Image: Kathryn Starratt
Larry Crowe  /  AP
Although Kathryn Starratt of Hopkinton, N.H., has made many healthy changes in her life, not even her high blood pressure has persuaded her to give up her favorite condiment, salt.
updated 8/7/2006 2:37:53 PM ET 2006-08-07T18:37:53

When it comes to seasoning food, there’s no shortage of salt options.

But when it comes to health, it doesn’t matter if it was mined in Kansas, solar-evaporated from the Mediterranean Sea or hand-harvested in French marshes. Salt is salt, the experts say, and it’s bad for your health. Chances are you’re eating way too much of it.

If you think setting down the shaker will make a difference, take that advice with a grain of salt. Most salt comes from processed foods and restaurants.

Here’s what’s known. For good health, most people need less than a quarter-teaspoon a day of salt — a natural mineral known as sodium chloride. Of course, except for medically supervised diets, it’s almost impossible to consume that little.

In fact, many foods exceed that amount per serving. Most Americans consume as much as 2 teaspoons of salt a day, far above the recommended half-teaspoon for healthy adults, according to the Institute of Medicine.

Deadly craving
That’s a serious problem. Though the mechanism behind it isn’t fully understood, high-salt diets can cause high blood pressure, a risk factor for heart and kidney disease and stroke.

“This is the equivalent of a jumbo jet with 400 people on it crashing every day,” says Dr. Stephen Havas, vice president of public health for the American Medical Association. He says if Americans cut their salt use in half, 150,000 lives a year could be saved.

Don’t think that having normal blood pressure exempts you. Because blood pressure naturally rises with age, people become increasingly susceptible to salt’s ill effects. Many researchers also think salt has a cumulative effect, triggering problems after years of overuse.

The good news is that much of the damage is reversible simply by cutting back on salt. The bad news?

“Reducing your salt doesn’t necessarily reduce your blood pressure to normal,” says Dr. Jeffrey Cutler, senior adviser at the National Heart, Lung and Blood Institute. “If you have hypertension, most likely you will need some medication.”

So what should you do about it? Start by understanding the source of the salt.

Health officials aren’t concerned about the dash in your pasta cooking water or the sprinkle on your scrambled eggs. Salt added at the table or during cooking accounts for less than a quarter of the sodium in the American diet.

It’s processed and restaurant foods that are the problem.

For perspective, a McDonald’s Quarter Pounder with Cheese contains nearly half a teaspoon of salt, while two slices of Pizza Hut Meat Lover’s Stuffed Crust pizza has more than a teaspoon. Even most low-sodium canned soups contain nearly a quarter teaspoon.

And taste isn’t always a good indicator. A serving of Cheerios has more salt than a serving of Ruffles potato chips.

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Because processed and restaurant foods dominate the American diet, it can be hard to cut back — unless you eat out less and buy fewer processed foods.

Health officials aren’t waiting for that to happen. That’s why they think change hinges more on the food industry than the consumer.

“You don’t have to ask people to do anything,” says Dr. Norman Kaplan, a blood pressure expert at University of Texas Southwest Medical Center in Dallas, “if you could get the food processors to do it.”

That’s a big if.

Advocacy groups, such as the Center for Science in the Public Interest, for years have pushed the government to regulate salt, put warning labels on high-sodium foods and devise a program for gradual reductions in restaurant and processed foods. To no avail.

Salt is classified “generally recognized as safe” by the Food and Drug Administration, which says it prefers a voluntary, industry-led approach to reductions. Industry and government officials also say consumers can make healthy choices using existing nutrition labels.

Recently, the debate intensified. The American Medical Association in June joined the push, urging the government to require labeling of high-salt foods, and called on the processed food and restaurant industries to cut salt levels by half during the next decade.

The group also asked the government to revoke salt’s status as safe.

So far, the government — which last year issued new dietary guidelines urging Americans to eat less than a teaspoon of salt, about 100 milligrams less than the previous guidelines — hasn’t committed either way. Officials say they are considering the best way to examine the issue.

So far, the government hasn’t committed either way, but says it is considering the best way to examine the issue.

To its credit, the food industry has worked to find a low-sodium salt alternative — which it calls the Holy Grail of food processing — and many companies have introduced lower-sodium products, or quietly lowered the salt in existing foods.

But salt is hard to replace. Besides enhancing other flavors, it also trains the palate, leaving unsalted foods tasting bland. As a result, low-sodium products remain a minority and most salt substitutes have disappointed.

Blame for that is shared, says Alison Kretser, nutrition director for the Grocery Manufacturers Association. She says consumers have spurned many low-sodium products and the government hasn’t done enough to fund research into salt alternatives.

Of course, industry fear and reluctance have a role, too. Salty foods drive beverage sales, so many companies stand to lose from low-salt foods. Meanwhile, food processors worry that lowering the salt in their products will push consumers to competitors.

In the United Kingdom, that fear was addressed by a government-led campaign to cut salt across the food industry. Already, salt in breads and soups is down 30 percent. The goal is to lower total sodium consumption to a teaspoon a day by 2010.

Staggered cutbacks
The salt cutbacks are staggered at 10 percent a year, so most consumers apparently don’t notice.

But that’s a cut Richard Hanneman, president of the Salt Institute, says is unnecessary. His group represents the United States’ $242 million food salt industry, and is critical of efforts to lower salt intake.

Hanneman says science has established no link between a reduced salt diet and improved health. He also says that even doctors disagree on what amount is safe.

Havas contends the science on salt is clear — and it’s bad.

Like so many Americans, Kathryn Starratt, a 56-year-old social worker from Hopkinton, N.H., acknowledges that. And ignores it.

Despite taking medicine for high blood pressure, Starratt loves salt. She lives on processed foods, estimates adding at least a teaspoon of salt to each meal, never has tried to cut back, and has no plans to do so.

“I quit smoking. I lost weight. I got divorced. It’s the only thing I have left and you want to take that, too?” she says.

(Copyright 2006 by The Associated Press.  All Rights Reserved.)

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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