SPECIAL FROM Next Avenue
We all know that consuming too much salt is bad for us — but mounting scientific evidence indicates it's even worse than we thought. More people in midlife and beyond are starting to get serious about slashing their salt intake to ward off heart disease and other life-threatening conditions. But they face an uphill climb.
Adults in the United States consume an average of 3,400 mg of sodium a day, more than double the 1,500 that the American Heart Association recommends. All that excess sodium contributes to high blood pressure, heart attacks and an increased risk of stroke, osteoporosis, stomach cancer and kidney disease.
Salt can also be bad for your bones. A study presented by Japanese researchers last month at the Endocrine Society's annual meeting in San Francisco found that a diet too high in salt can increase a postmenopausal woman's risk of breaking a bone, particularly a hip, regardless of her bone density. Older women in the study with the highest concentration of sodium in their diets appeared to be at least four times more likely to suffer fractures than women with the most modest consumption. (The study took place in Japan, where the average daily sodium consumption of nearly 4,000 mg is even higher than in the U.S.)
A separate study, directed by Harvard and Yale medical school researchers and published in the journal Nature in March, found that excessive salt in the body may also stimulate aggressive cells that trigger autoimmune diseases like multiple sclerosis and psoriasis. The study was inspired by the observation that eating fast-food appeared to boost production of inflammatory cells that could attack healthy tissue.
In a subsequent study of mice, the research team found adding salt to the animals' diet sparked production of a type of T cell associated with autoimmune diseases. The mice eating the high-salt diet were also prone to developing a more severe type of MS than others.
If Americans were to cut their average sodium intake to 1,500 mg a day, the heart association estimates, the result would be a nearly 26 percent decrease in high blood pressure and a savings of more than $26 billion in annual health care costs.
How Can You Cut the Salt?
Salt i's everywhere in our diet, especially in processed and frozen-food products. Further, nutritionists believe that a drastic cold-turkey reduction, unless mandated by a medical condition, is unlikely to succeed. Most people slide back into old habits after attempting a radical change in diet. The best approach: gradual, reasonable steps toward a new, healthier regimen. Consider starting with these five steps to reduce your salt intake.
1. Rethink breakfast cereal Yes, the whole grains can be a healthy choice, but many varieties still contain as much as 150 mg (or more) of sodium in a single cup.
Sodium is added to cereals, especially so-called "healthy" ones, to make them more palatable, says Amanda Gilley, a registered dietician and chef at LifeBridge Health & Fitness in Baltimore. "In fact, many products that market themselves as healthy or low-fat typically have extra sodium and sugar to help boost the taste."
As Pulitzer Prize–winning investigative reporter Michael Moss of the New York Times revealed in his book, Salt Sugar Fat: How the Food Giants Hooked Us, food companies often up the salt or sugar in their products when they reduce the fat, hoping consumers focused on low-fat items won't notice.
Swap cereal for oatmeal made with steel-cut oats. If you like, top it with fresh blueberries. This way, there's virtually no sodium in your bowl, making it a healthy way to start the day.
2. Simplify boiling water Most home cooks habitually add a dash of salt to the water they boil for pasta because it increases the boiling point and helps bring about a faster roll to the water. But that dash can have as much as 200 mg of sodium, says Gilley, who advises skipping that step going forward.
And don't worry about the pasta: Thanks to power burners and more efficient heating elements on cook tops and stoves, water usually boils in a few short minutes, so the added boost given by sodium is no longer needed. Salt is also thought to reduce pasta's stickiness, but stirring the pot provides the same service, as does a drop of fresh lemon juice, which will not affect the pasta's flavor.
Even better, Gilley says, cover your dish with a homemade sauce — from a recipe that doesn't call for added salt — instead of opening a sodium-laden store-bought bottle. "If time is of the essence," she says, "look for a low-sodium tomato sauce, but stay away from brands that are labeled 'reduced sodium' as these still contain a significant amount."
3. Drop the pizza Once and for all, we need to classify pizza as junk food and not a valid meal, says Mary Hartley, a registered dietician and nutritionist in Brooklyn, N.Y. Two slices of a 14-inch pepperoni pizza can have upwards of 1,280 mgs of salt, depending on the type and volume of sauce and topping. "A Big Mac with medium fries has 1,310 milligrams of sodium," she says, "but many still think of pizza as being a healthier option."
Can't imagine a life without slices? That's fine, Hartley says. Just make it yourself instead of ordering in. Make your crust from a low-sodium recipe — supermarket kits are loaded with salt. Use fresh vegetables like sliced tomato, green peppers and broccoli for toppings instead of sodium-filled meats like pepperoni or sausage. To spice it up, deploy fresh basil and garlic or a dash of oregano and, of course, use low-sodium cheese.
4. Use kosher salt Substituting this larger, coarser-grained salt for fine table salt can quickly slash your sodium consumption by 20 percent because its shape and texture give it less sodium by volume. (Sea salt provides the same benefit, but only if you use a coarse-grained variety). Standard table salt delivers 590 mg of sodium per quarter-teaspoon, whereas kosher salt has 480.
"Better yet, instead of salting food during cooking," Hartley says, "just add a few grains of kosher salt to your food at the table to get a pungent burst of flavor with much less sodium."
Or skip the salt altogether and use lower-sodium flavor enhancers like black pepper and turmeric; fresh basil and dried herbs; olive oil, lemon juice, wine and vinegar; or roots such as garlic and ginger.
5. Beware the chicken We often consider turkey and chicken healthy alternatives to red meat, but we should also be aware of their potentially high sodium content, which can be traced to the saltwater solution producers typically inject into poultry during processing. "This adds flavor and weight to the meat, and it plumps up the poultry," says Steve Hoad of Emma's Family Farm in Windsor, Maine, "although we process birds without salt or water added and they still taste very good."
While boneless, skinless chicken breast not treated with saltwater typically carries 50 to 75 mg of sodium per 4-ounce serving, Hartley says, "enhanced chicken often delivers over 400 milligrams of sodium per serving."
About a third of the fresh chicken found in supermarket cases has been synthetically saturated with saltwater, Hartley says. To spot (and avoid) the affected poultry, you've got to read the labels very carefully. Look for the phrase "Enhanced with up to 15 percent chicken broth" within the package's fine print, she advises, and be aware that poultry enhanced with saltwater can still be called "all natural" if the ingredients in the solution meet the U.S. Department of Agriculture's definition of "natural."
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