IOM Recommends Less Salt

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In February 2004 a panel of experts from the Institute of Medicine?s Food and Nutrition Board released its report on the need for water, salt and potassium.1 The new guidelines make it clear that the average American is consuming too much salt. This report sets a toxic upper limit (UL) for sodium as 2,300 mg. For young adults, the new guidelines state that 1,500 mg of sodium is an adequate intake (AI) and discourages even young, healthy Americans from consuming more than this amount. Unfortunately the average young American is consuming twice this amount even if she never touches a salt shaker. This is because at least 3/4 of the salt in the typical American diet comes from restaurant meals and convenience foods.

The report lists hypertension and cardiovascular and kidney diseases as the major adverse effects of excessive salt (sodium) intake. However, the report also notes evidence linking the toxic amount of salt in the American diet to atrophic gastritis and stomach cancer and increased calcium loss in urine, which contributes to kidney stone formation and osteoporosis. The report also sets a lower AI for older Americans because the toxicity of salt increases in older people. For those over 50, the new AI is 1,300 mg a day; and for those over 70, the new AI is 1,200 mg a day. The report states, ?Because the relationship between sodium intake and blood pressure is progressive and continuous without an apparent threshold, it is difficult to precisely set a UL, especially because other environmental factors (weight, potassium intake, alcohol intake) and genetic factors also affect blood pressure.? The more salt a person eats, the higher blood pressure will go over time. About 90% of Americans can expect to develop hypertension in their lifetime. The report also recommends Americans double their current potassium intake to 4,700 mg/day by eating a lot more fruits and vegetables. If Americans follow the new AI for salt, far fewer would die from cardiovascular disease.2

By Dr. James J Kenney, PhD, FACN


1. Institute of Medicine. DRI for water, potassium, sodium, chloride, sulfates. 2004. Chapt. 6. p. 247-392.

2. Kenney JJ. Diet, Hypertension and Salt Toxicity CPE courses at

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