Recommended Daily Sodium Intake
The recommended daily sodium intake is less than 2,300 mg for the general population, while individuals with hypertension, those over 40 years of age, and African Americans should limit intake to 1,500 mg per day. 1, 2
General Recommendations
- General population: <2,300 mg/day (approximately 1 teaspoon of salt)
- Special populations: <1,500 mg/day for:
- People with hypertension
- African Americans
- Adults over 40 years of age
- People with chronic kidney disease
These special populations represent approximately 70% of U.S. adults 3, 4, making the lower recommendation of 1,500 mg/day applicable to the majority of adults.
Evidence Supporting Sodium Recommendations
The American Heart Association recommends reducing sodium intake to help lower blood pressure 1. This is particularly important because excessive dietary sodium consumption increases blood pressure, which in turn increases the risk for stroke, coronary heart disease, heart failure, and renal disease 3.
For individuals with chronic kidney disease (CKD) and hypertension, sodium restriction is an important component of a comprehensive strategy for volume and blood pressure control 2. The most recent guidelines recommend limiting sodium to less than 2,000 mg (87 mmol) per day for these individuals 2.
Challenges in Meeting Recommendations
Despite these recommendations, actual sodium consumption in the U.S. is much higher, with average intake around 3,436 mg/day 5, 3. Studies show that only 9.6% of adults meet their applicable recommended sodium limit 3, highlighting the difficulty in adhering to these guidelines.
The challenge stems from the fact that approximately 75% of dietary sodium comes from salt added during food processing and manufacturing 2. Only about 10% occurs naturally in food, while another 5-10% comes from salt added during cooking or at the table 2.
Practical Strategies to Reduce Sodium Intake
To achieve the recommended sodium intake levels, consider these practical approaches:
- Read food labels to identify products with less sodium (look for foods with <140 mg or 5% DV per serving) 2, 1
- Replace processed and canned foods with fresh alternatives 1
- Reduce salt added at the table and during cooking; use herbs and spices instead 2, 1
- Limit consumption of fast food and restaurant meals 1
- Be aware of medications that may contain sodium (e.g., antacids, laxatives) 2
Controversies in Sodium Recommendations
It's worth noting that there are some controversies in the field. Some research suggests that a moderate range of sodium intake (2.3-4.6 g/day) may not be associated with increased cardiovascular risk, with risk increasing primarily when intake exceeds 5 g/day 6. However, the most recent and high-quality guidelines from the American Heart Association still recommend the lower targets outlined above 1.
Monitoring and Follow-up
For individuals attempting to reduce sodium intake, regular follow-up within 2-4 weeks to assess adherence and effectiveness is crucial 1. Home blood pressure monitoring can help track progress, especially for those with hypertension 1.
A comprehensive approach, including referral to a registered dietitian for personalized dietary guidance, may be beneficial for successful implementation of sodium reduction strategies 1.