Sodium Is Everywhere: Here’s How to Lower Your Intake

Sodium is an essential mineral and electrolyte that helps regulate the balance of fluids in our bodies, maintains proper nerve function, and supports muscle activity. Our bodies require a small amount of sodium to function, but too much of it can increase the risk of heart failure, kidney disease, stroke, and heart attacks.

Yet, nearly 90% of Americans consume more than the daily maximum of 2,300 milligrams (mg) recommended by the Food and Drug Administration (FDA)—equivalent to one teaspoon of salt. On average, U.S. adults consume about 3,400 mg of sodium per day.

"For best heart health, we really recommend 1,500 mg daily. So, the average American is eating more than double the optimal amount of sodium per day," says Nate Wood, MD, MHS, an internal medicine, obesity medicine, and primary care physician with special expertise in culinary medicine. "We're all at risk."

In 2021, the FDA provided food industry guidance in the form of voluntary sodium reduction targets for processed, packaged, and prepared foods to help combat overconsumption in the U.S. In August, it announced a proposal for further voluntary cuts to sodium. The agency aims to reduce the average amount of sodium consumed daily to 2,750 mg. The American Heart Association estimates that lowering daily sodium further to 2,300 mg—the daily maximum recommended by the FDA and the Dietary Guidelines for Americans, 2020-2025—could prevent 450,000 cases of cardiovascular disease and save $40 billion in health care costs over 20 years.

Below, Dr. Wood discusses the differences between salt and sodium, why excess sodium negatively affects the body, and how to lower your sodium intake.

Salt and sodium are related but distinct substances, and it's important to understand the difference between them:

Sodium is a single element naturally found in certain foods like celery, beets, and milk, while salt, or “table salt,” is a compound made up of sodium and chloride. Sodium on its own is an essential electrolyte for bodily functions, whereas salt is primarily used for culinary purposes and as a preservative. When people talk about reducing "sodium" in their diet, they often mean reducing their salt intake, because high salt consumption can lead to excessive sodium intake, which is linked to health issues like high blood pressure.

"Sometimes people get sodium and salt confused," Wood says. "When we think about salt, it is 40% sodium and 60% chloride." (Kosher salt and most sea salt are also about 40% sodium.)

Humans have been using salt for thousands of years to preserve and enhance the flavor of food. But with the increase in packaged and prepared foods over the past 100 years, our eating habits have shifted dramatically.

"We actually get most of our daily salt from fast food, restaurant food, and ultra-processed foods," Wood explains. "Those foods are packed with salt, and in general, we just eat too much of that every day."

More than 70% of the salt we consume comes from packaged foods—not from the salt we add to meals while cooking.

The biggest risk from a high-salt diet is developing hypertension, or high blood pressure. This condition is commonly referred to as the "silent killer" because of its ability to quietly wreak havoc on the body with few noticeable symptoms. If left untreated, high blood pressure can lead to serious complications, such as kidney failure, stroke, and heart attack.

Blood pressure is the measure of how forcefully blood pushes against the walls of your arteries. For a variety of reasons, including excess sodium consumption, pressure can build up in the walls of our blood vessels, which can damage the heart, kidneys, and brain.

Eating salty snacks like popcorn or chips can raise our blood pressure, because "water follows salt," Dr. Wood explains. "If you eat a lot of salt, you get very thirsty. This is to keep the level of saltwater in your blood at the right level."

When we drink more water to balance this ratio, the blood vessels in our bodies become packed with fluid, leading to a rise in pressure. In addition to hypertension, high sodium consumption can also increase the risk of kidney stones, osteoporosis, and stomach cancer.

"If you're eating a lot of sodium, your kidneys have to get rid of that excess," Dr. Wood says. "And in the process of ridding the body of sodium, you also lose calcium," increasing the risk of kidney stones. Losing too much calcium during urination can also lead, over time, to bone thinning and osteoporosis.

"The final concern with consuming too much sodium is that it causes direct damage to your stomach lining," Dr. Wood says. "That leads to inflammation and the cells of the stomach lining regenerating themselves more frequently to repair the damage. That combination of inflammation and cells replicating more quickly is a perfect recipe for cancer."

Many products in grocery stores or fast food restaurants are engineered to be addictive. Companies use a carefully formulated balance of salt, sugar, and fat to manipulate our bodies into craving more. "In our modern food environment, we see that combo of fat, sugar, and salt in ultra-processed foods," Dr. Wood says. "These are for-profit food companies, so the more you eat, the more you buy, and the more money they and their shareholders make. It's really about making the food so delicious that you can't stop eating it."

In low-income communities or areas with lower access to healthy foods (often called “food deserts”), processed foods may be the only option for many families.

"That includes older adults, too, because many of them experience food insecurity," Dr. Wood says. "Perhaps they can't drive or don't have someone to cook for them, so they end up eating a lot of pre-prepared and processed foods, like canned soups and restaurant foods."

Limiting ultra-processed foods, restaurant meals, and fast foods is the best way to decrease your daily sodium intake, Dr. Wood says. However, prepared foods tend to be more convenient and less expensive than other options, so getting rid of these meals altogether might not be feasible for every American.

When buying packaged and frozen foods, Dr. Wood suggests comparing labels and choosing the item with the lowest amount of salt. Often, companies will specifically make low-sodium versions of foods like crackers or potato chips to cater to individuals looking to lower their salt consumption. When cooking frozen meals, like pastas or stir-fries, "add in a bag of unsalted frozen vegetables," Dr. Wood says. "Per volume, the amount of salt in the dish will effectively go down."

Canned products like beans generally have a lot of added salt, so pouring them into a colander and rinsing away the salty liquid can help reduce total sodium, too.

For people cooking at home, "I encourage them to use salt, because it really does improve the flavor of their food. Then, they’ll be more likely to eat more of this home-cooked food, which is generally better than processed food," Dr. Wood says. "But knowing that most people eat too much salt, the recommendation is, basically, to be judicious."

To reduce the amount of salt added to home-cooked meals, Dr. Wood has a few different recommendations. First, salting a dish at the end instead of throughout the cooking process can make a dish taste good without being too salty. "Food that has salt on top of it ends up right on your tongue, and you can get away with using less salt overall," he says.

Next, he advises increasing the use of spices and herbs in a dish. All of these seasonings, including clove, thyme, sage, and oregano, are tasty and packed with healthy antioxidants—a "win-win," he says. People who don’t have kidney disease and are not at high risk of having too much potassium in their diet can also substitute potassium chloride for sodium chloride. Potassium chloride is a sodium-free salt alternative that has a salt-like taste but with a slightly metallic flavor. Replacing just a portion of the salt in a recipe can prevent the entire dish from being too bitter.

Lastly, a common cooking error Dr. Wood often sees is the failure to add acids, such as vinegar or citrus juice, to meals.

"Acid tickles the same taste buds as your salt receptors on your tongue," Dr. Wood says. "Most people don't use any acid unless it's naturally occurring, like in tomatoes, for instance. But most dishes benefit from a little bit of citrus juice or vinegar. So that's a big one."