Even at-risk patients struggle with low-sodium diets

New research from the American Heart Association has shown that heart failure patients who are actively trying to reduce sodium intake still consume more than is recommended even for healthy people.

Despite widespread industry efforts to cut sodium content in food products, it is estimated that Americans still get 70 to 80 percent of their sodium from packaged foods, rather than from salt added at the table.

At present, healthy US adults are advised to consume no more than 2,300mg of sodium each day, equivalent to about six grams or one teaspoon of salt. The effects of excessive salt consumption have been well-researched, including its contribution to heart disease, high blood pressure and stroke.

However, despite these health impacts, Americans currently consume an average of about ten grams of salt each day – or two-thirds more than the government-recommended maximum.

The American Heart Association’s research, presented at its 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, examined the sodium intake of 161 heart failure patients over a three-day period, and found a range of 522mg to 9,251mg per day, with an average of 2,671mg. The recommended daily maximum intake for heart failure patients is 2,000mg.

The results are consistent with trends across the American population, showing that people are generally unaware of how much sodium they consume.

‘Hidden’ salt

Abstract co-author and postdoctoral fellow at Atlanta’s Emory University Carolyn Reilly said that the patients exceeded the recommended amount despite the fact that most of them thought they had reduced their sodium intake.

She said: “There is so much salt hidden in foods that patients aren’t aware of…Everything processed has sodium in it to give it a longer shelf life. In addition to safety, sodium is also added to foods to enhance texture and mask bitterness. Some of the big culprits we have identified in this population are cured meats such as hot dogs and bacon, and other processed foods like canned soups, salad dressings and condiments.”

Dietary shortcomings

In addition, the patients’ dietary analysis showed that while they were eating more than enough protein, they were not getting enough whole grains, fruit, vegetables or low-fat dairy. Over the three days, more than 40 percent of patients ate at least one fast-food sandwich with 1,115 mg of sodium, and one in seven had pizza containing 1,461 mg of sodium.

Reilly added that simply giving patients a list of foods to eat and telling them to look at nutrition labels is not enough. Dietary guidelines need to be tailored to the individual, she said.

“The patients themselves were shocked to find out they were eating more than 2000 mg of sodium a day. Most of the patients thought they were taking steps to reduce their sodium, but focused on the wrong target.”

The study found that women and those earning over $35,000 a year were most likely to adhere to the low-sodium diet.