With nearly half of adults in the U.S. living with high blood pressure, a preventable risk factor for cardiovascular disease and stroke, let's consider something that contributes to the problem during people's formative years. According to the Center for Disease Control and Prevention, a staggering 9 in 10 children consume more sodium than recommended! Learn simple things you can do to help below.
February is Heart Disease Awareness Month so let's turn our attention to one of the frequent causes for high blood pressure (hypertension), a common risk factor for cardiovascular disease and stroke. Namely, dietary sodium from salt!
And if we pull at this loose thread, we find an overwhelming amount of children and adolescents, a shocking 90%, are eating too much sodium daily! (1) We also know that the dietary patterns that develop during these ages are what young people tend to carry on through adulthood. So by doing a better job with the nutrition of our youth, we are likely setting them up for better health outcomes for years to come!
Sodium vs. Salt: Understanding the Key Differences and Their Impact on Health
Many people use the words "sodium" and "salt" interchangeably, but they are not the same. Salt—commonly known as table salt—is a chemical compound consisting of sodium and chloride. While sodium is an essential nutrient, consuming too much can have significant health effects. Understanding the difference between sodium and salt is crucial, especially since their recommended daily allowances are not identical.
The Hidden Sources of Sodium
Salt is a staple in our diets, enhancing the flavor of food and serving as a key preservative in processed and canned products. However, sodium isn't just found in table salt; it appears in many other food additives used in manufacturing, such as:
Monosodium glutamate (MSG) – A flavor enhancer often found in fast food and snacks.
Sodium bicarbonate (baking soda) – Used in baking and some processed foods.
Sodium benzoate – A common preservative in soft drinks and packaged goods.
Many processed foods contain high amounts of sodium—even those that don’t necessarily taste salty. For example, items like bread, cereals, pastries, and fast food often have significant sodium levels, making it difficult to gauge intake based on taste alone.
Reading Nutrition Labels: The Key to Sodium Awareness
To make informed dietary choices, it's important to read nutrition labels carefully. Found on the back of food packaging, these labels list calories, macronutrients, and sodium content based on a specific serving size—usually one serving or 100 grams, not necessarily the entire package.
Low sodium = Less than 140 mg per serving
High sodium = More than 400 mg per serving (3)
By paying attention to these labels, consumers can make smarter choices and better control their sodium intake.
Within the U.S. diet, the average person consumes salt:
From processed and prepared foods — 77%
From natural sources — 12%
Adding while eating — 6%
Adding during cooking — 5%
One teaspoon of salt equals 2,300 milligrams of sodium.
Daily recommended sodium intake guidelines for children and adolescents are:
Ages 1–3 — Less than 1,200 milligrams
Ages 4–8 — Less than 1,500 milligrams
Ages 9–13 — Less than 1,800 milligrams
Ages 14–18 — 2,300 milligrams
One fast food kid's meal can easily exceed 1,500 milligrams of sodium.
***A good rule of thumb: 500mg of salt = 1/4 tsp***
Concerning statistics:
According to the 2015-2016 National Health and Nutrition Examination Survey:
Of surveyed children and adolescents, 90% exceeded the recommended sodium level for their age.
The average sodium intake was 3,393 milligrams per day, with a range of 2,000–5,000 milligrams per day.
High school-aged students consumed roughly 400–800 milligrams more than younger school-aged kids.
50% of sodium intake came from pizza, Mexican dishes, sandwiches — including burgers — cold cuts, soups, snacks and cheese.
Girls consumed significantly less sodium than boys.
Of total daily sodium consumption, 58% came from store-bought foods, 16% from fast food/restaurants and 10% from school cafeterias.
The Link Between Salt Intake, Weight Gain and High Blood Pressure
Research suggests that people who consume high-salt diets are more likely to experience weight gain compared to those with lower salt consumption. This is due to two main factors:
High-sodium foods are often high in calories and fat, contributing to increased energy intake.
Salt enhances the flavor of food, making it more appealing, which can lead to overeating.
This relationship between salt intake and obesity highlights the importance of monitoring sodium consumption—not just for heart health, but also for maintaining a healthy weight.
According to the World Health Organization (WHO), excessive sodium intake is defined as more than 2 grams of sodium (or more than 5 grams of sodium chloride) per day. Research has consistently shown that a high-salt diet is directly linked to high blood pressure —the more salt consumed, the higher the systolic blood pressure.
Beyond increasing blood pressure, excessive sodium intake has been found to:
Disrupt the natural nocturnal blood pressure dip, preventing the body from resting properly.
Increase daytime heart rate, putting extra strain on the cardiovascular system.
On the flip side, reducing dietary sodium intake not only lowers blood pressure but also decreases the risk of heart disease, stroke, and other cardiovascular complications.
Salty Science: How Excess Salt Contributes to Hypertension
Several biological mechanisms explain how a high-sodium diet leads to elevated blood pressure and heart disease:
1. Water Retention and Increased Circulating Volume
The classic Guytonian theory explains that high salt intake leads to water retention, which expands blood volume, increases cardiac output, and raises kidney perfusion pressure. This triggers the pressure-natriuresis mechanism, where the kidneys attempt to restore fluid balance by excreting excess sodium. However, when the kidneys' ability to excrete sodium is impaired, hypertension may develop. (6)
Interestingly, some studies suggest that salt-sensitive individuals may retain sodium without water retention due to non-osmotic sodium storage, further contributing to high blood pressure.
2. Increased Resistance in Small Arteries
Excess sodium can remodel small resistant arteries, making them stiffer and narrower, which increases vascular resistance and raises blood pressure. Even individuals with normal blood pressure (normotensive) may develop hypertension over time if they are salt-sensitive. (6)
3. Endothelial Dysfunction and Reduced Nitric Oxide (NO) Production
The endothelium (the inner lining of blood vessels) relies on nitric oxide (NO) to promote vascular relaxation. However, high salt intake reduces NO levels, leading to:
Increased blood pressure due to reduced vessel dilation.
Blood pressure-independent cardiovascular damage, increasing the risk of heart disease.
4. Structural Changes in Large Arteries
High salt intake affects large elastic arteries, leading to increased vascular stiffness. Stiffer arteries make it harder for blood to flow efficiently, raising the risk of hypertension and cardiovascular events.
5. Increased Sympathetic Nervous System Activity
Excess sodium can also stimulate the sympathetic nervous system, which controls heart rate and blood vessel constriction. This increased activity raises blood pressure and can contribute to long-term cardiovascular strain.
Action Steps
Since a significant portion of sodium consumption comes from processed and restaurant foods, reducing sodium levels in the overall food supply could greatly decrease intake among children, teens, and adults.
Preparing meals at home is another effective way to cut down on sodium, especially by using herbs and spices as flavorful alternatives. Checking nutrition labels on packaged foods—such as boxed, bagged, and canned items—is essential. Aim for products with less than 140–200 milligrams of sodium per serving, and try to limit each meal to just one processed item. Finally, involving children in grocery shopping, cooking, and mealtime not only fosters healthier eating habits but also allows parents and guardians to set a positive example for lifelong nutrition choices.
While salt is an essential part of our diets, moderation is key. Understanding the difference between sodium and salt, recognizing hidden sources of sodium, and reading nutrition labels can help individuals make healthier choices. By being mindful of sodium intake, you can take an important step toward better overall health and well-being.
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References
1. Center for Disease Control and Prevention. Vital Signs: Reducing Sodium in Children’s Diets.
U.S. Food & Drug Administration. Sodium in Your Diet. https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet
University of California San Francisco. Guidelines for a Low Sodium Diet. https://www.ucsfhealth.org/education/guidelines-for-a-low-sodium-diet
*image credits Center for Disease Control and Prevention. Vital Signs: Reducing Sodium in Children’s Diets. https://archive.cdc.gov/www_cdc_gov/vitalsigns/children-sodium
Center for Disease Control and Prevention. National Center for Health Statistics (NCHS), Division of Health and Nutrition Examination Surveys (DHANES). 2015-2016
Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G. Sodium Intake and Hypertension. Nutrients. 2019;11:1970. https://pubmed.ncbi.nlm.nih.gov/31438636
The content and any recommendations in this article are for informational purposes only. They are not intended to replace the advice of the reader's own licensed healthcare professional or physician and are not intended to be taken as direct diagnostic or treatment directives. Any treatments described in this article may have known and unknown side effects and/or health hazards. Each reader is solely responsible for his or her own healthcare choices and decisions. The author advises the reader to discuss these ideas with a licensed naturopathic physician.
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