Salt intake dietary recommendations

The UK Committee On Medical Aspects (COMA) of food policy reports of 1984 and 1994, in pointing out that coronary heart disease and cerebral vascular disease (stroke) account for more than one-third of the deaths in the UK and that one in two adults i.e. 20 million) in the UK are clinically overweight, suggest dietary changes. The main recommendations are that blood cholesterol levels are kept below 5.2 units (a figure currently exceeded by 70% of the UK adult population) and that more starchy foods, vegetables, fruit, and oily fish are eaten to replace reduced intakes of salt and of fatty and sugary foods. 

Calcium carbonate is the salt of choice because it contains the highest amount of elemental calcium and is the least expensive (see Table 88-5). The fraction of calcium absorbed is dose-limited, so maximum single doses of 600 mg or less of elemental calcium are recommended. Calcium carbonate tablets should be taken with meals to enhance absorption. Calcium citrate absorption is acid-independent and need not be administered with meals. Although tricalcium phosphate contains 39% calcium, nonabsorbable calcium-phosphorus complexes may limit overall calcium absorption compared to other products. This product may be required for up to 10% of seniors with hypophosphatemia that cannot be resolved with increased dietary intake. Disintegration and dissolution rates vary significantly between products and lots. Products with good disintegration and dissolution rates and lead contents of less than 1 mcg/day should be recommended. 

It has been estimated that the average American ingests 7.5-10 g of salt (NaCl) each day. Because NaCl is about 40% (by mass) sodium ions, this amounts to 3-4 g of sodium daily. Until 1989 the Food and Nutrition Board of the National Academy of Sciences National Research Council s defined estimated safe and adequate daily dietary intake (ESADDl) of sodium ion was 1.1-3.3 g. Clearly, Americans exceed this recommendation. 

The Food and Nutrition Board has removed the three electrolytes from its table of estimated safe and adequate daily dietary intake because sufficient information is not available to establish a recommended amount. The major dietary source of sodium and chloride is table salt (40% sodium and 60% chloride). Physicians still recommend that the intake of sodium be restricted to 1-2 g daily. The recommended intake of chloride is approximately 1.7-5.1 g daily. However, getting enough sodium and chloride is not a problem. In fact, sodium intake in the United States is about 5-7 g/day, far in excess of the 1-2 g/day required by a normal adult. 

Sodium is an important dietary mineral that we eat in our food, primarily as sodium chloride (table salt). Sodium is involved in the regulation of body fluids, and eating too much of it can lead to high blood pressure. High blood pressure, in turn, increases the risk of stroke and heart attack. Consequently, people with high blood pressure should limit their sodium intake. The FDA recommends that a person consume less than 2.4 g (2400 mg) of sodium per day. However, sodium is usually consumed as sodium chloride, so the mass of sodium that we eat is not the same as the mass of sodium chloride that we eat. How many grams of sodium chloride can we consume and still stay below the FDA recommendation for sodium ... 

RECOMMENDED DAILY ALLOWANCE OE CHLORINE. The are no recommended dietary allowances for chlorine because the average person s intake of 3 to 9 g daily from foods and added table salt easily meets the requirements. Also, diets that provide sufficient sodium and potassium provide adequate chlorine. 

RECOMMENDED DAILY ALLOWANCE OF CHROMIUM. A normal healthy adult loses about 1 meg (microgram) of chromium daily in his/her urine. The dietary intake of chromium needed to replace this loss ranges from 4 meg of GTF-chromium in brewers yeast (as much as 25% of this form may be absorbed) to 200 meg of chromium from an inorganic salt (as little as 0.5% of this form may be absorbed). 

Dietary intake surveys typically do not include estimates from salt substitutes and supplements. However, less than 10% of those surveyed in NHANES-III reported using salt substitutes or a reduced-sodium salt. Because a high dietary intake of potassium can be achieved through diet rather than pills and because potassium derived from foods also comes with bicarbonate precursors, as well as a variety of other nutrients, the preferred strategy to achieve the recommended potassium intake is to consume foods rather than supplements. 

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