16 November 10 The New Sodium Guideline

Did you know that the 2010 Dietary Guidelines for Americans are just about to be released? The updated sodium guideline will be 1500 mg for everyone, not just for those who are at risk for hypertension (high blood pressure) or already have hypertension. The 2005 U.S. Dietary Guidelines for Americans recommended 1500 mg for higher risk populations, but now that about 2/3 of the U.S. population has hypertension or is at risk for getting hypertension, the guideline has changed to reflect the fact that higher risk populations are now the majority, not the minority of Americans. This new guideline will be consistent with both the American Heart Association's sodium guideline as well as with the Institute of Medicine's Dietary Reference Intake for sodium (specifically, "Adequate Intake").

Groan. How can I argue against a guideline that is expected to save many thousands of lives if people can actually achieve the recommended intake level? But that is precisely the problem – I do not think that it is realistic to expect the general population to limit their sodium intake to 1500 mg of sodium. According to the Centers for Disease Control, the average intake of sodium for Americans over the age of two years is estimated to be about 3400 mg of sodium per day. This intake is consistent with Bernstein and Willett's (2010) estimated sodium intake of about 3500 mg per day (based upon a systematic review of urinary sodium excretion studies for the past 45 years). Wow! That means we have to reduce our sodium intake by 55% or by more than half of what we currently consume. That is a pretty tough goal to meet, even with a gradual step-down approach.

Track sodium
Most of the sodium in our diet comes from salt (sodium chloride) in processed foods and restaurant/fast foods. Less than 25% of our total sodium intake actually comes from using the salt shaker.

If you limit processed foods and dining out, will you meet the new guideline? Maybe not. You really won't know unless you track your sodium intake. I use MyNetDiary to track everything, including sodium. Tracking has helped me reduce my sodium intake while still choosing foods that I think taste good. I aim for an intake of less than 2300 mg of sodium. I will not be reducing my goal to 1500 mg unless my doctor specifically recommends that I do so. I am physically active most days of the week, do not have hypertension, am at a healthy body weight, and I have a very low risk of heart disease.

What should you do?
Should you now aim for an intake of 1500 mg of sodium? You must decide for yourself. Limiting sodium intake is one way of controlling risk for and management of cardiovascular disease. Ask your doctor if you have concerns about what sodium intake goal is right for you. As well, you might want to explore the "DASH Eating Plan" – an evidence-based eating plan that can help you lower blood pressure at either 1500 mg or 2300 mg sodium intake levels. Here is a link the eating plan in PDF format: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

Have questions about this topic? Let's hear from you! Post your questions on MyNetDiary's Community Forum.

Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

Bernstein, AM, Willett, WC. Trends in 24-h urinary sodium excretion in the United States, 1957-2003: a systematic review. Am J Clin Nutr. 2010;92:1172-80.

Centers for Disease Control. Americans Consume Too Much Sodium. Access online at: http://www.cdc.gov/Features/dsSodium/

Centers for Disease Control. Sodium, The Facts. Access online at: http://www.cdc.gov/dhdsp/library/pdfs/Sodium_Fact_Sheet.pdf
Katherine Isacks, MPS, RD
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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.



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