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Is advice on salt intake realistic?

Editor’s note: This column by Jennifer Motl will appear in Sunday’s Healthy Living section (March 18, 2012).

BY JENNIFER MOTL

Finally, some scientists are saying aloud what many dietitians have been grumbling about for years: Government recommendations for most American adults to cut sodium intake to 1,500 milligrams are unrealistic.

The government allows that it’s fine for young adults and athletes to get 2,300 milligrams, but insists that anyone over 50—or who is African–American or who has high blood pressure, diabetes or kidney disease—limits sodium to 1,500 milligrams. That covers 60 percent of adults.

Some scientists now say that to limit sodium that much, you’d be on a diet of fruit, nuts, and seeds! Becoming a fruitarian sounds extreme to me, but I do think the limits are extremely difficult to follow.

WHY WORRY?

I understand the point of reducing sodium—getting less of it can prevent high blood pressure and related problems such as strokes, heart attacks, heart failure and kidney failure.

And I agree that we currently consume too much sodium—well over 3,000 milligrams a day. I’m on board with my cardiologist friends who want to keep people healthy and energetic—and eating less salt is truly helpful.

Yet to eat enough food to feel full—2,000 calories worth of food for the average person—and still limit sodium to 1,500 milligrams a day, you’d have to be highly motivated.

This goes beyond choosing low-sodium soup. You’d also have to eliminate cheese, all lunch meats, most salad dressings and sauces, and most packaged snack foods. You could not use any salt whatsoever, nor salty condiments such as ketchup or soy sauce.

You’d even have to limit bread and cereals, milk, meat, chicken and fish. For example, a slice of bread, a cup of milk or a modest, 3-ounce serving of meat, chicken, or fish has 150 to 180 milligrams of sodium.

There are only 10 milligrams of sodium in one-half cup of these foods: fruits, vegetables, dry beans, rice, oatmeal, pasta, or unsalted nuts. But even though these foods are relatively low in sodium, it still adds up.

WHAT’S LEFT TO EAT?

If you want to be really strict and meet not just the government guidelines for sodium and calories, but also for carbohydrates, protein, fats, most vitamins, minerals and fiber, you’d have to give up just about everything, according to two scientists at University of Washington.

They say you’d be eating mostly fruits, nuts and seeds to meet the guidelines—very little meats or grains would be allowed. That would be a shock for most Americans. And while I like to shake things up once in a while, I think this is too radical for most people.

The Washington researchers included Matthieu Maillot and the well-known food and obesity researcher Adam Drewnowski. The pair analyzed diet patterns to meet guidelines for 27 nutrients; men and women of different ages require different amounts.

The researchers said it was impossible for folks under 50 to get all the nutrients they need and still limit sodium to 1,500 milligrams. The scientists did say that it’s feasible to meet less stringent restrictions of 2,300 milligrams of sodium daily with more familiar foods.

EXPERIMENTAL MENUS

I set out to test myself—is it really that hard to follow guidelines for good eating and limit sodium to 1,500 milligrams?

The government’s 2010 dietary guidelines for Americans has a 2,000-calorie meal plan: 2.5 cups of veggies, 2 cups of fruit, 6 ounces of grains, 3 cups of milk, 1.8 ounces of meat, 1.5 ounces of poultry, 0.4 ounces of eggs, 1.2 ounces of fish/seafood, 0.6 ounces of nuts/seeds, and up to 79 grams added sugars.

Following that dietary guidelines pattern, I plugged in actual foods to create a menu. For simplicity’s sake, I combined some of the protein foods together as most people won’t eat beef, chicken, eggs, and fish all on the same day, and these foods have similar amounts of sodium.

Here’s the sample menu:

Breakfast: 1 cup  of cooked oatmeal topped with cinnamon, 0.6 ounces of walnuts,  1/4 cup raisins, and 1 cup of milk.

Lunch: A sandwich with 2 slices of whole grain bread and 2.7 ounces of homemade roasted turkey breast, 2 leaves of lettuce and 2 slices of tomato; on the side,  3/4 cup cooked carrots,  1/4 cup peas, 1 pear, 1 cup of milk.

Dinner: 2 whole-grain rolls, 2 teaspoons of unsalted butter,  3/4 cup  baked sweet potatoes,  1/2 cup steamed cauliflower, 2.2 ounces of broiled salmon with lemon juice, 1 cup of low-fat milk, 1 cup of fresh strawberries.

Dessert: 1 ounce of semisweet chocolate.

I used a computer program to analyze the menu—and sure enough, despite being composed of fresh foods, it still may provide “too much” sodium.

I used two online programs to analyze the menu—the Nutrient Analysis Tool Version 2 at myfoodrecord.com calculated 1,200 milligrams of sodium, but the federal government’s own MyPyramidTracker.gov site calculated 3,000 milligrams.

Those are radically different answers, so I averaged the two for a total of 2,100 milligrams of sodium. That’s over the government’s limit, even though the foods in the menu don’t contain added salt.

If a menu based on the government’s own dietary guidelines has more than 1,500 milligrams of sodium, how can they expect regular citizens to eat much better?

WHAT YOU CAN DO

Rather than getting too hung up on the numbers, especially since  there are discrepancies in how they’re calculated, I think it’s most important to concentrate on choosing fresh, unprocessed foods to eat.

Most fruits, veggies, beans and nuts are naturally lowest in sodium, so eat them with abandon. Try not to overdo milk, meats and breads. And of course avoid obvious salt traps such as chips, regular canned soups and the like.

Setting sodium limits impossibly low may frustrate folks—if they don’t succeed, they may give up. And that could be harmful. After counseling people with heart failure who feel better when they reduce sodium intake, I truly believe sodium limits can be helpful. The question is how low should the limits be?

If you’re watching your sodium intake, choose fresh fish, poultry, fruits and veggies. Packaged foods such TV dinners and canned soups and veggies tend to be high in sodium, as are most restaurant meals, so watch out for those. And if a food comes with a label, read it.

Jennifer Motl welcomes reader questions via her website, brighteat ing.com, or by email at healthyliving@freelancestar.com.

 

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