Most of the sodium that Americans consume does not come from table salt, but from packaged, processed foods and restaurant meals.
Thus concludes a report from the Centers for Disease Control and Prevention (CDC), published in the latest Morbidity and Mortality Weekly Report (MMWR).
The report says over 90% of children and 89% of adults in the US - irrespective of age, race, gender or having high blood pressure - consume more than the recommended limits for sodium, not including salt added to food at the table.
CDC Director Dr. Tom Frieden says:
"The finding that 9 of 10 adults and children still consume too much salt is alarming."
The limits, as given in the 2015-2020 Dietary Guidelines for Americans, state that people over the age of 14 should consume no more than 2,300 mg of sodium per day - the equivalent to 1 tsp of salt - and less than this if they are younger.
The Dietary Guidelines - revised every 5 years - are based on the latest scientific evidence, which Dr. Frieden says clearly shows "too much sodium in our foods leads to high blood pressure, a major risk factor for heart disease and stroke."
Around 1 in 3 adult Americans - around 70 million people - have high blood pressure and only half of them have it under control.
Heart disease and stroke kill more Americans every year than any other cause. Together with other cardiovascular diseases, they claim more than 800,000 lives each year in the US and cost the nation nearly $320 billion a year in health care and lost productivity.
'Need to reduce sodium in manufactured and restaurant foods'
While one way to cut back on sodium is to go easy on the salt shaker, most of the sodium that Americans consume comes from packaged, processed foods and restaurant meals. Dr. Frieden urges:
"Reducing sodium in manufactured and restaurant foods will give consumers more choice and save lives."
For the report, CDC researchers calculated how much sodium Americans are eating from dietary data captured in the 2009-2012 National Health and Nutrition Examination Surveys (NHANES), which included over 15,000 people.
They found that excess sodium consumption is a problem across all groups - regardless of gender, race and health status. However, levels of excess vary within groups. For example, more men (98%) consume too much sodium than women (80%), and 90% of white adults consume too much, compared with 85% of black adults.
Also, while sodium consumption exceeds recommended limits in all age groups, it peaks between the ages of 19-50 - as does calorie consumption.
Equally alarming is the fact that among people at higher risk of heart disease or stroke - such as the over-50s, black people and those whose blood pressure is high or approaching high (pre-hypertensive) - more than 3 out of 4 consume more than the recommended limit of 2,300 mg of sodium per day.
'Little change over the past decade'
The CDC researchers say the new figures show there has been little change in Americans' sodium consumption over the last 10 years. And, because so much of it comes from food not prepared in the home, such as processed and restaurant food, consumers have little choice over how to reduce their intake.
The CDC say there is a need to lower sodium intake in the US population by gradually reducing levels in the nation's food supply.
They suggest there is a small movement in this direction as some food processing companies are voluntarily reducing sodium in their products and others begin to follow suit.
The report also notes the important part health professionals can play in helping patients reduce their excessive salt intake.
One of the authors, Sandra Jackson, an epidemiologist in CDC's Division for Heart Disease and Stroke Prevention, concludes:
"Sodium reduction is a key part of preventing heart disease and stroke. Reducing sodium is an achievable and effective strategy to improve heart health for everyone, but it's going to take all of us working together to make it possible."
The CDC website offers information about sodium in the diet and tips on how to reduce it.
Meanwhile, Medical News Today recently also learned that there is a need to more quickly recognize the symptoms of a heart attack. A study published in JACC: Cardiovascular Interventions shows how the sooner patients are treated following heart attack symptoms, the better the outcomes, and it also calls for better performance measures of the time gap between symptoms and treatment.