You’ll likely find sodium in the foods and drinks you consume every day. In fact, more than 70% of sodium intake comes from packaged and prepared foods. The sodium added to food via a salt shaker is still typically less than the amount of sodium you can consume in processed foods. You can find high sodium content in a deli sandwich, a can of soup, a restaurant salad, and even a breakfast sandwich. Too much sodium in your diet isn’t healthy. It can lead to high blood pressure and water retention, among other ailments. Here we will explore the different sources of salt and offer you healthier alternatives with lower sodium content that don’t sacrifice taste.
Your daily target
The American Heart Association recommends no more than 2,300 milligrams of sodium a day. If you’re living with high blood pressure, that recommendation goes down to 1,500 milligrams a day. Most Americans eat around 3,400 milligrams of sodium a day, which is well above both recommendations. To give you some perspective, one teaspoon of salt is 2,300 milligrams of sodium.
By lowering your sodium intake, fluid retention decreases, putting less pressure on your arteries. An easy way to watch your sodium intake is to look at the nutrition labels of the processed food you buy. Nutrition labels use 2,300 milligrams as 100% daily value. So, for example, 1,500 milligrams is less than that full daily value. That’s why even cutting just a thousand milligrams of sodium a day can help improve blood pressure.
The meals
1. Deli turkey sandwich
A simple and light turkey deli sandwich may seem like a healthy choice. But it isn’t when it comes to the amount of sodium it holds. Two ounces of deli turkey meat is 500 to 700 milligrams of sodium. When you eat the turkey between two slices of bread, that can bring the sodium content up to 1,020 milligrams.
The high sodium comes from the cured meat, and from the salt in the bread and cheese. In other words, a deli turkey sandwich is about two-thirds of the 1,500-milligram ideal sodium intake goal. And that’s before you add any sides.
2. Canned soup
A convenient can of soup may also seem like a healthy option. Some soups may have lower fat content with a reasonable amount of calories. But a single bowl, about one cup, of canned soup can be a whole day’s ideal sodium intake target. For example, let’s look at a can of turkey noodle soup. One cup is about 1,632 milligrams.
If you were to eat the whole can of soup, it would be 1,983 milligrams. A small serving of soup can be unsatisfying, which is why many people will eat the entire can of soup and not just a single cup. Soup is also made to be shelf-stable and needs the sodium to help keep it fresh. That one cup of turkey noodle soup is already more than the 1,500-milligram ideal goal.
3. Restaurant Caesar salad
Many restaurants offer side salads or salad entrees. Salads are typically made with a lot of lettuce and seem like a healthy choice, but you can’t forget about the dressing, the cheese, and the croutons that really can do the damage. Let’s break it down. Two tablespoons of Caesar dressing is about 370 milligrams of sodium.
A chicken Caesar salad, for example, can have around 841 milligrams of sodium. Restaurant portions are typically very generous, and they’re unlikely to skimp on the dressing, cheese, or the croutons. That’s where most of the sodium is coming from. A single salad is more than half the 1,500-milligram sodium goal.
4. Breakfast sandwich
Mornings are hectic, and it can be tempting to pick up a quick breakfast sandwich from the deli counter or drive-thru restaurant. However, don’t underestimate the sodium in these seemingly innocuous sandwiches. For example, a McDonald’s sausage, egg and cheese McGriddle has 1,290 milligrams of sodium.
The McMuffin version has a tad less, but still packs quite a sodium punch with 830 milligrams of sodium. Between the sausage, cheese, and griddle cake or muffin, the sodium piles up. One of these breakfast sandwiches could nearly reach your daily sodium goal of 1,500 milligrams, and that’s before you eat anything else.
5. Pepperoni pizza
Who doesn’t love a good slice of pizza? One is usually not enough for most people. A single slice of pepperoni pizza can have 660 to 920 milligrams of sodium.
This sodium comes from all of the ingredients that go into pizza, the cured pepperoni, cheese, sauce and even the crust. Two slices of pepperoni pizza have almost the entire recommended amount of sodium for the whole day.
6. General Tso’s chicken
General Tso’s chicken is a popular meal at restaurants and you can even find some versions in the freezer section. But getting a takeout box of General Tso’s chicken can really blow past a whole day. For example, one order of General Tso’s chicken weighs about 535 grams and contains an estimated 2,327 milligrams of sodium.
The salt is coming from the batter and the sauce. The takeout box is also likely to come in a large portion, which pushes the total sodium even higher. One order is more than 2,300 milligrams, the general limit, and well over the target if you have hypertension.
7. Frozen meal
The frozen food section at your grocery store is filled with a variety of options. The so-called healthy options may look perfectly portion-controlled in the freezer box but they aren’t sodium-controlled. Sodium varies by brand, so the tray is worth a quick look before you buy.
However, the sodium is necessary to keep the food fresh and frozen meals often come with sauces, processed meat and cheeses that have a high-sodium content on their own. A high-sodium frozen tray can be almost the entire recommended goal.
8. Italian sub sandwich
Your local deli and sub shop will likely offer Italian-style sandwiches. That may sound delicious, but it also means that it’s going to come with more cured meat, more layers, and more sodium. A typical Italian sub will layer ham, salami, pepperoni, provolone, plus dressing — all cured and all salty.
There isn’t a single measurement of the sandwich’s sodium content since it really depends on the restaurant or deli shop. But you can bet it’s definitely higher than a plain turkey sandwich. In fact, it’s easily over half and often close to most of the 1,500-milligram goal, before you even add chips.
The things that are not meals
The sodium content in the foods you eat isn’t the only thing that can raise your blood pressure. In fact, many of them aren’t food. Consuming alcohol can raise your blood pressure, not to mention it can add calories. It’s always a good idea to speak with your clinician about how much alcohol you drink and discuss a limit.
Many decongestants contain pseudoephedrine. The medications work by constricting the blood vessels in the nose and sinuses to relieve congestion. However, that constriction can also raise blood pressure throughout the body. If you’re living with high blood pressure, check the labels of any cold medicine that you buy or ask your pharmacist, since not all decongestants contain pseudoephedrine.
Nonsteroidal anti-inflammatory drugs, also known as NSAIDs, are a medication class that helps reduce pain, fever, and inflammation. But taking them regularly can raise your blood pressure, roughly 3 to 6 mmHg higher (mmHg means millimeters of mercury, the unit used to measure blood pressure). If you take blood pressure medicine, speak with your doctor before taking any NSAIDs.
Did you know that eating real licorice can also raise blood pressure? The candy has a mineralocorticoid effect that bumps up blood pressure and also lowers potassium. It may be a good idea to try to avoid eating real licorice in excess amounts.
What’s important to note is that none of these are meals. But they’re all still worth checking with the clinician or pharmacist to keep you healthy.
A note on salt substitutes
A great way to keep your blood pressure at bay and still season your food is by using a salt substitute. It works by using potassium chloride instead of sodium chloride for added taste. Many people find it useful when they’re trying to cut out sodium in their diets. However, it’s not ideal for everyone. For example, if you’re living with kidney disease or take any medicines or supplements that affect it, the salt substitute can lead to too much potassium in your blood. And excess potassium in the body can lead to irregular heart rhythms. The American Heart Association recommends consulting with a health professional before using a salt substitute.
The Bottom Line
If you have high blood pressure, it doesn’t mean that you have to give up on flavor in what you eat. It’s a good idea to just be aware and know what a meal may cost you. When grocery shopping, take the time to read the label and compare it to 1,500 or 2,300 milligrams a day. Start slow. Maybe make one swap at a time. You don’t have to worry about eating a perfect diet right away. It’s also important to know that diet alone may not be enough to control your blood pressure. Always speak to your clinician about your treatment options if needed. There are lots of foods out there that taste good but have a low-sodium content. The good news is that flavor can stay in your diet even as your sodium intake drops.
Stephanie Wright, RN, BSN, is a Registered Nurse with more than 15 years of experience in critical care, mental health, managed care, and clinical leadership.
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