Excess sodium intake can lead to hypertension, a major risk factor for cardiovascular disease. A meta-analysis concludes that a difference of 5g of salt intake a day is linked to a 23% difference in the rate of stroke and a 17% difference in the rate of total cardiovascular disease.20 The Institute of Medicine (IOM) has determined that a daily dietary intake of 2,300 mg of sodium is the tolerable upper intake level for adults. However, the average sodium intake among Americans is 3,400 mg/day and over 90% of adults exceed the recommended upper intake level. While reducing sodium intake to 1,500 mg provides better blood pressure control, the IOM found no evidence of benefit for overall health outcomes below the 2,300 mg level.21 Even without achieving this level, reducing sodium intake by at least 1,000 mg/day lowers blood pressure.

Because over 75% of consumed sodium comes from processed foods and less than 10% of Americans consume 2,300 mg/day or less of recommended dietary sodium, the American Heart Association and the IOM have jointly recommended populationwide salt reduction measures including government standards for manufacturers, restaurants, and foodservice operators.24,25 Advise patients to read the Nutrition Facts panel on food labels closely to help them adhere to the 2,300-mg/day guideline. Urge them to consider the well-investigated Dietary Approaches to Stop Hypertension, or DASH Eating Plan, for a model diet.

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