| BACK | INDEX | HOME | BOOK STORE | ASCVD TOC | NEXT |
| ASCVD Page Number Selection |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |
William H. McMicken, M.D.
Suite 323
2600 Philmont Avenue
Huntingdon Valley, Pennsylvania 19006
Page 13

In the United States, we are accustomed to highly salted food, and daily sodium intake may be 5,000 mg. daily or more. One teaspoon of salt contains approximately 2,000 mg. of sodium. About one-third of the salt in our diets comes from the salt naturally present in foods. Another one-third comes from salt added in cooking and at the table. There is "hidden salt" in many processed foods. For instance, McDonald's Big Mac®, a Burger King Whopper®, or a hot dog with chili have more than 900 mg. of sodium each, and a Kentucky Fried Chicken dinner with three pieces of chicken, potatoes, gravy, coleslaw, and a roll has as much as 2,285 mg. One large dill pickle may have over 1,900 mg. One green olive may have up to 165 mg. of sodium. One cup of Wheaties® or Total® cereal has over 350 mg. of sodium, before milk (which contains approximately 15 mg. sodium per ounce) is added. Other foods with high salt content include frankfurters, ham, bacon, bologna, salami, pastrami, sauerkraut, corned beef, processed cheeses, potato chips, pretzels, salted popcorn, salted crackers, corn chips, and frozen dinners.

One of the easiest ways to decrease your salt intake is always to taste food before adding salt. You may then decide to try some other condiment as an alternative. There are salt-free condiments now available in the spice department of the supermarket. There are low-sodium versions of such high sodium condiments as ketchup, Worcestershire sauce, and soy sauce. Angostura Aromatic Bitters is also a low sodium option to high salt flavorings. Herbs and spices, such as pepper, oregano, basil, coriander, dry mustard, curry, paprika, ginger and cinnamon are low in sodium and can flavor foods without salt. You can also make your own version of "lemon-pepper" seasoning by adding two teaspoonsful grated lemon peel to one tablespoonful ground black pepper.

Sodium restriction to 3,000 to 4,000 mg. daily is considered mild restriction, 2,000 to 3,000 mg. is moderate. Severe restriction to 1,000 to 2,000 mg. may be necessary when there is associated kidney impairment or congestive heart failure and fluid retention. Mild to moderate restrictions do not usually require a person to eliminate foods which naturally contain more sodium, such as milk. If possible, it is advisable to gradually reduce salt intake, since it may take up to three months of restriction to lose one's desire for salt. Most people adjust well, and then find ordinary foods "too salty" for them. It is useful to examine the labels of prepared foods in the supermarket when shopping.

In Table 3. below are the labeling guidelines that took effect in 1986. Terms such as "reduced sodium", "low sodium", etc., now have a legal definition which must be observed when sodium content is listed on the label. When not otherwise indicated, it is a good rule to choose foods in which the list of contents shows "salt" or "sodium" near the end of the list. It would not be very discriminating to choose foods which have salt near the beginning of the list. Such lists of ingredients are in decreasing order by weight. Just because the label states a food is "unsalted" or "without added salt" does not necessarily mean it is low in salt, since some foods are naturally high in sodium.

TABLE 3.SODIUM LABELING GUIDELINES

Reduced Sodium .. Usual sodium level reduced by 75%
Low Sodium ............ 140 mg. or less per serving
Very Low Sodium ........ 35 mg. or less per serving
Sodium Free ........... Less than 5 mg. per serving
Salt Free...................... Same as Sodium Free
Unsalted .......... No salt added during processing

Diets, Alcohol, and Mineral Supplements
There are a number of relationships linking hypertension and obesity. Obese persons have been shown to have a higher risk of developing high blood pressure. Thin hypertensive patients have a tendency to become overweight. Weight loss commonly reduces blood pressure in hypertensive patients, even in the absence of salt restriction or other treatment.

A diet low in saturated fat and cholesterol usually results in ingestion of fewer calories, and is helpful in maintaining ideal body weight. Almost half of hypertensive people are overweight. The blood pressure tends to rise and fall with the weight gain or loss. Reducing dietary saturated fats and cholesterol has already been discussed earlier in the material on risk factors. It will be addressed in more detail also in the section concerning coronary heart disease in particular.

 

Page 13

| BACK | INDEX | HOME | BOOK STORE | ASCVD TOC | NEXT |
| ASCVD Page Number Selection |
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 |