How Does Salt Affect Heart Health?

Forget the sweet tooth. Sometimes, your tongue craves something savory like a salty pile of pretzels or chips. But you’ve also heard too much salt (or sodium) can be bad for the heart.

So, then, how much salt is too much? And why does it matter? Cardiologist Luke Laffin, MD, answers your saltiest questions and gives us the low-down on sodium, your heart and your health.

Salt and your heart

Sodium is a mineral that we all need. It plays a role in the healthy function of nerves and muscles and helps keep your body’s fluid levels in proper balance.

But that fluid balance is delicate. “Too much sodium can cause fluid retention, which can increase blood pressure,” says Dr. Laffin. And high blood pressure is a major risk factor for heart attack, stroke and heart failure.

So keep tabs on your sodium, especially if you have high blood pressure or heart disease or are at risk of developing them.

Sodium recommendations

How much sodium is too much? A little goes a long way, according to Dr. Laffin. Here’s what the guidelines say.

Recommended sodium guidelines

Aim to keep sodium intake below 2,300 milligrams (mg) per day. “That’s equal to about 1 level teaspoon of salt,” Dr. Laffin says.

“Think about that 2,300 mg as a debit card you get every morning. Don’t spend it all in one place,” he adds. “And if you go over, you’ll pay interest — in the form of higher blood pressure.”

If you have high blood pressure

“Almost everyone with high blood pressure should be on a low-sodium diet,” Dr. Laffin says. That means capping daily sodium at 2,300 mg at the highest. “If you can get it down to less than 1,500 mg per day, that’s ideal,” he adds. Lowering blood pressure is an important way to reduce your risk of heart disease.

If you have heart failure

Doctors recommend that people with heart failure also eat a low-sodium diet. Too much salt can cause fluid to build up around the heart and lungs, making the heart work harder.

Evidence suggests that a limit of 2,000 mg per day of sodium is a good goal for people with heart failure, especially if they also have high blood pressure. But there’s an important caveat. “Some data suggests very low levels of sodium may lead to worse outcomes in people with heart failure, so discuss sodium intake with your healthcare provider,” Dr. Laffin says.

Tips for cutting salt from your diet

Most people think of salt as the stuff that comes out of a shaker. But that makes up a surprisingly small fraction of the sodium in an average diet. Most of the sodium we swallow comes from prepared and packaged foods.

Dr. Laffin offers these strategies for keeping sodium levels in the healthy range:

• Read labels: Check nutrition labels. Pantry staples like bread, canned soup and salad dressing often have a lot more sodium than you’d guess by tasting. Many other packaged foods can also be sneaky sources of sodium — even if they don’t taste particularly salty. But the numbers don’t lie.
• Beware the deli counter: “Deli meats, sausages, pickles and even cheese can have a lot of salt,” Dr. Laffin says. So think twice before you order that sky-high club sandwich.
• Get creative: Instead of letting salt do all the work, look to other spices and seasonings to give your meal some gusto. Try adding garlic, fresh herbs or a squeeze of lemon to kick the flavors up a notch.
• Be smart when dining out: Fear of sodium shouldn’t stop you from the occasional restaurant or takeout meal, Dr. Laffin says. But think about your choices ahead of time. Skip the soup or saucy pasta. Order fish or chicken and ask them to prepare it with no salt. (You can add a bit to taste at the table.) “Even fast-food restaurants will prepare a no-salt burger or no-salt fries if you ask,” Dr. Laffin says. “People often don’t think to ask, but restaurants are usually happy to do it.”
• Don’t be fooled by fancy salt: Some people think that sea salt or Himalayan salt is better for them than table salt. “When it comes to sodium, they affect blood pressure in the same way,” Dr. Laffin says.

Reading labels and tweaking your diet might sound daunting. But like anything else, it gets easier with practice. It’s a habit your heart will thank you for.