How Much Salt Is Too Much? The Hidden Link Between Salt, Blood Pressure & Your Health

Smart Health Key 12/12 – Use Salt/Sodium (and Salty Foods) Sparingly

If you've been told that your blood pressure is too high, you may have immediately thought about stress, exercise, weight or genetics.

But there's another everyday habit that can have a surprisingly powerful effect on your health: how much salt you're eating.

And here's the frustrating part: you don't necessarily have to be sprinkling salt all over your food to be eating too much of it.

In South Africa, the average person consumes around 8 g (one and a half teaspoons) of salt a day—almost twice the recommended amount. Thus, every 1g of salt (about 1/4 tsp or 1.25ml) contains about 400mg sodium. Much of that salt doesn't come from the saltshaker at all. It comes hidden in processed and packaged foods that can look perfectly ordinary.

That's why the Smart Health advice is simple: Use salt sparingly and limit salty, processed foods.

Your body needs sodium. But you don't need nearly as much as you think.

Salt consists of approximately 40% sodium and 60% chloride, and both sodium and chloride (electrolytes) have important functions in the body. The problem isn't that salt is inherently "bad." The problem is how much we're consuming.

For most of human evolution, salt intake appears to have been considerably lower than it is today—less than 250 mg of sodium (less than 1/4 tsp) per day in some populations. Interestingly, hypertension and age-related increases in blood pressure are virtually absent in populations where salt intake remains very low.

People also differ in how sensitive they are to salt, but there is a direct, progressive relationship between salt intake and hypertension.

And this isn't just an issue for adults. Salt intake during childhood and adolescence may influence blood pressure later in life. Children today consume large amounts of processed food, which means they're often getting far more sodium than their parents realise.

So this is one of those health habits that's worth getting right long before your doctor tells you that your blood pressure is a problem.

Too much salt affects more than blood pressure

High salt intake is a direct risk factor for stroke, heart failure and chronic kidney disease, independently of its effect on blood pressure.

It's also associated with kidney stones, osteoporosis and increased severity of asthma, and may contribute significantly to stomach cancer.

So when we tell you to use salt sparingly, we're not talking about making your food bland for the sake of it. We're talking about protecting your health.

And there's something else worth knowing:

Most of the salt you're eating may not be coming from your salt shaker.

Although around one in five South Africans add salt to their food before even tasting it, more than 48% of excessive salt intake comes from the food you eat.

That means you can be quite restrained with the saltshaker and still end up consuming far more sodium than you intended.

The salt shaker isn't the biggest or only problem

If you want to reduce your salt intake, the most important thing you can do is eat fewer processed foods and more unprocessed foods.

Consider a fruit and a few raw nuts, a small packet of peanuts and raisins and a small packet of crisps or chips:

A fresh fruit e.g. one apple or pear and a few raw nuts contain negligible sodium.

Peanuts and raisins contain around 70 mg of sodium per small packet (40g).

Crisps or chips contain round 250 mg per small packet (36g).

That's a huge difference between three snack foods that you might all consider to be a healthy snack.

And the same thing happens with other foods. Processing can dramatically change the amount of energy, fat, protein and salt you're getting from a food.

For example, compare these:

	Energy/100g	Protein/100g	Fat/100g	Sodium/100g
Fish Fingers	1136 kJ	15.7 g	12.2 g	582 mg
Grilled Fish	462 kJ	23.2 g	1.3 g	105 mg
Boerewors	1658 kJ	13.8 g	36.3 g	805 mg
Lean Beef Mince	917 kJ	27.4 g	11.3 g	70 mg

The difference between the fish fingers and grilled fish is striking. The grilled fish provides more protein, less than half the energy, dramatically less fat and far less sodium per 100 g.

The same applies to boerewors versus lean beef mince. The lean beef mince contains considerably more protein, while providing less energy, less than a third of the fat and a fraction of the sodium.

The point isn't that you can never eat fish fingers or boerewors again.

It's that processing can change the nutritional profile of a food dramatically, so try to limit it and choose lower sodium options more regularly.

So be especially careful of packets, powders (e.g. soup powder), sauces, food flavour enhancers, salted spices, stock cubes, powders, spreads, soya sauce and other highly processed foods like smoked, processed and fake meat. Also be aware that smoked fish is usually higher in salt and that most olives are salted and pickled foods are higher in salt.

Also note that any ingredient that contains the word sodium, is actually salt, e.g. preservative sodium benzoate, flavour enhancer mono sodium glutamate (MSG), etc. Check the nutrition label rather than assuming that something is healthy because it looks healthy.

Learn to read the sodium label

Here's a useful guide when checking the sodium content of packaged foods:

Sodium per 100 g	What it means
Less than 120 mg	Low
120–600 mg	Medium
More than 600 mg	High

As a general rule, choose foods that are low in sodium most of the time, and be more cautious with products in the high-sodium category.

And remember that "healthy" packaging doesn't necessarily mean low in sodium.

The nutrition label tells you much more than the front of the packet does.

How much added salt should you use?

As a practical Smart Health guideline, limit added salt to around half a teaspoon per day (just over 1000mg sodium). The rest of the recommended not more than 2000mg sodium per day will come from the hidden salt (sodium) in the food you eat.

All the recipes in the Eating for Sustained Energy books limit sodium to not more than 500mg per serving/person per meal, which leaves 500mg more for snacks, before you reach the recommended < 2000mg sodium/day.

Note that many recipes and restaurants and take-away outlets add too much salt during cooking. But in our recipes we intentionally use sodium-reduced stock powder, sometimes instead of salt, as well as sodium-reduced soya sauce in recipes requiring soya sauce.

You could also use Himalayan rock salt or pink salt (which is lower in sodium), instead of regular salt.

But here's the good news: you don't have to choose between eating bland food and eating too much salt. You just need to teach your taste buds to appreciate something else.

Fresh herbs and natural spices can transform a meal while adding flavour and nutrients. Lemon juice and lemon zest can add brightness to food without reaching for the saltshaker.

And don't underestimate a good combination of herbs and spices. Experiment with different flavours until you find combinations you genuinely enjoy.

The Greeks from the Blue Zone island of Ikaria, for example, traditionally consume fresh herbal teas, made from herbs they pick in the garden or surrounding fields, which may also support healthy blood pressure.

Some herbs like hibiscus flowers, cinnamon, garlic, basil, parsley lower blood pressure by dilating arteries and/or reducing water retention.

Your taste buds aren't as fixed as you think

Here's something that can make reducing salt much easier: Salt is a learned taste.

When you regularly eat salty food, your taste buds become accustomed to that level of saltiness. Over time, food that once tasted perfectly seasoned can start to taste bland, so you add more. And then the cycle continues.

The good news is that you can reverse it!

Rather than cutting your salt intake dramatically overnight and deciding that healthy food is boring, reduce it gradually. 

Your tongue can only taste salt, sweet, sour and bitter; the rest of your "taste" comes from your ability to smell with your nose. So, give your taste buds time to adjust while you increase the natural flavours of the food itself. If you reduce added salt during cooking and eating gradually, your tongue won't even notice it.

Eventually, foods that once seemed normal may start tasting surprisingly salty.

And don't forget potassium

There's another important piece of the blood-pressure puzzle: potassium.

Fruit and vegetables are naturally rich in potassium (also an electrolyte), which plays an important role in helping to regulate blood pressure.

Recent studies have found that, if you reduce salt and salty foods while simultaneously increasing vegetables and fruit, the blood-pressure-lowering effect is just about doubled!

And beetroot is especially effective at lowering blood pressure, as it naturally contains nitric oxide as well, which dilates arteries and thus lowers blood pressure. So, try to eat it every day if you struggle with high blood pressure.

So instead of thinking only about what you need to take away from your diet, think about what you can add...

More fruit.

More vegetables.

More fresh, unprocessed foods.

More herbs, natural spices, lemon and natural flavour.

Less processed food.

Less hidden sodium.

Less salt in cooking and at table.

That's a much more useful approach than simply being told, "Don't eat salt."

The bottom line

You don't need to be afraid of salt. Your body needs sodium and chloride to function properly. But you also don't need nearly as much salt as modern diets provide, although active people and endurance athletes need more sodium than the general public.

If you want to protect your blood pressure and reduce your long-term risk of lifestyle diseases, start by eating fewer processed foods, checking sodium levels on food labels and gradually reducing the amount of salt you add during cooking and to your meals.

And remember: healthy food doesn't have to taste bland. Use those herbs and pure spices (not spice mixes) instead because they can help reduce salt intake and support better health.

Your taste buds can learn. Give them time, give them better ingredients, and give the natural flavours of your food a chance to shine!

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AUTHOR: ELIZABETH (LIESBET) DELPORT - Registered Dietitian, M.Sc. Dietetics.

Liesbet Delport has over 40 years of experience helping over 10,000 people improve their health through practical, evidence-based nutrition.

After struggling with her own weight as a teenager, Liesbet learned that lasting health isn't about willpower or another restrictive diet. Her approach is simple: people aren't failing, the diets are. She helps people build a balanced, delicious way of eating they can actually follow for life.