The Shifting Science of Sodium Limits
For many years, a Tolerable Upper Intake Level (UL) of 2,300 mg per day for sodium was referenced based on its link to blood pressure and chronic disease risk. However, the Dietary Reference Intake (DRI) model has changed, leading to a reclassification. In 2019, the National Academies of Sciences, Engineering, and Medicine (NASEM) concluded that a specific toxicological UL for sodium could not be established. This change reflects a separation of toxicological risk from the ongoing risk associated with chronic disease within the DRI framework.
Why a Toxicological UL is 'Not Determined'
The UL represents the highest average daily intake unlikely to pose adverse health effects for most healthy individuals. Establishing a UL requires identifying a specific toxicological effect and quantifying its relationship to intake. For sodium, this has been difficult. While very high acute doses are toxic, this differs from the effects of chronic excessive intake, such as increased blood pressure. NASEM found insufficient data on specific indicators of sodium toxicity in the general healthy population to set a quantitative UL. Chronic high intake's link to elevated blood pressure is now addressed under the Chronic Disease Risk Reduction (CDRR) category in the new DRI model.
From UL to Chronic Disease Risk Reduction (CDRR)
The revised DRI model dedicates the UL to toxicological risk, introducing the CDRR category for dietary factors impacting chronic disease risk. For adults, the sodium CDRR is 2,300 mg per day. This level signifies that exceeding this intake is linked to increased chronic disease risk, particularly through elevated blood pressure. It serves as a goal for intake reduction rather than a strict maximum.
Current Sodium Recommendations from Health Organizations
Despite the absence of a toxicological UL, leading health organizations provide sodium intake recommendations based on chronic disease risk.
| Health Organization | Adult Daily Sodium Recommendation | Basis for Recommendation |
|---|---|---|
| Dietary Guidelines for Americans (FDA) | Less than 2,300 mg | Supports lowering blood pressure and reducing risk of chronic disease |
| World Health Organization (WHO) | Less than 2,000 mg | Aligns with global targets for population-wide reduction to combat non-communicable diseases |
| American Heart Association (AHA) | An ideal limit of 1,500 mg | Strongly recommends this limit, especially for those with or at risk for hypertension |
Major Sources of Dietary Sodium
Most dietary sodium comes from processed foods, not just added salt. Key sources include:
- Processed and Packaged Foods: Canned items, snacks, and processed meats.
- Restaurant and Fast Food: Meals from these sources are often high in sodium.
- Hidden Sodium: Sodium is also found in foods like bread, cheese, and salad dressings.
How to Reduce Your Sodium Intake
Reducing sodium intake effectively lowers blood pressure and improves heart health. Strategies include:
- Checking food labels for % Daily Value of sodium.
- Cooking at home to manage ingredients.
- Using herbs, spices, and citrus for flavor.
- Choosing fresh or frozen vegetables without added salt.
- Rinsing canned beans and tuna.
- Reducing high-sodium food portion sizes.
Conclusion: Understanding Your Sodium Intake
While a toxicological UL for sodium isn't set, the link between high intake and chronic disease risks, particularly high blood pressure, remains clear. The focus is now on a Chronic Disease Risk Reduction intake, set at less than 2,300 mg for adults. Adopting simple habits like limiting processed foods and using alternative seasonings can help meet health goals and reduce long-term risks. For detailed guidance, consult resources like the FDA's recommendations.