Robin Allen, MSPH, RDN, LDN
The 2010 US Dietary Guidelines recommends a reduction in sodium intake to less than 2300 mg a day and to 1500 mg for persons who are 51 and older, African American, have hypertension, diabetes or chronic kidney disease. At that time I was an Administrative Dietitian for a large multi-unit college food service. When these guidelines came out I immediately and naively went to my Chefs (yes they were all trained certified chefs) and asked them to decrease the amount of salt being used. From the horrified expressions and anguished protests you would have thought I was taking away their first born!
I started looking into our recipes and menus, which thankfully were all in our menu management system with the nutritional analysis. Now I began to understand the magnitude of the problem! Reducing the use of salt was only the tip of the ice berg! Many foods, not naturally high in sodium, became so because of soup base mixes, seasoning mixes, and use of processed foods. Even some chicken breasts, my go to “healthy meal”, may contain excessive sodium due to a process called “plumping”. Plumping is the injection of a saline solution into the chicken breast during processing to enhance flavor , and add weight. Changing over 1500 recipes which fed up to 20,000 students per day was massive and monumental undertaking! This would also involve a change in purchasing products, food preparation, such as making soup base from scratch, changing the Chefs’ attitudes and changing our entire taste profile. And finally our customers would complain and add salt! It is no wonder that consumers are confused and have difficulty controlling their sodium intake.
So where so we get the most sodium in our diet if it not just salt? According to the Centers for Disease Control and Prevention (CDC) the following is true about sodium content of the diet:
- Americans get 75% of the sodium from restaurants, prepackaged, and processed foods.
- Salt added during cooking at home is only 5% of the intake of sodium.
- Some foods naturally contain sodium which makes up the remaining 12%.
- Many processed, packaged food are high in sodium but do not taste salty.
- Bread and rolls, luncheon meat, cured meats, and pizza top the list in sodium.
- Bread can contain anywhere from 80 to 230 mg of sodium per slice.
- 1 serving of lunch meat can contain 750mg of sodium, half of some peoples’ daily allowance.
Sodium intake is not just a problem for Americans. Excessive sodium intake is a key factor contributing to prehypertension and hypertension all over the world. Identifying food sources of sodium is critical. Using data from the INTERMAP Study to define major food sources of sodium in diverse East Asian and Western population samples, researchers set out to discover the source of sodium in the diets of these countries. According to the World Health Organization (WHO), most of the world’s population consumes 2,300 mg to 4,600 mg sodium per day. Where is this sodium coming from? In Japan, China and Southern China, salt added during cooking, soy sauce and salted vegetables were the main source of sodium. In the United Kingdom (UK) and United States (US), breads, grains, cereal, salt from restaurants, fast food and processed foods at home, and red meats, poultry and eggs were the primary source. The conclusion of the study indicated that China should focus on reducing salt in cooking and Japan, the UK and US must reduce sodium in processed food.
So how do Dietitians and Health educators help their patients/clients lower their sodium intake? The following steps are outlined by the CDC.
- Eat more fresh or frozen (no sauces) fruits and vegetables.
- Look for no salt added or low sodium versions when using canned vegetables, or choose frozen varieties without sauce.
- Read the nutrition labels on packaged foods. Compare sodium in different brands.
- More home cooked meals prepared without using processed or packaged foods.
- Use salt free herbs and spices rather than processed sauces, packaged broths, packaged seasoning mixes or condiments.
- When you do go out to eat, ask restaurants not to add salt to your meal. Use condiments in small amounts; ask for lemon, vinegar or other condiments to help with flavor.
- Ask your favorite restaurants, stores, and food manufacturers to offer more low-sodium options.
- You CAN re-train your taste buds. Over time, the less sodium you eat, the less you’ll want.
What are you doing to help your patients/clients reduce their sodium intake?
Are you looking at your facilities’ menus and recipes to see if adjustments can be made to food preparation and purchasing?
Are you educating your staff of the importance of sodium reduction in the diet and food supply?
ANDERSON,CA, APPEL,JA, OKUDA, Dietary Sources of Sodium in China, Japan, the United Kingdom, and the United States, Women and Men Aged 40 to 59 Years: The INTERMAP Study. J Am Diet Assoc. 2010;110:736-745.
This post was written by Robin Allen, member of the Military Families Learning Network (MFLN) Nutrition and Wellness team which aims to support the development of professionals working with military families. Find out more about the MFLN Nutrition and Wellness concentration on our website, on Facebook, on Twitter and on LinkedIn.