By: Anjali Rana PharmD. Candidate c/o 2025

             While too much of any food or substance is not good, sodium-rich diets are especially harmful to the body causing increases in blood pressure and fluid retention. Sodium is found in majority of the foods consumed. People should be cautious of processed goods and restaurant meals which tend to contain a lot of salt. Even dishes cooked at home may have a high sodium content. Consistently eating meals with a high salt content produces respiratory risks that effect  functions of the heart, kidney, and brain. ³ This continuous cycle prevents patients from attaining optimal health. By making the body work harder through changes in the potassium sodium channels, heavy salt intake leads to a mass consumption of calories, increased blood pressure, and the potential for stroke, heart attack, and premature death.⁵ Pharmacists can play a vital role in educating patients of the harmful effects high sodium diets can have on their health and encourage positive lifestyle modifications by actively discussing patients’ nutrition and exercise regimen.

The body functions as an energy pathway continuously keeping systems in balance. When natural processes are disturbed, order will breakdown. Disparities throughout the body’s natural physiology causes chaos to occur, stemming from direct effects on the sodium potassium pump. These channels found on red blood cells can have a direct impact in consuming calories at a rapid pace. Sodium and potassium are electrolytes needed to maintain normal fluid and blood volume, amongst other functions. ¹ However, fluctuations in each ion can result in extreme consequences, especially changes in sodium levels. Hypernatremia, or an increased level of sodium, causes the body to counteract this imbalance by retaining water, causing excess of fluid. This imbalance creates the gain in weight suggesting abnormal calorie intake. Salt has the ability to cause individuals to eat more food then desirable. It can prevent the body from recognizing when its full, taking in more energy than necessary which can produce fat.⁶ This suggests that as individuals obtain more fat, they are acquiring extra calories that are not utilized by the body. ⁶

The average American consumes about 3,400 milligrams of sodium a day while relatively healthy individuals get no more than 2,300 milligrams of sodium a day. ² By consuming about one-third more the amount than what is considered healthy, patients force their hearts to work much harder than necessary. Many individuals may not be aware of what foods are high in sodium or can only afford foods high in sodium due to their often-lower prices. This is most notably visible in table salt, a common household ingredient. ³ Salt has been used for centuries as a preservative and is used as flavoring because it is cheaper compared to other spices. ³ This means that sodium can be found in almost every meal, emphasizing how difficult it is to lower its use in patients’ meals due to its many versatile applications. Fresh foods, such as vegetables and fruits, are foods naturally low in sodium and provide many other nutrients that can help improve the health of patients when combined with exercise.

With increased sodium intake, changes in blood pressure occur due to the stiffening of the arteries and veins found in the heart. Blood pressure is how great the force of blood is flowing through the blood vessels. This plays a factor in how the blood is circulated throughout the body and establishes how oxygen is supplied to necessary organs and tissues. If the value is greater than 130/80mmHg it demonstrates hypertension. Many factors can contribute to people developing hypertension. Modifiable risk factors include diets high in sodium and minimal potassium, consumption of saturated or trans fats, lack of exercise, and being overweight. Sodium is a key risk factor for developing hypertension. Untreated hypertension can cause fatal health conditions over time, such as heart disease and stroke. ¹ To help manage blood pressure, the Centers for Disease Control and Prevention recommends following the DASH diet, adhering to medication regimens, and exercising routinely. ⁴ The DASH diet calls for limiting food high in added sodium and expanding consumption of vegetables. All these factors can help patients live a healthier lifestyle that paves the way for better emotional, physical, and mental health.

Other than high blood pressure, consuming large amounts of sodium can be deleterious for other major organs such as the heart, kidney, and brain. The heart pumps oxygen-rich blood and carries nutrients throughout the rest of the body. ⁵ Increased sodium intakes will enlarge the size and increase the thickness of the left ventricle, creating difficulties circulating blood due to decreased pumping efficiency. The kidney filters waste out of the body and reabsorbs nutrients back into the bloodstream. Increased sodium that leads to hypertension makes it harder for the kidneys to filter blood which will contribute to kidney damage, and if left uncorrected, will result in kidney failure. ³ Lastly, increased sodium levels have a direct influence on brain health. It harms the nervous system, which creates extreme fatigue and headache. ¹ If patients do not address increased salt intake, overtime it will manifest into more severe outcomes.

Pharmacists can play an important role to increase awareness of the health consequences associated with high sodium diets. Educating patients how to properly read nutrition labels can help patients make informed decisions about the amount of sodium contained in foods. According to the Food and Drug Administration, when the percent of the daily value for one serving size is five percent or less, the amount is considered “low sodium” while twenty percent or more is considered “high sodium”. ²

This allows individuals to quickly identify if there is too much sodium within the contents of their food. Removing salt from meals entirely and using alternate forms of seasoning is another way for patients to reduce sodium content. Preparing dishes from scratch allows people to control how much sodium they will consume. It gives them the opportunity to choose fresh foods such as vegetables which are naturally low in sodium. There is evidence that sodium can also be reduced when individuals are cognizant when eating out at restaurants. The National Heart, Lung, Blood Institute believe researching the restaurant’s menu, making special requests to prepare foods without added salt, and substituting sides for healthier alternatives are ways to reduce sodium when dining out. ⁷ This suggests there are ways to maintain wellness both at home and when out to eat. Changing ones eating plan is one way to address sodium consumption and it can be further managed through physical activity. Exercise is related to the loss of sodium due to the production of sweat during physical activity. As one sweats at a rapid pace, the fluid and salt that is lost allows for the blood pressure to drop allowing the body to work more efficiently. ⁶

Heavy salt intake leads to an increased consumption of calories, higher blood pressure, and potential for stroke, heart attack, and premature death if uncontrolled.⁵ Whether an individual is eating a snack or a meal, traces of sodium can be found which add up throughout the day. As the most accessible health care providers, pharmacists can make an impact educating the general population about the harms of high sodium diets and provide lifestyle modifications to improve the health of our patients.

References

1. CDC. The role of potassium and sodium in your diet. Cdc.gov. Published October 3,2018. Accessed November 21, 2020. https://www.cdc.gov/salt/potassium.htm
2. Center for Food Safety, Applied Nutrition. Sodium in Your Diet. Fda.gov. Published February 4, 2020. Accessed November 21, 2020. https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet
3. Cox L. Why is too much salt bad for you? Live Science. Published May 30, 2013. Accessed November 21,2020. https://www.livescience.com/36256-salt-bad-health.html
4. Farquhar WB, Dornauer M, Bhatla A, et al. Too much sodium can cause more than high blood pressure. Statnews.com. Published December 24, 2015. Accessed November 21,2020. https://www.statnews.com/2015/12/24/sodium-diet-high-blood-pressure
5. Holland K. High blood pressure: Causes, symptoms, medication, diet, and more.Healthline.com. Published October 27, 2014. Accessed November 21, 2020. https://www.healthline.com/health/high-blood-pressure-hypertension
6. Medical News Today. Salt could lead to weight gain by driving fatty food intake. Published March 13, 2016.Accessed December 14, 2020. https://www.medicalnewstoday.com/articles/307820
7. Tips to reduce salt and sodium. Nih.gov. Accessed November 27, 2020. https://www.nhlbi.nih.gov/health-topics/all-publications-and-resources/tips-reduce-salt-sodium

Published by Rho Chi Post