This presentation’s topic was “Sodium Reduction Monitoring and Applied Research”; the presenter Dr. Mary Cogswell covered background information on sodium then discussed sodium reduction and the types and accuracy of sodium intake measurement methods. Dr. Cogswell is a Senior Scientist with the Epidemiology and Surveillance Branch, Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and also a Registered Nurse.
Dr. Cogswell’s introduction covered the differences between salt versus sodium, how the human body uses, processes and excretes sodium, its adverse affects, as well as additional facts on the topic. Sodium (Na) is an element found in nature, while table salt (NaCl) is a compound made of forty percent sodium and sixty percent chloride. Once ingested through the oral cavity and absorbed in the blood, the kidneys are the body’s main form of sodium regulation/filtration; almost 90% of consumed sodium is excreted through urine. In the body, sodium is essential to many functions, it is used to generate muscular contractions, maintain cell’s ion gradient, and regulate blood pressure. When your intake of sodium exceeds the body’s requirement, your kidneys can’t keep up and the body retains water to regulate levels; this excess fluid can increase blood pressure over time. The dietary reference intake (DRI) for sodium is just 2,300mg a day, however the average American’s intake is 3,400mg a day; Dr. Cogswell stated, “about 9/10 Americans exceed the DRI”. This excess consumption is evidence to the fact that forty-one percent of Cardio-Vascular Disease (CVD), the number one cause of death in the United States, can be attributed to high blood pressure. Dr. Cogswell explained that she addresses these facts initially because of a lack of public knowledge on sodium in general and the prevalence of problems that occur from its excess consumption. She went on to say, “current research shows that seventy-one percent of American’s daily sodium consumption comes from prepared or processed foods with restaurant food making up a large portion of this”. Taking this fact into consideration, sodium reduction seems simple; if Americans prepared more fresh food at home versus fast-food or carry-out we could greatly reduce or even eliminate excess sodium intake and/or high blood pressure. This is much easier said than done.
Different methods of sodium reduction monitoring was the next topic discussed in the presentation. Sodium intake can be measured with dietary recalls or biomarkers in the urine. In a dietary recall you record everything eaten and drank over the past 24-48 hours and add up the sodium content from each item to determine your daily intake. There are two different urine tests to determine sodium intake, a 24 hour urinary sodium excretion test and a one time (spot) urine assessment. The 24 hour method is accepted as the most accurate approach, in which an entire day’s worth of urine is collected and analyzed for total sodium content. In the spot assessment, one urine sample is collected and the volume is then multiplied by sodium content; this method is less accurate because it is a predicted amount and one sample’s sodium content can vary greatly.
One of the most interesting aspects of the presentation to me was the fact that 9/10 Americans are exceeding the DRI for sodium. I am a very health conscious person and it made me think to myself whether or not I might be over the DRI.. I actually brought up the conversation with my roommate and we discussed the foods we most commonly consume that might be sneaking extra sodium into our diets. With a quick Internet search we found that meat and dairy both contain a naturally high amount yet they pale in comparison to processed foods. I challenge those reading to also sit down and determine whether they are consuming over the DRI – your own consumption may surprise you!
As for how these facts are relevant to health intervention implementations, with CVD as the number one cause of death in the United States being attributed to high blood pressure, a condition frequently caused by high sodium intake, it seems that health practitioners could combat CVD by increasing public awareness of american’s high sodium intake. An intervention spreading tips for reducing sodium consumption in your diet could be implemented in neighborhoods and the effects studied. Before this presentation I had no idea that high sodium intake was such a prevalent issue; I can only assume that if I am lacking this knowledge so are many other Americans.