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Assessing the Salt Content of Processed Foods
About a month ago I had to update our page on Low Sodium Diets (Bite, 03/03/10). Turns out the estimates of how much salt people in the United States were consuming, on average, had gone up: to over 10 GRAMS of salt per day for men and 7.4 grams per day for women. If everyone reduced their salt intake to the recommended maximum of 2.4 grams per day, we could avoid as many as 92,000 deaths every year.

Not Much Better (But at Least No Worse) Redux: Processed Food Edition
A couple of months ago I reported on a survey of the healthfulness of fast food restaurant foods. The study found that when compared to the US Government's recommendations for a healthy diet, overall the healthfulness of fast foods had increased by a mere 3% overall over the last fourteen years while still averaging less healthy than the average American's diet. An article published in JAMA Internal Medicine (2013;173(14):1285-1291) takes a similar approach, comparing levels of sodium in processed foods and fast foods between 2005, 2008, and 2011.

Sodium Claims on Food Labels
Since you're a Dr. Gourmet reader, you're probably well aware of the relationship between high sodium intake and the increased risk of high blood pressure and heart disease. Because processed foods are the largest source of sodium in a Western diet, many countries allow specific health claims related to sodium to be listed on a food's label in addition to the sodium information listed in the Nutrition Facts.


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Good news about sodium

processed meats in the form of hot dogs and condiments, both major sources of purchased sodium

Long-time readers of Dr. Gourmet's Health & Nutrition Bites will be aware that the average American consumes as much as three to five times the recommended amount of sodium each and every day. Since packaged foods (as opposed to fresh ingredients) have been identified as a major source of sodium in the typical American diet, and cutting one's sodium intake can help reduce your risk of high blood pressure and heart disease, the Institute of Medicine called on packaged food producers to reduce the amount of sodium in their packaged food products.

Some processed food producers, most notably Nestle and General Mills, responded with voluntary pledges to reduce the amount of sodium in their foods. The question, of course, is whether this has made a difference in the amount of sodium in the foods people are buying.

An international team of researchers (JAMA Int Med doi:10.1001/jamainternmed.2017.1407) utilized data collected by The Neilsen Company as part of their 2000 to 2014 Nielsen Homescan Consumer Panel. This survey includes between 30,000 and 60,000 American households each year, and each household records all packaged food and beverage purchases using a handheld UPC code scanning device. For the purposes of this analysis the data included over 170,000 US households and nearly 1.5 million food and beverage products.

The scanned UPC codes allowed the authors to identify exactly which products the participants purchased, then link those products to their official Nutrition Information panels, which include sodium content. Thus the authors could break out each household's purchases by year, product, and type, and then analyze the amount of sodium those purchases contained.

The authors looked at not only the average amount of sodium (in milligrams) purchased daily per person, but also could calculate the average amount of sodium by weight of the food purchased as well as the food's sodium density (amount of sodium per calorie in the food).

The good news is that the amount of sodium purchased in the form of processed foods (that is, foods that come with a Nutrition Facts panel) is down: between 2000 and 2014 the average US household purchased 396 milligrams less of sodium per day per person, even though the households purchased about the same amount of packaged foods. The authors estimate that a decrease in sodium intake of this size would "reduce new cases of coronary heart disease by 20,000 to 40,000" each year while reducing the number of deaths from all causes by up to 32,000 people per year.

What this means for you

Yes, the amount of sodium in processed foods appears to be down, but only by about 12% overall, which still does not bring the average US household under the Institute of Medicine's recommendation of not more than 2,000-2,400 milligrams of sodium per day for a healthy adult. The top ten sources of sodium, in terms of percentage of sodium contributed to the household, in the foods in this study were as follows:

1. Condiments, sauces, and dips
2. Mixed dishes
3. Salty snacks
4. Breads
5. Processed meat
6. Cheese
7. Soup
8. Grain-based desserts [cookies and cakes]
9. Vegetables [remember these are foods with a Nutrition Facts panel and not fresh foods]
10. Breakfast cereal

At least 5 of these - condiments, sauces, and dips; salty snacks; soup; vegetables; and breakfast cereal [or some other healthy breakfast option] - can easily be made at home from fresh ingredients. With a little planning these foods will be cheaper and contain less sodium than their boxed cousins, and it's likely you'll save money as well.

First posted: June 7, 2017