It is not secret that our diet is very high in salt. The average adult male in the U.S. consumes 10.4 g of salt per day, while the average adult female consumes 7.3 g per day. These amounts greatly exceed the recommended guidelines of 5.8 g of salt per day (equivalent to 2,300 mg of sodium). However, it is important to note that 75% to 80% of the salt in our diet comes from eating processed foods, not from salt that we add during food preparation or consumption.

Countries across the world (such as Japan, the U.K., Finland, Portugal, etc.) have used a variety of approaches to reduce population-wide salt intake. These included a combination of regulations on the salt content in processed foods, labeling of processed and prepared foods, public education, and collaboration with the food industry. A new study suggests that if similar approached were to be adopted in the U.S., important gains in disease reduction and cost savings can be achieved.

The study, published online this week in the New England Journal of Medicine, used a model to quantify the benefits of potentially achievable, population-wide reductions in dietary salt of up to 3 g per day (1200 mg of sodium per day). The results show that reducing salt by 3 g per day can reduce the annual number of new cases of Coronary Heart Disease by 60,000 to 120,000, stroke by 32,000 to 66,000, and myocardial infarction (heart attack) by 54,000 to 99,000. It can also reduce the annual number of deaths from any cause by 44,000 to 92,000. Some specific segments of the population that are especially vulnerable, such as African Americans, women, and older adults, would benefit even more from disease and mortality reductions.

The effects of reducing salt intake on cardiovascular diseases and deaths are very similar to the effects of reducing tobacco-use, obesity, and cholesterol levels! The study estimates that “a regulatory intervention designed to achieve a reduction in salt intake of 3 g per day would save 194,000 to 392,000 quality-adjusted life-years and $10 billion to $24 billion in health care costs annually.” Quality-adjusted life-years is a measure of disease burden, including both the quality and the quantity of life lived.

One very interesting conclusion is that these interventions would be worth the money spent even if only a modest reduction of 1 g per day were achieved gradually between 2010 and 2019. It would be even more cost-effective than if all people with hypertension were taking medications to lower their blood pressure everyday.

These results suggest that there is an urgent need for dietary change in relation to salt intake. Since changes in behavior are notoriously difficult to achieve, and attempts to lower dietary salt intake on an individual basis have largely proved to be ineffective, focus on other approaches such as reducing salt content in processed foods and better labeling of all processed and prepared foods can go a long way.