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Is Salt the Next Health Focus?

A recent study suggests that a low sodium diet may reduce the risk of heart disease by as much as 25 to 30 percent.

In the past four years the number of reduced-salt alternatives on grocery shelves, from V8 juice to Goldfish crackers, has more than doubled. Indeed, “low-sodium” seems poised to follow “trans-fat-free” as the next rallying cry in the campaign for healthier diets, especially as new evidence underscores the benefits of easing up on salt.

The most startling numbers come from a study published in the April 2007 British Medical Journal, which found that reducing sodium slashed cardiovascular-disease risk by 25 to 30 percent—far more than even many advocates of low-sodium diets imagined. “We’ve known for a long time that excessive sodium raises blood pressure,” says Nancy Cook, Sc.D., an associate professor of preventive medicine at Brigham and Women’s Hospital in Boston, who led the study. Two previous investigations, reported in 1992 and 1997, had shown that when some of the participants were counseled to reduce sodium, average blood pressure levels fell. Cook and her team decided to check back to see if the volunteers in the low-sodium group—1,169 people in all—were any healthier 10 to 15 years later. They were. Surveys showed that people who’d been counseled to cut back on salty foods were still following that advice. And they were as much as one-third less likely to have suffered a heart attack, stroke or other complications of cardiovascular disease.

“The numbers really surprised us,” says Cook, who acknowledges that while cutting back on salt has been shown to lower blood pressure, the reduction is usually fairly modest—a few points, on average, in those with borderline hypertension. The reduction in the study participants’ heart-disease risk, by contrast, was dramatic. One reason may be that elevated blood pressure is only one way excessive sodium is bad for the body. Recent studies show it can also stiffen artery walls and may even damage heart muscle. Too much sodium may also be a factor in fueling the epidemic of insulin resistance, a risk factor for both type 2 diabetes and cardiovascular disease.

How much sodium is too much? Federal experts recommend a maximum of 2,300 milligrams (mg) a day—the amount in a teaspoon of table salt. Some studies show that cutting back even further (to a Spartan 1,500 mg daily) offers additional protection against hypertension.

Unfortunately, most Americans still consume about 3,375 mg of sodium a day. The growing ranks of low-sodium processed foods should help bring those numbers down, since processed foods account for a whopping 80 percent of sodium in Americans’ diets.

Bottom Line: Watching your sodium intake now can provide big health payoffs later. Reduced-sodium processed foods can help, but you’ll get even more benefit by choosing whole, unprocessed foods, cooking more from “scratch” and using just a dash of salt as needed. By gradually reducing the amount you use, you can reset your taste buds so that less salt doesn’t mean bland. “Many of the people in our study reported that they had grown to prefer low-sodium alternatives,” says Cook.

—Peter Jaret

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