Heart patients still typically eat too much of this

People with heart disease are typically advised by their cardiologist to eat a low-sodium diet, but a new study published by the American College of Cardiology indicates that a low percentage of these patients actually follow that advice.

The study of more than 3,100 people with heart disease found that 89 percent consumed more than the recommended dose of sodium a day and, on average, study participants consumed more than twice the recommended amount.

Cardiologist Lawrence McAuliffe, MD, FACC, at Cape Cod Healthcare Cardiovascular Center in Hyannis finds this figure to be “remarkable,” especially given the health risks of excess sodium.

“The major issue for us in medicine and cardiology is hypertension and the role salt plays in that. And then hypertension’s role in heart attacks, strokes and kidney failure,” he said. “It’s the common denominator in all of those diseases.”

Why Cut the Salt?

Salt causes your body to retain fluids, which elevates blood pressure which then causes hardening of the arteries. It also affects the sympathetic nervous system in terms of response to blood pressure.

Historically, salt has been used as medicine and to preserve foods. It is still used as a preservative today in canned and frozen foods, which is why those foods are considered high sodium. Dr. McAuliffe recommends limiting sodium to 2.5 grams (2,500 milligrams) a day and only 1.5 grams of sodium for those with heart failure.

The USDA and FDA have made it easy for consumers to keep track of their sodium intake, he said. All foods have labels that inform consumers about the sodium content per serving and how that content compares to the recommended daily allowance. Unfortunately, most people don’t pay attention to that information.

“It’s a function of our fast-food society and getting away from healthy natural foods,” Dr. McAuliffe said. “The truth is that if we never added a smidgeon of salt to anything that we eat or cook, and if we were using natural and freshly grown materials, you’d get all the salt that you ever needed.”

As proof he points out that there are societies in the world who consume extremely low levels of salt, and the incidence of cardiovascular disease in those populations is significantly lower than most people around the world who consume much higher amounts of salt.

Read Labels and Find Alternatives

In addition to reading labels, Dr. McAuliffe recommends that people find alternate sources of flavoring for food.

“Things taste better if they are spiced, but it doesn’t require salt to give things their spice or taste,” he said. “There are things like potassium salt. There are natural spices that don’t have fluid retention or hypertensive components or side effects to them. You can create a reasonable tasting diet without the salt shaker.”

The other hidden source of sodium is over-the-counter pain relief medicines that contain ibuprofen. Ibuprofen is sodium retentive and can drive up a person’s blood pressure.

Salt is Still Important

With all the talk about lowering sodium intake, it is also important to note that people do need some sodium in their diet because it is vital for many cellular functions. Even though low sodium (hyponatremia) is far less common than high sodium, it can be dangerous.

“Sometimes it’s chronic and doesn’t cause a lot of issues,” Dr. McAuliffe said. “But with a sudden onset, it can be a medical emergency and cause seizures, swelling of the brain and other issues.”

There are three major causes of hyponatremia. The most common one is a dysfunction of the endocrine system. The endocrine organs like the adrenal glands and the pituitary gland maintain homeostasis of a lot of bodily functions including sodium metabolism and keeping our blood at the right saline concentration.

The second cause is a side effect of certain antidepressants called Syndrome of Inappropriate Antidiuretic Hormone (SIADH). It is a condition in which high levels of a hormone cause the body to retain water instead of secreting it normally in urine. This upsets the body’s balance of electrolytes, including sodium. If you are prescribed one of the antidepressants that can cause SIADH, your doctor should monitor the sodium levels in your bloodstream.

“The other cause is excessive free water intake,” Dr. McAuliffe said. “That sort of intuitively dilutes out the system and the pituitary and the kidneys know that and try to get rid of the fluid. But if you overwhelm the ability of the kidneys to get rid of free water, then your sodium content goes down.”

People who participate in vigorous physical activities tend to think they need to drink a lot of water. Instead, Dr. McAuliffe recommends drinking a fluid that is rich in nutrients, electrolytes and magnesium like Pedialyte or sugar-free Gatorade.

With salt intake at epidemic levels, it’s important to note that consuming more salt isn’t the answer to correcting hyponatremia.

“None of the conditions of hyponatremia are due to lack of eating and consuming enough salt,” Dr. McAuliffe said. “They are due to an abnormality of the homeostasis of the body.”