Where's the sodium? There's too much in many common foods.

About 90% of Americans eat more sodium than is recommended for a healthy diet.

For American Heart Month, the February edition of CDC Vital Signs focuses on the amount of sodium in Americans' diets and what we can do to reduce it. Too much sodium increases a person's risk for high blood pressure. High blood pressure often leads to heart disease, stroke, and other vascular diseases.

Most of the sodium we eat comes from processed foods and foods prepared in restaurants. Sodium is already part of processed foods and cannot be removed. Learn what you can do to reduce sodium in your diet.

Highlights from the Report:

Different brands of the same foods may have different sodium levels, so be sure to read the labels.

• About 90% of Americans eat more sodium than is recommended for a healthy diet.
• Reducing the sodium Americans eat by 1,200 mg per day on average could save up to $20 billion a year in medical costs.
• Types of foods matter—More than 40% of sodium comes from the following 10 types of foods: breads and rolls, cold cuts and cured meats such as deli or packaged ham or turkey, pizza, fresh and processed poultry, soups, sandwiches such as cheeseburgers, cheese, pasta dishes*, meat mixed dishes such as meat loaf with tomato sauce, and snacks such as chips, pretzels, and popcorn.
• Brands of foods matter too. Different brands of the same foods may have different sodium levels.For example, sodium in chicken noodle soup can vary by as much as 840 milligrams (mg) per serving.
• About 65% of sodium eaten comes from food bought at retail stores, so look for lower sodium choices. About 25% comes from restaurants, and it can be hard for a person to tell how much sodium is in restaurant foods.
• Americans eat on average about 3,300 mg of sodium a day. The U.S. Dietary Guidelines recommend limiting sodium to less than 2,300 mg a day, and about 6 out of 10 adults should further limit sodium to 1,500 mg a day.**

*The pasta dishes category does not include macaroni and cheese. Macaroni and cheese is its own category.

Eating Less Sodium is A Challenge.

It can be challenging to reduce sodium in the diet because it can be included in foods in surprising ways. In fact, foods that otherwise seem healthy may have high levels of sodium (e.g., cottage cheese and turkey breast luncheon meat). Some foods that you eat several times a day, such as bread, add up to a lot of sodium even though each serving is not high in sodium. There are steps that you can take, however, to reduce sodium in your diet.

What Can Be Done:

This issue of CDC Vital Signs includes ways that we can all help reduce sodium in our diets:

Places that produce, sell, or serve food can:

• Consider joining voluntary initiatives to reduce sodium such as the National Salt Reduction Initiative (http://www.nyc.gov/health/salt)
• Give choices to consumers to help them reduce sodium in their diet by:
  • Stocking lower sodium foods.
  • Asking food manufacturers to provide lower sodium foods.
• Make phased reductions in the amount of sodium they add to foods they sell or serve.
• Limit the amount of sodium in food products.
• Provide information about sodium in foods.

Federal government is:

• Using the national "Million Hearts™" initiative to prevent a million heart attacks and strokes over the next five years (http://millionhearts.hhs.gov). Reducing sodium in the population is a major part of this initiative.
• Encouraging its agencies and departments to adopt the HHS/GSA or similar procurement guidelines that define how much sodium there can be in products that are sold or served in their facilities (www.cdc.gov/chronicdisease/resources/guidelines/food-service-guidelines.htm).
• Improving data collection on sodium, including the amount of sodium people consume, and their knowledge, behaviors and health outcomes.

State and local health departments can:

• Develop and implement efforts that:
  • Increase public awareness about the amount of sodium added to processed and packaged foods.
  • Increase public awareness of the health outcomes of a high sodium diet.
  • Help reduce sodium in people's diets.
• Encourage reductions in the amount of sodium in foods purchased in cafeterias and vending machines.

Everyone can:

• Choose to purchase healthy options and talk with your grocer or favorite restaurant about stocking lower sodium food choices.
• Read the Nutrition Facts Label while shopping to find the lowest sodium options of your favorite foods.
• Eat a diet rich in fresh fruits and vegetables and frozen fruits and vegetables without sauce.
• Limit processed foods high in sodium.
• When eating out, request lower sodium options.
• Support initiatives that reduce sodium in foods in cafeterias and vending machines.

**Centers for Disease Control and Prevention (CDC). Usual sodium intakes compared with current dietary guidelines---United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2011 Oct 21; 60(41):1413-7

More Information

• Vital Signs - Where's the Sodium?
• Vital Signs Issue details: Food Categories Contributing the Most to Sodium Consumption — United States, 2007–2008 (MMWR)
• Too Much Sodium [PODCAST - 01:15 minutes]
• Too Much Sodium [PSA - 0:60 seconds]
• MedlinePlus - Heart Diseases
• MedlinePlus - Coronary Artery Disease
• MedlinePlus - High Blood Pressure
• MedlinePlus - Dietary Sodium
• MedlinePlus - Potassium