Too much sodium is bad. Hidden sources of sodium are worse!

Sometimes in the hubbub of today, we miss simple things that can have a lasting impact. This is true for parents and for doctors. As part of my ongoing board certification as a pediatrician, I was thrilled recently to see an important nutrition question:

“A 5-year-old boy is brought to the physician for a health care supervision visit. The parents have no particular concerns. Which of the following interventions would be most likely to lead to a predicted decrease in mortality in a population of healthy 5-year-old children?”

1. Decreased potassium intake
2. Decreased sodium intake
3. Increased caffeine intake
4. Increased fluoride intake
5. Increased magnesium intake

Correct Answer: Decreasing sodium in healthy kids’ diets is a tangible way to set them on a course for a longer, healthier life.

Most American kids get far too much sodium in what they eat every day. It’s not from the saltshaker: it’s an ingredient used to make processed foods and restaurant foods more compelling.

The Top Sources of Sodium in Kids’ Diets

Potato chips? French fries? Fritos? Decreasing sodium is tough to do, if you don’t know where it’s found. Sodium lurks in unseen places. McDonald’s shakes can have more sodium than their fries! Surprisingly, the top sources of sodium in the American diet are, in order:

1. Bread
2. Chicken and chicken dishes (Think nuggets)
3. Pizza
4. Pasta and pasta dishes (Mac and sodium)
5. Cold cuts

The amount of sodium in bread is low, but kids eat a whole lot of it. But a single small box of Mac and Cheese, prepared, can have 2130 mg of sodium on its own.

Decreasing Sodium in Kids’ Diets

So what’s a busy parent with a finicky child to do?

1. Know your numbers. The USDA says the most sodium anyone should get for a healthy life is 2300 mg per day. The American Heart Association says 1500 mg. For kids, I’d aim for only 1200 mg on average (1000 mg for kids under 4). The average American age 2 and above currently gets about 3400 mg per day!
2. Do it together. Lowering sodium is good for the whole family (1200 mg would be healthier for all of us) – and far easier to do for kids if you do it together.
3. Choose fresh. Fresh fruits and vegetables and lean meats and poultry are naturally low in sodium. Frozen, canned and processed foods and condiments tend to be the biggest culprits.
4. Pay attention to poultry. Poultry is naturally low in sodium, but some providers like to plump your poultry with saltwater, increasing the sodium by as much as 700%, usually without parents knowing. You are paying for saltwater weight. Learn about plumping and choose alternatives. Maddeningly, plumped poultry can still carry the “All-Natural” or “100% Natural” label.
5. Choose “one-to-one.”  Check every label for sodium. Aim for the sodium number per serving to be the same as the calorie number, or less. For extra credit, half the calorie number is even better – but I’d be happy if we just got to one-to-one.
6. Spice it up! Learn to make good food tastier with other herbs and spices, sauces and marinades. Squeeze a lemon. Food without the added salt can taste far better than just relying on salt for flavor.
7. Be patient. Tastes change – dramatically. As you become used to less added sodium, that food will taste better – and when you taste the old, super high sodium Mac and Cheese, it will taste just too salty. It’s worth the wait, to help your family live longer and happier.

By Alan If-I-Had-a-Magic-Wand-Sodium-Would-be-on-Restaurant-Menus Greene, MD