Too Much Salt Can Slowly Kill You, TMA Physicians Warn

Main Category: Primary Care / General Practice
Article Date: 18 Nov 2008 - 5:00 PST

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Texans could unwittingly be eating themselves to death. Texas doctors are sounding the alarm and taking measures to prevent it.

The killer, say physician leaders of the Texas Medical Association (TMA), is sodium - known as salt - in our food. People are consuming twice the recommended amount of sodium every day. "This is simply unhealthy for our patients," says George W. Wharton, MD, chair of TMA's Council on Scientific Affairs. Doctors are taking action to educate patients. They also are working to influence restaurants and processed-food manufacturers to cut sodium and add nutrition information to menus, to help people eat better.

The American Heart Association and other scientific and governmental organizations recommend that Americans consume no more than 2,300 milligrams of sodium daily. However, people with hypertension should only consume 1,500 milligrams per day. A diet high in sodium can contribute to hypertension, which can cause heart attacks and strokes. More than 65 million Americans suffer from hypertension, and a half-million Americans die each year from heart disease and stroke.

Yet limiting and monitoring sodium intake is tougher than most people imagine. "Even if a person never added salt while cooking or at the table, they are still getting more than 1,500 milligrams of salt every day," says Vincent Fonseca, MD, MPH, a member of the TMA Council on Scientific Affairs. Why? Because most restaurant food and prepared packaged food contain lots of salt, and people eat lots of those.

More than three-quarters of the salt we typically consume is hidden in restaurant food and prepackaged food from a store. Just take a look at how much sodium these foods contain:

- A McDonald's Quarter Pounder with Cheese: 1,190 milligrams (mg) of sodium;
- One Wendy's Chicken BLT salad with no dressing: 1,280 mg;
- Salad dressing for the salad: 330 mg; and
- A half-cup serving of canned green beans: 400 mg of sodium.

Totaling these examples demonstrates how unattainable the 1,500 mg or even 2,300 mg targets seem. And it is difficult if not impossible to find nutritional information when dining out, making it a challenge for people to select low-salt foods.

Doctors say eating all of this sodium makes people 90 percent more likely to develop hypertension. TMA's Texas Medicine magazine reports that cutting 50 percent of the sodium in processed food could save 150,000 lives each year.

"This is a man-made problem caused by conscious decisions by food processors to disguise their food with so much salt," says Dr. Wharton. TMA's Council on Scientific Affairs is asking the association's governing body to push the U. S. Food and Drug Administration (FDA) and Congress to act. TMA's Council on Scientific Affairs physicians want food manufacturers to reduce the salt content of food served in schools. They also want manufacturers to put warning labels on high-sodium foods. The American Medical Association is among the medical groups already on the salt-reduction bandwagon. TMA's national affiliate petitioned the FDA to toughen the regulatory status of salt and revoke its status as "generally regarded as safe."

The Texas Public Health Coalition, which TMA helped form in 2007 and of which TMA is a member, also supports local and state efforts to push manufacturers to reduce sodium content, and to more clearly label processed foods and restaurant meals. "We know that merely labeling changes behavior," says Dr. Fonseca, arguing that people would make healthier choices if high-sodium foods were more clearly labeled.

These actions come not a moment too soon. Physicians say children as young as 5 years are beginning to suffer from kidney stones, a health condition that once only adults faced. Medical experts believe that kidney stones - painful crystallizations of several substances in urine, are chiefly caused by improper diet: A diet too high in sodium and too low in water consumption. "As a pediatric nephrologist, I have seen a remarkable increase in kidney stones in children," says TMA physician leader Watson Arnold, MD, clinical professor in the Department of Pediatrics at Texas Tech University Health Sciences Center School of Medicine. Beyond salty foods and snacks, he blames high-sodium athletic drinks like Gatorade and PowerAde as chief culprits. He says "simply eliminating these salt-saturated drinks in many cases removes the [higher calcium] that causes kidney stones."

Food manufacturers in America are reluctant to cut the salt in their products, according to Dr. Fonseca. He says they claim using other flavorings instead of salt would increase costs. However one major food corporation, Yum! Foods, just announced they will begin posting caloric information on menus in their restaurants, Kentucky Fried Chicken, Taco Bell, Pizza Hut, Long John Silver's, and A&W All-American Food. The new menus apparently will not list sodium content, but the corporation pledges to "look at ways to reduce sodium" in its food.

Dr. Fonseca notes that some European countries have been reducing sodium in food for years. Menu items at European McDonald's restaurants have lower sodium than their American counterparts. "They're still selling Big Macs," he says. "They're still making money. The manufacturers already know how to reduce sodium."

Dr. Wharton hopes for eventual national policy to reduce sodium and improve food safety. "We must educate physicians and the public so that public pressure can reverse this costly health crisis," he says. "We have to act to protect patients before it's too late."

TMA is the largest state medical society in the nation, representing more than 43,000 physician and medical student members. It is located in Austin and has 120 component county medical societies around the state. Organized in 1853, TMA's key objective is to improve the health of all Texans.

Texas Medical Association