Don't Pass the Salt

Doc

tors have long known that cutting back on salt or sodium can help lower blood pressure in folks with hypertension, a silent condition that increases the risk of heart attack and stroke. What hasn't been so clear is whether reducing the amount of sodium in the diet will benefit those whose blood pressure is normal. Now comes word that restricting salt can indeed lower normal blood-pressure levels. Though the effect isn't as great, it's still important, according to a study published in last week's New England Journal of Medicine.

The decrease in blood pressure occurred regardless of race or gender and whether or not study participants ate a "typical American diet," which is high in saturated fats and skimps on fruits and vegetables, or the so-called DASH (for Dietary Approaches to Stop Hypertension) diet, which emphasizes lots of fresh produce, low-fat dairy, fish and fewer sweets and which was proved in 1997 to reduce hypertension. The biggest decreases in blood pressure in this study were recorded in subjects who ate the DASH diet and reduced their sodium intake to 1,200 mg a day.

Why is this significant? Public-health experts estimate that Americans consume, on average, about 3,500 mg of sodium--equal to about 9 grams of salt--each day. Current guidelines recommend consuming no more than 2,300 mg of sodium--about 6 grams of salt--daily. It's not that we're that heavy-handed with the saltshaker. Most of our dietary sodium is added during food processing. To get down to 1,200 mg, you'd have to forgo most prepared foods, take-out deliveries and restaurant meals.

As someone who periodically comes home late from work too pooped to do anything but dial up some sodium-packed Thai food, I know that eating home-cooked meals all the time is not terribly practical. But with a little planning and some self-awareness, you can work around those occasional slips. Salt is, after all, essential to life. The trick is to adopt an overall pattern of healthy living and not depend on any one thing to make up for bad habits.

So pay attention to how much salt you're eating, but don't forget to make fruits, vegetables and whole grains a larger part of your diet. They'll help lower your cholesterol levels as well as your blood pressure. Be sure to drink alcohol moderately, if at all. Losing weight--even just 10 lbs.--and exercising at least 30 minutes most days of the week can also have a marked effect on blood pressure.

Folks with kidney problems should check with their doctor before cutting back on salt. If you do decide to cut down on salt, do it gradually to give your taste buds time to adjust. Try substituting lemon, parsley, pepper or oregano for salt.

Check food labels. Pasta sauces, sandwich breads and frozen dinners often contain lots of sodium.

And remember, even if you don't have to worry about this now, you probably will eventually. Half of U.S. adults have a blood pressure of at least 120/80 mm Hg, which is at the high end of what's considered ideal--and blood pressure usually increases with age. "We can't put everyone on drug therapy," says Dr. Frank Sacks of the Brigham and Women's Hospital in Boston and the chairman of the DASH-sodium study. But everyone can try to do with a dash less salt.

For more on salt and hypertension, visit dash.bwh.harvard.edu. Also try Salt and Hypertension: Facts and Flavorful Solutions from the American Dietetic Association, and the website for the American Society of Hypertension

E-mail Christine at gorman@time.com