How Much Sodium Do You Need?

You’ve probably heard before that we should cut back on how much sodium we are eating.


Sodium is an essential nutrient found naturally in many foods, ranging from meat to celery to beets to milk. It is also added to many packaged and prepared foods in the form of salt (sodium chloride) or baking soda (sodium bicarbonate). And of course, many of us add salt during cooking or with the salt shaker at our meals.


How much sodium do you need | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



While our body needs some sodium to maintain fluid balance and keep our muscles and nerves running smoothly, it is very difficult to eat too little sodium because it is found in so many everyday foods.


In fact, most Canadians can benefit from reducing salt intake. On average, Canadians eat 2760 mg/d of sodium - that’s almost double what we need!


Read on to learn about:




How much sodium do you need?


Did you know, Health Canada recommends an upper limit of 2300 mg of sodium daily. 1 teaspoon of salt is equal to 2300 mg of sodium | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian

Health Canada recommends that most Canadians consume only 1500 mg per day, with the upper limit set at 2300mg. 2300mg is approximately 1 teaspoon of table salt.


The World Health Organization, World Cancer Research Fund, Diabetes Canada and Hypertension Canada all recommend limiting sodium intake to less than 2000 mg per day.


How much sodium should we be eating? 1500 mg is the recommended sodium intake for most Canadian adults | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



What are the health benefits of reducing sodium intake?


Cutting back on sodium intake can help to reduce the risk of:


Hypertension (high blood pressure)

  • It has been estimated that over 30% of high blood pressure cases in Canada are due to high sodium intake.

  • For people who are already living with high blood pressure, cutting back on sodium intake not only lowers blood pressure directly, it can also enhance your body’s response to blood pressure medications

  • Specific to people with diabetes, high blood pressure further increases risk of both microvascular (retinopathy, nephropathy) and cardiovascular complications.

Heart disease

  • Via impact on blood pressure

  • High blood pressure can damage your arteries, which can lead to reduced flow of blood and oxygen to your heart.

Stroke

  • Via impact on blood pressure

  • High blood pressure can cause blood vessels in the brain to clog more easily or burst

Kidney failure

  • Via impact on blood pressure

  • High blood pressure can damage the arteries in our kidneys which interferes with the kidney’s ability to filter blood effectively. High blood pressure is one of the leading causes of kidney failure

Erectile dysfunction

  • Via impact on blood pressure

  • High blood pressure can damage blood vessels throughout the body.

Stomach cancer

  • High salt intake can increase risk of gastric (stomach) cancer by damaging the mucous lining of the stomach and by increasing risk of H pylori infection

Kidney stones

  • High sodium intake increases loss of calcium in your urine. Higher calcium content in your urine increases risk of developing calcium oxalate stones (the most common type of kidney stones).

Reduced bone density

  • Some studies have shown that high sodium intake is linked to reduced bone density and weakened, brittle bones due to excessive calcium loss with high sodium intake.


Reducing sodium intake helps to reduce risk of high blood pressure | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian

You may also be recommended a low sodium diet if you have congestive heart failure, kidney disease or liver disease. Because salt can make your body hold on to water, cutting back on sodium intake can help to reduce fluid build up in your ankles (edema), lungs (shortness of breath), and abdomen (ascites).




Which foods are high in sodium?


It may surprise you that most of the sodium in our diet does not come from the salt shaker! In Canada, the top sources of sodium in our diet comes from processed, packaged and restaurant foods. The top sources of sodium in our diet comes from:

  • Bakery products - e.g. bread, buns, muffins, cookies and crackers

  • Appetizers/entrees - e.g. pizza, lasagna, refrigerated or frozen entrees and appetizers

  • Processed meat - e.g. sausages, deli meat, canned meats, chicken wings, burgers and meatballs, bacon, hot dogs

  • Cheese

  • Canned soups

  • Sauces/condiments


Top sources of sodium in the Canadian diet: baked goods, pizza/frozen meals, processed meat, cheese, soups, sauces and condiments | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



Does the type of salt you use make a difference?


No. While some types of salt may look prettier than others and people may have preferences in terms of taste or texture, whether you are using table salt, kosher salt, sea salt, or Himalayan salt - the sodium content is about the same.




Is it okay to use salt substitutes?

Check with your healthcare team before switching to a salt substitute. Often times, salt substitutes (e.g. NoSalt) replace sodium with potassium. If you have been advised to limit potassium intake (e.g. in some people with kidney disease), avoid these potassium-based salt substitutes. Instead, try out salt free seasoning blends such as Mrs. Dash or ClubHouse Salt-free Seasoning Blends.




Tips for lowering your sodium intake


While you may find yourself missing your salt at first, rest assured that our taste buds do adapt to lower salt intake! Studies have found that it takes about 8 weeks for your taste buds to actually start preferring the lower salt choices.


To start training your taste buds, follow these tips to reduce sodium in your diet:

  • Read food labels.

  • Sodium content is always listed on packaged food items.

  • Use the % Daily Value on the Nutrition Facts table to choose and compare foods. Remember, 5% DV or less is a little and 15% DV or more is a lot.

  • Choose spices and seasoning blends that do not contain salt.

  • For example, choose garlic powder instead of garlic salt. Or replace it with fresh garlic or onion!

  • If able, choose fresh or frozen vegetables and dried beans and lentils.

  • If using canned vegetables or beans/lentils, drain and rinse well to get rid of some of the sodium

  • Use fresh cuts of meat (E.g. beef, chicken, pork, etc) rather than packaged or pre-seasoned varieties.

  • Cook pasta and rice without adding salt to the water.

  • Taste your food before adding salt

  • Cut out the salt in recipes a little at a time until you can use the least amount possible while still enjoying the food

  • Experiment with adding herbs and spice to enhance flavour






References


D’Elia L, Rossi G, Ippolito R, et al. Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies. Clinical Nutrition (Edinburgh, Scotland), 2012; 31(4): 489–498. https://doi.org/10.1016/j.clnu.2012.01.003


de Wardener HE, & MacGregor GA. Harmful effects of dietary salt in addition to hypertension. Journal of Human Hypertension, 2020;16(4), 213–223. https://doi.org/10.1038/sj.jhh.1001374


Health threats from high blood pressure. American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure. Accessed Aug 18, 2021.


Mattes, RD. The taste for salt in humans. The American Journal of Clinical Nutrition. 1997;65(2): 692S-697S. https://doi.org/10.1093/ajcn/65.2.692S


Rabi D, McBrien K, Sapir-Pichhadze R, et al. Hypertension Canada’s 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. Can J Cardiol. 2020;36: 596-624. https://doi.org/10.1016/j.cjca.2020.02.086


Salt Reduction. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/salt-reduction. Accessed August 18, 2021.


Salt: shaking up the link with stomach cancer. World Cancer Research Fund International.https://www.wcrf.org/salt-shaking-up-the-link-with-stomach-cancer/. Accessed August 18, 2021.


Sodium Intake of Canadians in 2017. Government of Canada. https://www.canada.ca/en/health-canada/services/publications/food-nutrition/sodium-intake-canadians-2017.html. Accessed Aug 18, 2021.


Tobe S, Gilbert R, Jones C, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Treatment of Hypertension. Can J Diabetes. 2018;42(Suppl 1):S186-S189.


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