Nearly half of Americans’ sodium consumption can be traced to 10 types of foods, according to data from the Centers for Disease Control and Prevention published Feb. 7 in the CDC’s Morbidity and Mortality Weekly Report.
The top 10 sources, which account for 44% of sodium consumption in Americans over age 2 years, are white bread and rolls; lunch meats, including deli turkey and ham; pizza (frozen or restaurant); poultry; soups; sandwiches; cheese; meat dishes; pasta dishes: and salty snack foods such as potato chips, pretzels, and popcorn.
Some 90% of Americans eat too much sodium, which increases their risk for developing high blood pressure, which in turn can increase the risk for heart disease and stroke, CDC Director Dr. Thomas R. Frieden said in a media telebriefing.
"One of the things that is driving our blood pressure up is that most of the adults in this country eat or drink twice the amount of sodium that is recommended," Dr. Frieden said. Most of that comes from sodium already present in food, not what is added at the table, he noted.
According to the CDC report, the average American older than 2 years consumes 3,300 mg of sodium daily from food alone, not including any salt added at the table. The U.S. Dietary Guidelines recommendation is less than 2,300 mg/day, and only 1,500 mg/day for individuals at increased risk for heart disease and stroke: adults aged 51 years and older; individuals with high blood pressure, diabetes, or chronic kidney disease; and African Americans.
Foods that seem nutritious may have high levels of sodium, such as cottage cheese or turkey breast from a deli.
"Potato chips, pretzels, and popcorn only account for about 3% of sodium consumption," Dr. Frieden said.
Overall, 65% of Americans’ sodium intake comes from food sold in grocery stores and 25% comes from restaurant foods, he said.
Cutting back on sodium is a challenge because it is present in so many processed foods and restaurant foods, said Dr. Frieden. However, the sodium content of processed foods can vary widely by brand, so simply reading the labels and comparing products is an easy way to cut down on sodium. The sodium in a single piece of pizza can vary as much as two or three times, depending on the brand, he said. Eating more fresh or frozen fruits and vegetables (without sauces) can curb sodium consumption, as can preparing more food at home instead of eating out or eating processed foods, he said.
Physicians can play an important role in helping everyone reduce their sodium intake, especially those at increased risk for heart disease and stroke.
"Physicians can work with nutritionists and other health professionals to help patients understand what the sources of sodium are in their own diets," Dr. Frieden explained. "They may be surprised to find that their breakfast cereal contains the equivalent of 8-10 shakes of salt," he said.
Individuals may find options for cereals, meals, and snacks that contain much less sodium and taste just as good, said Dr. Frieden. "We encourage salting to taste," by adding minimal salt at the table rather than consuming products that are already high in salt, and by using alternatives to salt to flavor food, he said. "There are plenty of spices other than sodium that can make food taste great," he added.
Some companies are already working to gradually reduce the salt in processed foods. A report issued last year by the Institute of Medicine recommended that food manufacturers gradually reduce the amount of sodium in their products.
This process will take time, but the goal is to improve consumer choices, said Dr. Frieden.
"The bottom line is that heart disease and stroke are leading causes of health care spending in this country, and it is possible to reduce that by reducing the sodium in our diets," Dr. Frieden emphasized.
"We can substantially reduce sodium intake, save lives, and save money," he said.
The data were taken from "What We Eat in America," part of the national Health and Nutrition Examination Survey, 2007-2008.
For guidance on a low-sodium eating plan, visit the National Institutes of Health’s website for the DASH diet.