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AS the FDA is encouraging the food industry to cut back on added sodium in commercially processed and prepared food, it also serves as a good reminder for all of us that too much salt in the diet is risky for health — but how much is too much is still being debated, says the November 2016 issue of the Harvard Medical School Harvard Health Letter.

So, how much salt is too much?

“It’s controversial, although I don’t think anyone is in favor of unlimited salt intake,” says Dr. Randall Zusman, a cardiologist with Harvard-affiliated Massachusetts General Hospital.

While we need a certain amount of the sodium in salt for the health of all cells and organs, and to maintain a proper fluid balance in the body, usually when a person consumes too much sodium, the kidneys efficiently flush the excess sodium out of the body.

However, some individuals retain excess sodium which causes adverse effects, such as:

• It increases the amount of body fluid and blood pressure — which makes the heart work harder.

• Persistent high blood pressure increases the risk of developing the artery-blocking plaques of atherosclerosis.

• Too much salt on a regular basis can increase the risk of a heart attack or a stroke.

• “Salt can also negate the effects of many medications to treat high blood pressure, such as diuretics and ACE inhibitors,” says Dr. Zusman.

The controversy centers on how much salt is safe for consumption, and is still being debated:

• The American Heart Association recommends a limit of 1,500 milligrams (mg) per day

• The FDA recommends a limit of 2,300 mg of sodium per day

• The U.S. Dietary guidelines used to recommend a limit of 1,500 mg per day for a wide swath of individuals (everyone 51 and older, all African-Americans, and anyone with high blood pressure, kidney disease or diabetes), but this year changed it to 1,500 mg per day for only individuals with high blood pressure, and 2,500 mg for everyone else.

Meanwhile, most of us in the United States are consuming too much sodium, an average of 3,400 mg per day (the amount in about 1 1/2 teaspoons of salt) which comes from various sources:

a) Some comes from the saltshaker;

b) Some occurs naturally in foods, such as milk, beets and celery;

c) “But the majority comes from processed foods, especially anything that is smoked, processed, instant or cured,” says Debbie Krivitsky, director of clinical nutrition at the Cardiovascular Disease Prevention Center at Massachusetts General Hospital;

d) Sodium is frequently added during manufacturing, to improve the taste, to act as a preservative or a binder to help yeast rise;

e) There’s a lot of sodium in many TV dinners, such as the 1,250 mg of sodium in a serving of Stouffer’s Swedish meatballs and pasta;

and f) Sodium is hiding in everything from bread to jarred pasta sauce to lunch meats and breakfast cereals — for example, one cup of Post Grape-Nuts has 540 mg of sodium and half a cup of Prego traditional tomato sauce has 480 mg of sodium.

To avoid the health risks of too much salt, these self-help tips are offered:

• Choose fresh, frozen (no sauce or seasoning), or no-salt-added canned vegetables

• Opt for fresh poultry, seafood and lean meat, rather than processed meat and poultry

• Limit sodium to 500 or 600 mg per meal, and make sure it comes from healthy sources, like whole grain breads and cereals — for example, one cup of Post shredded wheat has no sodium and half a cup of Prego No Salt Added pasta has just 40 mg of sodium

• Find low sodium options by reading Nutrition Facts labels

• Ditch saltshakers and flavor food instead with spices, such as cumin, rosemary, basil, ginger or dill; flavored vinegars and lime or lemon juice — “Low salt doesn’t mean less flavor,” says Krivitsky. “It just means less salt.”

• A salt substitute may do the trick when you want to add something salty to food — substitutes are made from potassium chloride, which is similar to table salt (sodium chloride).

There are two categories of substitutes: a) Low-sodium or “light salt,” which replaces half of the sodium chloride with potassium chloride; and b) No sodium or “salt-free” salt, which contains only potassium chloride.

Some individuals find potassium chloride can leave a bitter aftertaste.

Also, individuals with certain types of heart or kidney disease, or taking certain potassium-retaining medicines, may be advised to avoid potassium-based substitutes.

For others, potassium chloride is advisable: Aside from helping avoid excess sodium, it also helps lower blood pressure, concludes the health letter.

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