On March 9, 2023, the World Health Organization (WHO) released a report on the progress of sodium reduction goals in U.N. member countries. The news wasn’t encouraging: Although all 194 member countries committed to the goal of reducing sodium intake 30% by 2025, only 5% (9 countries) have implemented comprehensive, mandatory sodium reduction policies. According to the WHO, putting these policies into effect all over the world could save 7 million lives by 2030.
The WHO report urged governments to impose stricter rules on the sodium content of packaged foods – forcing food manufacturers to reformulate their products, clearly mark the sodium content on food packaging, and create media campaigns to increase public awareness about the health dangers of a high-sodium diet.1
The Global Burden of Disease Study, which tracks health metrics in 195 countries, estimated in 2019 that 22 percent of deaths around the world are caused from poor diet. Of the dietary factors they studied, high sodium intake was responsible for the greatest number of deaths: 3 million deaths per year worldwide.2
According to the WHO report, the average sodium intake globally is about 4310 mg/day (10.78 grams of salt), more than twice the WHO’s recommended maximum of 2000 mg sodium/day.1 Much evidence demonstrates that even this 2000 mg/day figure contributes to disease and premature death.3,4
GBD Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
Blood Pressure Effects of Sodium Reduction: Dose-Response Meta-Analysis of Experimental Studies
Global sodium consumption and death from cardiovascular causes
The most well-known consequence of a long-term high-sodium diet is elevated blood pressure. Many people believe they don’t need to be concerned about sodium intake if their blood pressure isn’t already high. But if you’re eating the standard American diet, and your blood pressure isn’t high, it’s probably only a matter of time. In the U.S., the lifetime risk of hypertension is estimated at 70-85%.5 In the Framingham Heart Study, among men and women with normal blood pressure levels at age 55-65, 90% of those who survived to age 80-85 had developed hypertension.6
Also, there detrimental health effects of high sodium intake that are unrelated to blood pressure.
Lifetime Risks for Hypertension by Contemporary Guidelines in African American and White Men and Women
Residual lifetime risk for developing hypertension in middle-aged women and men: The Framingham Heart Study
Excess sodium increases heart disease and stroke risk, through both elevation of blood pressure and blood pressure-independent pathways. These include production of reactive oxygen species, arterial stiffening, impairing endothelial function, reducing the release of nitric oxide, and effects on the water and salt-balancing hormone aldosterone.7-14
Negative effects on the kidneys: High sodium intake increases urinary calcium excretion, which can lead to kidney stones. Also elevated blood pressure increases the risk of chronic kidney disease.10, 12, 15, 16
There is evidence that high sodium intake promotes the production of pro-inflammatory immune cells that contribute to autoimmune diseases.12,17,18
A high-salt diet is associated with a greater risk of gastric cancer, which is thought to be because sodium supports the growth of the ulcer-promoting bacteria H. pylori in the stomach.10,19-21
Recent evidence shows a link between a high-salt diet and greater risk of obesity.22 High-sodium foods are usually high-calorie foods; in addition, salt stimulates thirst and often intake of sugar-sweetened beverages. High sodium intake may also affect satiety signals.23 But higher sodium intake is associated with greater body fat mass independent of calorie intake, and the reasons aren’t completely clear yet.24
The high salt intake in the American diet doesn’t come from adding salt from the shaker at the table. Most of it – over 70% – comes from packaged and restaurant foods.25 The way to consume less sodium is to consume less packaged and restaurant food, and carefully read labels to limit your sodium intake from any packaged foods you do consume.
The U.S. requires sodium to be listed on the Nutrition Facts label of packaged foods, and there is a mandatory sodium limit for foods served in schools. But all other sodium reduction policies are voluntary for food manufacturers.1 This means that, in the U.S., it’s up to the individual to monitor and reduce their own sodium intake.
But reducing salt doesn’t mean eating bland, boring food for the rest of your life. Eating large amounts of salt for years desensitizes your taste buds so you don’t notice excessive saltiness. But when you reduce the salt in your diet, your taste buds will adjust surprisingly quickly. Then, you’ll finally start tasting the other spices and flavors in the food. Plus, if your blood pressure is high, you can expect to see meaningful reductions in blood pressure in just a few weeks.26
Learn how to adjust to cooking without salt here: Add flavor, not salt
There is sufficient naturally occurring sodium in vegetables, beans, nuts, and other plant foods. To keep your sodium intake favorable, I suggest limiting the sodium in any packaged foods – by choosing low-sodium or no-salt-added versions of condiments, sprouted grain breads or tortillas, packaged tomatoes, and vegetable broth, whenever possible.
My Nutritarian Food products are unique in that they are made without added sugar, salt and oils. These products include soups, salad dressings, ketchup, sauces, kale chips, and other foods. All are either certified organic or made with organic ingredients. You can easily add convenience and flavor—without damaging your health in the process.
Abstinence – from salt, sugar and other addictive substances – makes the heart grow stronger. By eliminating them from your diet, you’ll discover that your cravings and desire for these dangerous food additives will disappear over time. Just like sugar, salt is addicting and kills millions of people around the world – don’t let one of them be you.
He FJ, Li J, Macgregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev 2013:CD004937.
Joel Fuhrman, M.D. is a board-certified family physician, seven-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 30 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.
*There is no guarantee of specific results. Results can vary. All material provided on the DrFuhrman.com website is provided for informational or educational purposes only. Consult a physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.