Heart Disease

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Shake the Salt Habit


Cut your heart attack risk with one small change

By Meg Walker


Updated March 30, 2015


Matters of the heart are rarely simple. But one thing is clear: to lower your risk of heart disease and heart attack, cut back on salt. Americans — from teens to adults — consume too much salt in their diet, putting them at risk for high blood pressure and heart disease, according to recent studies.

Despite evidence linking salt intake to these serious cardiovascular issues, salt consumption among Americans has risen by 50% and blood pressure has risen by nearly the same amount since the 1970s, according to the American Heart Association.

A series of recent studies from academic researchers and the Institute of Medicine (IOM), an independent nonprofit organization that is the health arm of the National Academy of Sciences, have highlighted the poor outcomes of a salty diet, and urged Americans to shake the salt habit to improve their health.

"A very modest decrease in the amount of salt — hardly detectable in the taste of food — can have dramatic health benefits for the US," says Kirsten Bibbins-Domingo, MD, PhD, an associate professor of medicine and epidemiology at the University of California San Francisco (UCSF), and lead author of two studies on dietary reductions in salt.

If Americans cut their daily salt intake by 3 grams, or half a teaspoon, nearly 100,000 heart attacks and 92,000 deaths could be prevented each year, adding up to a savings of about $24 billion in anuual healthcare costs, according to a study issued in January 2010 by a team including UCSF's Bibbins-Domingo and researchers from Stanford University Medical Center and Columbia University Medical Center.

Current guidelines set an upper limit of 2,300 milligrams of sodium a day. But recommendations from the American Heart Association set a stricter limit of 1,500 milligrams daily for people with high blood pressure, middle-aged and older adults, and African Americans, who are particularly sensitive to the effects of salt. This is equal to the IOM's recommended adequate intake of sodium — the amount the average healthy person needs each day; people over 50 need even less, according to the IOM.

On average, Americans consume more than 3,400 milligram of sodium daily, about 1.5 teaspoons of salt, according to the Centers for Disease Control and Prevention. The recommended maximum daily intake of sodium — the amount above which health problems appear — is 2,300 milligrams per day for adults, or the equivalent of about 1 teaspoon of salt. 

A second study conducted by Bibbins-Domingo showed that teenagers eat more salt each day than any other age group, consuming more than 9 grams of salt (3,800 milligrams of sodium) daily, with most of that coming from processed foods. For teens, the biggest culprit when it comes to salt intake is pizza. Adults also consume most of their dietary salt — or about 80% of their daily intake — from processed or prepared foods, including cereals, breads and pastries.

Though salt may not present immediate risks for healthy teens, it's important for them to choose foods with less salt now, says James Beckerman, MD, a cardiologist with Providence Heart & Vascular Institute in Portland, OR, and author of The Flex Diet. If teens similarly cut their consumption by 3 grams, or half a teaspoon, of dietary salt from processed foods, they can reduce their risk of high blood pressure, heart disease and stroke in adulthood.

"If they consume a lot of salt today, they are more likely to consume a lot of salt tomorrow," says Beckerman, "and their dietary pattern could continue that way into adulthood." As people age, they are at risk of elevated blood pressure, and people with high blood pressure are more sensitive to the effects of salt, Beckerman adds.

Beckerman says the message to reduce salt needs to be heard by parents. "Teens eat a lot of fast food and pizza, but the majority of their meals comes through their parents," he explains. "They help decide what's available for breakfast and lunch. We need to put out the message that a lower salt diet isn't just good for you, it's good for your kids."

The war on salt escalated again this year when the IOM issued a report in April calling on the US Food and Drug Administration (FDA) to use its regulatory powers to state that sodium above a certain level in supermarket and restaurant foods should be declared unsafe. The FDA acknowledged Americans eat too much salt, which can have a serious effect on health. It said it would continue to work with other federal agencies and the food industry on how to reduce sodium levels in the food supply. 

"We have a lot of work to do,'' Beckerman says. "We can make an impact on how much salt we use in cooking, but one of our choices should be to eat less processed food."

Salt is an acquired taste, so Beckerman suggests that by cutting back on salt gradually, you won't notice it's missing.

To achieve a low-salt diet:

  • Don't use the salt shaker.
  • Choose fresh, frozen or canned foods without added salt.
  • Select unsalted nuts or seeds, dried beans, peas and lentils.
  • Limit salty snacks like chips and pretzels.
  • Add salt sparingly to homemade dishes.
  • Learn to use spices and herbs such as basil and oregano to enhance the taste of your food.
  • Add fresh lemon juice instead of salt to fish and vegetables.
  • Specify how you want your food prepared when dining out. Ask for your dish to be prepared without salt.


Published November 24, 2010.


Reviewed by Joseph Sclafani, MD on April 13, 2015.