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Sodium
and Blood Pressure: What’s the Target?
Two-thirds of U.S. adults should
be making major reductions in sodium consumption, according to
a Centers for Disease Control report. Along with major sodium
reductions, there are other equally important steps people can
take for blood pressure control that may be lost in this message.
The 2005 Dietary Guidelines for
Americans recommend that adults consume no more than 2300 milligrams
(mg) of sodium daily. That equals about a teaspoon of salt. Groups
most likely to develop high blood pressure from sodium are advised
to eat less than 1500 mg of sodium daily. At-risk groups are
people with hypertension, adults age 40 and older and all African
Americans.
The average American consumes
over 3,400 mg of sodium daily, so getting down to 2300 or 1500
mg is a major drop. Limiting table salt will help, but most of
our dietary sodium comes from processed foods. Avoid the processed
foods highest in sodium, such as bacon, sausage, hot dogs, processed
cheese and regular canned soup. |
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Many ready-to-eat cereals contain
200 to 360 mg of sodium. Instead, choose options like shredded
wheat and regular (not instant) oatmeal with 1 to 5 mg. Look
for low-sodium versions: Natural, reduced-fat cheese has about
250 mg of sodium per ounce, low-sodium versions keep it to about
6 mg per ounce. Some foods you will have to carefully limit,
such as regular bread, which has 100 to 175 mg in each slice
or small roll. For low-sodium and whole grains, you can try unsalted
crackers, brown rice and other cooked grains. Sodium from condiments
like regular salad dressing and ketchup requires changing selections.
In some people, blood pressure
changes only modestly when sodium consumption changes; "salt
sensitive" individuals’ kidneys are unable to filter
out excess sodium without significant increases in blood pressure.
It might seem that sodium restriction should only be urged for
those who are salt sensitive. But in one large study of diet
and blood pressure, 29 percent of adults were consistently salt
sensitive, yet an even larger group showed inconsistent reactions
to sodium. These and other researchers concluded that trying
to identify which individuals are salt sensitive is too difficult.
However, blood pressure is more
than just a sodium issue. Potassium works with sodium to regulate
blood pressure. Diets low in potassium magnify the blood pressure-raising
effect of excess sodium. Conversely, a diet rich in potassium
(due to nine to ten daily servings of vegetables and fruits)
can create as big a drop in blood pressure as decreasing sodium
consumption 1000 mg.
Weight is also important. Research
suggests that obesity leads to a third to more than two-thirds
of cases of hypertension. Even modest weight gain increases risk
of high blood pressure. As overweight people lose weight, blood
pressure can drop. Following the general health alcohol guidelines
of no more than one standard drink daily for women or two for
men is also linked to better blood pressure.
The CDC is calling for Americans
to work harder to reduce sodium. But along with sodium reduction,
research also shows that a healthy diet, weight control and limiting
alcohol consumption are important strategies as well. |
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