What is considered excessive sodium intake?

Excessive Sodium Intake Guidelines

Daily sodium intake above 2,300 mg is considered excessive for most adults, with a lower threshold of 1,500 mg recommended for specific populations at higher cardiovascular risk. 1

General Population Recommendations

• General population: Sodium intake should not exceed 2,300 mg/day 1
• Higher risk populations: Sodium intake should be limited to <1,500 mg/day for:
  • People with hypertension
  • African Americans
  • Adults over 51 years of age
  • People with diabetes
  • People with chronic kidney disease 1

These higher-risk groups represent approximately 70% of the U.S. adult population 2, 3.

Age-Specific Recommendations

The American Heart Association/American College of Cardiology (AHA/ACC) provides specific sodium intake limits based on age:

Age Group	Maximum Recommended Sodium (mg/day)
1-3 years	1,500
4-8 years	1,900
9-13 years	2,200
≥14 years	2,300
High-risk adults	1,500

Current Consumption Patterns

Despite these recommendations, actual sodium consumption in the U.S. is significantly higher:

• Average adult intake: 3,266-3,436 mg/day 4, 5
• Only 9.6% of U.S. adults consume sodium within their recommended limits 3
• Only 5.5% of those who should limit intake to 1,500 mg/day actually meet this target 3

Health Implications of Excessive Sodium

Excess sodium intake directly contributes to:

• Hypertension (primary mechanism)
• Increased risk of stroke and cardiovascular events
• Kidney damage through both blood pressure-dependent and independent mechanisms
• Left and right ventricular hypertrophy and fibrosis
• Perivascular fibrosis of coronary arteries
• Diastolic dysfunction 6

Sources of Dietary Sodium

• 75-80% of sodium consumption comes from processed and restaurant foods 6, 5
• Top 10 food categories contributing to sodium intake (44% of total):
  • Bread and rolls
  • Cold cuts/cured meats
  • Pizza
  • Poultry
  • Soups
  • Sandwiches
  • Cheese
  • Pasta mixed dishes
  • Meat mixed dishes
  • Savory snacks 5

Practical Recommendations for Sodium Reduction

1. Read food labels to identify lower sodium options (foods with <140 mg or 5% Daily Value are considered low in sodium) 1
2. Replace processed foods with fresh alternatives 1, 6
3. Reduce salt added during cooking and at the table 1
4. Use herbs and spices as flavor alternatives to salt 1
5. Be aware of hidden sodium sources in medications (e.g., antacids, laxatives) 1

Special Considerations

• For patients with CKD and hypertension, sodium restriction is an essential tool for volume and blood pressure control 1
• For patients with diabetes and hypertension, setting a sodium intake goal of <2,300 mg/day is recommended 1
• For stroke prevention, daily sodium intake should be limited to no more than 2,000 mg 1

Common Pitfalls

• Underestimating sodium in restaurant foods: Restaurant meals typically contain significantly more sodium per calorie than home-prepared foods 5
• Focusing only on table salt: Table salt accounts for only 5-10% of total sodium intake 1
• Overlooking medication sources: Some medications contain significant amounts of sodium 1
• Assuming "healthy" foods are low in sodium: Many foods marketed as healthy may still contain substantial sodium

Despite slight declines in sodium consumption among some population groups, excessive sodium intake remains prevalent across all age groups in the United States, highlighting the need for continued public health efforts to reduce population sodium intake 7.