Personal Health|October 21, 2012 7:00 AM

Salt: The tasty killer

Too much sodium can lead to heart failure – even for 30-year-olds

Meals should average about 600 mg of salt, but all of these contain surprisingly high hidden amounts. Photo by Robert D. Tonsing for Colorado Public News

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Not many people would pour a teaspoon of salt over their plates at dinner. Yet with so much hidden salt in processed foods, that’s what most Coloradans are eating.

And it’s proving to be a killer.

Americans are consuming so much salt – much of it unknowingly – that it has helped set blood pressure soaring for one in three adults.

Long-term high blood pressure silently inflames or hardens arteries, eventually damaging hearts. Consistent high blood pressure also is also a factor in strokes, which occur when either blockages or ruptures interrupt the blood supply to the brain.

Surprisingly high-salt foods

The Center for Science in the Public Interest and the Food and Drug Administration have highlighted numerous high-salt foods, which is identified in stores as “sodium” on the package nutrition information. Normal consumption should be 2,000 to 2,300 mg a day, or about 600 mg per meal, plus snacks. Here is a sample of foods high in salt:

  • Red Lobster New England Lobster and Crab Bake, 6,000 mg
  • Chili’s Original Ribs 6,650 mg
  • Dunkin’ Donuts Salt Bagel 3,380 mg
  • Schlotzky’s Original Sandwich 2,504 mg
  • 1 tablespoon La Choy soy sauce 1,160 mg
  • Outback Bloomin’ Onion 4,102 mg
  • Maruchan Roast Chicken Instant Lunch 1,280 mg
  • Many Chinese food restaurant meals 2,000 to 3,000 mg
  • Pillsbury Grands Homestyle Biscuits 560 mg each

“The high-sodium food is causing a lot of high blood pressure and stroke, and it’s killing people,” said Debbie Lathrop, a registered nurse at Exempla Lutheran Hospital in Wheat Ridge. Sodium is the name for salt as it is listed on food labels.

Fifteen years ago, potentially fatal damage to hearts occurred mostly in older people, Lathrop said. “It’s not an old people’s disease anymore. People in their 30s are having heart attacks and heart failure,” because they have risk factors of extra weight, inactivity and unhealthy diet, she said.

One of those high-salt meals can be much more immediately dangerous to patients who’ve just had an incident of heart failure. Hospitals now track such departing patients to make sure they don’t return within weeks. And, many nurses tell patients to check the salt in every meal. At Lutheran, tracking heart failure patients to prevent this is Lathrop’s job.

High blood pressure, consistently higher than 120/80, can weaken the heart in the first place, Lathrop said. But for people who’ve just survived heart failure, the heart is already weakened, and salt causes the body to act like a sponge and retain sodium and water, Lathrop said. So one high-salt meal can cause swelling and raise blood pressure. Dizzy and miserable, the patients end up back in the hospital and sometimes die, Lathrop said.

A normal amount of salt is 2,000 mg a day, or about one teaspoon, Lathrop said. Many Americans are eating 3,000 to 4,000 mg day. Where a single meal should average about 600 mg maximum, many meals are well over 1,000 or 2,000 mg.

Half the population should consume no more than 1,500 mg a day. That’s everyone with high blood pressure, middle-aged or older, or African-Americans, who are often more susceptible to heart disease.

So what are these dangerously high-salt foods?

“The chances are that almost any restaurant you go to, you will easily go over 2,000 mg,” Lathrop said.

Joe Lederhos exercises at Exempla Lutheran Hospital in Wheat Ridge to recover after an incident of heart failure. He reads labels and skips salty foods now because one high-salt meal can send him back into the hospital. Photos by Stephen Swofford/Colorado Public News

Store shelves are also loaded with high sodium foods. Campbell’s Broccoli Cheese Condensed soup contains 820 mg in a 1 cup serving; but many people eat the whole can of 2.5 servings and get 2,050 mg in one bowl. Chicken fingers marketed for kids often measure well over the daily 1,200 mg maximum for a child, according to the center. Fast-food pancakes and syrup are high in salt. Low-calorie and organic foods often aren’t any better when it comes to salt, Colorado Public News has found.

The Center for Science in the Public Interest has termed salt, “The Forgotten Killer,” and the Food and Drug Administration is considering regulating its use in food. Each year, 150,000 lives could be saved, along with $28 billion in health care costs, the center said.

Some in the food industry are fighting back, saying salt makes food taste better, and consumers like it that way. ConAgra, which makes Healthy Choice and Chef Boyardee, once said that simply eating less food would be better than eating less salt. But now, the food giant has promised to cut 20 percent of the salt out of its foods by 2015.
“We’re halfway there, said Mark Andon, vice president of nutrition.

But some foods need a lot more than 20 percent of the salt removed to fall within the recommended guidelines.

“Things that you wouldn’t think were that salty are just loaded with salt,” said Colorado resident Joe Lederhos, who survived heart failure and was exercising recently at Lutheran Hospital. “Marinara sauce. And clam chowder, which I love.”

To keep patients from overdoing the salt, Lutheran and other hospitals are calling them at home to check for swelling, trouble breathing and abrupt water weight gain from salt, such as three pounds in 24 hours. Such signs trigger a call to the doctor and perhaps medications to reduce the symptoms and prevent re-hospitalization, Lathrop said.

Extra salt causes the body to retain fluids, thus increasing the volume of blood. “The heart has to work extra hard to squeeze that blood through blood vessels,” and that’s what strains the heart and causes blood pressure to rise, Lathrop explained.

Nationally, 24.7 percent of heart failure patients return to the hospital within 30 days, a dangerous sign for them and expensive for the health care system. Last year, Lutheran had a 20.6 percent readmission rate for heart failure, among the best in the country. It says it has cut that rate to 15 percent now with Lathrop’s follow up care.
In Colorado, 19 hospitals face small cuts in their Medicare payments next year for having high readmission rates for heart failure, heart attack and pneumonia. That costs taxpayers $17.5 billion a year.

Do all patients listen? Lathrop hesitated, choosing her words. “That could be better,” she said.

Carol McKinley contributed to this story.

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