Jeremiah Farias

How Much Sodium Should Be In Our Diet?

Written by Jeremiah Farias on September 7, 2020

In Alan Aragon’s August Research Review, he covers the topic of sodium. The topic of sodium is up there with other controversial subjects, including saturated fat, red meat, dairy, and eggs.

The American Heart Association (AHA) currently advises that the maximum intake of salt should be 2,300 mg/day, but states 1,500 mg/day is more ideal. However, are these recommendations appropriate given the current data?

Sodium is an essential macromineral, and the minimum intake of sodium/day is thought to be less than 500 mg/day. The average sodium intake in Americans appears to be around 3,600 mg/day, while Aragon cites data that puts average global sodium intakes around 3,660 – 4,000 mg/day.

With that said, the Institute of Medicine (IOM) states: 

Existing evidence, however, does not support either a positive or negative effect of lowering sodium intake to <2300 mg/d in terms of cardiovascular risk or mortality in the general population.”

Further, the IOM states:

“For other at-risk populations (e.g., those with diabetes or prehypertension), the available data do not support additional benefits of lowering sodium intake to <2300 mg/d.”

According to a meta-analysis done by Graudal et al., there is a U-shaped association between sodium intakes and health outcomes. Meaning, both low and high intakes of sodium are associated with increased mortality. 

Instead of mentioning what constitutes low vs. high, we will look at what is optimal. The same meta-analysis by Graudal et al. states the optimal range of 2,645 – 4,945 mg/day of sodium is associated with the most favorable health outcomes. 

Lastly, Aragon mentions there has unfortunately been a lack of emphasis on dietary potassium, despite an inverse relationship between potassium intake and blood pressure. Therefore, the greater potassium intake, ideally from one’s diet, the lower one’s blood pressure tends to be. 

The takeaways:

  • Recommendations for limiting sodium intake to no more than 2,300 mg/day in the general population are not evidence-based. However, those with hypertension and/or overweight/obesity may benefit from recommendations. 
  • Ensuring an adequate intake of Potassium-rich foods versus restricting sodium may be a better approach for improving health.
  • While there is a lack of evidence for restricting sodium to ≤ 2,300 mg/day, this does not mean consuming highly-processed food high in sodium is warranted. These recommendations for sodium should be in the context of a whole, minimally-processed, diet.

I hope you found this information interesting. If you have questions or suggestions for topics you would like me to cover please do not hesitate to reach out!

That’s all for now!

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2 Responses

  1. Thanks for the information, it is always good to know which salt is best. I do find the pink very flavorful!

Sources:

Antman, E. M., Appel, L. J., Balentine, D., Johnson, R. K., Steffen, L. M., Miller, E. A., Pappas, A., Stitzel, K. F., Vafiadis, D. K., & Whitsel, L. (2014). Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the American Heart Association Sodium Conference 2013 Planning Group. Circulation, 129(25), e660–e679. https://doi.org/10.1161/CIR.0000000000000051

Aragon, A. AARR. Aug. 2020.

Cogswell, M. E., Loria, C. M., Terry, A. L., Zhao, L., Wang, C. Y., Chen, T. C., Wright, J. D., Pfeiffer, C. M., Merritt, R., Moy, C. S., & Appel, L. J. (2018). Estimated 24-Hour Urinary Sodium and Potassium Excretion in US Adults. JAMA, 319(12), 1209–1220. https://doi.org/10.1001/jama.2018.1156

Farquhar, W. B., Edwards, D. G., Jurkovitz, C. T., & Weintraub, W. S. (2015). Dietary sodium and health: more than just blood pressure. Journal of the American College of Cardiology, 65(10), 1042–1050. https://doi.org/10.1016/j.jacc.2014.12.039

Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014). Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. American journal of hypertension, 27(9), 1129–1137. https://doi.org/10.1093/ajh/hpu028

McGuire S. (2014). Institute of Medicine. 2013. “Sodium intake in populations: assessment of evidence.” Washington, DC: The National Academies Press, 2013. Advances in nutrition (Bethesda, Md.), 5(1), 19–20. https://doi.org/10.3945/an.113.005033

Poorolajal, J., Zeraati, F., Soltanian, A. R., Sheikh, V., Hooshmand, E., & Maleki, A. (2017). Oral potassium supplementation for management of essential hypertension: A meta-analysis of randomized controlled trials. PloS one, 12(4), e0174967. https://doi.org/10.1371/journal.pone.0174967

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