Salt is a compound composed of 40% sodium and 60% chloride. The importance of salt in our diet should never be under estimated, as many life-sustaining bodily functions would fail without the chemical support of salt.
Salt is required for the:
- Regulation of blood pressure
- Maintenance of proper balance between intra-and interstitial fluids
- Maintenance of proper blood concentration levels
- Many chemical processes within body systems
- Transmit nerve impulses
- Muscle contractions
- Metabolic acid-base balance
A number of sources including The National Research Council of the National Academy of Sciences recommend a dietary intake (RDI) of sodium to be in the range of 500mg to 2400 mg per day. Another source at the Mayo Clinic, (mayoclinic.com/health/sea salt) recommends between 1500 mg and 2300 mg for a healthy adult. Variations are related to many factors, which is why it is important to check with your primary care physician to determine the correct RDI:
- Medical history
- Health status
- Activity level
The Salty Taste of Control
As nurses, we know that there is a strong correlation between a patient's perceived level of control over the illness, and their willingness to be dietary compliant. This can be observed among the chronically ill, for example, end stage renal disease, cardiac disease, and diabetes mellitus. In some cases, as the illness took more and more control away from the patient, the less compliant they were with the food regimen.
My father is 89 years-old and on a cardiac diet, which restricts a number of his favorites, salt being just one of them. Although he still lives independently, he frustrates easily because of limited mobility and other age-related difficulties. Even though his choices are not in his best interest, he feels it is far more important for him to have some control over his life, than to do what he is told, and have no control. Therefore, he continues to eat the foods he loves, and tells everyone he is being compliant.
On the other side of the spectrum was my late grandmother who in 1977, made the decision to completely remove salt from her life. Grandmother was convinced that salt was the root of all-evil. She felt strongly that removing the salt would keep her from having another stroke. She lived for another three years and then died in 1980 from another stroke. She spent the last three years of her life tolerating unpalatable meals, when she could have enjoyed those meals with a little education about salt reduction.
Canned Foods and Hidden Salt
Consumers can achieve quite the education by merely looking through and reading the labels of products found in their home pantry, refrigerator, and freezer. I was not surprised by what I found in my father's kitchen, and I am sure many of my readers will find similar experiences with their elderly parents and relatives. Purchasing can products is the only way that many elderly who live on a fixed income, can adequately afford to eat three meals a day. Unfortunately, we know that canned products also contain a large amount of salt, which is contraindicated in most elderly diet regimens.
Moderation of Salt
It is all about moderation and not so much about elimination. I prepare meals that are fresh and natural and perhaps use canned products 25% of the time to enhance what I am cooking or to help when I do not have a lot of preparation time. Bottom-line, sometimes it is just easier to open up a can of tuna fish or Spaghetti-Ohs. It is far more important to look at the entire day's intake than to worry about one can of Spam.
I would much rather see my elderly father eat a can of tuna fish packed in water, than to see him not eat any protein because he can't afford to purchase fresh. I have shown him how to make his food dollars go further by purchasing frozen vegetables on sale, cooking and freezing meals, and using canned goods sparingly. He can use coupons, buy meat at the end of the day when many go on clearance, and to read and compare labels. I made it sort of a game, something to challenge him to an activity that will not only serve to help him eat healthier, but to occupy him during those times when he is bored.
Foods High in Sodium
Canned products are not the only place for hidden salt. Some foods contain enough salt to consume several days' worth of RDI; the worst offenders are:
- Bacon, deli meats, hotdogs
- Processed cheeses
- White breads and rolls
- Pickled foods
- Salty snacks like pretzels, potato chips, and nuts
- Canned soups and vegetables
- Marinades, jar sauces, soy sauce
Other Ways to Reduce Salt
In our body sodium and potassium work together as a pump, so another way to combat high levels of sodium is to eat more potassium-rich foods like bananas, tomatoes, and watermelon. In restaurants, look towards the healthy choice options, or focus on fresh salads and vegetables; but remember to watch the dressing as it can contain a lot of salt. In addition, request all sauces on the side so you can control how much of the sauce you eat. I also suggest that the saltshaker be removed from the kitchen table as for many salting food is habitual.
By the way, in case you're wondering if there is a health difference among sea salt, kosher salt, and table salt, the answer is, only in the way the salt is processed, its texture, and taste.* No matter how you sprinkle it, pinch it, or toss it, salt is always going to be a chemical compound of sodium and chloride.
In conclusion, a prescription to limit salt intake is no longer the dietary challenge it was decades ago. Today, we have choices to moderate, rather than eliminate.
*This does not include salts that have been processed with iodine (iodized salt), a mineral necessary for a healthy thyroid.
Greeley, Alexandra, "A Pinch of Controversy Shakes up Dietary Salt." FDA Consumer Magazine, November-December, 1997. Accessed December 30, 2009.
Zied, Elisa, "Learn to Shake the Salt Habit." MSNBC, May 23, 2008. Accessed December 30, 2009
"Sodium Recommended Daily Allowance." RDA. Accessed December 30, 2009.
Disclaimer: Dr. Mundorff is a Registered Nurse and Board Certified Traditional Naturopath, and not a medical doctor. The information in this column is for educational purposes only and should not be used to self-diagnose and treat diseases, nor be misinterpreted as a prescription. This information is provided with the understanding that the author is not engaging in a health-care practitioner/patient relationship with her readers. In the author's best judgment, the information and opinions expressed here are accurate and sound at the time of publication. Readers who rely on the information in this book as a replacement of the advice of a medical doctor assume all risks of such conduct. The author is not responsible for errors or omissions. Please consult your doctor before starting any alternative modalities.