How to Lower Your Sodium Intake

Reduction of salt consumption by just 15 percent could save the lives of millions. If we cut our salt intake by half a teaspoon a day, which is achievable simply by avoiding salty foods and not adding salt to our food, we might prevent 22 percent of stroke deaths and 16 percent of fatal heart attacks—potentially helping more than if we were able to successfully treat people with blood pressure pills. As I discuss in my video Salt of the Earth: Sodium and Plant-Based Diets, an intervention in our kitchens may be more powerful than interventions in our pharmacies. One little dietary tweak could help more than billions of dollars worth of drugs.

What would that mean in the United States? Tens of thousands of lives saved every year. On a public-health scale, this simple step “could be as beneficial as interventions aimed at smoking cessation, weight reduction, and the use of drug therapy for people with hypertension or hypercholesterolemia,” that is, giving people medications to lower blood pressure and cholesterol. And, that’s not even getting people down to the target. 

A study I profile in my video shows 3.8 grams per day as the recommended upper limit of salt intake for African-Americans, those with hypertension, and adults over 40. For all other adults the maximum is 5.8 daily grams, an upper limit that is exceeded by most Americans over the age of 3. Processed foods have so much added salt that even if we avoid the saltiest foods and don’t add our own salt, salt levels would go down yet still exceed the recommended upper limit. Even that change, however, might save up to nearly a hundred thousand American lives every year.

“Given that approximately 75% of dietary salt comes from processed foods, the individual approach is probably impractical.” So what is our best course of action? We need to get food companies to stop killing so many people. The good news is “several U.S. manufacturers are reducing the salt content of certain foods,” but the bad news is that “other manufacturers are increasing the salt levels in their products. For example, the addition of salt to poultry, meats, and fish appears to be occurring on a massive scale.”

The number-one source of sodium for kids and teens is pizza and, for adults over 51, bread. Between the ages of 20 and 50, however, the greatest contribution of sodium to the diet is not canned soups, pretzels, or potato chips, but chicken, due to all the salt and other additives that are injected into the meat.

This is one of the reasons that, in general, animal foods contain higher amounts of sodium than plant foods. Given the sources of sodium, complying with recommendations for salt reduction would in part “require large deviations from current eating behaviors.” More specifically, we’re talking about a sharp increase in vegetables, fruits, beans, and whole grains, and lower intakes of meats and refined grain products. Indeed, “[a]s might be expected, reducing the allowed amount of sodium led to a precipitous drop” in meat consumption for men and women of all ages. It’s no wonder why there’s so much industry pressure to confuse people about sodium.

The U.S. Dietary Guidelines recommend getting under 2,300 milligrams of sodium a day, while the American Heart Association recommends no more than 1,500 mg/day. How do vegetarians do compared with nonvegetarians? Well, nonvegetarians get nearly 3,500 mg/day, the equivalent of about a teaspoon and a half of table salt. Vegetarians did better, but, at around 3,000 mg/day, came in at double the American Heart Association limit.

In Europe, it looks like vegetarians do even better, slipping under the U.S. Dietary Guidelines’ 2,300 mg cut-off, but it appears the only dietary group that nails the American Heart Association recommendation are vegans—that is, those eating the most plant-based of diets.


This is part of my extended series on sodium, which includes:

If you’re already cutting out processed foods and still not reaching your blood pressure goals, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

The Benefits of Wakame Seaweed Salad on Blood Pressure

I used to think of seaweed as just a beneficial whole-food source of minerals like iodine, for which it is the most concentrated dietary source. Indeed, just a daily half-teaspoon of mild seaweeds, like arame or dulse, or two sheets of nori should net you all the iodine you need for the day. But, the intake of seaweeds is advised not only as a whole-food source of iodine, but also, evidently, “for the prevention of lifestyle-related diseases, including cancer, cardiovascular and cerebrovascular disease….” Based on what?

As I discuss in my video Wakame Seaweed Salad May Lower Blood Pressure, the reasoning is that the Japanese live long and eat seaweed, so there is speculation that seaweed might have “influence on life expectancy,” based on suggestive reports. But when we see long lists of the supposed benefits a particular food is purported to have, such as “compounds found in [seaweed] have various biological activities including anticoagulant, anti-viral, antioxidant, anti-allergic, anti-cancer, anti-inflammatory, anti-obesity, and neuroprotective properties,” we need to know if they are based on clinical data, meaning studies with actual people, or so-called preclinical data, that is, from test tubes and lab animals. I mean, what are we supposed to do with a study talking about the effects of “seaweed-restructured pork diets” on rats? Those researchers tried to use seaweed, as well as other ingredients, to “improv[e] the ‘image’ of meat product.” Researchers also tried to add grape seeds to meat, they tried flaxseeds, they tried walnuts, they tried purple rice, and they even tried “thong-weed.”

When you look at epidemiological studies, where you compare the diets and disease rates within a population, you see that Japanese pre-schoolers who eat seaweed tend to have lower blood pressures, suggesting “seaweed might have beneficial effects on blood pressure among children.” That could make sense given all the minerals and fiber in seaweed, but cause and effect can’t be proven with this kind of study. Perhaps other components of the diet that went along with seaweed eating that made the difference.

It’s even harder to do these kinds of studies on adults, since so many people are on high blood pressure medications. University of Tokyo researchers took an innovative approach by comparing the diets of people on different intensities of medication: low-dose of a single blood pressure drug, high-dose of a single drug, and multiple drugs. And, although they all had artificially normalized blood pressure “as a result of effective medication,” those who ate the most fruits and sea vegetables tended to be the ones on the lower dose of a single drug, supporting a dietary role for seaweed. An interesting finding, but why not just put it to the test?

A double-blind, crossover trial found that seaweed fiber lowered blood pressure, apparently by pulling sodium out of the system. Real seaweed couldn’t be used in the study, because the subjects wouldn’t be able to be fooled with a placebo, but why not just put whole powdered seaweed into pills? That was finally attempted ten years later. Compared to doing nothing, subjects receiving a daily dose of dried wakame powder in capsules had beautiful drops in blood pressure. The researchers, however, desalinized the seaweed, taking out about two-thirds of the sodium naturally found in it. So, we still don’t know if eating seaweed salad is actually going to help with blood pressure. What we need is a randomized, controlled trial with plain, straight seaweed. No one had ever done that research, until…they did!

Six grams of wakame, with all of its natural sodium, led to a significant drop in blood pressure, especially in those who started out with high pressure. The subjects experienced only minor side effects and ones that could be expected with increasing fiber intake. A nice thing about whole-food, plant-based interventions is that we sometimes get good side effects, such as the resolution of gastritis (stomach inflammation) some subject had been having, as well as the disappearance of chronic headaches. 


What other foods might help with high blood pressure? See:

For more on preventing and treating hypertension, one of our leading killers, see:

Want more on seaweed and iodine? Check out:

My video Salt of the Earth: Sodium and Plant-Based Diets further addresses the sodium question.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How Not to Die from Kidney Disease

Kidney failure may be both prevented and treated with a plant-based diet, and it’s no wonder: Kidneys are highly vascular organs, packed with blood vessels. Harvard researchers found three significant dietary risk factors for declining kidney function: “animal protein, animal fat, and cholesterol.” Animal fat can alter the actual structure of our kidneys. In my video How Not to Die from Kidney Disease, you can see plugs of fat literally clogging up the works in autopsied human kidneys from a study published in The American Journal of Pathology.

Animal protein can have a “profound effect” on normal kidney function, inducing “hyperfiltration,” increasing the workload of the kidney. Not plant protein, though. After eating a meal of tuna fish, the increased pressure on the kidneys goes up within only a few hours. We aren’t talking about adverse effects decades down the road, but literally within hours of it going into our mouths. What happens if, instead of having a tuna salad sandwich, you had a tofu salad sandwich with the exact same amount of protein? No effect on your kidneys. Our kidneys have no problem dealing with plant protein is no problem.

Why does animal protein cause the overload reaction, but plant protein doesn’t? It appears to be due to the inflammation triggered by the consumption of animal products. Indeed, taking a powerful, anti-inflammatory drug along with that tuna fish sandwich can abolish the hyperfiltration, protein-leakage response to meat ingestion.

There’s also the acid load. Animal foods, such as meat, eggs, and dairy, induce the formation of acid within the kidneys, which may lead to “tubular toxicity,” damage to the tiny, delicate, urine-making tubes in the kidney. Animal foods tend to be acid-forming—especially fish, which is the worst, followed by pork and poultry—whereas plant foods tend to be relatively neutral, or actually alkaline or base-forming to counteract the acid, especialy green leafy vegetables. So, “[t]he key to halting progression of CKD [chronic kidney disease] might be in the produce market, not in the pharmacy.”

It’s no wonder plant-based diets have been used to treat kidney disease for decades. In my video, you can see a remarkable graph that follows the protein leakage of subjects first on a conventional, low-sodium diet, which is what physicians would typically put someone with declining kidney function on, then switched to a supplemented vegan diet, back to the conventional diet, once more on the plant-based diet, and back and forth again. The chart is filled with zig-zags, showing kidney dysfunction was effectively turned on and off like a light switch, based on what was going into their mouths.


The first time someone visits NutritionFacts.org can be overwhelming. With videos on more than 2,000 health topics, where do you even begin? Imagine stumbling onto the site not knowing what to expect and the new video-of-the-day is about how a particular spice can be effective in treating a particular form of arthritis. It would be easy to miss the forest for the trees, which is precisely why I created a series of overview videos that are essentially taken straight from my live, hour-long 2016 presentation How Not to Die: Preventing, Arresting, and Reversing Our Top 15 Killers.

For the other videos in this overview series, see:

Inspired to learn more about the role diet may play in preventing and treating kidney disease? Check out these other popular videos on the topic:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: