Features February 2013 Issue

Avoid the “Salty Six” for a Healthier Heart

Some of the foods on this list may surprise you for their high-sodium content.

You’ve probably lost count of the times you’ve read or heard from your doctor that you need to reduce your sodium intake to help manage your blood pressure and keep your heart healthy. But even with the salt shaker safely tucked away in the pantry, you’re still likely to be consuming too much sodium. That’s because the sodium added to a wide range of food products makes it a real challenge to keep your intake down to the 1,500 mg target recommended by the American Heart Association (AHA).


In an effort to raise awareness of the sodium levels in everyday foods, the AHA recently released its list of the “Salty Six,” common foods that contain more sodium than you might expect. Dietitian Julia Renee Zumpano RD, LD, with Preventive Cardiology & Rehabilitation at Cleveland Clinic, praises the list and says it addresses the most common culprits. She adds that several of the items on the list are also high in fat and calories, making them especially dangerous to your heart health.

“I think it all comes down to portions and how frequently you eat the item,” she says. “For instance, most people eat two or three slices of pizza, which has, on average 275 calories, 10 grams of fat and 550 mg of sodium per slice.”

The harmful half dozen
The following foods were chosen, partly for their sodium content, but also because they are foods that are eaten every day. Fortunately, eating smaller or fewer portions can make a big difference, as can simply finding lower sodium alternatives. Here are the “Salty Six” and some healthier options:

1. Bread and rolls: These baked goods are especially deceiving because they don’t even taste salty. But one slice of bread can have as many as 230 mg of sodium. Zumpano recommends reading the labels and looking for lower-sodium breads. “You can also replace bread with a plain cooked starch, such as oatmeal, whole-grain pasta or brown rice or potatoes—white or sweet—with the skin,” she suggests.

2. Cured meats, cold cuts: It’s not just bacon and salami and the usual suspects that pack a lot of sodium. Even deli or packaged turkey can contain more than a 1,000 mg per serving. Zumpano suggests opting for low-sodium meats or fresh meat, as well as canned tuna with no added salt.

3. Pizza: As mentioned earlier, pizza is not only high in sodium, but it can also deliver more saturated fat and calories in two slices than you have at any one meal. “Try making your own pizza at home, using half the cheese and veggies instead of meat,” Zumpano suggests.

4. Poultry: Chicken can usually be a healthy food, but the way it’s prepared can make all the difference. Choosing lean, skinless, grilled chicken is the best choice, but be aware that packaged chicken may also include sodium. And for products such as chicken nuggets, the sodium levels can shoot up in a hurry.

5. Soup: Canned soup is among the most notorious foods for packing a lot of sodium into a small serving size. Don’t be fooled by all the vegetables and nutrients. A can of chicken noodle soup can have up to 940 mg of sodium. It’s also worth remembering that one can often contains more than one serving, even though we tend to treat a single can like a single serving—so read the label and serving size information carefully if you’re watching your sodium intake.

There are many soups that are marketed as “low-sodium” options, but Zumpano still recommended studying the nutrition information on the can. “Compare labels, but try making fresh soup or just have a salad instead,” she recommends.

6. Sandwiches: Yes, there’s more bread, which we’ve already covered, as well as deli meats. But when it comes to grilled cheese, hamburgers and other sandwich varieties, the sodium levels can climb quickly. And condiments, such as ketchup or salad dressing can also bump the sodium totals even higher.

“Make a sandwich a salad with just oil and vinegar on top,” Zumpano says. “Or make it an open-face sandwich, with just one slice of bread, and ask for no cheese, half the meat and just oil and vinegar, instead of the usual condiments.”

Zumpano also advises those watching their sodium to be careful when they eat out at restaurants. Even if you don’t notice a salty taste, chances are the sodium levels are higher in restaurant food than you might imagine.

So while you’re reading labels and adjusting your food choices accordingly, Zumpano says a key is also to limit portion sizes. And remember that even though we have the holidays behind us, it’s still important to be vigilant about what you eat.

Zumpano sums it up this way: “People worry about what they eat between Thanksgiving and Christmas, when what they need to worry about is what they eat between Christmas and Thanksgiving.”