure Also known as hypertension Normal 120/80 mm Hg Pre-Hypertension ( )/(80-89) mm Hg Stage 1 Hypertension ( )/(99-90) mm Hg Stage 2 Hypertension 160/100 mm Hg

High blood pressure Most people have no signs or symptoms Risk Factors: Age – Middle aged men/post menopausal women Race – African American Family History Sedentary Lifestyle High sodium intake/low potassium intake Alcohol and tobacco use

Sodium insensitive hypertension Resistance of blood pressure changes with decreased sodium intake 2007 study, Florida, 45 people, 1 year Goal was to reduce body weight by 7% Restricted diets Brisk walking 150 min/week Salt sensitivity was tested at beginning and end of trial Salt resistant participants were defined by lack of blood pressure lowering after correction of obesity and related metabolic abnormalities

Dietary Approaches to Stop Hypertension (DASH) Diet Study 412 Adults assigned to one of the following diets DASH diet: Emphasize fruits, vegetables, low fat dairy products, whole grains, poultry, fish, and nuts Typical US diet Results: The DASH diet significantly lowered blood pressure Long-term health benefits depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods

Heart disease Number 1 cause of death worldwide Often caused by a buildup of fatty plaques in arteries Risk Factors Age Gender – Men Family History Smoking High blood pressure/cholesterol levels Diabetes and obesity

Research Study Follow-up study previously on a previous population of pre- hypertension adults Individual and group counseling sessions specific to sodium reduction Questionnaire given 10 years later found: Involvement in sodium reduction intervention lowered CVD risk by 25-30%

Stroke Blood supply to the brain is interrupted or reduced Caused by a blockage in an artery or blood vessel leak or burst Risk Factors: Family History Age – 55 or older High blood pressure/cholesterol Diabetes and obesity Tobacco and alcohol use

At-risk populations High blood pressure Kidney disease Diabetes African American Middle-aged or older

Reducing Sodium Intake What are some lifestyle changes that you could make to reduce your sodium intake?

Ways to reduce sodium intake Food items without added salts Unsalted nuts, seeds, beans Limit salty snacks (pretzels and chips) Avoid adding salt and canned vegetables to homemade dishes Unsalted and sodium, fat-free broths and soups Skim or 1% milk Low sodium, low fat cheeses Add spices and herbs to enhance taste Add fresh lemon juice instead of salt to fresh vegetables

Summary Sodium has many functions in food flavor, texture, preservation 2005 Dietary Guidelines 2,300 mg per day Read Food Labels High sodium intake linked to high blood pressure, heart disease and stroke