Processed, Restaurant Foods Still High-Sodium

By Reena L. Pande, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

Eat less sodium. Eat less sodium. Eat less sodium. The message is loud and clear.

You do need some sodium for your body to work properly. But Americans, on average, eat about 3,400 milligrams (mg) of sodium per day. That's more than double the recommended amounts for some adults.

For most adults, the recommended daily sodium intake is less than 2,300 mg per day (about 1 teaspoon of salt). The U.S. government recommends less than 1,500 mg per day for adults over age 50 or those with certain medical problems. The problems include high blood pressure and diabetes.

Why does sodium matter? There is a clear link between too much sodium intake and high blood pressure. And high blood pressure greatly increases the risk of heart disease and stroke. Nearly 75 million Americans have high blood pressure. Many more are at risk of developing it.

People develop high blood pressure for many reasons. But eating too much sodium is a major contributor. Some of that sodium comes from the salt we add to our foods. But by far the greater problem is the amount of sodium already in the processed foods we commonly eat. We do have control over the foods we choose to eat. However, we do not have control over the amount of sodium in processed foods.

Companies and restaurants have been urged to reduce the sodium in their foods. But how good a job have they done?

It appears that not much has changed. A pair of research studies, out this week, remind us just how much sodium is in processed foods and restaurant meals. One study showed that the average single meal at a sit-down restaurant contains 2,269 mg of sodium. That's almost as much as the recommended sodium limit for an entire day for an average adult.

A second study looked at whether there have been any changes in how much sodium is in processed foods we buy or in the restaurant foods we order. The study looked at 402 processed foods and 78 fast-food restaurant items. Some foods had lower sodium content. But overall there had been no significant change when comparing average sodium content in foods in 2005 to foods in 2011.

What Changes Can I Make Now?

The first step is to try to limit how much sodium you are eating. You have the power to choose what you eat. Here are some tips:

1. Pay attention to how much sodium is in the food you buy. Check the labels. Make note of how many servings are in the package. Most labels indicate how much sodium is in one serving. If you eat the whole package, you need to multiply the amount of sodium by the number of servings you have. It's much harder to know how much sodium is in a restaurant meal. But many chain restaurants are now making the nutrition information for their foods available. Take a look. You might be shocked at what you find.
2. Cook your own food. Much of the sodium in our diets comes from processed and pre-prepared foods. If you make your food yourself, from fresh ingredients, you will automatically cut down your sodium intake. Of course, this is hard, especially in our fast-paced lives, but it's well worth the effort.
3. Don't be fooled by "low fat" or "low cholesterol" on the labels. Some packages say "low fat," some say "low cholesterol" and some say "low salt." But most foods don't have all of these in one. Remember that a food that's good for you in one way may not be good for you in another. Even those foods that are labeled as "low salt" may still have more sodium than you need. Read the labels carefully.

What Can I Expect Looking to the Future?

There is no debate that Americans have too much sodium in their diets. It is well-recognized that higher levels of dietary sodium intake are linked to higher rates of heart disease and stroke. Yes, people do need to take responsibility for the foods they eat. But the food industry also needs to take responsibility by reducing the sodium in processed foods.

It seems that allowing food manufacturers and restaurants to voluntarily reduce sodium has not been successful. In the future, the government may require companies and restaurants to lower sodium levels in foods.

In the meantime, there is much we can do to reduce the sodium we consume. We can pay attention to labels, focus on eating fresh fruits and vegetables, and cook our own food. Otherwise, we will see the consequences of our high-sodium diets in the next decades with an increase in the rates of high blood pressure, heart disease and stroke.