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America's pressure cooker.


"The number of deaths that occur because we eat too much salt is equivalent to a jumbo jet crashing every single day," says Stephen Havas, a professor of epidemiology, preventive medicine, and medicine at the University of Maryland School of Medicine. "People should be outraged."

Havas and experts at the National Heart, Lung, and Blood Institute estimate that 400 Americans die each day of heart attacks, strokes, and other diseases caused by salt's impact on their blood pressure. "And that may be a conservative estimate," he adds.

Yet the food and restaurant industries behave as though sald didn't matter.

Salt does matter, according to every major health authority. It matters to the roughly 30 percent of American adults with hypertension, to the 30 percent with pre-hypertension, and to the 90 percent who will eventually get hypertension if they live to age 75.

It's time the food industry stopped dumping so much salt into our food.

"Organic" foods are hot. So are "low-sugar," "whole-grain," "low-fat," and "low-calorie" foods, according to industry analysts. But foods that are lower in sodium? Not so hot.

Why don't Americans care about salt? Health officials haven't exactly waged a campaign to warn us about its dangers. The media--perhaps under the food industry's influence--has largely ignored or downplayed its risks. And many people think they can ignore salt because their blood pressure is low, or it's so high that they need drugs anyway.

Whatever the reason, we're eating more salt just when health authorities are urging us to eat less. The Institute of Medicine--independent scientists who advise the government--recently cut the recommended sodium intake from 2,400 milligrams a day to 1,500 mg or less. Most people eat at least 4,000 mg a day. An order of General Tso's Chicken has more than 3,000 mg.

Here's why and how--to steer clear of salt.

The science on salt is more solid than ever. Among the key studies:

* The Trials of Hypertension Prevention (TOHP TOHP - Transmit Overhead Processor (Nortel) II) looked at 1,100 moderately overweight, middle-aged adults with pre-hypertension (see "How High is High?"). (1) After three years, those who cut their sodium by 25 percent (by roughly 930 milligrams per day) had blood pressures that were lower (by 1.7 over 0.9 points) than those who weren't told to eat less salt.

* The Trial of Nonpharmacologic Interventions in the Elderly (TONE) tested a lower-sodium diet on almost 1,000 men and women with pre-hypertension who were between the ages of 60 and 80. (2) After 2 1/2 years, those who cut their sodium by about 25 percent had blood pressures that were lower (by 2.6 over 1.1 points) than people who did not.

* The Dietary Approaches to Stop Hypertension (DASH) trial fed more than 400 people diets with high levels of sodium (3,300 mg a day), medium levels (2,400 mg), or low levels (1, 500 mg) for one month. (3) For those who were eating a typical American diet, going from high to low sodium cut blood pressure the most (6.7 over 3.5 points). For those who were eating a healthier "DASH" diet (packed with fruits, vegetables, and low-fat dairy foods), blood pressure also fell (by 3.0 over 1.6 points). Interestingly, the drop was bigger when they switched from medium to low sodium levels than from high to medium.

Blood pressure falls even more in people whose pressure is already high. (4) "In people with hypertension, a reduction in sodium to 2,400 mg a day lowered blood pressure by about 5 points over 3 points," says Norman Kaplan, a hypertension expert at the University of Texas Southwestern Medical Center in Dallas. "That's about as much as we see with blood pressure medications."

All told, dozens of studies on thousands of people have reached similar conclusions. "The evidence that links salt intake to blood pressure is now overwhelming," says Graham MacGregor of the St. George's Hospital Medical School in London.

A blood pressure drop of just a few points may seem trivial, but it can reduce the chances of having a heart attack or stroke, which increase with every rise in pressure.

"What seems like a relatively small effect on blood pressure at the moment may in the long term prevent the further increase in pressures that occurs with age," says Kaplan.

Pressure Creep

In industrialized countries, blood pressure creeps up, millimeter by millimeter, as people age. "The Framingham Heart Study took people who had normal blood pressures at age SS or 65 and followed them for 20 years," says Kaplan. "At age 75 or 85, close to nine out of ten had high blood pressure."

So either your blood pressure is already high or it eventually will be. "The threat of hypertension is pervasive," says Kaplan. "Just because you have normal blood pressure when you're 40 or 50 or 60 doesn't mean that you can escape hypertension. Anything that slows the process is good for everyone."

Cutting back on salt may prevent or at least delay that upward creep. "People think that hypertension is an inevitable consequence of aging," says the University of Maryland's Stephen Havas. It's not. "High blood pressure is largely caused by excess salt, excess weight, and insufficient exercise and fruits and vegetables. If people watched their diet and exercised, their blood pressure would be much less likely to drift up into the hypertensive range."

In non-industrialized populations that consume very little salt, blood pressure doesn't rise with age. (5) "If you could lock blood pressure in place in your 20s and 30s, we wouldn't have an epidemic," says Eva Obarzanek of the National Heart, Lung, and Blood Institute.

And it's not just a diagnosis of hypertension that matters. The risk of a heart attack or stroke starts to rise long before blood pressure reaches 140 over 90. That's the cut-off for hypertension, the point at which doctors consider prescribing blood-pressure-lowering drugs (see "How High is High?" p. 3). But "normal" blood pressure is much lower (120 over 80 or below). "And the best blood pressure may be 115 over 75 or below," says Kaplan.

For the nation, even a small drop in average blood pressure can have a profound impact on heart attack and stroke rates. (4) "If you lower the blood pressure of the overall population by, say, two millimeters, it would have enormous benefits for reducing deaths from coronary heart disease and stroke," says Kaplan.

A 50 percent drop in the sodium content of packaged and restaurant foods would lower the average systolic blood pressure by five points, according to estimates by Havas; Claude Lenfant, former director of the National Heart, Lung, and Blood Institute; and Ed Roccella, coordinator of the institute's National High Blood Pressure Education Program. (6) "That would lead to at least a 20 percent reduction in the prevalence of hypertension, and to roughly 150,000 fewer deaths per year," Havas notes.

And that figure may underestimate the number of lives saved, because salt may raise the risk of heart attacks and strokes apart from its effect on blood pressure, at least in overweight people. (7)

Sensitive to Salt

As people age, it's usually their systolic blood pressure (the higher number) that climbs the most. "Most older people develop isolated systolic hypertension due to the rigidity of clogged arteries," says Kaplan. "It's like rust in the pipes."

The force that blood exerts on the artery wall when the heart beats is called systolic pressure; the force between heartbeats is called diastolic pressure. Researchers think systolic pressure rises because partially clogged arteries are stiffer.

"Systolic hypertension has the greatest impact on stroke because the blood is constantly beating against the vessel wall, causing tiny breaks," Kaplan explains. "That's where a cholesterol plaque is more likely to develop."

When a blood clot gets stuck in an artery clogged by plaque, the person has a heart attack (if the artery feeds the heart muscle) or a stroke (if the artery feeds the brain).

Higher pressure also raises the risk of strokes caused by burst blood vessels in the brain. What's more, says Kaplan, "elevated systolic pressure puts a load on the heart because that's the pressure that the heart has to pump against."

While older people may be more likely to have high blood pressure, age comes with a silver lining: cutting back on salt is more likely to trim their blood pressure. "People get more sensitive to salt as they get older," says Kaplan.

Years ago, the salt industry convinced millions of consumers that salt had no impact on blood pressure. But most of the studies it cited were flawed.

"The literature had studies in which researchers put people on a salt-restricted diet and then gave them a salt load," explains Eva Obarzanek of the National Heart, Lung, and Blood Institute. "Then, based on a single measurement of blood pressure, they were classified as salt-sensitive or not."

Obarzanek's research shows that it takes many measurements to reach any conclusions about sensitivity, because blood pressure varies so much from day to day. (8) "There's such high variability that you'd have to repeat the measurements on many days to see if they're salt-sensitive," she says.

And that's simply impractical. "We just don't have a feasible way to identify who are the most salt-sensitive and who are the least." And salt sensitivity is common whether people have hypertension or not.

But the DASH trial and other studies did show that some groups are more sensitive to salt than others. "People who were at least 45 years old were more sensitive than those who were younger," says Obarzanek. So are African Americans.

Already High

Roughly one out of two people over the age of 60 has high blood pressure. Why should they bother cutting salt if they're already taking drugs to lower it?

"All blood pressure medications have their effectiveness enhanced by a lower sodium intake," says Kaplan. "That's been shown particularly in people taking the most popular drugs--the ACE inhibitors and the angiotensin receptor blockers." (That includes drugs like Vasotec Vas·o·tec (vz-tk, Lotensin Lo·ten·sin (l-tns, Hyzaar Hy·zaar (hzär, Avapro Av·a·pro (v-pr, and Diovan Di·o·van (d-vn.)

Most blood pressure drugs (except beta-blockers) are vasodilators--that is, they expand the blood vessels. That lowers the pressure of blood against the artery walls. "But the kidney responds to lower blood pressure by holding on to salt and water so it can keep blood flow constant," explains Kaplan.

"That fills the blood vessels back up," bringing blood pressure closer to its unhealthy level. "But if you keep excess salt out of the circulation, the kidney doesn't hold on to as much salt and fluid, and the pressure stays down."

Diuretics (like hydrochlorothiazide hydrochlorothiazide /hy·dro·chlo·ro·thi·a·zide/ (-klor?o-thi´ah-zid) a thiazide diuretic, used for treatment of hypertension and edema.

hy·dro·chlo·ro·thi·a·zide (h
, or HCT) increase the amount of salt excreted by the kidneys, which is why Kaplan and many other doctors often prescribe them along with other pressure-lowering drugs. But diuretics can only do so much. "If you put enough sodium through the kidneys, the diuretic can't keep it all from being retained," he explains.

The bottom line: "The efficacy of blood-pressure-lowering drugs--how well they work--is doubled on a lower-sodium diet," says Kaplan.

What's more, cutting sodium can get some people with high blood pressure off drugs entirely. When researchers in the TONE study took 975 older people off hypertension drugs and had them cut sodium by 1,000 mg a day, half were able to keep a normal blood pressure without drugs for the rest of the 2 1/2-year study. (2) "Lowering sodium intake diminished the return of hypertension," says Kaplan.

"For someone who has high blood pressure, you can get almost as much impact by cutting sodium as you can from prescribing a single drug," says the University of Maryland's Stephen Havas. "When I had a medical practice, I was able to control blood pressure without drugs in about half of my hypertensive patients."

And that was before anyone knew that a DASH diet--which trims saturated fat and cholesterol and boosts fruits, vegetables, and low-fat dairy foods--could also lower blood pressure. "If I had had the arsenal that's now available, it would have been even easier to keep people off drugs," says Havas.

What's Up, Doc?

Why don't physicians try harder to change their patients' diets instead of just prescribing drugs?

"They're convinced that people won't adhere to a diet," says Havas, who has taught medical students for 20 years. "They don't realize that roughly half of people who are prescribed drugs to lower blood pressure, blood cholesterol, and blood sugar decide to stop taking them within a year."

In most cases, it's not side effects that are to blame. Rather, "people don't understand that hypertension is a lifetime condition," says Havas. "It's hard to keep taking a drug once you feel fine, and except for the diuretics, the drugs are expensive."

Yet physicians don't push lower-salt diets. "Most doctors do a lousy job at lifestyle counseling," says Havas. "They think it takes a large amount of time and people won't want to change. And people won't change if doctors don't help."

What's more, physicians don't know how to teach people to avoid salt. "They have no idea that three-quarters of our sodium comes from processed and restaurant foods, not from the salt shaker," says Havas. "Doctors are a major source of health advice, and if they don't know about salt, their patients won't get the message. In fact, you don't need much training, just some passion."

Misinformation also explains why many Americans aren't worried about eating too much sodium. "Most consumers think they've taken care of the problem because they don't add salt when cooking or at the table," says Havas. "So salt is low on their priority list."

Swing Low

The latest report from the Institute of Medicine recommends only 1,500 mg of sodium a day, less (1,300 mg) for people in their 50s and 60s, and even less (1,200 mg) for anyone over 70.

That's low.

The average American eats about 4,000 mg of sodium a day. Dropping down to 1,500 mg is possible, but only if you avoid most processed foods and choose everything else carefully. And it's almost impossible to eat out unless you order unsalted poultry, seafood, or meat with a baked potato and salad (with oil and vinegar). Many Chinese, Indian, Italian, Mexican, Thai, and other ethnic dishes would use up more than the entire 1,500 mg in one meal (see "Want Salt with That?" p. 5).

But that doesn't mean you should throw up your hands and forget about salt.

"Even though we think that it would be best to lower sodium in the diet to 1,500 mg," says Kaplan, "we have to face the reality that we are living in an industrialized, commercialized world where average sodium consumption is high because food processors have been putting so much salt in our food."

"Cutting down is the main message," be adds. "How low one can go may be less important than trying to start the process of getting excess salt out of the diet."

Since so much salt comes from processed foods, the solution is to get food companies to take it out. "People should shoot for 1,500 mg a day," says Havas. "But 2,300 mg is fine as an interim target until the food supply changes. The greatest culprit now is the Food and Drug Administration, for not pushing the food industry to reduce sodium."

At least one government is doing more. British authorities have publicly embarrassed more than two dozen companies, including Heinz, McDonald's, and Nestle, for failing to draw up adequate plans to cut salt in their foods.

"There's a whole range of sodium in foods," says Havas. "The British government is telling companies that they need to at least be at mid-level."

Britain has launched a major public health campaign--using Sid the Slug--to warn people about salt's dangers. "The government might even require foods to be labeled 'high in salt,'" adds Havas.

In the U.S., the Center for Science in the Public Interest (publisher of Nutrition Action Healthletter) has sued the Food and Drug Administration, trying to force it to classify salt as a food additive, rather than an ingredient that is "Generally Recognized As Safe."

Until sodium levels in foods fall, people can drive down their blood pressure by eating a DASH diet (see "A DASHing Pyramid," p. 7). "We don't know which features of the DASH diet are responsible," says Kaplan, "but increasing fruits and vegetables and lowering fat can help."

Researchers do know that potassium, which is abundant in the DASH diet, accounts for some of the diet's impact on blood pressure. Potassium seems to keep sodium from raising blood pressure by making the kidneys excrete more salt.

"If you give people an extra few grams of potassium, it can lower blood pressure by three or four points," says Kaplan. "But potassium can cause stomach irritation if you get it in a salt substitute," he adds. It's better to get it from potassium-rich foods (see "The Sodium Antidote").

In other words, snacking on a banana instead of a bag of pretzels can kill two birds (more potassium and less sodium) with one food. And the DASH diet may polish off a few other birds. It can also lower LDL ("bad") cholesterol and boost bone density. (9, 10)

The key is to cut sodium whenever and wherever you can. "We don't want to interfere with the enjoyment of food," says Kaplan. "But avoiding heavily salted food is a reasonable thing for everyone to do."
The Salt Sellers

Here's a broad-brush picture of sodium in the supermarket.
Since some brands have much less than others, always
check the Nutrition Facts panel before you buy.

Food                                             Sodium (mg)

Barley, oats, pasta, or rice (1 cup cooked)      less than 10
Beans, dried (1/2 cup cooked)                    less than 10
Fruit--fresh, frozen, dried, or canned           less than 10
Fruit juice (1 cup)                              less than 10
Nuts and seeds, unsalted (1 oz.)                 less than 10
Tofu (3 oz.)                                     less than 10
Swiss cheese (1 oz.)                                       50
Mustard, yellow (1 tsp.)                                   60
Fresh vegetables--raw or cooked                  less than 80
Mayonnaise (1 Tbs.)                                        80
Fresh meat, poultry, or fish (3 oz. cooked)      less than 90
Mustard, Dijon (1 tsp.)                                   120
Milk (1 cup)                                              140
Yogurt (6 oz.)                                            140
Ketchup (1 Tbs.)                                          170
Cheddar cheese (1 oz.)                                    180
Potato chips (1 oz.-20 chips)                             180
Shrimp, fresh (3 oz. cooked)                              190
Canned tuna, drained (2 oz.)                              200
Peanuts, dry roasted, salted (1 oz. 30 nuts)              230
Canned chickpeas, drained and rinsed (1/2 cup)            270
Bread-white or whole-wheat (2 slices)                     320
Feta cheese (1 oz.)                                       320
Raisin bran (1 cup)                                       350
Dill pickle (1 medium spear)                              390
Green olives (5 medium)                                   410
Cottage cheese (%2 cup)                                   420
Bread--pumpernickel or rye (2 slices)                     460
Pretzels (1 oz.--9 thin twists)                           560
Salt (1 tsp.)                                           2,330

Sources: U.S. Department of Agriculture, food companies, and CSPI.

Want Salt With That?

It's almost impossible to eat out without getting at least 1,000
milligrams of sodium. But if you're careful, you can dodge the dishes
with 2,000 to 4,000 mg. That's a teaspoon or two of salt in your lunch
or dinner.

Food                                               Sodium (mg)

McDonald's Fruit & Walnut Salad                           90
McDonald's Fruit 'n Yogurt Parfait                        90
McDonald's French Fries (large)                          330
Einstein Bros. Plain Bagel                               520
Salmon, vegetables, baked potato with sour cream         700
Pizza Hut Veggie Lover's Pan Pizza, large                880
  (2 slices)
Auntie Anne's Original Pretzel                           930
Roast beef sandwich with mustard (9 oz.)                 990
McDonald's Big Mac                                     1,010
McDonald's Chicken McGrill                             1,010
Burger King Whopper                                    1,020
Burger King French Fries (King)                        1,070
Panera Low-Fat Chicken Noodle Soup (8 oz.)             1,080
McDonald's Quarter Pounder with Cheese                 1,150
Tuna salad sandwich (11 oz.)                           1,320
Burger King Chicken Whopper                            1,410
Turkey sandwich with mustard (9 oz.)                   1,410
Au Bon Pain Broccoli Cheddar Soup (12 oz.)             1,440
Au Bon Pain Chicken Salsa Wrap (12 oz.)                1,440
Spaghetti with marinara sauce (3 1/2 cups)             1,450
Chicken Caesar salad with dressing (4 cups)            1,490
McDonald's Chicken Selects (5 pieces)                  1,550
Bacon, lettuce, and tomato sandwich (8 oz.)            1,560
Panera Greek Salad with Greek Dressing                 1,560
Sbarro Supreme Pizza (1 slice)                         1,580
Panera French Onion Soup (8 oz.)                       1,810
Baja Fresh Cheese Nachos                               1,880
Corned beef sandwich with mustard (9 oz.)              1,920
Baja Fresh Cheese Quesadilla                           2,030
Lasagna (2 cups)                                       2,060
Linguine with red clam sauce (3 cups)                  2,180
Chipotle Vegetarian Burrito, with cheese,              2,270
  guacamole, and salsa
Panera Smokehouse Turkey Panini on Artisan             2,320
  Three Cheese
Ham sandwich with mustard (9 oz.)                      2,340
Buffalo wings with blue cheese dressing                2,460
  (12 wings)
Szechuan shrimp with rice (311, cups)                  2,460
Chipotle Chicken Burrito, with cheese and salsa        2,490
Pizza Hut Meat Lover's Stuffed Crust Pizza,            2,500
  large (2 slices)
Chef salad with dressing (5 cups)                      2,510
Kung Pao chicken with rice (4 1/2 cups)                2,610
Beef and broccoli with rice (4 cups)                   3,150
Reuben sandwich (14 oz.)                               3,270
House Lo Mein (4 1/2 cups)                             3,460
Chicken fajitas with tortillas (4), with beans,        3,660
  rice, and guacamole
Cheese fries with ranch dressing (4 cups)              4,890

Sources: U.S. Department of Agriculture, restaurant chains, and CSPI.

What Works?

If your pressure is high, here's how much lifestyle
changes should lower it. So far, studies have found that
taking calcium, fish oil, or herbal supplements has little
or no effect on blood pressure.

                                                      Drop in
                                                      Systolic Blood
Advice         Details                                Pressure

Lose excess    For every 20 pounds you                5 to 20 points
weight         lose

Follow a       Eat a lower-fat diet rich in           8 to 14 points
DASH diet      vegetables, fruits, and low-
               fat dairy foods

Exercise       Get 30 minutes a day of                4 to 9 points
daily          aerobic activity (like brisk
               walking)

Limit          Eat no more than 2,400 mg              2 to 8 points
sodium         a day (1,500 mg is better)

Limit          Have no more than                      2 to 4 points
alcohol        2 drinks a day for men
               1 drink a day for women

               (1 drink = 12 oz. beer, 5 oz. wine,
               or 1.5 oz. 80-proof whiskey)

Source: The Seventh Report of the Joint National Committee
on Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure (www.nhlbi.nih.gov/guidelines/hypertension).

The Sodium Antidote

Potassium isn't a household name, but it oughta be. It helps neutralize
sodium's effect on blood pressure. It also seems to lower the risk of
stroke apart from its effect on blood pressure. And it helps prevent
kidney stones and the bone loss that can lead to osteoporosis.

Unfortunately, we don't get enough potassium. Experts recommend 4,700
milligrams a day. The typical American man gets roughly 3,000 mg; the
typical woman closer to 2,300 mg. The answer isn't the potassium
chloride in supplements or salt substitutes, since that form doesn't
help bones and stones. Instead, you can get what you need from the
naturally occurring potassium in foods like these.

Food                                          Potassium)
(1/2 cup cooked vegetable, fruits raw)              (mg)

Potato (1)                                           940
Sweet otato (1)                                      540
Banana (1)                                           490
Halibut (3 oz. cooked)                               490
Lima beans                                           490
Fresh tuna (3 oz. cooked)                            480
Swiss chard                                          480
Acorn s uash                                         450
S y i nach                                           420
Salmon (3 oz. cooked)                                390
Cantaloupe (1/4 melon)                               370
Lentils (1/2 cup cooked)                             370
Milk (1 cup)                                         370
Watermelon (2 cups)                                  320
Graves (1 cup)                                       310
Pork (3 oz. cooked)                                  310
Raisins (1/4 cup)                                    310
Pistachios (1 oz.-50 nuts)                           300
Flounder (3 oz. cooked)                              290
Parsnip s                                            290
Pinto beans, canned (1/2 cup)                        290
Beef (3 oz. cooked)                                  270
Wheat germ (2 Tbs.)                                  270
Brussels sprouts                                     250
Prunes (4)                                           250
Orange (1)                                           230
Zucchini                                             230
Artichokes                                           220
Almonds (1 oz.-20 nuts)                              210
Chick eas, canned (1/2 cup)                          210
Collard greens                                       210
Chicken (3 oz. cooked)                               200
Peanuts (1 oz.-30 nuts)                              190
Tuna, canned (2 oz.)                                 130


(1.) J. Human Hypertens. 19:33 2005.

(2) J. Amer. Med. Assoc. 279: 839, 1998

(3) New England Journal of Medicine 344: 3. 2001

(4) Hypertension 42: 1093, 2003

(5) BMJ 297: 319, 1988.

(6) Amer. J. Public Health 94: 19, 2004

(7) J. Amer. Med. Assoc. 282: 2027, 1999.

(8) Hypertension 42:459, 2003

(9) Hypertension 43: 393, 2004

(10) J. Nutr 133:3130, 2003.

RELATED ARTICLE: 10 Sodium trouble spots.

The easiest way to steer clear of excess sodium is to buy foods with only a single ingredient--fruits, vegetables, grains, nuts, meat, poultry, fish ... you get the idea. The sodium starts to climb once you move on to cheese, bread, salted nuts, and other foods with multiple ingredients. Worse yet are the real supermarket sodium bombs. Here are 10 trouble spots and how to avoid them.

Soup. Brace yourself for 700 to 1,000 mg of sodium in a modest one-cup serving.

Look for: If you can't find (or make your own) low-sodium soups, try Amy's three delicious Light in Sodium canned soups (Butternut Squash, Cream of Tomato, and Lentil Vegetable), which keep sodium in the low 300 mg range. Imagine Organic soups (which come in shelf-stable boxes) are in the mid-300s, while both Healthy Choice and Campbell's Healthy Request (canned) soups clock in at 480 mg or less. For soup, that's not bad.

Frozen entrees. You can find Stouffer's, Boston Market, and Marie Callender's meals with more than 1,500 mg of sodium.

Look for: Healthy Choice never tops 600 mg--not low but they could be worse. Some Lean Cuisine and Smart Ones are in the same ballpark.

Lunch meats. You could easily swallow 600 to 1,000 mg of sodium in just two slices.

Look for: Healthy Choice meats hover around 480 mg of sodium. Uncured meats are generally lower: Most Wellshire Farms dell meats, for example, range from 150 to 250 mg. Applegate Farms roast beef (230 mg) and turkey bologna, breast, etc. (360 mg) are also lowish.

Salad dressing. If you're not careful, two tablespoons can add 400 or 500 mg of sodium to your salad.

Look for: Olive-oil-and-vinegar and sweet dressings generally are low. Try Newman's Own Olive Oil & Vinegar (150 mg) or Ken's Steak House Lite Raspberry Walnut Vinaigrette (130 mg) ... or make your own (see p. 9 for recipes).

Soy sauce. Each tablespoon has some 850 mg of sodium.

Look for: Soy sauce labeled "lite" or "less salt" typically has about 550 mg of sodium per tablespoon. While that's still high, saving 300 mg of sodium ain't peanuts.

Marinades. It does no good to buy unseasoned poultry, fish, or vegetables if you douse them in marinades that have 250 to 500 mg of sodium in every tablespoon.

Look for: Mrs. Dash Salt-Free Mesquite Grille, Lemon Herb Peppercorn, Southwestern Chipotle, and Zesty Garlic Herb 10 Minute Marinades are delicious. Add olive oil and the Zesty Garlic Herb doubles as a salad dressing. (See May 2005, p.15, for quick homemade marinade recipes.)

Tomatoes. From spaghetti sauce (900 to 1,200 mg per cup) to canned tomatoes (400 to 800 mg) to tomato juice (700 mg), almost any tomatoes except fresh are soaked with sodium.

Look for: You can save a nice chunk of sodium by choosing the right brand. Take pasta sauce. Classico Tomato & Basil (620 mg per cup) or any Cucina Antica (around 500 mg) has much less sodium than Prego Traditional (1,220 mg) or Ragu Traditional (1,540 mg), though still far more than homemade (see p. 9 for recipe).

As for chopped tomatoes, try a low-sodium or no-salt-added brand. If it tastes more like the can than tomatoes, try Parmalat Pomi no-salt-added Chopped Tomatoes, which come in shelf-stable boxes. Once you've added other ingredients to your soup, spaghetti sauce, or whatever, you shouldn't notice the missing salt.

Chicken broth. A good chicken broth can work wonders in your rice, soup, sauce, or stir-fry, but most brands--Swanson, for example--have around 900 mg of sodium per cup.

Look for: Any low-sodium broth (like Herb-ox Very Low Sodium Chicken Bouillon) will do. If you can't find one, try Health Valley Fat-Free Chicken Broth. Its 390 mg of sodium per cup is much less than most broths, and it adds a full-bodied chicken flavor to any dish.

Chicken. Many processors add salt and water to keep their raw poultry moist. For example, Tyson Boneless Skinless Chicken Breasts look just like your local supermarket's raw chicken breasts, yet they have three times as much sodium (230 mg vs. 80 mg in four ounces). Seasoned parts often have much more. Watch out for products like Tyson Roasted Chicken Breast Halves (670 mg in a five-ounce breast) or Louis Rich Chicken Breast Strips (780 mg in a three-ounce serving).

Look for: Check the label to find chicken with the least added salt. Then use Mrs. Dash marinades or make your own (see May 2005, p.15, for recipes).

Rice & pasta mixes. Uncle Ben's, Near East, Rice-A-Roni, Zatarain's, and other rice or pasta mixes offer convenience at a price--some 500 to 1,000 mg of sodium in just one cup.

Look for: A few small brands--like Bean Cuisine, Taste Adventure, and Chef's Originals RiceSelect--cut the sodium to the mid-200s or 300s. Your best bet: check out our recipes on p. 9.

RELATED ARTICLE: A DASHing pyramid.

Here's how the DASH diet would look if it took the shape of a pyramid. If you want to follow it, make sure you pay attention to the rather small serving sizes.

A serving of grains, for example, is just half a cup of cereal, pasta, or rice or a one-ounce slice of bread. That's far less than a typical bagel (four or five ounces), a serving of most cereals (one cup), or a restaurant-size serving of spaghetti (about three cups). Servings of seafood, poultry, meat, oils, fruits, and vegetables are also petite.

If you think you'd starve on this diet, remember that it's for someone who eats 2,000 calories a day. Many men are likely to need closer to 2,500 calories.

Sweets (no more than 5 per week)

What's a Serving

1 cup fat-free or low-fat fruit yogurt 1/2 cup fat-free or low-fat frozen yogurt 1 Tbs. maple syrup, sugar, or jam

Beans, Nuts, Seeds (1 per day)

What's a Serving

1/2 cup cooked beans 1/3 cup nuts 2 Tbs. sunflower seeds

Oils, Salad Dressing, Mayo (2-3 per day)

What's a Serving

1 tsp. oil or soft margarine 1 tsp. regular mayonnaise 1 Tbs. low-fat mayonnaise 1 Tbs. regular salad dressing 2 Tbs. light salad dressing

Low-Fat Dairy (2-3 per day)

What's a Serving

1 cup fat-free or low-fat milk or yogurt 1 1/2 oz. fat-free or low-fat cheese

Seafood, Poultry, Lean Meat (0-2 per day)

What's a Serving

3 oz. broiled or roasted seafood, skinless poultry, or lean meat

Grains (preferably whole) (7-8 per day)

What's a Serving

1 slice bread 1/2 cup dry cereal 1/2 cup cooked rice, pasta, or cereal

Vegetables, Fruits (8-10 per day)

What's a Serving

1 cup lettuce 1/2 cup other vegetables

What's a Serving

1 medium fruit 1/2 cup fresh, frozen, or canned fruit 1/2 cup dried fruit 3/4 cup fruit juice

Choose salt-free or low-salt foods from all categories.
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Title Annotation:salt induces hypertension
Publication:Nutrition Action Healthletter
Article Type:Cover Story
Geographic Code:1USA
Date:Jul 1, 2005
Words:5241
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