Fire Life

Salt/Sodium: A Heart Adversary

By Mary Jane Dittmar
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Salt has long been known to have negative effects on heart health for many people. The American Heart Association (AHA) this month has renewed its call to the public, health professionals, the food industry, and the government to “intensify” efforts to reduce Americans’ intake of sodium in their diet. In its President’s advisory in Circulation: Journal of the American Heart Association, the AHA recommends that we eat no more than 1,500 milligrams (mg) of sodium a day. Many Americans consume more than twice this recommended upper limit. More than three-quarters of sodium in the diet comes from packaged, processed, and restaurant foods.

Among sodium’s harmful effects are elevated blood pressure and increased risk of stroke, heart attacks, and kidney disease. The AHA advisory committee, made up of leading scientists, says that even modestly decreasing salt intake by 400 mg per day can be beneficial. The committee reviewed the most recent scientific studies.

The AHA’s 1,500-mg daily recommendation was based on a report from the Centers for Disease Control and Prevention, which found that a majority of the American population has high blood pressure or is at high risk for developing it.

Among the information contained in the advisory is the following:
  • Blood pressure and the risk of negative health outcomes rise as sodium intake rises.  
  • Excess sodium intake adversely affects the heart, kidneys, and blood vessels independently of its effects on blood pressure.  
  • The potential public health benefits of sodium reduction are enormous and extend to all Americans.
  • Scientific evidence on the adverse effects of excess sodium is strong and compelling. 
The AHA has among its 2020 impact goals the improvement of the cardiovascular health of all Americans by 20 percent while reducing deaths from cardiovascular disease and stroke by 20 percent. Among the factors the AHA will use to determine the nation’s cardiovascular health status will be a populationwide reduction of sodium consumption to less than 1,500 mg/daily and a normal range blood pressure.  
The AHA is part of the National Salt Reduction Initiative, which is working with the food industry to reduce sodium content in packaged and restaurant food. Following are some suggested ways to monitor your sodium intake based on information from the AHA’s Web site:
Cutting Down on Salt
You can gauge the parameters of the salt content in a food product by the label: Sodium free or no sodium indicates that there are less than 5 mg of sodium and no sodium chloride in the ingredients; Very low sodium indicates that the product has 35 mg or less of sodium; Low sodium, 140 milligrams or less of sodium; and Reduced or less sodium , at least 25 percent less sodium than the regular product. (In the latter case, the product can still have an overabundance of salt/sodium to meet the guidelines.) These products include canned soups and dry soup mixes; canned meats and fish; ham, bacon and sausage; salted nuts and peanut butter; instant cooked cereals; salted butter and margarine; processed meats, such as deli items and hot dogs; prepared baking mixes (pancake, muffin, cornbread, etc.); prepackaged frozen dinners (look for options where one serving has less than 400 mg of sodium); preseasoned mixes (tacos, chili, rices, sauces, gravies, etc.); snack foods (pretzels, potato chips, olives, pickles); cheese; tomatoes; salad dressings; and fast food.

Note: The label usually specifies the sodium for a serving size. If the label states that a specified serving size has 200 mg of sodium and that the soup container contains two servings, if you eat the contents of the entire can, you will have consumed 400 mg of sodium.

The label lists all ingredients. Be aware that some foods contain more than one form of sodium. Some common ingredients that are high in sodium include the following: sodium alginate, sodium sulfite, sodium caseinate, disodium phosphate, sodium benzoate, sodium hydroxide, monosodium glutamate or MSG, and sodium citrate. Another thing to look for is the position of the sodium ingredients on the list. The higher on the ingredient list a substance is, the more of that substance is in the product.

Two of the most obvious ways to decrease sodium intake are to limit salt when cooking and not salting your food at the table (in fact, do not put the salt shaker on the dinner table). There are salt substitutes, but some of them can cause side effects in people with certain medical problems. Always check with your medical provider before using them. 

Other suggestions include the following: 

  • Avoid seasonings that taste salty, including bouillon cubes, cooking sherry or cooking wine, chili sauce, meat tenderizer, seasoned salts, soy sauce, steak sauce, tamari, and Worcestershire sauce. Substitute salt-free seasonings such as lemon juice, vinegar, and herbs.
  • Drain and rinse canned foods before preparing them to remove some of the salt. Look for unsalted canned vegetables. I have found unsalted string beans, peas, and spinach. I also found that crushed tomatoes have a much higher sodium content than tomato puree and tomato paste and that sodium content in Italian brand tomatoes can vary significantly.
  • Substitute fresh fruits and vegetables for canned or frozen versions with added salt.
  • Avoid packaged foods such as soups or rice dishes that come with a packet of powdered seasoning. 
  • Avoid processed convenience foods.
  • When dining out, avoid foods prepared as follows: au gratin, basted, braised, buttered, casserole, creamed, crispy, escalloped, fried, hash, hollandaise, in cheese sauce, in cream sauce, in gravy, pan-fried, pan-roasted, pot pie, prime, rich, sautéed, stewed, and with bacon or sausage.
  • Check over-the-counter medications as well. Some are high in sodium. Read the sodium content and warnings. Don’t take headache or heartburn medicines that contain sodium carbonate or bicarbonate.


Mary Jane Dittmar is senior associate editor of Fire Engineering and conference manager of FDIC. Before joining the magazine in January 1991, she served as editor of a trade magazine in the health/nutrition market and held various positions in the educational and medical advertising fields. She has a bachelor’s degree in English/journalism and a master’s degree in communication arts.