lIMIT INTAKE OF FOODS CONTAINING SATuRATED FAT, ADDED SAlT, ADDED SuGARS AND AlCOHOl
75Guideline 3
Bone health
Evidence suggesting an association between a low sodium diet and markers of bone health in postmenopausal
women is inconclusive (Evidence Report, Section 13.3).
3.2.3 How limiting intake of foods and drinks containing added salt may improve health outcomes
Sodium and other electrolytes are needed to maintain extracellular volume and serum osmolality. There are
various systems and hormones that influence sodium balance including the renin-angiotensin-aldosterone
hormone system, the sympathetic nervous system, atrial natriuretic peptide, the kallikrein-kinin system,
various intrarenal mechanisms, and other factors that regulate renal and medullary blood flow.^8
Future data may lead to a refined understanding of the underlying mechanisms. For example, the ratio of sodium to
potassium may influence blood pressure more strongly than the amount of sodium alone742-744 and reducing sodium
intake may be particularly important for overweight people with certain conditions.74 5 The Dietary Guidelines for
Americans, 2010 comment that the effects of higher sodium intake can be countered if potassium intake is
also higher and note that potassium intake in the uS is lower than desirable.^198
3.2.4 Practical considerations: limit intake of foods and drinks containing added salt
There has been a shift in the language on this issue. The first edition of the dietary guidelines included the
recommendation to ‘Eat less salt’.^750 The second edition revised this to ‘Choose low salt foods and use salt
sparingly’.^751 The third edition advised Australians to ‘Choose foods low in salt’.^36 In these Guidelines, it is
recognised that any reduction in dietary sodium will reduce blood pressure in those with normal levels of
blood pressure, reduce risk of developing hypertension and also reduce blood pressure in those with elevated
blood pressure.
The NRV Document recommends an intake of sodium in the range 460–920mg/day for adults to cover the essential
requirement. Current advice in Australia is for dietary sodium intake to be preferably less than 1,600mg/day for adults
or no higher than the set upper level (ul) of 2,300mg/day.^8 Among those with high sodium intake, reduction in
sodium intake would reduce blood pressure even if specific targets were not achieved.
Diets that are consistent with the Guidelines will help to limit sodium intake. Fresh, unprocessed or minimally
processed foods such as fresh vegetables (including legumes/beans) and fruit, frozen or tinned vegetables
(including legumes/beans) and fruit with no added salt, meats, fish and milk are generally lower in sodium.
Some breads and cereal products and cheeses have higher levels of salt and make a significant contribution to
sodium intake, although there is considerable variation between products and brands. However, these foods
provide other important health benefits outlined in relevant sections of the Guidelines. The public should not avoid
these foods, but should be encouraged to check food labels and select lower-sodium products in these categories.
Some foods are labelled ‘low sodium/salt’ if the food contains no more than 120mg of sodium per 100g.^752
Not all foods that meet this criterion carry a ‘low sodium’ claim.
Because salt is 40% sodium, avoiding discretionary salt in cooking or at the dinner table will also reduce sodium
intake (the set ul of 2,300mg/day is approximately equal to 6g of table salt). In the 1995 National Nutrition
Survey, 62% of the population aged 2 years and older reported always or usually adding salt at the table or during
cooking.^45 Since 1995, Asian-style cooking has become increasingly popular in Australia and many Asian-style
sauces such as soy, oyster and fish sauces are particularly high in sodium. lower sodium options of these foods
should be chosen, recognising that they may still have high sodium content. Salt substitutes or ‘lite’ salts that
replace some sodium chloride with potassium chloride can provide a salt taste with lower levels of sodium.
Herbs, spices, garlic, lemon juice and vinegars can also be used to season foods without adding salt.
Iodine deficiency previously existed in Australia and has re-emerged in recent years. Iodised salt is one way to
increase iodine intake. Since 2009, it has been mandatory for any salt used in commercial bread baking to be
iodised (organic bread is exempt from this requirement).^753 Milk and dairy foods are an important source of
iodine in Australia.
Pregnant and breastfeeding women
Advice to limit the intake of sodium for the general population is also applicable to pregnant and breastfeeding
women.^754