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GET THE FACTS: Salt & Sodium An educational resource for daily sodium guidelines, the role and sources of sodium in food, and tips on how to reduce the amount of sodium you eat. GET THE FACTS: Sodium and the Dietary Guidelines The U.S. government recently released the newest version of Dietary Guidelines for Americans, a researchbased guide designed to help Americans make healthier food choices. So, what does all of this mean for you and your family? And what steps can you take to reduce sodium? What Do the 2010 Guidelines Say About Sodium? The first thing to know is that the salt you use at the dinner table is not the biggest sodium contributor in the American diet. In fact, the majority of the sodium Americans consume—more than 75%—is found in processed food and restaurant meals. Sodium Can Add Up Quickly The problem of eating too much sodium is covered in the report: The Dietary Guidelines for Americans, 2010 recommend that Americans aged 2 and up reduce sodium intake to less than 2,300 milligrams (mg) per day. n People 51 and older and those of any age who are African Americans or who have high blood pressure, diabetes, or chronic kidney disease—about half the U.S. population and the majority of adults—should further reduce sodium intake to 1,500 mg per day. n Based on these guidelines, the vast majority of adults eat more sodium than they should—an average of more than 3,300 mg each day. n And don’t let your taste buds fool you. Foods like grains, baked goods, and meats may not taste salty, but they add up to major sources of daily sodium because they are eaten so often. The majority of Americans’ daily sodium intake comes from grains and meat, and other top contributors include processed poultry, soups, and sandwiches. Depending on your food choices, it doesn’t take much to consume more sodium than recommended. One slice of bread can contain anywhere from 80 to 230 mg of sodium, and a slice of frozen pizza can contain between 370 and 730 mg. n Some breakfast cereals contain 150 to 300 mg of sodium before milk is added. n Eating too much sodium puts Americans at risk for developing serious medical conditions, like high blood pressure, heart disease, and stroke. SODIUM ADDS UP QUICKLY Not all foods are high in sodium. But when you combine foods with varying levels as part of your daily diet, sodium can add up quickly. BREAKFAST LUNCH 250 mg sodium 2,200 mg sodium + Bowl of cereal with skim milk DINNER 710 mg sodium + Cup of soup and a turkey sandwich TOTAL SODIUM = Slice of pizza and salad with light dressing National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention 3,160 mg sodium GET THE FACTS: Sodium and the Dietary Guidelines Canned soups and soups served in restaurants can contribute high amounts of sodium. n Processed tomato products and salad dressings often include salt and other ingredients that contain sodium. n Many snack foods—chips, crackers, and pretzels— contain several hundred milligrams of sodium per serving. n Tips for Shopping Smarter n n The more you know about the food you eat, the better the decisions you can make for yourself and your family. n Eat more fresh fruits and vegetables and low-fat dairy. Research shows that foods low in sodium and high in potassium can help reduce blood pressure and the risk for other serious conditions. Examples include bananas, dried apricots, and spinach. Low- or no-fat yogurt, beans other than green beans, and potatoes are also low in sodium and high in potassium. n When buying processed foods, read nutrition labels and choose products with less sodium. • Notehowmanymilligramsofsodiumareineach serving—and how many servings are in the package. • Foodsthatcontain35 mg or less per serving are very low in sodium. Foods that contain 140 mg or less per serving are defined as low sodium. Check processed meat and poultry, which are often “enhanced” with salt water or saline. Opt for lower sodium or no salt added breads, crackers, and cereals. Tips for Cooking at Home Use lemon juice and salt-free herbs and spices, such as garlic and pepper, to flavor your food instead of sauces and prepackaged seasonings. n Limit added salt while cooking, and taste food first before salting at the table. n Tips for Eating Out Chain restaurants often put nutritional information online. Check ahead to find the lower sodium options. n Ask restaurants not to add salt to your meal, and use sauces and condiments only in small amounts. n Reduce your portion size—less food means less sodium. For example, ask the server to put half of your meal in a take-out container before it comes to your table, or split an entree with someone else. n Ask your favorite restaurants, stores, and food manufacturers to offer more low sodium options. n In addition to low sodium foods, eating high-potassium foods can help lower your blood pressure. n When eating frozen and canned vegetables, choose no salt added or low sodium versions, or choose frozen varieties without sauce. Learn more at www.cdc.gov/salt For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail:[email protected]•Web:www.cdc.gov Publication date: 06/2012 GET THE FACTS: The Role of Sodium in Your Food Where Does Dietary Sodium Come From? Although many people are quick to blame the salt shaker, only a small amount of dietary sodium is added during home cooking and at the table. An overwhelming majority of sodium consumed—more than 75%—comes from restaurant, prepackaged, and processed foods, including many products that don’t even taste salty. For consumers to make informed decisions about what they eat, it’s helpful to understand the role that sodium plays in different foods. Why Is Sodium Added to Processed Food? Sodium plays many roles in our foods, mainly: Why Is Eating Too Much Sodium a Bad Idea? Our bodies require only a small amount of sodium each day to function normally. Eating too much sodium can lead to increased blood pressure, which can raise the risk of heart attack, stroke, and other cardiovascular conditions. n Onaverage,Americanadultsexceedtheir recommended daily limit of sodium. n Reducing your sodium intake can help lower your blood pressure and improve the health of your heart. n To Enhance Flavor • Addsasaltytaste • Boostsflavorbalanceandcanenhancethesweetness of sugary items • Masks“offnotes,”suchasbitternessandstrange tastes, that can result from food processing • Makessometypesofprocessedfoods more palatable n To Preserve Freshness • Increasesshelflife • Helpspreventgrowthofbacteriaandother disease-causing agents n ToImproveTextureandAppearance • Makestheproductseemthickerorfuller • Enhancescolorandhue • Helpsretainmoistureinprocessedmeatproducts as a trade-off for saturated fat • Stabilizestexture,allowingbreadtoriseandcheese to stick together • Preventsunwantedchemicalchangestootheringredients in many baked items n Sodium levels may vary greatly in otherwise similar products. National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention GET THE FACTS: The Role of Sodium in Your Food n Is All of This Sodium Necessary? In many cases, no. For many products, sodium’s technical functions can be accomplished with lower levels than are currently being used. n Alternatives to added sodium do exist. n Many familiar products already contain lower amounts of sodium in other countries. This international variability indicates that these companies could readily introduce lower sodium versions of popular products in the United States. n Sodium levels in similar U.S. products vary greatly across—and even within—brands, indicating consumers’ willingness to buy less salty products. n Althoughmanyfoodmanufacturersexpressconcern about the altered taste of low sodium products, salt is an acquired taste. Some research indicates that consumers—and their taste buds—adapt to the taste of lower sodium foods. n Certain study results indicate that when a reducedsodium version of a popular food is served, the typical consumer adds less than 20% of the removed sodium back. This behavior demonstrates that individuals are relatively comfortable with gradual sodium reductions in products. n There are several new salt substitutes on the market— and many more in development. Learn more at www.cdc.gov/salt SODIUM LEVELS VARY BY COUNTRY UNITED KINGDOM UNITED STATES Popular Restaurant ChainVeggiePizza 320 mg (per 100 g serving) 610 mg (per 100 g serving) For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone:1-800-CDC-INFO(232-4636)/TTY:1-888-232-6348 E-mail:[email protected]•Web:www.cdc.gov Publicationdate:06/2012 GET THE FACTS: Sodium’s Role in Processed Food What Do Sodium and Processed Food Have to Do with Heart Health? Eating too much sodium can lead to increased blood pressure, which in turn contributes to heart disease and stroke. Reducing sodium intake to recommended amounts is important to maintaining heart health. It may surprise you to learn that more than 75% of the sodium Americans consume comes from processed and restaurant foods. Only a small amount comes from the salt shaker, either during home cooking or at the dinner table. Processed Food: A Definition The U.S. Food and Drug Administration defines “processed food” as “any food other than a raw agricultural commodity and includes any raw agricultural commodity that has been subject to processing, such as canning, cooking, freezing, dehydration, or milling.” By this definition, nearly all food served in restaurants and many grocery store products are considered processed. Here are a few other ways to think about processed food: A processed food is any food that has been changed from its original, raw form. n Processing a food often involves the use of added ingredients, including sodium-containing additives, which could make the product less healthy. n “From Scratch” Versus “Processed”— Are They Always Different? Americans’ use of packaged food has increased in the past 50 years. Many of the ingredients that we now use when we cook “from scratch” at home are processed in some way. n n n n n Many processed foods at the grocery store are easy to identify—in general, anything with a Nutrition Facts label on the package has been processed. Frozen meals, snack foods like chips and cookies, and most beverages have been processed. Such staples as sugar, flour, chicken broth, and canned or frozen vegetables have also been processed in some way. Products that use labels such as “all natural” or “whole grain” are still processed. “Processed” can mean many different things, but not all of these foods are bad for your health. Products such as frozen vegetables are often still low in sodium. That’s why it’s important to check Nutrition Facts labels and choose the option lower in sodium. More than 75% of the sodium Americans consume comes from processed and restaurant foods— not the salt shaker. National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention GET THE FACTS: Sodium’s Role in Processed Food If So Much Food Is Processed, What Can I Do to Cut Sodium? How Much Sodium Should I Eat? n According to the Dietary Guidelines for Americans, 2010: Americans aged 2 years and up should reduce sodium intake to less than 2,300 milligrams (mg) per day. n People aged 51 and up and those of any age who are African Americans or who have high blood pressure, diabetes, or chronic kidney disease— about half the U.S. population and the majority of adults—should further reduce sodium intake to 1,500 mg per day. n Making smart food choices, including limiting your daily sodium intake, is critical to protecting your heart health. n n n n n At the grocery store or farmers’ market, purchase whole, unprocessed foods when available, such as fresh vegetables and meats. Similar products can vary greatly in sodium content. When purchasing processed foods, compare labels and choose the option with the least amount of sodium. Cook at home more, and use as many fresh ingredients as possible. Scale back how often you eat restaurant food, which is frequently high in sodium. Request nutrition information when dining out, and ask your server about lower sodium options. Whether eating out or in, eat less. Reducing portion sizes can help limit how much salt you eat. Learn more at www.cdc.gov/salt To reduce sodium in home cooking, season foods with fresh herbs and spices instead of salt. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: [email protected] • Web: www.cdc.gov Publication date: 06/2012 GET THE FACTS: Sources of Sodium in Your Diet All across the United States, high sodium intake is a major problem. On average, American adults eat more than 3,300 milligrams (mg) of sodium a day, more than double the recommended limit for most adults. The Dietary Guidelines for Americans, 2010 recommend that Americans aged 2 and up reduce sodium intake to less than 2,300 mg per day. People 51 and older and those of any age who are African Americans or who have high blood pressure, diabetes, or chronic kidney disease—about half the U.S. population and the majority of adults—should further reduce sodium intake to 1,500 mg per day. The vast majority of U.S. adults eat more sodium than they need. Having accurate information about where dietary salt comes from can help Americans stick to the recommendations. Food (in milligrams) 1 slice white bread 3 oz turkey breast, deli or pre-packaged luncheon meat 80 - 230 450 - 1,050 4 oz slice frozen pizza, plain cheese, regular crust 370 - 730 4 oz slice restaurant pizza, plain cheese, regular crust 510 - 760 4 oz boneless, skinless chicken breast, fresh 40 - 330 3 oz chicken strips, restaurant, breaded 430 - 900 3 oz chicken nuggets, frozen, breaded 200 - 570 1 cup chicken noodle soup, canned prepared 100 - 940 1 corn dog, regular 1 cheeseburger, fast food restaurant 1 oz slice American cheese, processed (packaged or deli) 1 cup canned pasta with meat sauce The Salt Shaker Is Not to Blame Sodium Range 5 oz pork with barbecue sauce (packaged) 1 oz potato chips, plain 350 - 620 710 - 1,690 330 - 460 530 - 980 600 - 1,120 50 - 200 More than 75% of the sodium Americans eat comes from restaurant, prepackaged, and processed foods. n Only 5% of dietary sodium is added during home cooking and only 6% is added at the table. n The remaining 12% of dietary sodium occurs naturally in foods. n Surprising Sources of Sodium Lots of packaged and processed foods can have high levels of sodium, and they may not even taste salty to many consumers. n Breads and rolls, cold cuts/cured meats, and pizza are top contributors of sodium in the American diet. n For example, one slice of bread can contain anywhere from 80 to 230 mg of sodium. n Lunch meats are a major source—1 serving, around 6 thin slices, typically can contain 750 mg or more of sodium. n Sodium levels of the same food can vary widely, so choose wisely. National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention GET THE FACTS: Sources of Sodium in Your Diet Keeping an Eye on Labels as You Shop Is Important n n n n n intake can help lower these risks. To help protect your heart, make a commitment to: Frozen pizza typically contains between 370 and 730 mg of sodium in just 1 slice. Soup can also be high in sodium. For example, tomato soup can range from 700 to 1,260 mg of sodium in 8 ounces (1 cup). Many seemingly healthy foods, such as canned vegetables, often contain added sodium. Raw chicken and other meats can have sodium and flavor solutions added. Even foods labeled as “less sodium” or “reduced sodium” can contain significant amounts. One tablespoon of “less sodium” soy sauce typically contains more than 500 mg, and consumers often eat more than 1 serving at a time. Why Cut Back? And How? n n n n n Eating too much sodium can lead to increased blood pressure, which can raise your risk for heart attack, stroke, and other cardiovascular conditions. Reducing sodium Try to eat more fruits and vegetables. For canned and frozen vegetables, look for no salt added or low sodium versions, or choose frozen varieties without sauce. Check nutrition labels on packaged foods. Compare sodium in different brands for products like processed soups, dressings/sauces, breads, and frozen meals, and choose those with lower sodium. Eat at home more frequently, and prepare more meals from scratch. To boost flavor, use salt free herbs and spices rather than processed sauces, packaged broths, or condiments. Ask restaurants not to add salt to your meal, and use condiments in small amounts. Also ask your favorite restaurants, stores, and food manufacturers to offer more low-sodium options. Re-train your taste buds. Over time, the less sodium you eat, the less you’ll want. Learn more at www.cdc.gov/salt CHOOSE FRESH OR LOW SODIUM FOODS FRESH TOMATOES NO SALT ADDED CANNED TOMATOES CANNED TOMATOES 6 mg (whole) 20 mg (per 1/2 cup) 220 mg (per 1/2 cup) For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: [email protected] • Web: www.cdc.gov Publication date: 06/2012 GET THE FACTS: Sodium Reduction Tips Tips for Reducing Sodium ■ Buy fresh, frozen (no sauce), or no-saltadded canned vegetables. ■ Use fresh poultry,* fish, pork,* and lean meat, rather than canned or processed meats. ■ When available, buy low-sodium, lowersodium, reduced-sodium, or no-salt-added versions of products. ■ Limit sauces, mixes, and “instant” products, including flavored rice and ready-made pasta. ■ Compare Nutrition Facts labels on food packages for percent Daily Value or amount of sodium in milligrams. * Check to see if saline or salt solution has been added— if so, choose another brand. Choose wisely—sodium content can vary within food categories Total = 1,522 mg Total = 852 mg per whole sandwich per whole sandwich Which of These Sauces Is Lower in Sodium? The majority of sodium in our diets is from packaged food and is a direct result of food processing. Even foods that may not taste salty can be substantial sources of sodium. Check the amount of sodium per serving, and don’t forget to check the number of servings per container! Remember, the 2010 Dietary Guidelines for Americans recommend that Americans aged 2 and up reduce sodium intake to less than 2,300 milligrams (mg) per day. People 51 and older and those of any age who are African Americans or who have high blood pressure, diabetes, or chronic kidney disease—about half the U.S. population and the majority of adults—should reduce sodium intake to 1,500 mg per day. Learn more at www.cdc.gov/salt. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: [email protected] • Web: www.cdc.gov Publication date: 08/2011 National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention Online Sodium Resources •CDC Sodium Reduction in Communities Program (SRCP) http://www.cdc.gov/dhdsp/programs/sodium_reduction.htm •CDC High Blood Pressure Web Site http://www.cdc.gov/bloodpressure/index.htm •American Heart Association—Shake Your Salt Habit http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/ PreventionTreatmentofHighBloodPressure/Shaking-the-Salt-Habit_UCM_303241_Article.jsp •American Society of Hypertension http://www.ash-us.org/ •Center for Science in the Public Interest http://www.cspinet.org/salt/index.html •NHLBI—Reduce Salt and Sodium in Your Diet http://www.nhlbi.nih.gov/hbp/prevent/sodium/sodium.htm •National High Blood Pressure Education Program http://www.nhlbi.nih.gov/about/nhbpep/index.htm •Dietary Approaches to Stop Hypertension (DASH) Diet http://www.nhlbi.nih.gov/hbp/prevent/h_eating/h_eating.htm •New York City Department of Health and Mental Hygiene http://www.nyc.gov/html/doh/html/cardio/cardio-salt-coalition.shtml •Nutrition.gov: What’s in Food—Salt and Sodium http://www.nutrition.gov/whats-food/salt-sodium •United States Department of Agriculture—Information on Salt/Sodium http://snap.nal.usda.gov/resource-library/balance-your-lifestyle/information-sodiumsalt •U.S. Food and Drug Administration—Lowering Salt in Your Diet http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm181577.htm •U.S. Food and Drug Administration—How to Understand and Use the Nutritional Facts Label http://www.fda.gov/Food/ResourcesForYou/Consumers/NFLPM/ucm274593.htm For more information on heart disease, stroke or related risk factor education and information, please contact the Nebraska Department of Health and Human Services, Heart Disease and Stroke Prevention Program at 402-471-2101.