Earlier this year, the World Health Organization (WHO) released a report sharply critical of the progress the world has made in achieving its global target of reducing sodium intake by 30 percent by 2025. Such a reduction could save seven million lives globally by 2030, WHO estimates, yet only nine countries—Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain, and Uruguay—have comprehensive polices in place to lower sodium intake among its citizens. Among the underperforming countries, the U.S. scored a 3 out of 4 in terms of sodium-reduction policies implemented. The headline of WHO’s news release said it in a nutshell: “Massive efforts needed to reduce salt intake and protect health.” The whole world should get on the ball.
Admittedly, this is a challenge. The human craving for salt, which has been used for millennia as a preservative, developed because of its remarkable ability to enhance the flavor of food. And while a small amount of salt is essential for various bodily functions, it is often harmful at the high levels typically consumed. Through a variety of mechanisms, such as holding onto fluid in our bloodstream, the sodium portion of salt (table salt consists of 40 percent sodium and 60 percent chloride) can raise blood pressure, which increases the risk of heart attack and stroke.
The USDA’s Dietary Guidelines for Americans recommend consuming less than 2,300 milligrams of sodium a day, which is about the amount in one teaspoon of table salt; WHO recommends less than 2,000 milligrams a day. One McDonald’s Quarter Pounder with Cheese has 1,140 milligrams of sodium, while a 1-ounce serving of Doritos (about 12 chips) provides 210 milligrams. Wash that down with a 5.5-ounce can of V8 vegetable juice, and you’ll get another 440 milligrams of sodium. That meal alone: 78 percent of the daily sodium limit.
We’re not evolutionarily adapted to having the superabundance of salt that’s available today. Yes, there are some people who can tolerate enormous amounts without experiencing a rise in blood pressure or an excess of body fluid resulting in edema. But I think it’s a fair statement to say that the vast majority of people are consuming far more salt than needed to meet their physiological needs—and far more than the USDA’s and WHO’s recommended limits.
The U.S. government is making efforts to improve the situation. In 2021, the Food and Drug Administration issued voluntary sodium reduction guidelines for industry. And earlier this year, the agency issued a proposed rule that would allow food manufacturers to use other ingredients in place of salt in standardized foods (certain foods must meet so-called standards of identity to maintain their names, and generally these standards don’t allow for the substitution of salt).
But we can’t count on the food industry to shake things up—especially considering that the government’s guidance to them is voluntary. Individual awareness and self-control remain the best tools for reducing sodium intake, at least for now.
It’s relatively easy, when someone sees the saltshaker in front of them, to say, I’m going to take better care of myself by not picking it up. But it’s important to recognize that their well-intended efforts are going up against firmly entrenched industry norms and cultural habits. Most of the sodium in the typical American diet comes not from the saltshaker but from processed and prepared foods, including restaurant meals. Combating that reality requires heightened levels of attention and action.
Even those who say that maybe we’ve gone too far in demonizing sodium would agree that the kinds of food that have an enormous amount of it—fast-food burgers, pizza, salty snacks—are not what we should be consuming in large or even moderate quantities anyway. But the food industry has convinced us that this is the best way to eat. Having sold that concept to consumers, it isn’t eager to change. Manufacturers have perfected the art of making foods nearly irresistible, having taken the seven recognized flavors of foods that the tongue can detect—sweet, bitter, sour, meaty (umami), cool, hot, and salty—and developed the perfect ratios of all these to maximally attract people to their products. The industry has essentially learned how to create addiction. No, not in the sense of a narcotic addiction, but rather in terms of the consumer wanting to go back for more and experiencing withdrawal when deprived. The food industry knows how first to attract and then how to create constant desire.
When it comes to salt, though, we can break our craving. At home we can adapt to a low-salt diet (as we discuss here) by readjusting our taste buds so that they perceive less salty or unsalted foods as more palatable. And we can learn how to cook with minimal or no salt and still make foods tasty. For instance, the other night, my wife and I made a salt-free bean-and-kale dish. We added a little lemon juice, and it perked the dish right up, just like salt would have. Also consider traditional cuisines such as Indian that achieve incredibly rich flavors from a range of herbs instead of relying primarily on salt. If you’re dining out, you can order salt-light dishes, or at least ask that the preparer not add extra salt. You can also request that salt-heavy sauces and dressings be served on the side.
In regard to processed foods, if you really want to control your sodium intake and improve your health—and I think that for the vast majority of people, the two go together—here are two strategies: Await future adjustments by the food industry to significantly lower the salt in processed foods. Or, my personal recommendation and preference: To whatever extent is feasible, cut back on eating processed foods in favor of cooking more “from scratch” with healthful whole ingredients.
