The Truth About Salt and Your Health Why Potassium May Be the Antidote

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TABLE OF CONTENTS

Salt: What Should You Believe? .............................. 1

Salt Tips ............................. 3

Potassium Power ............... 4

Making It Add Up: A Sample Menu ................. 5

Salt: What Should You Believe?

A high salt intake and high blood pressure (hypertension) have been linked for many years, not only by scientific research but in the minds of many health-conscious people. However,

the furor about trans fat and carbs has moved salt way down on the list of our dietary villains. Only a few people (7%, according to one survey) ever bother to check labels for salt anymore.

As concern has faded, people have been eating more salt. Since the early 1980s, U.S. per capita salt intake has risen by about 50%. In large part, this is because Americans have turned increasingly toward takeout and restaurant meals, fast foods, prepared foods, and snacking. Low-sodium foods don’t sell well. Most packaged foods and restaurant meals are salty—not just at McDonald’s, but also elegant meals on white tablecloths. Portion sizes have increased dramatically, along with the prevalence of obesity and high blood pressure. No connection with salt intake, says the Salt Institute, which looks after the interests of this billion-dollar industry. But we think there is.

The U.S. Dietary Guidelines recommend an upper limit of 2,300 milligrams of sodium daily for young people, and no more than 1,500 milligrams for the middle-aged and older, for blacks (who are more prone to hypertension), and for people who already have hypertension. Table salt is actually 40% sodium and 60% chlorine. A teaspoon of salt contains about 2,300 milligrams of sodium, so 1,500 milligrams is only about two-thirds of a teaspoon. However, Americans consume, on average, about 3,400 milligrams of sodium a day, and many eat much more. Health Canada (the Canadian equivalent of the U.S. FDA) is in favor of limiting salt, too; its upper daily limit is also 2,300 milligrams.

The American Medical Association is campaigning to lower Amer-

The Truth About Salt And Your Health

And Why Potassium May Be the Antidote

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The Truth About Salt and Your Health



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In Finland, salt con-sumption has fallen by

one-third in 30 years—accompanied by a large

decrease in average blood pressure and a 75

to 80% decrease in deaths from strokes and heart disease. Is the salt

decrease responsible?

icans’ salt intake; for example, it wants restaurants and food manu-facturers to reduce salt levels voluntarily. It also wants the government to reclassify salt as a food additive so it can be regu-lated. The Salt Institute is fighting this, claiming health authorities are acting without solid evidence.

One thing is clear: A low-salt diet benefits many people with hypertension. But do other people need to cut back on salt?

What the Studies ShowMany large observational studies over the years have linked a high sodium intake to high blood pressure and increased deaths from heart attacks and strokes. For example, the Intersalt study looked at 10,000 people in 32 countries and concluded that high salt intake was directly related to hypertension and deaths from stroke. But according to critics, these big population studies do not prove much. Most relied on personal recall—people reported what they thought they ate, which may have been different from what they did eat.

It is much harder to dismiss the research on the DASH (Dietary Approaches to Stop Hypertension) diet, which consists of fruits, vegetables, and whole grains, plus small servings of meat and dairy. It also provides a lot of potassium, magnesium, and other minerals that help control blood pressure. DASH comes in two versions—one with 2,300 milligrams of sodium a day, the other with 1,500. Both diets lower blood pressure in healthy people, but most dramatically in those with hypertension. The lower-sodium version lowers blood pressure even more. If your blood pressure is normal, and you keep your sodium intake moderate, will that prevent hypertension? We have to admit that nobody knows for sure.

But think of this: A 2007 study in Progress in Cardiovascular Diseases from researchers at the University of Helsinki reports that thanks to consistent efforts in Finland, salt consumption has fallen by one-third in 30 years—accompanied by a large decrease in average blood pressure and a 75 to 80% decrease in deaths from strokes and heart disease. Is the salt decrease responsible? The pro-salt faction would say no, but we think it played a role. If you want to avoid cardiovas-cular disease, salt reduction is a very good bet.

Advice, and More AdviceHere’s what the salt industry advises: There’s no ironclad evidence a high salt intake is bad, so don’t worry. Eat what you want, and enjoy yourself. Help us make a lot of money out of salt.

Here’s our advice: Hypertension and heart disease are highly com-plex disorders. Nobody has yet pinned down a high salt intake as





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the chief or only villain. It may turn out that salt is just some kind of fellow-traveler. That is, salty foods like French fries, fast-food sandwiches, pizza, TV dinners, and canned soups are usually also high in calories and “bad” fats and low in nutrients. You get a lot of salt, but not much potassium, magnesium, or other nutrients that help keep blood pressure normal and that constitute healthy eating. What you can achieve by cutting down on salt is a better diet.

Bottom line: Everyone should try to consume no more than 2,300 milligrams of sodium a day. However, if you’re middle-aged or older, black, or have hypertension (that’s about 70% of the population), 1,500 milligrams is a better goal. In addition, if you have pre-hyper-tension (120/80 to 139/89), you should also aim for a maximum of 1,500 milligrams a day. If you don’t know your blood pressure, get it checked.

Fresh fruits, vegetables, whole grains, fish, and meats are naturally low in sodium. You don’t need to add lots of salt. But your salt shaker is the least of your worries. To really cut down on sodium, you’ll need to limit or avoid most processed foods and restaurant meals, or at least choose carefully among them, since they provide about three-quarters of the sodium consumed in this country. Most people can quickly get used to a lower-sodium diet by using pepper, herbs, spices, lemon juice, garlic, vinegar, and other flavoring

✓ Always read labels. Buy reduced-sodium products.

✓ Avoid highly processed foods. Pick a plain turkey breast or pork tenderloin rather than one packaged with a marinade or sauce.

✓ Beware of canned or packaged soups, broths, and stocks.

✓ Soy sauce, tamari sauce, and most sauces used in Asian cook-ing are salt bombs.

✓ Watch out for canned vegetable juices, usually very salty.

✓ Drain and rinse canned goods, such as beans, to remove most salt.

✓ If your food is being prepared to order, ask the server to ask the cook not to add salt.

✓ Reducing portion sizes also reduces sodium intake.

A Few Tips

Nobody has yet pinned down a high

salt intake as the chief or only villain behind

hypertension and heart disease. But

what you can achieve by cutting down on salt is a better diet.





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While Americans consume far too much

sodium, they get too little potassium (Canadians do only a little better).

That may be one reason why most people here

eventually develop high blood pressure.

agents. After a short time, you’ll begin to appreciate the flavors of foods, and salty things won’t taste as good.

Potassium Power

If sodium is a bad guy, then potassium is a good guy. While sodium is linked to hypertension, potassium helps lower blood pressure. Sodium tends to be found in junk food, while potassium is mostly found in very nutritious foods. In fact, a recent Canadian study sug-gested that a simple test for urinary potassium level (which closely follows dietary potassium intake) provides an accurate picture of how good someone’s diet is. It found that the higher the potassium level, the better the diet tends to be (accompanied by lower blood pressure and body weight as well). If other research confirms these findings, such a test would be a good way for doctors to assess their patients’ eating habits, always a tricky matter.

Like sodium, potassium helps control blood pressure, among other vital functions. While Americans consume far too much sodium, they get too little potassium (Canadians do only a little bet-ter). That may be one reason why most people here eventually develop high blood pressure. But in the developing world, where

If you knew that a meal at a restaurant contained a day’s worth of sodium, would you still order it? According to a report from the Cen-ter for Science in the Public Interest, which looked at complete meals at 17 chain restaurants, it’s actually very easy to get at least this much sodium.

For example, if you order the Buffalo Chicken Fajitas at Chili’s, with tortillas and condiments, you’ll get close to 7,000 milligrams of sodium. That’s three days worth of sodium for healthy people, who should limit their intake to 2,300 milligrams a day. And it’s close to five day’s worth for those who should limit sodium to 1,500 milligrams a day.

This is alarming news for anyone who frequents chain restaurants. Regularly consuming large amounts of sodium increases the lifetime risk of high blood pressure and other health problems. And a single large load of sodium can precipitate heart failure in some susceptible people. Children who eat a lot of sodium (and children’s meals were found to have as much as 2,400 milligrams) are also at risk for high blood pressure and early cardiovascular disease.

Salt Mines





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How can you possibly get 4,700

milligrams of potassium a day, as recommended?

Actually, potassium is found in many foods,

even tea and coffee. So it usually isn’t hard to

reach that goal, especially if your diet

is semi-vegetarian.

diets tend to be relatively rich in potassium and low in sodium, high blood pressure is nearly nonexistent. When people move from developing to industrialized countries, however, their blood pres-sure tends to rise, and the change in diet may be a factor in this.

A Mineral SeesawThe U.S. government recommends at least 4,700 milligrams of potassium a day—twice as much potassium as sodium. That’s what the anti-hypertension DASH diet provides. However, most Ameri-cans get only half that much potassium, and many consume less potassium than sodium.

An easy way to cut down on sodium is to choose more potassium-rich foods. As one mineral goes up in the diet, the other tends to go down. Vegetables (especially leafy greens and potatoes), bananas, citrus fruits, and beans are rich in potassium. Dairy products, fish, and nuts are also good sources. These foods help keep us healthy in other ways, too. Don’t take potassium supplements, unless your doc-tor has recommended them. Potassium supplements can supply dangerous amounts, resulting in abnormal heart rhythms; there’s little or no potassium in multivitamin/mineral pills. In any case, the beneficial effects appear to come mainly from the form of potassium found in foods, not the type in most supplements.

Keep in mind: Potassium is not great for everyone. People who have impaired kidney function or are taking certain medications may need to limit their intake in order to prevent potentially dan-gerous arrhythmias. This is especially true for those taking ACE inhibitors or potassium-sparing diuretics.

Potassium: Making It Add UpYou may have wondered, if you consume 1,500 to 2,000 calories a day, how can you possibly get 4,700 milligrams of potassium, as recommended? Actually, potassium is found in many foods, even tea and coffee. So it usually isn’t hard to reach 4,700 milligrams, especially if your diet is semi-vegetarian.

Obviously, if you are a man who consumes, say, 2,700 calories a day, the 4,700-milligram goal is easier. However, if you take in just 1,500 calories, it can be harder. Like most dietary guidelines for vitamins and minerals, this advice is one-size-fits-all. If you are small and consume relatively few calories, you probably need less potas-sium. In addition, sodium intake also affects potassium needs. Thus, if your diet is low in sodium, you may need less than 4,700 milli-grams of potassium.





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Below is a menu that provides 4,700 milligrams of potassium a day. Though we chose these foods only because of their potassium, all together they supply just 1,700 milligrams of sodium and 1,957 calories—even with a deli sandwich for lunch.

Food

Shredded wheat, 1 cupMilk, nonfat, 1 cupCantaloupe, cubed, 1/2 cupOrange juice, 6 ozCoffee, black, 6 oz

Banana

Sandwich (turkey, swiss, tomato, lettuce, mayo, on whole wheat)Baby carrots, 8Fig bar cookies, 2Iced tea, 8 oz, unsweetened

Almonds, unsalted, 1 ozRaisins, 1 ozMilk, nonfat, 1 cup

Baked salmon, 3 ozBrown rice, 1/2 cupTossed salad, low-fat dressingSpinach, cooked, 1/2 cupAngel food cake with strawberries, 1 sliceWine, red, 4 oz Coffee, decaf, black, 6 oz

Total

Calories

183 80 27 82 6

105 395

28 110 3

170 84 80

150 108 100 20 110 110 6

1,957

Potassium (mg)

248 380 215 375 85

490

500

190 66 88

210 200 380

257 42 350 420 140 125 85

4,846

meal

Breakfast

Snack

Lunch

Snack

Dinner

A Sample Daily Menu





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for consultation with a physician.

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The Truth About Salt and Your Health Why Potassium May Be the Antidote