BOSTON — Most Americans eat much more sodium than recommended. The average intake is over 3,400 milligrams (mg) a day, far above the federal guideline of 2,300 mg and the American Heart Association’s goal of 1,500 mg. Most of this sodium comes not from the saltshaker, but from processed and restaurant foods like bread, deli meats, and canned soups.
Health experts warn that high sodium levels are driving a nationwide increase in high blood pressure, a major cause of heart disease and stroke.
New research from Beth Israel Deaconess Medical Center (BIDMC) shows that reducing sodium or following a heart-healthy diet called the DASH diet can each lower the 10-year risk of developing atherosclerotic cardiovascular disease (ASCVD). ASCVD is a condition where the arteries harden, which can lead to chest pain, heart attacks, or strokes. When the DASH diet and sodium reduction were combined, the benefit was even greater.
The study, published in the American Journal of Preventive Cardiology, highlights the importance of public health efforts to reduce salt intake. “Even modest sodium reductions can have a positive effect and may be easier for people to stick with,” said lead author Dr. Hanna M. Knauss.
The DASH diet, created through research funded by the National Institutes of Health (NIH), is designed to prevent and treat high blood pressure. It focuses on foods rich in potassium, calcium, magnesium, and fiber. The diet includes several servings of fruits and vegetables daily, encourages lean proteins like poultry, fish, and beans, and limits red meat and sweets. Sodium, saturated fats, and added sugars are also restricted.
In the study, 390 adults with high blood pressure but no history of heart disease were assigned either the DASH diet or a typical American diet. Each group consumed three levels of sodium: high (typical American intake), intermediate (federal guideline), and low (below guidelines).
After 12 weeks, results showed that both the DASH diet and reduced sodium intake lowered the participants’ estimated ASCVD risk. Even moderate sodium cuts were helpful. The biggest improvement came when both strategies were used together.
“Reducing sodium to recommended levels or lower significantly lowered heart disease risk, especially in women, Black adults, and those with more severe high blood pressure,” said senior author Dr. Stephen P. Juraschek. “These findings show the need for stronger dietary guidelines and public health strategies that people can follow long-term.”
Other researchers on the study included Dr. Kenneth J. Mukamal (BIDMC), Dr. Lara C. Kovell (University of Massachusetts Chan Medical School), Dr. Edgar R. Miller III and Dr. Lawrence J. Appel (Johns Hopkins University), and Dr. Timothy B. Plante (Larner College of Medicine, University of Vermont).
The study was funded by the NIH’s National Heart, Lung, and Blood Institute (grants R21HL144876, K23HL135273) and other NIH offices. The authors reported no financial conflicts of interest.
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