Most people consume more sodium than is recommended. This is because sodium is present in almost everything we eat. It is naturally present in many foods, such as vegetables, eggs, and meats, and is also added to most processed foods, from breakfast cereals to potato chips. Continue reading to learn about the health effects of sodium, how much sodium per day you need, and how you can reduce your sodium intake for better health. (13)(22)
What is sodium?
Sodium (Na), most commonly known as a component of salt (NaCl), is an electrolyte that is essential to human life. (8) Electrolytes are minerals that carry an electrical charge. They are present in the bloodstream, tissues, urine, and other bodily fluids. (19) Sodium’s primary function is to maintain homeostasis, the regulating processes that occur to maintain balance and stability in the body. (16) Sodium helps to maintain homeostasis by working with the other electrolytes, including calcium, chloride, magnesium, phosphate, and potassium, and is involved in the regulation of:
- The amount of water in the body
- The balance of the body’s acid/pH level
- The movement of nutrients into cells
- The movement of waste out of cells
- The proper functioning of the nerves, muscles, heart, and brain (19)
Sodium intake: how much sodium is too much?
Although sodium is necessary for cellular homeostasis and physiological function, we only require a small amount for optimal functioning. Adults only need about 500 mg per day of sodium to maintain homeostasis. (6) The American Heart Association recommends that people should not consume more than 2,300 mg of sodium per day and, ideally, reduce their intake to 1,500 mg or less. However, on average, most Americans consume more than 3,400 mg per day—more than double the ideal intake recommended by the American Heart Association. (3)(13)
Health effects of high sodium intake
We have already established that most Americans consume more sodium than is recommended, but does excess sodium consumption have consequences? Excessive dietary sodium has been linked to a number of serious health concerns, such as arterial stiffness, high blood pressure, cardiovascular disease, and premature death. (10)
Arterial stiffness and target organ damage
High dietary sodium can cause target organ damage by directly affecting the brain, heart, kidneys, and vasculature (blood vessels). These effects can occur even if blood pressure is not elevated. (6) This was demonstrated by a human study in which increased arterial stiffness was observed in groups that did not have high blood pressure and consumed higher sodium. (1) Other studies have found that decreasing sodium intake improved arterial elasticity in those with high blood pressure. (6)(7)(17) In addition to sodium’s effects on arterial stiffness, there is also some research suggesting that high amounts of dietary sodium are associated with reduced kidney function. (6)(15)
Research has associated excess sodium intake with elevated blood pressure levels and hypertension. Sodium draws fluid into blood vessels causing volume expansion and increases in blood pressure. (5) A meta-analysis of 103 randomized trials concluded that blood pressure decreased when sodium intake was reduced in both the presence and absence of hypertension. (12) Another study which included adults both with and without hypertension found that the groups who consumed the most sodium had greater left ventricle mass, a cardiovascular complication that can occur due to high blood pressure. (14)
Excess sodium consumption also increases risk of death from complications related to heart disease. A meta-analysis showed that higher sodium consumption was associated with a higher rate of death from coronary heart disease and death from a stroke. In 2010, 1.65 million deaths globally occurred as a result of cardiovascular causes and 10% of these deaths were linked to sodium consumption of more than 2 g per day. (12)
Health effects of low sodium
Low levels of sodium in the blood is referred to as hyponatremia. (21) Considering the amount of sodium most people consume, sodium deficiency is not very common. Conditions that may lead to sodium deficiency are typically conditions that also cause dehydration, including:
- Chronic diarrhea
- Continuous gastric suction (a procedure to empty the contents of your stomach through suction) (20)
- Diabetic ketoacidosis (a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones) (18)
- Excessive intake of diuretics (medications or other agents that increase urine output) (2)
- Extensive burns
- Extreme and prolonged sweating
- Severe adrenal insufficiency
- Sodium-losing kidney disease
- Uncontrollable vomiting (16)
However unlikely, sodium levels can fall under optimal levels as a result of insufficient intake or the conditions mentioned above. Sodium deficiency is associated with severe consequences. Symptoms of sodium deficiency include anhedonia (the inability to feel pleasure which is often seen in depression and other mental health conditions), impaired cognition, fatigue, and muscle cramps. (9)(11)
How to reduce sodium intake
There are a number of ways to decrease sodium intake. One simple way is to use less salt when preparing meals at home. To enhance the flavor of your food without the use of excess salt, try incorporating other herbs and spices, such as garlic, cumin, and pepper. Since most people get about 70% of their sodium intake from high-sodium processed and packaged foods, decreasing your intake of these foods or opting for low-sodium alternatives may be an effective way to decrease sodium levels. (6) However, even if a product is marketed as reduced or low sodium, always check the sodium content found on the nutrition facts label.
Nutrition labels: what to look for when trying to reduce sodium intake
When purchasing processed or packaged foods always look at the nutrition facts label. The % Daily Value (% DV) represents how much a specific nutrient contributes to the total recommended intake for that nutrient. For example, if a single serving of salted nuts has 25% DV of sodium, a serving of nuts contributes to 25% of the total recommended daily intake for sodium. Use the % DV to determine if a serving of the food is high or low in sodium based on recommended intake. When reducing sodium intake, choose foods that will add to less than 100% DV of sodium each day. (4)
The bottom line
Sodium is essential for many body functions; however, most people consume far more salt than is recommended. Excessive dietary sodium intake has been linked to high blood pressure, cardiovascular disease, and other health complications. Sodium deficiency is rare but can occur, most commonly as a result of dehydration.
For guidance on how much sodium per day you need, achieving optimal nutrient intake, including sodium levels, speak to your integrative healthcare provider before making significant changes to your diet.
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- Cook, N. R., He, F. J., MacGregor, G. A., & Graudal, N. (2020). Sodium and health—concordance and controversy. BMJ, m2440.
- Farquhar, W. B., Edwards, D. G., Jurkovitz, C. T., & Weintraub, W. S. (2015). Dietary sodium and health. Journal of the American College of Cardiology, 65(10), 1042–1050.
- Gates, P. E., Tanaka, H., Hiatt, W. R., & Seals, D. R. (2004). Dietary sodium restriction rapidly improves large elastic artery compliance in older adults with systolic hypertension. Hypertension, 44(1), 35–41.
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- McCance, R. A. (1936). Experimental sodium chloride deficiency in man. Proceedings of the Royal Society of London. Series B – Biological Sciences, 119(814), 245–268.
- Mozaffarian, D. (2014). Global sodium consumption and death from cardiovascular causes. New England Journal of Medicine, 371(7), 624–634.
- National Center for Chronic Disease Prevention and Health Promotion. (2021, February 26). Sodium and Food Sources | cdc.gov. Centers for Disease Control and Prevention. https://www.cdc.gov/salt/food.htm
- Rodriguez, C. J., Bibbins-Domingo, K., Jin, Z., Daviglus, M. L., Goff, D. C., & Jacobs, D. R. (2011). Association of sodium and potassium intake with left ventricular mass. hypertension, 58(3), 410–416.
- Smyth, A., O’Donnell, M. J., Yusuf, S., Clase, C. M., Teo, K. K., Canavan, M., Reddan, D. N., & Mann, J. F. E. (2014). Sodium intake and renal outcomes: a systematic review. American Journal of Hypertension, 27(10), 1277–1284.
- Strazzullo, P., & Leclercq, C. (2014). Sodium. Advances in nutrition, 5(2), 188–190.
- Todd, A. S., MacGinley, R. J., Schollum, J. B., Johnson, R. J., Williams, S. M., Sutherland, W. H., Mann, J. I., & Walker, R. J. (2010). Dietary salt loading impairs arterial vascular reactivity. The American Journal of Clinical Nutrition, 91(3), 557–564.
- U.S. Department of Health and Human Services. (n.d.-a). Diabetic ketoacidosis. MedlinePlus. Retrieved September 21, 2021, from https://medlineplus.gov/ency/article/000320.htm
- U.S. Department of Health and Human Services. (2016, June 20). Fluid and electrolyte balance. Medlineplus.Gov. https://medlineplus.gov/fluidandelectrolytebalance.html
- U.S. Department of Health and Human Services. Gastric suction. MedlinePlus. Retrieved September 21, 2021, from https://medlineplus.gov/ency/imagepages/8653.htm
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