On April 2, 2024, the consumption of high-salt foods has long been associated with an increased risk of hypertension and heart diseases. However, much of the research on the effects of salt has been conducted with populations of moderate to high income.
According to a study, a large portion of low-income African American and white Americans exceed the currently recommended sodium intake. Why is this population consuming too much salt?
„In this marginalized group, access to food is almost always limited,“ said Lena Beal, registered dietitian and spokesperson for the Academy of Nutrition and Dietetics. The limited access to healthier foods leads to few options beyond processed foods, lack of education about healthier food choices, and affordability issues with high-quality foods, she said.
Salt is a necessary nutrient, but a diet high in salt can lead to death from heart diseases.
A large portion of low-income African American and white Americans exceeded the currently recommended sodium intake in the new study, „potentially contributing to their high mortality rate from cardiovascular diseases,“ said lead author Xiao-Ou Shu, MD, PhD, a researcher in the Department of Medicine, Division of Epidemiology at Vanderbilt University Medical Center in Nashville. Cardiovascular diseases refer to problems with the heart and blood vessels.
About 80% of the 65,000 individuals in the study exceeded the daily recommended amount of salt (or sodium) in their diet. The federal government recommends 2,300 milligrams or less per day. In contrast, black Americans consumed an average of 4,512 milligrams of sodium per day, while low-income white Americans consumed an average of 4,041 milligrams daily.
Overall, a high sodium content in the diet was associated with approximately 10 to 30% of deaths from cardiovascular diseases in the study published online in the journal JAMA Network Open on March 26.
Barriers to Healthier Foods
„It is a solid study. We often see this in our daily practice, so it’s good to have a study that supports this,“ said Beal, who was not involved in the research.
„We have our urban food deserts in Atlanta, where there is no grocery store within walking distance or easily accessible by public transportation, so people end up shopping at the proverbial corner store,“ said Beal, a cardiac dietitian at Piedmont Atlanta Hospital.
„The barriers for this population are very real and palpable when you deal with them every day,“ she said.
According to the city of Atlanta, in 2015, only 52% of city residents lived within a half-mile radius of fresh foods. This figure increased to 75% by 2020. The city aims to increase this to 85% by 2025.
Beal hopes for more action in the future. „We need to invest time, energy, research funds, and resources into these communities to improve their access to healthy, affordable options.“
Excess Salt, Excessive Risk of Death
Shu and colleagues examined patients an average of 14 years after they joined the Southern Community Cohort Study. Between 2002 and 2009, individuals aged 40 to 79 were enrolled in the study, mainly from health centers serving underserved Americans in one of 12 southern states. They were 72% black and 28% white, with about 83% living in households earning less than $25,000 annually.
Myths and Potential Solutions
People have several misconceptions about excess salt, said Beal. On the medical side, they tend to misunderstand the strong association with heart diseases, and on the nutrition side, people misconstrue how easy it is to combat it.
Avoiding excess salt does not mean consuming tasteless foods. Instead of sprinkling salt, add herbs and spices, Beal suggested. For example, choose rice in a bag that you cook and season yourself instead of rice that comes with a seasoning packet you cook and serve.
Shu said that „a specific program aimed at educating about the health risk of high sodium intake and promoting a healthy diet in these vulnerable populations should be a public health priority.“
Beal encourages people to change their lifestyle in two ways, even if they are financially constrained. „It’s about how much or how often you do something – the quantity or frequency.“