THE DETAILS: The authors' goal was to find out whether increasing the price of salty foods would lead to overall improvements in public health by reducing the incidence of heart attacks and stroke. Using computer models, they tested a scenario in which the price of salty foods was raised by 40 percent, which they assumed would lower overall salt intake among the general population by 9.5 percent. Their models projected there would be 513,885 fewer strokes and 480,358 fewer heart attacks over the course of a lifetime among adults aged 40 to 85. The authors also estimated that the country would save $32.1 billion in medical costs. Even if the country's salt intake only dropped by 6 percent, we'd still see benefits: 327,892 fewer strokes and 306,137 fewer heart attacks, with $22.4 billion in savings.
WHAT IT MEANS: Most of the assumptions made in this study were modeled after an existing program in the United Kingdom, where the Food Standards Agency (equivalent to the U.S. Food and Drug Administration) worked with food manufacturers to cut sodium in processed foods to reach voluntary maximum levels for specific foods. The program started in 2003 and has already achieved a 9.5 percent reduction in sodium consumption there.
Read on for tips on how to cut salt out of the saltiest foods in your diet.
The proposed tax in this study would be levied on salt purchased by industrial food manufacturers, not on the finished product the consumer buys, and that could have repercussions for the two largest sources of sodium in the American diet: restaurants and processed-food manufacturers. The Center for Science in the Public Interest notes that Americans now eat a third of their calories at restaurants, and nutritional studies have found that 75 percent of our sodium intake comes from processed and prepared foods like the ones served in restaurants.
Here are a few tips and tactics for keeping your dinner's sodium content from threatening your health:
#1: Ask what the heart means. Most restaurants offer some sort of healthier dish, generally designated by a heart or some other "heart-healthy" symbol on the menu. Just don't assume that "heart-healthy" equals "low-sodium." "Every time you see that on the menu, you have to figure out what the restaurant is using it for," says Joan Salge Blake, MS, RD, LDN, spokesperson for the American Dietetic Association. Sometimes it means low in fat, she says, sometimes in means lower in sodium, and sometimes it means both. Ask your server before assuming it signifies a low-salt dish.
#2: Go au natural. "The major source of sodium in the American diet is from already prepared food, whether in restaurants or in processed food, because they have control over how it's seasoned," says Blake. What you want to do at a restaurant, she adds, is figure out which foods are going to arrive on your plate in the least processed, most natural state possible. And that means keeping an eagle-eye out for added seasonings. "At a restaurant, you're at the mercy of how the chef seasons your food," she says. Vegetables or a simple piece of grilled chicken may be sautéed in healthy olive oil, but then seasoned with high-sodium seasonings, Blake cautions. "You have to figure out how they're prepared," she says. So ask the server how the food is seasoned, and ask that the chef hold the salt, in whatever form that salt may come.
Read on for more restaurant-ordering tips.
#3: Get everything on the side. Salad dressings are a salad's biggest hidden source of fat and calories, and Blake says they're a hidden source of sodium, too. But while you may already ask for your salad dressing on the side, Blake recommends asking for any kind of sauce—whether it's the barbecue sauce for a piece of chicken or the gravy for your steak—on the side, and using it sparingly. "Anything that you can control is going to help cut your sodium intake," she says.
#4: Add steamed vegetables. "You have less control in restaurants because a lot of times, things are done in advance," Blake says. It may not always be easy for a chef to, say, cut the salt out of your pasta sauce or give you a low-sodium salad dressing if those are made in bulk earlier in the day or come premixed. So Blake's favorite restaurant tip is to order a side or two of simple steamed vegetables and an ordinary entrée. When she gets the entrée, she cuts it into halves or thirds to take home, and then fills the rest of her plate with the vegetables. "That way, I control the sodium at the meal," she says, "and I'm a smart girl because now I don't have to cook the next day."
#5: Eat less. That trick also helps Blake eat less sodium because she's eating less overall. "At a restaurant, they're typically giving you too much anyway," she says. "So anybody who eats half an entrée is going to be cutting that entrée's sodium by half." You're also spreading out that sodium over the course of two or three days, so you can enjoy the flavor without worrying about eating too much salt. A classic food-saving tactic: As soon as the food arrives, have half of it boxed to take home. That way you won't keep eating "one more bite" until there's nothing left.
#6: Be a pest. The best way to get the food industry to cook lower sodium foods is to demand it, says Blake. Tell your server that you're trying to watch the sodium in your diet and that you want the chef to avoid seasonings and salty sauces and cheeses on your dinner. "You have to get to know your restaurant and have a relationship with that restaurant," Blake says. "See if they can make dishes more tailored to your needs." If the big chains can't work with you, patronize a smaller neighborhood joint with a friendlier chef who can. "As more people demand this, more and more restaurants are going to keep taking it out, and start looking to other flavors to make their meals taste great," says Blake. And be sure to make these requests when you're dining with a group; your example makes it easier for others to do the same.