Sodium Reduction: A Practical Guide to Cutting Salt Intake

The average American adult consumes about 3,400 mg of sodium per day, according to CDC surveillance data from the National Health and Nutrition Examination Survey, which is roughly 50 percent above the 2,300 mg ceiling recommended by the Dietary Guidelines for Americans and more than double the American Heart Association's ideal target of 1,500 mg for most adults. Excess sodium raises blood pressure, and high blood pressure is the leading modifiable risk factor for cardiovascular disease worldwide. This guide covers the evidence, where sodium actually comes from, and how to cut it without making food taste like cardboard.

The evidence: DASH and beyond

The DASH (Dietary Approaches to Stop Hypertension) trial, published in the New England Journal of Medicine in 1997 by Appel and colleagues, randomized 459 adults to one of three diets for 8 weeks. The DASH diet, rich in fruits, vegetables, and low-fat dairy and low in saturated fat and sodium, reduced systolic blood pressure by 5.5 mm Hg and diastolic by 3.0 mm Hg compared with the control diet. The follow-up DASH-Sodium trial published in 2001 found that lowering sodium from 3,300 to 1,500 mg per day reduced systolic blood pressure by an additional 6.7 mm Hg in hypertensive participants on the DASH diet.

A 2014 meta-analysis by Aburto and colleagues in BMJ pooled 36 trials and found that reducing sodium intake by about 1,750 mg per day lowered systolic blood pressure by 3 to 4 mm Hg in hypertensive adults and 1 to 2 mm Hg in normotensive adults. A 2007 follow-up of the Trials of Hypertension Prevention by Cook and colleagues, published in BMJ, found that sodium reduction over 18 months was associated with a 25 percent lower risk of cardiovascular events 10 to 15 years later. The evidence is consistent: lower sodium intake lowers blood pressure and reduces cardiovascular events.

Where sodium actually comes from

The CDC reports that roughly 70 percent of dietary sodium in the American diet comes from processed and restaurant foods, not from the salt shaker. The top sources, in order of contribution, are:

1. Bread and rolls (a single slice has 100 to 200 mg, and we eat several slices)
2. Pizza (a single slice has 500 to 900 mg)
3. Sandwiches and burgers (1,000 to 2,500 mg per serving)
4. Cold cuts and cured meats (a 2 oz serving has 500 to 800 mg)
5. Soups (canned soup has 600 to 1,000 mg per cup)
6. Burritos and tacos (800 to 1,500 mg)
7. Savory snacks like chips and pretzels (200 to 500 mg per ounce)
8. Poultry (much commercial chicken is plumped with saltwater solution, adding 200 to 400 mg per serving)
9. Cheese (175 to 400 mg per ounce)
10. Pasta dishes with jarred sauce (700 to 1,200 mg per serving)

Notice that bread is number one not because it is the most salt-dense food but because we eat a lot of it. The same applies to poultry and cheese. Use the Sodium Calculator to total your daily intake from these sources, and the Blood Pressure Calculator to estimate your cardiovascular risk.

Reading labels: the sodium claims decoded

FDA regulates sodium-related claims on food labels, but the terminology is confusing:

• "Sodium free" means less than 5 mg per serving.
• "Very low sodium" means 35 mg or less per serving.
• "Low sodium" means 140 mg or less per serving.
• "Reduced sodium" means at least 25 percent less sodium than the regular product, which can still be very high.
• "No salt added" or "Unsalted" means no salt was added during processing, but the food may still contain naturally occurring sodium.
• "Lightly salted" means at least 50 percent less sodium than the regular product.

The Daily Value for sodium on the Nutrition Facts label is 2,300 mg. A food with 460 mg per serving has 20 percent of the Daily Value, which the FDA considers high. Aim for foods under 5 percent of the Daily Value per serving as a working rule.

Restaurant sodium and how to navigate it

Restaurant meals are a sodium minefield. A 2023 analysis by the Center for Science in the Public Interest found that entrees at casual dining chains routinely exceeded 2,000 mg, with some pasta and Asian dishes topping 4,000 mg. Fast food burgers with fries typically deliver 1,500 to 2,000 mg. Strategies:

• Ask for sauces and dressings on the side, and use half.
• Request that no salt be added at the grill or in the kitchen; many restaurants will comply.
• Avoid dishes described as cured, smoked, pickled, teriyaki, or in broth.
• Order the smaller portion; restaurant sodium scales with portion size.
• Drink water, not soda or alcohol, which add their own sodium or dehydrate.
• Compensate by eating lower-sodium meals the rest of the day.

Low-sodium swaps that actually taste good

The sodium in most meals comes from a handful of ingredients. Swapping those ingredients cuts sodium without losing flavor:

• Swap canned beans for dried, or rinse canned beans to remove about 40 percent of the sodium.
• Swap jarred pasta sauce for crushed canned tomatoes plus garlic, olive oil, and herbs (cuts sodium by 60 to 80 percent).
• Swap deli meat for roasted chicken or turkey you cook yourself (cuts sodium by 70 percent).
• Swap seasoned rice packets for plain rice with your own spices (cuts sodium by 90 percent).
• Swap canned soup for homemade (cuts sodium by 70 to 85 percent).
• Swap salted butter for unsalted (cuts 90 mg per tablespoon).
• Swap soy sauce for lower-sodium soy sauce or coconut aminos (cuts sodium by 40 to 70 percent).
• Swap salted nuts for raw or dry-roasted unsalted (cuts sodium by 95 percent).

Cooking techniques for flavor without salt

Palate fatigue is the main reason sodium reduction fails. The fix is layering flavor from other sources:

• Acid from lemon or lime juice, vinegar, and wine brightens dishes the way salt does. A squeeze of lemon on roasted vegetables or soup before serving is a restaurant trick.
• Umami from mushrooms, tomatoes, aged cheese, miso paste, and nutritional yeast adds savory depth. A small amount of parmesan rind in soup delivers umami with less sodium than table salt.
• Heat from chili flakes, fresh chiles, and black pepper stimulates the palate and reduces the perception of missing salt.
• Herbs and spices add aromatic complexity. Toast whole spices in oil to bloom their flavor before adding other ingredients.
• Maillard browning from proper searing and roasting adds depth that salt only enhances, never replaces.

It takes about 4 to 6 weeks for the palate to adjust to lower sodium. Salt perception is calibrated to what you are used to. After a month of lower-sodium eating, previously normal foods will taste oversalted.

Potassium: the counterweight

Potassium blunts the blood pressure effect of sodium by promoting sodium excretion through the kidneys. The DASH diet is high in potassium for this reason. A 2017 meta-analysis by Filippini and colleagues in the Journal of the American Heart Association pooled 21 trials and found that higher potassium intake lowered systolic blood pressure by 3 to 5 mm Hg. The ideal sodium-to-potassium ratio is roughly 1 to 3, but the average American diet is closer to 2 to 1. Use the Potassium Calculator to estimate your potassium intake and the Electrolyte Balance Calculator to assess the ratio. See also our Sodium-Potassium Ratio guide and our DASH Diet Score Calculator.

A 7-day sodium reduction plan

This is a staged reduction that avoids the shock of cutting sodium all at once:

• Day 1 to 2: Track current intake honestly with the Sodium Calculator. Identify your top three sources.
• Day 3 to 4: Swap your top source for a lower-sodium alternative (for example, switch from deli sandwiches to home-roasted turkey, or from canned soup to homemade).
• Day 5: Remove the salt shaker from the table. Season at the stove only, by measured quarter teaspoon.
• Day 6: Add a potassium-rich food to each meal (a banana, a cup of spinach, a sweet potato).
• Day 7: Cook one full day of meals from scratch. Note the sodium difference versus your baseline.

Recheck your intake at day 7. Most people who follow this plan drop from 3,400 mg to 2,000 to 2,500 mg without major effort. Getting below 1,500 mg usually requires more aggressive elimination of processed foods.

Special populations

About 50 percent of people with hypertension are salt-sensitive, meaning their blood pressure rises more steeply with sodium intake. Salt sensitivity is more common in older adults, Black Americans, people with chronic kidney disease, and people with the metabolic syndrome. For these groups, sodium reduction has an outsized benefit. For people with advanced chronic kidney disease, sodium reduction is critical for blood pressure and fluid control, but potassium intake may need to be limited in parallel; work with a renal dietitian. People on lithium, certain blood pressure medications, or with orthostatic hypotension should consult their clinician before aggressive sodium reduction.

Sodium and specific health conditions

Sodium reduction is not a one-size-fits-all prescription. For most people with elevated blood pressure, the DASH-Sodium evidence supports a target under 2,300 mg and ideally near 1,500 mg. But the response varies by condition:

• Stage 1 or 2 hypertension: Sodium reduction is first-line. Expect a 3 to 8 mm Hg drop in systolic pressure with a 1,000 mg reduction in daily sodium, larger if combined with the DASH pattern and weight loss.
• Heart failure: The evidence here is more nuanced. Severe sodium restriction (under 2,000 mg) was standard advice for decades, but a 2022 trial by Solomon and colleagues in the Journal of the American College of Cardiology found that aggressive restriction did not improve outcomes and may worsen them in some heart failure patients. Most guidelines now recommend 2,000 to 3,000 mg, individualized with the cardiology team.
• Chronic kidney disease: Sodium reduction helps blood pressure and fluid control, but must be coordinated with potassium and phosphorus management. The KDIGO guidelines recommend under 2,000 mg per day for most CKD patients.
• Diabetes: Sodium reduction lowers blood pressure in people with diabetes, who are already at elevated cardiovascular risk. The target is the same 1,500 to 2,300 mg, with extra attention to avoiding processed meats, which combine sodium with preservatives linked to diabetes risk.
• Normotensive, salt-resistant adults: The blood pressure effect is smaller, but cohort evidence still favors lower sodium for long-term cardiovascular risk. There is no benefit to high sodium for anyone.

A low-sodium pantry and shopping list

If you are committed to cooking under 2,000 mg of sodium per day, these are the staples to keep on hand. They form the base of nearly every low-sodium recipe:

• Grains and starches: brown rice, oats, barley, quinoa, whole-wheat pasta, potatoes, sweet potatoes. Avoid flavored rice and pasta packets.
• Proteins: dried or no-salt-added canned beans, fresh chicken, turkey, fish, eggs, unsalted nuts and seeds, plain yogurt, cottage cheese. Avoid deli meats, bacon, sausage, and salted canned fish.
• Vegetables: fresh and frozen without sauce, low-sodium canned tomatoes, no-salt-added canned vegetables. Avoid pickled vegetables and canned soups.
• Fats and oils: olive oil, canola oil, unsalted butter, avocado. Avoid salted butter and most bottled dressings.
• Flavor builders: fresh and dried herbs, whole spices, citrus, vinegar, garlic, ginger, onion, miso (in small amounts), nutritional yeast, unsalted stock or homemade stock. Avoid bouillon cubes, jarred gravy, and most packaged seasoning blends, which are mostly salt.

With this pantry, a typical dinner of pan-seared chicken with roasted vegetables and brown rice comes in under 200 mg of sodium before any added salt, leaving room for a measured quarter teaspoon (about 575 mg) of table salt at the stove if needed.

The bottom line

Sodium reduction is one of the highest-value dietary changes you can make for cardiovascular health. The DASH and DASH-Sodium trials, plus decades of cohort and trial evidence, show that cutting sodium from 3,400 mg to under 2,300 mg lowers blood pressure and reduces cardiovascular events. The main lever is reducing processed and restaurant foods, which contribute 70 percent of dietary sodium. Track your intake with the Sodium Calculator, swap your top sources, layer flavor from acid and umami, and pair reduction with higher potassium intake. Your palate will adjust in 4 to 6 weeks, and your blood pressure will follow.