Hold the salt -- it's better for your long-term health

Ed Goldston used to sprinkle salt on almost everything he ate -- from soups and salads to steak. That changed about 15 years ago when his doctor diagnosed him with hypertension and told him to go on a low-sodium diet. The Pittsburgh real-estate investor agreed to stop adding salt to his meals, but that wasn't enough. "I found out there was so much salt added to food before I even picked up a shaker."

French fries were an obvious source, but he didn't realize that ketchup was packed with sodium, too. He stopped topping his pizza with anchovies, then realized that even a slice of plain cheese can have more than 750 milligrams of sodium, about a third of the recommended daily allowance.

Goldston, now 72, started avoiding pizza altogether. Soon he'd added packaged lunchmeats, snack foods and canned soup to his blacklist. "I was really amazed at how much salt I was consuming without even realizing it," he says.

Stories like Goldston's have doctors concerned. The U.S. Department of Health and Human Services recommends no more than 2,300 milligrams of sodium a day, or about a teaspoon of salt. Those with, or at risk for, high blood pressure should limit their intake to 1,500 milligrams. But most Americans consume triple that amount -- about three-quarters of it from processed foods.

If the body's kidneys can't eliminate enough sodium, it starts to accumulate in the blood. That increases blood volume, which makes the heart work harder and puts more pressure on the arteries. Studies have linked high-sodium diets with an increased risk of stroke, heart disease and high blood pressure. "It's a major health problem," says Dr. Daniel Jones, president of the American Heart Association.

Last month the Food and Drug Administration called a hearing to review its policies on salt in food. The Center for Science in the Public Interest has asked the agency to add health warnings to salt packets a half ounce or larger and to impose stricter limits on salt in processed foods, a move the American Medical Association supports. Richard Bonnette, a consumer-safety officer at the FDA, says implementing such regulations would be "challenging" and could take several years.

What to do in the meantime? Madelyn Fernstrom, founder and director of the University of Pittsburgh Medical Center's Weight Management Center (where Goldston is a patient), urges her clients to read nutrition labels and avoid high-sodium processed foods like canned vegetables, rice and noodle mixes and microwavable meals.

She recommends buying sodium-free foods or products marked "low sodium," which must contain 140 milligrams or less per serving. And though only about 10 percent of the salt Americans consume comes from the shaker (some is also found naturally in foods), Fernstrom suggests using other seasonings instead.

Ultimately, says Dr. Christine Gerbstadt, a physician and spokeswoman for the American Dietetic Association, "If you leave it to chance, you're going to eat too much salt. You have to be conscious about it."

That strategy has worked for Goldston, who lowered his blood pressure from 172 over 82 to 120 over 70 with the added help of a hypertension drug. "I still try to stay under 1,500 milligrams of sodium each day, and that's hard," he says. "But it's worth it. I feel great." Doctors hope that with more publicity about the benefits of a low-sodium diet, millions of other Americans will feel better, too.