of sodium), severe burns, taking certain drugs that
cause the kidney to selectively excrete sodium, extreme
overconsumption of water (water intoxication, a problem
among the elderly with dementia), hormonal imbalances,
kidney failure, and liver damage. Symptoms include
nausea, vomiting, headache, tissue swelling (edema), con-
fusion, mental disorientation, hallucinations, muscle
trembling, seizures, and coma.
Hypernatremia and hyponatremia are at the
extreme ends of sodium imbalance. However, high diet-
ary intake of salt can cause less visible health damage in
the form of high blood pressure (hypertension). Hyper-
tension silently damages the heart, blood vessels, and
kidney and increases the risk of stroke, heart attack,
and kidney damage. A low-salt diet significantly lowers
blood pressure in 30–60% of people with high blood
pressure and a quarter to half of people with normal
blood pressure. Some individuals are more sensitive to
sodium than others. Those people who are most likely
to see a rise in blood pressure with increased sodium
intake include people who are obese, have type 2 dia-
betes, are elderly, female, and African American.
The American Heart Association recommends
reducing sodium in the diet to between 1,500 mg and
2,300 mg daily. Below are some suggestions for cutting
down on salt.
Eat more fresh fruits and vegetables.
Look for processed foods that say ‘‘no salt added’’
Limit or eliminate salty snacks such as chips and
pretzels.
Restrict the amount processed meats such as hot
dogs, pepperoni, and deli meats.
Avoid high salt canned soups; choose heart-healthy
lower salt soups instead.
Use spices instead of salt to give foods flavor.PrecautionsPeople who are salt-sensitive may need to keep
their salt intake at levels below the suggested daily
amounts to control their blood pressure.InteractionsCertain drugs cause large amounts of sodium to be
excreted by the kidneys and removed from the body in
urine.Diuretics(‘‘water pills’’) are among the best known
of these drugs. Other types of drugs that may cause
low sodium levels, especially in ill individuals, include
non-steroidal anti-inflammatory drugs (NSAIDs) such
as Advil, Motrin, and Aleve, opiates such as codeine
and morphine, selective serotonin-reuptake inhibitors(SSRIs) such as Prozac or Paxil, and tricyclic antidepres-
sants such as Elavil and Tofranil.Complications
Health concerns about sodium have been discussed
above. Most problems related to high blood pressure
are chronic, slow to develop disorders that do not cause
serious complications until the second half of an indi-
vidual’s lifetime. Kidney failure, heart attack, and
stroke are all complications of high blood pressure
and potentially of high sodium intake.Parental concerns
Salt is an acquired taste. Parents can help their
children control their salt intake and discourage the
development of a craving for salt by substituting low-
salt foods for high-salt foods.Resources
BOOKS
American Heart Association.American Heart Association
Low-Salt Cookbook: A Complete Guide to Reducing
Sodium and Fat in Your Diet. 3rd ed. New York:
Clarkson Potter Pubs., 2006.
Hawkins, W. Rex.Eat Right—Electrolyte: A Nutritional
Guide to Minerals in Our Daily Diet. Amherst, NY:
Prometheus Books, 2006.
James, Shelly V,The Complete Idiot’s Guide to Low-Sodium
Meals. Indianapolis, IN: Alpha Books, 2006.
Pressman, Alan H. and Sheila Buff.The Complete Idiot’s
Guide to Vitamins and Minerals. 3rd ed. Indianapolis,
IN: Alpha Books, 2007.
ORGANIZATIONS
American Heart Association. 7272 Greenville Avenue,
Dallas, TX 75231. Telephone: (800) 242-8721.
Website:<http://www.americanheart.org>
International Food Information Council. 1100 Connecticut
Avenue, NW Suite 430, Washington, DC 20036. Tele-
phone: 02-296-6540. Fax: 202-296-6547. Website:
<http://ific.org>
Linus Pauling Institute. Oregon State University, 571
Weniger Hall, Corvallis, OR 97331-6512. Telephone:
(541) 717-5075. Fax: (541) 737-5077. Website:<http://
lpi.oregonstate.edu>
OTHER
American Heart Association. ‘‘Sodium.’’ undated, accessed
April 27, 2007,<http://www.americanheart.org/
presenter.jhtml?identifier=4708>
Higdon, Jane. ‘‘Sodium.’’ Linus Pauling Institute-Oregon
State University, February 16, 2004.<http://lpi.ore-
gonstate.edu/infocenter/minerals/sodium>
Mayo Clinic Staff. ‘‘Sodium: Are You getting Too Much?’’
MayoClinic.com, May 24, 2006.<http://www.mayo
clinic.com/health/sodium/NU00284>Sodium