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Diet recommendations were already confusing before the Institute of Medicine (IOM) increased its maximum recommended sodium intake for adults over 50 and those with heart risk from 1,500 milligrams (mg) to 2,300, more than a 50 percent increase.

The American Heart Association, however, is sticking with 1,500 mg. Other organizations have yet other opinions. Here are some frequently asked questions.

Q: Is sodium the same as salt?

A: Table salt, sodium chloride, contains approximately 40 percent sodium and is the most common source of dietary sodium. One teaspoon of salt — 6,000 mg — has 2,400 mg of sodium. Most food packaging lists sodium but some still show salt; don’t be fooled, since sodium comes from more sources than salt.

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Q: Does sodium intake matter if I don’t have high blood pressure?

A: Salt intake is important for everyone. In addition to heart and cardiovascular diseases including stroke, high-salt diets are associated with some cancers and autoimmune diseases. Too much salt can also cause edema and make your clothes and rings fit tighter.

Salt, however, is a required dietary nutrient. Too little salt, less than 500 mg, can cause headaches, nausea, confusion, weakness, seizures, even death.

Q: What is a reasonable amount of salt per day?

A: Given the latest research, the Institute of Medicine recommendation of 2,300 mg sodium per day makes sense to prevent future problems. For those with cardiovascular risk factors, a lower sodium diet may still have benefits since it can further reduce strain on the heart. Get an individualized plan from your doctor.

Q: Does this mean I need to start calculating salt intake every day?

A: For most of us, it’s as easy as making healthy choices. Read labels and avoid sodium bombs. Skip the canned chili with 1,400 mg sodium and choose one with just half that amount. You can always add a little salt if it’s too bland.

Fresh foods are typically much lower in sodium than processed ones. Go to the American Heart Association website,, and type in “low sodium recipes” or consult a dietitian.

Most restaurants can tell you how much sodium is in their menu items and recommend entrees that have less.

Soups and sauces are the worst offenders. It’s easy to leave a restaurant with 5,000 more milligrams of sodium than you walked in with.

Q: How can I do this if I crave salt?

A: Salt craving is not normal and can be a sign of poor absorption of nutrients, kidney, heart or adrenal problems, dehydration and some drugs. Your doctor can figure this out. There is no question the American average of 3,400 mg of sodium increases the future risk for diseases we would all like to avoid.

With a little planning, you can enjoy a tasty, lower sodium diet. You won’t miss the salt or, for that matter, the cardiologist or oncologist either.

Dan Labriola, N.D.: Labriola is director of the Northwest Natural Health Specialty Care Clinic and medical director for naturopathic services, Swedish Medical Center’s Cancer Institute. The clinic website is

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