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Salt & Sodium: The Real Danger

September 23, 2015

We all know that consuming too much salt isn’t good for your health. But just how much of it people with certain chronic conditions should consume is currently the subject of much debate.

As a registered dietitian, I know the nutritional advice we share today may change tomorrow. It’s happened recently, with the transition from low fat to unsaturated fat foods. This change took years, with documented and repeated research to support the recommendations.

Today, several longstanding nutrition mantras are being tested, one of which is sodium. Americans are well versed in the fact that sodium has a negative impact on blood pressure and heart disease risk. But in 2013, a report from the Institute of Medicine (IOM) challenged existing nutritional guidelines about sodium.

The IOM is a nonprofit organization that works outside of the government to provide evidence-based research and recommendations for public health. The IOM reviewed sodium guidelines and supported the fact that lowering sodium from the current intake reduces the risk of high blood pressure, heart disease and stroke.

But the report did note that there wasn’t enough evidence to recommend lowering sodium to 1500 mg/day for people with diabetes, kidney disease and heart disease as recommended in the 2010 dietary guidelines.

The American Heart Association has argued in support of the 2010 dietary guidelines. It contends that some of the data used by the IOM to evaluate sodium levels were flawed.

The disagreement is not whether sodium increases the risk for high blood pressure and cardiovascular disease, but whether a lower amount of sodium is necessary for special populations.  

While the disagreement still exists, the following facts about salt support the notion that less is better:

  • Excessive salt consumption and low levels of potassium may lead to heart and brain complications.
  • Experts say 2.5 million deaths could be prevented every year if people reduced their salt intake to the recommended level or below. 
  • The majority (75%) of the sodium we eat comes from processed foods.
  • Table salt is 40% sodium and 60% chloride. 1 teaspoon salt has about 2300 mg of sodium—an entire days’ worth!
  • Foods can have high salt content and not even taste salty. Salt is hidden in foods that you might not expect, including salad dressings, cheeses, pasta sauces, breads, tomato juices, and condiments.  
  • It doesn’t matter what type of salt you use. Sea salt and table salt also contain high levels of sodium.
  • Experimenting with herbs and spices can help change your taste for salt. Try fresh garlic or garlic powder, lemon juice, flavored vinegar, salt-free herb blends, cumin, nutmeg, cinnamon, fresh ground pepper, tarragon, oregano to name a few.
With this in mind, stick to the nutritional guidelines of less than 2,300mg of sodium a day (or even less than this if you have diabetes, high blood pressure, kidney or heart disease).

If you want to lower your sodium intake, here are some alternatives to try:

Home Made Salt Substitute


  • 2 tablespoons black pepper
  • 1 tablespoon cayenne pepper
  • 1 tablespoon paprika
  • 1 tablespoon onion powder
  • 1 tablespoon garlic powder
  • 1 bay leaf, ground
Herbal Salt Substitute


  • 1 tablespoon dried basil
  • 1 tablespoon dried thyme
  • 1 tablespoon ground coriander
  • 2 teaspoons onion powder
  • 2 teaspoons dried parsley flakes
  • 2 teaspoons ground cumin
  • 1 teaspoon garlic powder
  • 1 teaspoon ground mustard
  • 1 teaspoon cayenne pepper
  • 1 teaspoon paprika
As Americans, we eat way too much sodium from processed foods. Healthy adults should limit sodium intake to the recommended guidelines, yet we greatly exceed this limit by consuming over 3,000 mg daily. To maintain the best possible health and reduce the risks of sodium complications, it is critical to lower that amount. Using substitutes and forgoing salt whenever possible are excellent first steps toward living healthier.

Adults with high blood pressure, congestive heart failure, liver cirrhosis and kidney disease should consult with their healthcare provider to see if a lower sodium level is appropriate and warranted.