Limit Sodium and Salt Intake

OVERVIEW

People of all ages require some amount of sodium, an essential mineral and electrolyte, in their bodies. The many everyday heart and muscular functions carried out by the body cannot be completed without a small amount of sodium. Sodium is also needed for nerve cell transmission and to keep bones strong. But, most people, including teens and young adults, consume far more sodium than the body requires. The problem is not only a result of the sodium obtained from the shaker on the table. Rather, it is a direct result the high amounts of sodium frequently found in prepared and processed foods.

WHAT THE EXPERTS SAY

There Is an Association between Sodium Intake and Blood Pressure Readings in U.S. Children and Adolescents

In a study published in 2012 in the journal Pediatrics, researchers based at the Centers for Disease Control and Prevention in Atlanta, Georgia, investigated the association between the intake of sodium and elevated levels of blood pressure in children and teens. They also reviewed the role that weight may play in this association. The cohort consisted of 6,235 children and adolescents between the ages of 8 and 18 years who participated in the National Health and Nutrition Examination Survey from 2003 to 2008. All of the subjects provided at least one 24-hour dietary recall at the examination center, and 91 percent provided a second recall during a telephone interview conducted 3 to 10 days later. During visits to the examination center, blood pressure measurements were taken up to three times. The researchers found that the study subjects consumed an average of 3,387 mg/day of sodium, and the average sodium intake appeared to increase with age. Thirty-seven percent of the subjects were either overweight or obese. Each 1,000 mg/day was associated with an increase in the systolic blood pressure (top blood pressure number). High sodium intake was also associated with the risk for pre-high blood pressure and high blood pressure. Sodium consumption was higher among males than among female subjects and higher among those of normal weight than among those who were overweight or obese. But, the high intake of sodium may affect overweight and obese children and adolescents more than those with normal weight, making them more at risk for pre-high blood pressure and high blood pressure. The researchers commented that “evidence-based interventions that help participants reduce their sodium intake, increase physical activity, and attain or maintain a healthy weight may help reduce the greater than expected prevalence of HBP [high blood pressure] and other cardiovascular disease risk factors among children and adolescents.” 1

There May Be an Independent Association between the Intake of Salt and Obesity

In a study published in 2015 in the journal Hypertension, researchers from the United Kingdom and China wanted to learn more about the association between the intake of salt and obesity. They used data obtained from the U.K. National Diet and Nutrition Survey 2008/2009 to 2011/2012 that included 458 children and 785 adults who had completed 24-hour urine collections. Energy intake was calculated from a four-day diary. The researchers found that salt intake was higher in people who are overweight or obese. In fact, a one gram/day increase in salt intake was associated with a 28 percent increase in the risk of obesity in children and a 26 percent increase in the risk of obesity in adults. Higher salt intake was also significantly related to higher body fat mass in children and adults. The researchers commented, “Salt intake is a potential risk factor for obesity independent of energy intake,” and that their findings have important public health implications. People trying to lose weight should reduce their intake of salt. “Salt reduction could also reduce obesity risk.” 2

People Are Consuming Excess Amounts of Salt

In a study published in 2015 in the journal Nutrients, researchers from China wanted to determine sources of dietary salt as well as quantify the actual amount of salt people were consuming. Nine hundred and three families, including 1,981 adults and 971 children, participated in a one-week salt estimation trial. The children were students in schools in urban and suburban Beijing. The researchers found that, on average, the daily dietary salt intake of family members in Beijing was 11 grams for children and teens and 15.2 grams for adults, and 10.2 grams for people 60 years and older. These amounts are at least twice the Word Health Organization’s recommendation of no more than 5 grams/day. Slightly over 60 percent of the salt was consumed at home; the remaining salt was consumed outside the home, specifically in cafeterias and restaurants. Suburban residents consumed more salt than urban residents, and men consumed more salt than women. The researchers concluded that “more targeted interventions aimed at altering domestic cooking habits and commercial cooking methods to use less salt should be undertaken to reduce the harm and risk posed by a high salt diet.” 3

BARRIERS AND PROBLEMS

Teens Tend to Obtain High Levels of Sodium from the Snacks They Eat, and That Is Associated with Elevated Blood Pressure 4

People May Be Confused by Sodium Information on Nutrition Labels

In a study published in 2015 in the journal Preventing Chronic Disease, researchers from the Centers for Disease Control and Prevention conducted an assessment of consumers’ use of sodium information on U.S. nutrition labels. The cohort consisted of 3,729 people aged 18 years or older who participated in two national cross-sectional mail panel surveys in 2010. The researchers determined that 19.3 percent of the respondents were confused about the amounts of sodium in the food that they were eating. Close to 60 percent of the respondents noted that the person who shops for their food purchases foods labeled low salt or low sodium, and, hoping to lower their intake of sodium, almost half reported checking labels for sodium content. Consumers with a high school education or less were more likely than college graduates to report that they were confused about sodium content on labels. Adults aged 71 years or older, non-Hispanic blacks, and people with diabetes were also more likely to be confused about sodium labeling. The researchers suggested that food manufacturers should produce food products that are lower in sodium and include low sodium information on the front of packages. “Doing so will offer greater choice and availability for the majority of consumers who want to buy low sodium products.” 5

Restaurant Meals May Contain High Amounts of Sodium 6

Many Children Appear to Prefer the Taste of Saltier Foods

In a study published in 2013 in the online journal PLoS ONE, researchers from France noted that there has been little research on the role that salt plays in the willingness of children to eat certain foods. The researchers recruited 75 children between the ages of 8 and 11 years to participate in five lunches in their school cafeteria. The green beans and pasta had two different amounts of added salt. The children’s intake of all lunch items was measured, and the children ranked the foods according to preferences and saltiness. While the primary reason the children ate was hunger, the second most important factor was the enjoyment of the food. And, the children preferred the food with more salt. A reduction in the salt content of green beans decreased their intake by 21 percent, and an increase in the salt content in pasta increased their intake by 24 percent. “Taking into account children’s preferences for salt … may lead to excessive added salt.” 7

NOTES

1. Q. Yang, Z. Zhang, E. V. Kuklina et al., “Sodium Intake and Blood Pressure Among US Children and Adolescents,” Pediatrics 130, no. 4 (2012): 611-19.

2. Yuan Ma, Feng J. He, and Graham A. MacGregor, “High Salt Intake: Independent Risk Factor for Obesity?” Hypertension 66, no. 4 (2015): 843-49.

3. Frang Zhao, Puhong Zhang, Lu Zhang et al., “Consumption and Sources of Dietary Sat in Family Members in Beijing,” Nutrients 7 (2015): 2719-30.

4. V. Ponzo, G.P. Ganzit, L. Soldati et al., “Blood Pressure and Sodium Intake from Snacks in Adolescents,” European Journal of Clinical Nutrition 69, no. 6 (2015): 681-86.

5. Jessica Lee Levings, Joyce Maalouf, Xin Tong, and May E. Cogswell, “Reported Use and Perceived Understanding of Sodium Information on US Nutrition Labels,” Preventing Chronic Disease 12 (2015): 140522.

6. Jessica Lee Levings and Janelle Peralez Gunn, “From Menu to Mouth: Opportunities for Sodium Reduction In Restaurants,” Preventing Chronic Disease 11 (2014): 130237.

7. Sofia Bouhlal, Claire Chabanet, Sylvie Issanchou, and Sophie Nicklaus, “Salt Content Impacts Food Preferences and Intake Amoung Children,” PLoS ONE 8, no. 1 (2013): e53971.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Bouhlal, Sofia, Claire Chabanet, Sylvie Issanchou, and Sophie Nicklaus. “Salt Content Impacts Food Preferences and Intake Among Children.” PLoS ONE 8, no. 1 (2013): e53971.

He, Feng J., Yangfeng Wu, Xiang-Xian Feng et al. “School Based Education Programme to Reduce Salt Intake in Children and Their Families (School-EduSalt): Custer Randomised Controlled Trial.” BMJ 350 (2015): h770.

Hoeft, Kristin S., Claudia Guerra, M. Judy Gonzalez-Vargas, and Judith C. Barer. “Rural Latino Caregivers’ Beliefs and Behaviors Around Their Children’s Salt Consumption.” Appetite 87 (2015): 1-9.

Levings, Jessica Lee, Joyce Maalouf, Xin Tong, and Mary E. Cogswell. “Reported Use and Perceived Understanding of Sodium Information on US Nutrition Labels.” Preventing Chronic Disease 12 (2015): 140522.

Levings, Jessica Lee, and Janelle Peralez Gunn. “From Menu to Mouth: Opportunities for Sodium Reduction in Restaurants.” Preventing Chronic Disease 11 (2014): 130237.

Ma, Yuan, Feng J. He, and Graham A. MacGregor. “High Salt Intake: Independent Risk Factor for Obesity?” Hypertension 66, no. 4 (2015): 843-49.

Ponzo, V., G. P. Ganzit, L. Soldati et al. “Blood Pressure and Sodium Intake from Snacks in Adolescents.” European Journal of Clinical Nutrition 69, no. 6 (2015): 681-86.

Yang, Q., Z. Zhang, E. V. Kuklina et al. “Sodium Intake and Blood Pressure Among US Children and Adolescents.” Pediatrics 130, no. 4 (2012): 611-19.

Zhao, Frang, Puhong Zhang, Lu Zhang et al. “Consumption and Sources of Dietary Salt in Family Members in Beijing.” Nutrients 7 (2015): 2719-30.

Web Site

American Heart Association. www.heart.org .

  This information is not a tool for self-diagnosis or a substitute for professional care.