Nutrition Notes: Sodium and Blood Pressure: What's the Target?

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By Karen Collins, MS, RD, CDN - 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.

Washington, D.C. - infoZine - American Institute for Cancer Research - 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.

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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