It is well documented that excessive salt (sodium chloride) intake can raise blood pressure. A recent study reported in the online edition of Circulation¹ postulates that eating too much salt over time may affect the lining of blood vessels and increase the likelihood of developing high blood pressure. High blood pressure, or hypertension, can contribute to heart disease, stroke, kidney failure, and blindness.

Blood Pressure

Blood pressure readings vary depending on several factors prior to the test so in order to diagnosis hypertension, a pattern of elevated readings should be documented. A person may test in a variety of different relaxed settings besides the physician’s office. It is best to have a blood pressure at or near 120 systolic over 80 diastolic. Prehypertension levels are 120-139 (systolic) over 80 -89 (diastolic). Hypertension is diagnosed when blood pressure consistently is at or greater than 140 over 90. To be medically diagnosed with hypertension a person should consult with their primary physician.

How much Salt do we need to consume?

The body only needs approximately 500 milligrams of sodium each day which equates to approximately ¼ teaspoon of salt.²

The 2010 Dietary Guidelines for Americans recommend the general population consume less than 2300 milligrams (approximately 1 teaspoon) of sodium per day.³ Yet, these same guidelines estimated the sodium intake of all Americans ages 2 years and older is approximately 3400 milligrams per day. In addition, the guidelines recommend that some groups of people should reduce their sodium intake further to 1500 milligrams per day. These groups include those individuals who: are 51 years or older; are African American; or have high blood pressure, diabetes, or chronic kidney disease.

Foods lower in sodium should be consumed more often and those foods higher in sodium should be only consumed sparingly. Below are some examples of foods lower and higher in sodium.⁴

Foods LOWER in Sodium

• Fresh non processed meats
  
• Fresh fish or rinsed canned fish such as salmon or tuna
  
• Canned foods packed in water
• Low sodium or reduced sodium cheeses
  
• Low salt or salt free chips, nuts, pretzels
  
• Plain rice, noodles, pasta
  
• Homemade, low sodium, or reduced sodium chips
  
• Fresh, frozen, “no salt added”, or rinsed canned vegetables
  
• Spices, herbs, and flavorings such as cilantro, dill, basil, parsley, garlic powder, onion powder, vinegar, chili

Foods HIGHER in Sodium

• Smoked and cured meats such as bacon, ham, sausage, hot dogs, and bologna
  
• Canned lunch meat, canned fish such as sardines (not rinsed)
  
• Canned foods packed in broth or salt
• Most cheeses
  
• Salty chips, crackers, nuts, and pretzels
  
• Quick cooking rice, boxes of mixed rice, potatoes, or noodles
  
• Regular canned soups or instant soups
  
• Regular canned vegetables, pickles, olives, and pickled vegetables
  
• Condiments and seasonings such as soy sauce, ketchup, garlic salt, seasoning salt, bouillon cubes, meat tenderizer, monosodium glutamate (MSG)

One of the best dietary approaches to maintaining or lowering blood pressure is to follow the Dietary Approaches to Stop Hypertension (DASH) eating plan.⁵ This plan consists of eating the following foods daily:

Food	Servings (on a 2000 Calorie diet)
Fruits	4-5
Vegetables	4-5
Low Fat or Non Fat Dairy	2-3
Beans/Nuts	4-5 per week
Lean Meat/Fish/Poultry	2 or less
Grains (at least 3 whole grains)	7-8
Fats/Sweets	Limited

In the original DASH trial, the DASH diet resulted in a significant reduction in blood pressure compared to the control diet, or the diet typical of what many Americans consume. This is an overall healthy eating plan that most people should consume regardless of blood pressure levels.

References:

¹Circulation. Online edition June 18, 2012. John P. Forman et al. Journal of the American Heart Association. Association between sodium intake and changes in Uric Acid, Urine Albumin Excretion, and the risk of developing Hypertension.
²U.S. Department of Health and Human Services. National Institutes of Health. Indian Health Service. Honoring the Gift of Health - Health Educator’s Manual for American Indians. November 2003.
³Dietary Guidalines for Americans, 2010. Relased January 31, 2011 and available at http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm.
⁴This list taken is from NIH Honoring the Gift of Heart Health Curriculum (see footnote 2)
⁵U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, National Institutes of Health, National Heart, Lung, and Blood Institute, NIH Publication No. 06-4082. Originally Printed 1998; Revised April 2006. Available at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf