Just the facts. From the experts.

When it comes to sodium, Best Food Facts experts agree: we need to pay attention to sodium levels in the foods we eat. To decrease sodium consumption, experts encourage choosing foods closest to their natural state and checking labels for foods with less sodium.


We’ve heard it for a while now: Americans are eating too much salt. Because of the risks of high sodium consumption, there have been efforts to reduce salt consumption by consuming less processed foods and considering government regulation. But just how much salt is too much? We reached out to experts Dr. Lawrence Appel, Director of the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, and Dr. Ethan Bergman, Registered Dietitian and Professor of Food Science and Nutrition, Associate Dean, College of Education and Professional Studies, Central Washington University, to get their thoughts on salt in the diet.



Dr. Lawrence Appel                     Dr. Ethan Bergman


What is sodium and are there different levels of it in different kinds of salt such as table salt, sea salt, kosher salt, etc.?

Dr. Appel: “The term salt that we use commonly is actually a compound called sodium chloride. We typically use the terms sodium and salt interchangeably because about 90 percent of our sodium comes in the form of salt. The vast majority of sea salts are just salt. They may have some minor additional chemicals or flavors in them but they’re going to have the same biological effects as routine table salt. There are a few salts that tend to be higher in potassium or magnesium or calcium and reduced in sodium and some of them have been used as salt substitutes because of their reduced sodium content. That might be a reasonable approach for someone who wants to put salt on their food.”

Dr. Bergman: “Salt's make up is sodium chloride. Salt is a generic term that refers to many different types of ionic combinations, and the vast majority of what we’re talking about is a sodium chloride compound. Sea salt, kosher salt and table salt all are made up of sodium chloride. There are other salts, like potassium chloride or a combination of sodium and potassium chloride, which does reduce the amount of sodium intake, but sodium tends to be the culprit. There are products on the market that are salt replacements or salt substitutes that have a similar taste, but don’t have the sodium content, but sea salt, kosher salt and table salt are all sodium chloride.”


Do we need sodium in our diet?

Dr. Appel: “Yes, the body requires salt but it’s so little it is trivial. Sometimes I say, ‘You can breathe the air and get all the salt you need.’ There are studies showing you need only 200 or 300 milligrams of salt per day but the average person is consuming 10 to 20 times that amount. The human body will adjust to whatever sodium intake we choose. It’s pretty remarkable. With very high intake the body retains sodium and blood pressure rises. The kidney has a remarkable capacity to adjust and get rid of a lot of the sodium. There is a 'puffiness' that occurs in the body when people consume higher levels of sodium. You might notice it after eating at certain restaurants. Many times when a person feels like they’ve gained weight during the holidays it’s really sodium retention. You usually notice that this puffiness goes away after a period of reduced sodium intake."

Dr. Bergman: “Yes, salt is required. Salt makes up a lot of our body: aqueous solutions in our body have sodium, and we have to maintain that concentration to be functional. The problem lies in the fact that there’s virtually nobody in the United States that consumes too little, because it is such a widely-found flavor enhancer. It’s something that we’re attracted to, and we tend to want to consume more. We learn to consume salty foods.  We typically get enough sodium without even thinking about it.”


Why is too much sodium bad for you?

Dr. Appel: “Smoking and sodium are the two leading causes of preventable death in the world. There are clinical trials showing that sodium reduction lowers not just blood pressure but the risk of heart disease and stroke. Sodium is one of the main determinants of high blood pressure – not the only one but a major one. It has been estimated that roughly one-third of cardiovascular events that occur in this country and around the world occur in people who would benefit from a lower sodium intake.”

Dr. Bergman: “The number one problem with sodium is that it is hydrophilic. It attracts water, which tends to increase blood volume, and by doing that, increases blood pressure. However, high blood pressure doesn’t happen for everyone who consumes too much sodium. But probably half the population is sodium sensitive, which can cause high blood pressure and can affect circulation and cause heart disease.”


Any tips on how to go about reducing sodium in the diet?

Dr. Appel: “Fresh foods are typically lower in sodium. Processed foods tend to be higher. When people go out to eat and are selecting foods they should look for individual items that contain less than 200 milligrams of sodium. Full entrees should have less than 600 milligrams per serving. Another thing is to just be an advocate for lower sodium consumption because a lot has to do with food manufacturers and if they feel pressure to reduce sodium intake."

Dr. Bergman:  “We tend to see lots of sodium in processed foods, foods that are far away from the farm. If you eat foods that are close to their natural state, the lesser chance you’ll have of added sodium. Reduced-sodium foods help lower sodium intake. Canned soups are often high in sodium, the lower sodium varieties of canned soups really are less and contribute to lower sodium intake. Also, when you’re flavoring foods, look for ways to flavor it without a sodium-containing product.”


Do you think the government should help regulate salt levels in food?

Dr. Appel: “I think sodium should be reduced in the food supply and I think the government has an important role. There have been efforts to do it voluntarily but if a product is too high in sodium it should be labeled as such. People want to know what’s in their food. They want a way to easily identify products that are good for them. Nutrition labels are problematic. They are hard to read. It would be great if there was just a label that was as easy to read as a traffic light – red, yellow, green. An individual can still do what they want. They can add salt to their food if they want. But for individuals who are interested in reducing their sodium intake a label could be quite valuable.”

Dr. Bergman:  “The school lunch program, for example, has had a hard time finding products that are low in sodium, especially when foods are manufactured specifically for school foodservice. Registered dietitians and food technologists are joining forces to try to find products kids will eat, but don’t have as much sodium. That same sort of model can happen in all types of food, not only for school foodservice, but in other areas, to help manufacturers find products that people will still purchase that don’t have as much sodium.

“I think population-based strategies and increased public health efforts when it comes to salt are very important. How do we go about coming up with strategies that help everybody meet their public health needs according to sodium intake? Over the years, we haven’t been very successful in finding answers. We need to look at ways to change population strategies, or have regulations that preserve flavors while reducing sodium intake. “



In late 2011, Best Food Facts polled readers, asking, “Do you think sodium levels should be regulated by the government?”

53% answered: No, it's a terrible idea

27% answered: Yes, it's a great idea

20% answered:  Indifferent, there are pros and cons to both sides


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