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Why is it always Sodium that we talk of in blood pressure?

Why is it always Sodium that we talk of in blood pressure?


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Why is that we emphasize so much on sodium in blood pressure? I understand that it is a major extracellular ion, but, it also is tightly regulated. So when something is that tightly regulated, won't small concentrations of the potassium matter? And what about the chloride and bicarb? They are all there in the blood in comparable quantities but we never talk of their osmotic importance. Sodium retention and blood pressure - why not chloride retention?

Is it not required (like calculating sodium includes them too)? or is it that they actually don't matter? Also aldosterone, we conserve the sodium but aren't we pushing out potassium? Potassium also is an ion with oncotic activity right? Why is Natriuresis so important why not say, Chloriuresis?

So all in all, why does sodium steal the limelight?


The key is in fluid compartments and osmotic activity. For the purposes of this discussion, let us say that there are two fluid compartments the ExtraCellular Fluid (ECF) and IntraCellular Fluid (ICF). Only the ECF contributes to blood volume and blood pressure.

Na is not only the major ECF ion, but it is also confined there. The ICF concentration of Na is much lower than in the ECF, and it is continuously, invariably and actively kept out of the ICF. In other words, the vast majority of ingested Na ends up in the ECF, and drag the associated amount of water (ie volume, thereby increasing blood pressure). It is the opposite for K, which is mainly in the ICF. As for Cl, it is more or less equal in the ICF and ECF, and is allowed to move freely between them, meaning that you need to ingest twice as much as a given amount of Na for a similar effect on volume distribution. Bicarb is a minor ion, and moves freely between compartments. These are the reasons why, clinically, if someone is hypovolemic (ie dehydrated, losing blood) they are given a sodium based fluid or a protein based fluid (colloid), because both will drag volume and stay in the ECF.

As for the other part of your question, isn't it tightly regulated? Yes, but extra sodium takes some time to get excreted (much less than 1% of sodium that goes through the kidneys is excreted). In other words, any extra sodium (i.e. extra volume as we have established) will stay there for some time, and if you are continually having high sodium meals, every day, you will walk around with extra sodium most of the time. Therefore, your blood pressure will be higher than it would be, if your diet was lower in sodium.

So, no, sodium is not stealing the spotlight from anyone when it comes to ECF. But the other ions have their glory under other spotlights.


Eating Salt When You Have High Blood Pressure

Mark Stibich, PhD, FIDSA, is a behavior change expert with experience helping individuals make lasting lifestyle improvements.

Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist.

Salt (sodium) is essential to our bodies. Normally the kidneys control the level of salt. If there is too much salt, the kidneys pass it into the urine. But when our salt intake levels are very high, the kidneys cannot keep up and the salt ends up in our bloodstream.   Salt attracts water. When there is too much salt in the blood, the salt draws more water into the blood. More water increases the volume of blood which raises blood pressure.

Blood pressure refers to the amount of pressure on the walls of your arteries.   Think of a garden hose. When the water is off, there is no pressure on the walls of the hose. When the water is on halfway, there is some pressure on the walls of the hose. When the water is on full the way, there is more pressure on the walls of the hose.


The Truth About Salt & Hypertension (High Blood Pressure)

The initial recommendation to ‘eat less salt’ stems from research by Lewis Dahl in the 1950’s, who decided feeding rats 500 grams of sodium per day (almost 50 times the average intake) was viable evidence for showing an association between sodium intake and hypertension (high blood pressure).

But if that wasn’t misleading enough, he later followed up this research with several studies identifying correlations between populations with a high average salt intake and high blood pressure.

Which, similar to the Seven Country Study on fat intake (from Ancel Keys in the 1970s), was full of scientific flaws. With a future analysis finding no association between the 2 variables. And sadly, just like low-fat, suggesting the opposite:

Although before we get into that, the reason there’s a lack of association in the first place, is because elevated blood pressure is a symptom not a cause. With salt reduction doing nothing for heart disease because the cause of hypertension (and heart disease) is obesity, insulin resistance, and elevated triglycerides (Syndrome X) - not excess salt!

For instance, in a 1998 paper in the Journal of Applied Physiology, researchers showed that hypertension is the 4th and final step in the progression from ‘Syndrome X’ to ‘The Deadly Quartet’

  • At 2 weeks – insulin resistance (hyperinsulinemia)
  • At 2 months – elevated triglycerides (hyperlipidemia)
  • At 6 months – obesity (high bodyfat)
  • At 12 months – high blood pressure (hypertension)

Meaning, sodium reduction can lower blood pressure in the short-term, but does NOTHING for the other 3 problems.

The disturbing part being, that reducing your salt intake too much appears to elevate your cardiovascular risk:

Also known as, the whole reason you stopped eating salt, and the whole reason you have elevated blood pressure in the first place!

With the most notable evidence coming in a 1998 review study in the Lancet that analyzed NHANES data on 11,348 North Americans in the early 70’s, and determining that the risk of cardiovascular mortality was inversely related to salt take.

And a 2nd NHANES study in the American Journal of Medicine determined that sodium intake of less than 2400mg (or what the FDA and AHA recommend as a daily intake) results in a 50% higher risk of heart disease!

Realistically, there’s only one food you need to lower if you have high blood pressure. And aside from reducing hypertension it addresses the Syndrome X (triglycerides, insulin resistance, obesity) that’s causing it.

I’m talking about lowering your carbohydrate (sugar) intake which among other things:

And drops your blood pressure!

Since low insulin levels make us release salt, while high insulin (from excess carbohydrates) makes us hold onto it.

Interestingly, lowering your carbohydrate intake can drop your blood pressure so fast, that it has forced some nutrition advisors (me included) to lean towards making salt a requirement. Especially for those with a high activity level.

When carbohydrate intake is excessive, salt becomes damaging. When carbohydrate intake is restricted, salt becomes critical.

---- To learn more, check out Live It NOT Diet! where Coach Mike delivers his progressive plan for losing the fat and keeping it off WITHOUT counting calories, doing cardio, or sacrificing your health. ----


Potassium lowers blood pressure

When it comes to fighting high blood pressure, the average American diet delivers too much sodium and too little potassium. Eating to reverse this imbalance could prevent or control high blood pressure and translate into fewer heart attacks, strokes, and deaths from heart disease.

Normal body levels of potassium are important for muscle function. Potassium relaxes the walls of the blood vessels, lowering blood pressure and protecting against muscle cramping. A number of studies have shown an association between low potassium intake and increased blood pressure and higher risk of stroke. On the flip side, people who already have high blood pressure can significantly lower their systolic (top number) blood pressure by increasing their potassium intake when they choose to eat healthy foods.

Most Americans get barely half of the recommended amount of potassium — 4,700 milligrams (mg) a day. Fruits, vegetables, beans, and some seeds offer good ways to get more of it. Bananas (about 425 mg of potassium in a medium-sized one) are often held up as the poster child for potassium, but there are better sources.

Since people with high blood pressure may also be trying to lose weight, consider potassium rich foods that are low in calories and carbohydrates. Good examples include broccoli, water chestnuts, spinach, and other leafy greens. Also good—although slightly higher in carbs and calories—are butternut squash and sweet potatoes, and fruits such as cantaloupe, kiwi, and nectarines.

Potassium also carries a caveat. For people with kidney problems, loading up on the mineral may actually do harm. Also, don’t take supplements without a doctor’s advice—overly high levels of potassium can lead to dangerous irregular heart rhythms.


It's Time to End the War on Salt

For decades, policy makers have tried and failed to get Americans to eat less salt. In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.

This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine&mdashan excellent measure of prior consumption&mdashthe greater their risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.

Fears over salt first surfaced more than a century ago. In 1904 French doctors reported that six of their subjects who had high blood pressure&mdasha known risk factor for heart disease&mdashwere salt fiends. Worries escalated in the 1970s when Brookhaven National Laboratory's Lewis Dahl claimed that he had "unequivocal" evidence that salt causes hypertension: he induced high blood pressure in rats by feeding them the human equivalent of 500 grams of sodium a day. (Today the average American consumes 3.4 grams of sodium, or 8.5 grams of salt, a day.)

Dahl also discovered population trends that continue to be cited as strong evidence of a link between salt intake and high blood pressure. People living in countries with a high salt consumption&mdashsuch as Japan&mdashalso tend to have high blood pressure and more strokes. But as a paper pointed out several years later in the American Journal of Hypertension, scientists had little luck finding such associations when they compared sodium intakes within populations, which suggested that genetics or other cultural factors might be the culprit. Nevertheless, in 1977 the U.S. Senate&rsquos Select Committee on Nutrition and Human Needs released a report recommending that Americans cut their salt intake by 50 to 85 percent, based largely on Dahl's work.

Scientific tools have become much more precise since then, but the correlation between salt intake and poor health has remained tenuous. Intersalt, a large study published in 1988, compared sodium intake with blood pressure in subjects from 52 international research centers and found no relationship between sodium intake and the prevalence of hypertension. In fact, the population that ate the most salt, about 14 grams a day, had a lower median blood pressure than the population that ate the least, about 7.2 grams a day. In 2004 the Cochrane Collaboration, an international, independent, not-for-profit health care research organization funded in part by the U.S. Department of Health and Human Services, published a review of 11 salt-reduction trials. Over the long-term, low-salt diets, compared to normal diets, decreased systolic blood pressure (the top number in the blood pressure ratio) in healthy people by 1.1 millimeters of mercury (mmHg) and diastolic blood pressure (the bottom number) by 0.6 mmHg. That is like going from 120/80 to 119/79. The review concluded that "intensive interventions, unsuited to primary care or population prevention programs, provide only minimal reductions in blood pressure during long-term trials." A 2003 Cochrane review of 57 shorter-term trials similarly concluded that "there is little evidence for long-term benefit from reducing salt intake."

Studies that have explored the direct relationship between salt and heart disease have not fared much better. Among them, a 2006 American Journal of Medicine study compared the reported daily sodium intakes of 78 million Americans to their risk of dying from heart disease over the course of 14 years. It found that the more sodium people ate, the less likely they were to die from heart disease. And a 2007 study published in the European Journal of Epidemiology followed 1,500 older people for five years and found no association between urinary sodium levels and the risk of coronary vascular disease or death. For every study that suggests that salt is unhealthy, another does not.

Part of the problem is that individuals vary in how they respond to salt. "It's tough to nail these associations," admits Lawrence Appel, an epidemiologist at Johns Hopkins University and the chair of the salt committee for the 2010 Dietary Guidelines for Americans. One oft-cited 1987 study published in the Journal of Chronic Diseases reported that the number of people who experience drops in blood pressure after eating high-salt diets almost equals the number who experience blood pressure spikes many stay exactly the same. That is because "the human kidney is made, by design, to vary the accretion of salt based on the amount you take in," explains Michael Alderman, an epidemiologist at the Albert Einstein College of Medicine and former president of the International Society of Hypertension.

Some physicians argue that although tiny blood pressure drops will not have a big effect on individuals&mdashthey will not really affect your risk of having a heart attack&mdashthey may end up saving lives at the population level, in part because a small percentage of the population, including some African-Americans and elderly individuals, seem to be hypersensitive to salt. For instance, a study published in February 2010 in the New England Journal of Medicine estimated that cutting salt intake by about 35 percent would save at least 44,000 American lives per year. But such estimates are not evidence, either they are conjecture. And low-salt diets could have side effects: when salt intake is cut, the body responds by releasing renin and aldosterone, an enzyme and a hormone, respectively, that increase blood pressure.

Rather than create drastic salt policies based on conflicting data, Alderman and his colleague Hillel Cohen propose that the government sponsor a large, controlled clinical trial to see what happens to people who follow low-salt diets over time. Appel responds that such a trial "cannot and will not be done," in part because it would be so expensive. But unless we have clear data, evangelical antisalt campaigns are not just based on shaky science they are ultimately unfair. "A great number of promises are being made to the public with regard to this enormous benefit and lives saved," Cohen says. But it is "based on wild extrapolations."


How to Prevent Sudden High Blood Pressure Problem?

In 2013, more than 360,000 deaths in the United States had high blood pressure as primary or contributing cause. Each year, the government spends an estimated $46 billion for workers’ missed days, health care services, and high blood pressure medications. Talk to your doctor about treatment for high blood pressure medications. In the meantime, there are precautions you can take right now.

1. Avoid Stress

Become involved in hobbies such as painting, exercise, and other physical activities to have a stress outlet and keep fit.

2. Limit Caffeine Intake

Talk with your doctor about your caffeine habits and stick to a plan to limit your daily intake.

3. Quit Smoking />

As one of the biggest health risks, smoking can lead to serious heart and lung conditions and death.

4. Eat Healthy Foods

Avoid saturated fats and junk food to maintain healthy blood pressure levels.

5. Reduce Sodium in Diet

Added salt and salt found in food products can lead to high blood pressure as it increases the solute content in our blood.

6. Exercise Regularly

A healthy heart, and body, requires regular exercise daily for 20 to 30 minutes.

7. Monitor Vitals

It is important to keep an eye on your blood pressure, heart rate, and blood sugar levels, especially if you have been diagnosed with high blood pressure.


Sodium imbalance

The normal concentration of sodium in the blood plasma is 136-145 mM. If thesodium level falls too late, it's called hyponatremia if it gets too high, it's called hypernatremia.

A sodium level in the blood that is too low is dangerous and can cause seizures and coma. Very high sodium levels can lead to seizures and death.

Sodium is a mineral element and an important part of the human body. It controls the volume of fluid in the body and helps maintain the acid-base level. About 40% of the body's sodium is contained in bone, some is found within organs and cells and the remaining 55% is in blood plasma and other fluids outside cells. Sodium is important in proper nerve conduction, the passage of various nutrients into cells, and the maintenance of blood pressure.

The body continually regulates its handling of sodium. When a person eats toomuch or too little sodium, the intestines and kidneys respond to adjust concentrations to normal. During the course of a day, the intestines absorbs dietary sodium while the kidneys excrete a nearly equal amount of sodium into theurine.

The concentration of sodium in the blood depends on the total amount of sodium and water in arteries, veins, and capillaries (the circulatory system). Thebody regulates sodium and water in different ways, but uses both to help correct blood pressure when it is too high or too low.

If the body has too little sodium (called hyponatremia), the body can eitherincrease sodium levels or decrease water in the body. Too high a concentration of sodium (hypernatremia), can be corrected either by decreasing sodium orby increasing body water.

There are many diseases that can cause abnormal salt levels, including diseases of the kidney, pituitary gland, and hypothalamus. This is especially a concern in elderly patients, who have a harder time regulating the concentrations of various nutrients in the bloodstream.

Low salt levels can be caused by eating too little salt or excreting too muchsodium or water, and by diseases that impair the body's ability to regulatesodium and water. Keeping to a low-salt diet for many months or sweating toomuch during a race on a hot day, can make it hard to keep sodium levels highenough. While these conditions alone aren't likely to cause loss salt levels,it can occur under special circumstances. For example, patients taking diuretic drugs who eat a low-sodium diet may have hyponatremia. term="Diuretics" type="print-hyplink" >Diuretic drugs can correct high blood pressure by helping the body get rid of sodium into the urine -- but excreting too much sodiumcan cause hyponatremia. Usually only mild hyponatremia occurs in patients taking diuretics. However, sodium levels can fall dangerously low in patients who eat a low-sodium diet and drinking too much water. Severe and prolonged diarrhea also can cause low sodium levels. A person with severe diarrhea can lose large amounts of water, sodium, and various nutrients. Some diarrheal diseases release especially large amounts of sodium and are most likely to cause hyponatremia. Drinking too much water may cause low sodium levels, because when the water is absorbed into the blood, it can dilute the sodium. This causeof hyponatremia is rare, but has been found in mentally ill patients who compulsively drink more than 20 liters of water a day. Excessive drinking of beer, which is mostly water without much sodium, can also produce hyponatremia when combined with a poor diet.

Marathon running under certain conditions can lead to hyponatremia, since sweat contains both sodium and water. Studies show that about 30% of marathon runners experience mild hyponatremia during a race. However, drinking water during a race isn't the answer -- this can lead to severe hyponatremia because the drinking water dilutes the sodium in the bloodstream. Such runners may experience brain problems as a result of the severe hyponatremia and require emergency treatment.

Hyponatremia also develops from disorders in organs that control the body's regulation of sodium or water. The adrenal gland secretes a hormone that travels to the kidney, where it prompts the kidney to retain sodium by not excreting it into the urine. Addison's disease, which damages the adrenal gland, cantherefore lead to low levels of sodium in the body.

The hypothalamus and pituitary gland are also involved in sodium regulation by making and releasing vasopressin, known as the anti-diuretic hormone, intothe bloodstream. Vasopressin prompts the kidneys to reduce the amount of water released into urine. If the body produces too much vasopressin, it promptsthe body to conserve water, causing a lower concentration of sodium in the blood. In addition, certain types of cancer cells produce vasopressin, which also can lead to hyponatremia. If the body produces too little vasopressin, thebody doesn't conserve enough water and the level of sodium in the body rises.

High sodium levels may occur in diabetes insipidus, a disease that causes toomuch urine to be produced. In this type of diabetes, either the hypothalamusfails to make vasopressin, or the kidneys don't respond to vasopressin. In either case, the kidney is able to regulate the body's sodium levels, but can't retain water. High sodium levels don't occur in diabetes insipidus if the patient is able to drink enough water to keep up with urinary loss, which maybe as high as 10 liters per day.

Sodium levels may rise in unconscious patients because they can't drink water. Water is continually lost by evaporation from the lungs and in the urine if the patient isn't given water intravenously, the sodium concentration in the blood may increase and hypernatremia could develop. Hypernatremia can alsooccur in rare diseases in which the thirst impulse is impaired. Hypernatremiaalso can occur accidentally in the hospital when patients are given solutions containing sodium.

Symptoms of high sodium levels can include confusion, coma, paralysis of thelung muscles, and death. The severity of the symptoms is related to how quickly the high sodium levels developed. If the levels build up suddenly, the brain cells can't adapt to their new high-sodium environment. Hypernatremia is especially dangerous for children and the elderly. Moderately low sodium levels may trigger fatigue, confusion, headache, muscle cramps, and nausea. Severehyponatremia can lead to seizures and coma.

Abnormal sodium levels are diagnosed by measuring the concentration of sodiumin the blood. In low sodium levels, unless the cause is obvious, a variety of tests are needed to determine if sodium was lost from the urine, diarrhea,or from vomiting. Tests are also used to determine hormone problems. The patient's diet and use of diuretics must also be considered.

Severely low sodium levels can be treated by giving intravenous sodium and water into the blood. Moderate hyponatremia due to use of diuretics or high levels of vasopressin is often treated by drinking less water each day. Hyponatremia due to an abnormal adrenal gland is treated with hormone injections. High sodium level is treated with an intravenous solution of water a normal concentration of sodium. The infusion is performed over many hours or days to prevent abrupt and dangerous changes in brain cell volume. In emergencies, suchas when a high sodium level is causing brain symptoms, infusions may be conducted with half the normal concentration of salt.

A low sodium level is just one manifestation of a variety of disorders. Whileit can easily be corrected, the prognosis for the underlying condition thatcauses it varies. The prognosis for treating a high sodium level is excellent, unless neurological symptoms are severe or if a doctor tries to reverse thecondition too quickly.

It is not always easy to prevent abnormal salt levels. Patients who take diuretic medications must be checked regularly for the development of hyponatremia. High levels occur only in unusual circumstances that are not normally under a person's control.


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Amount Of Sodium in Salt

Since sodium levels are so critical to so many chemical reactions in your body, the amount of sodium you eat or drink has important implications for your health. If you are trying to regulate or limit your intake of sodium, you need to realize the quantity of salt you eat is related to the amount of sodium but is not the same. This is because salt contains both sodium and chlorine, so when salt dissociates into its ions, the mass is divided (not equally) between sodium and chlorine ions.

The reason salt isn't just half sodium and half chlorine is because a sodium ion and a chlorine ion don't weight the same amount.


The Truth about Salt

America has declared war on salt. The nutrition militia, claiming that the enemy is attacking you and your buddies, points to hypertension stats: More than 20 percent of American men between 35 and 44 have high blood pressure. Even the Institute of Medicine is leaning on the government to set standards for sodium content in foods and the American Heart Association, along with the City of New York and 30 other cities, is promoting a new National Salt Reduction Initiative.

So should you enlist? It's a tough battle. "If people want to avoid salt, they really can't&mdashnot unless they skip processed, prepared, and restaurant foods," says Marion Nestle, Ph.D., M.P.H., a professor of nutrition, food studies, and public health at New York University.

What's more, salt may not even be the true enemy. Before you sign up to fight, tune out the hysteria and plunge into the latest nutrition intel.

Can I live without salt?

Salt is essential to health. Your body can't make it, and your cells need it to function, says Aryan Aiyer, M.D., director of the heart center at Magee-Womens Hospital at the University of Pittsburgh medical center. In fact, the Institute of Medicine recommends consuming at least 3.8 grams of salt a day (just over 1/2 teaspoon), mainly for the sodium.

Sodium is an electrolyte, a humble member of that hyped class of minerals that help maintain muscle function and hydration that's why sport drinks contain sodium. You're constantly losing sodium through sweat and urine, and if you don't replenish that sodium and water, your blood pressure may drop far enough to make you dizzy and light-headed. "Sodium acts like a sponge to help hold fluids in your blood," says Rikki Keen, R.D., an adjunct instructor of dietetics and nutrition at the University of Alaska.

However, people who chug too much water can lower their sodium levels so far that they develop hyponatremia, a potentially deadly condition more common among recreational exercisers than professional athletes, says Marie Spano, R.D., a sports nutritionist in Atlanta. Salt does more than just make our food taste good without it, we'd die.

Do I need to watch my salt intake like a hawk?

If you have high blood pressure, you've probably been advised to cut back on salt. The mechanism seems clear: Sodium causes your blood to hold more water, so your heart has to pump harder, making your blood pressure rise. If your blood pressure is already high, that's a problem. (A high intake of salt can also be dangerous for people who are salt-sensitive&mdashthat is, they have trouble excreting excess salt.)

What if you're a healthy guy? The Institute of Medicine is adamant in recommending that people ages 14 and over consume no more than 2,300 milligrams of sodium a day&mdashabout a teaspoon of salt. The Institute of Medicine sets a lower limit (1,500 milligrams, or slightly more than 1/2 teaspoon) for middle-aged and older adults, African Americans, and people with kidney disease, hypertension, or diabetes.

But even though the average American blows past both limits, consuming an average of 3,400 milligrams of sodium a day, some experts say that's not a problem for most men. "I don't know of any evidence that suggests that healthy men with normal blood pressure should reduce their sodium intake," says Michael Alderman, M.D., a professor of medicine at Yeshiva University.

For starters, reducing the salt content of your diet could adversely affect your health, Dr. Alderman says. In a study review published in the Journal of Hypertension, people who reduced their sodium intake by about 1,000 milligrams experienced lower blood pressure, but also higher heart rates and decreased insulin sensitivity, which can raise diabetes risk. Because of these effects, he says, we need clinical trials to determine whether lowering salt intake actually improves health outcomes in the general population.

And let's not forget that sodium isn't the only blood-pressure booster. "The huge message everyone overlooks is that being overweight also contributes to high blood pressure," says Spano.

Can anything I eat counteract the effect of salt on my BP?

Quick biology lesson: Your body is constantly balancing the sodium on the outside of each cell and the potassium on the inside. A 2006 statement from the American Heart Association in the journal Hypertension revealed that an increase in potassium can lower blood pressure just as much as a decrease in sodium can. Even the Institute of Medicine doesn't deny this: "The sodium:potassium ratio is typically more closely associated with blood pressure than with intake of either substance alone."

Unfortunately, supersalty processed meals tend to crowd out our main dietary sources of potassium&mdashfresh fruits and vegetables. Nutrition surveys reveal that younger men consume only about 60 percent to 70 percent of the recommended daily intake: 4,700 milligrams of potassium. Imagine the effect on our blood pressure levels if fast-food cashiers always asked, "You want broccoli with that?"

Should I cut back on salt when I cook?

Tossing some salt into your pasta water isn't likely to send your blood pressure soaring. That's because 77 percent of the sodium in the average diet comes from processed and restaurant foods, according to the Centers for Disease Control and Prevention. Only 12 percent of sodium is naturally occurring in foods, and just 5 percent comes from home cooking.

So there's no need to ban salt from your house or buy an additive-laden salt substitute&mdashespecially since salt is an important seasoning and the only natural source of that basic taste, says Harold McGee, the author of On Food and Cooking. After all, our brains evolved to crave salt because it's necessary for survival, says Leslie Stein, Ph.D., a senior research associate at Monell Chemical Senses Center, in Philadelphia. Salt creates a fuller mouthfeel when you eat, while suppressing bitterness and releasing sweetness. In fact, without a decent hit of salt, many foods would taste flat, not flavorful. It's also essential in the chemistry of baking, says Stein. Stick with kosher salt for cooking and try flaky sea salt for finishing a dish both types are free of additives.

Why are so many processed foods packed with salt?

Sure, salt makes food taste good. But that's not the only reason fast-food meals and processed foods are laced with it.

For starters, people become hooked on the flavor profile of familiar products, says Howard Moskowitz, Ph.D., a food scientist and cofounder of the journal Chemical Senses. "They've become accustomed to this richer, deeper taste due to salt. Take out the salt, and people will complain and stop buying the product."

Salt also masks off-flavors created during the production of processed foods while acting as a preservative and improving texture and color. And let's face it, where else can a $600 billion industry find an ingredient that can do so much, so cheaply? Whether or not salt itself is dangerous for you, it can definitely run with a bad crowd.

America's 5 Saltiest Foods

These meals contain at least a day's worth of sodium&mdashalong with gobs of fat and calories. Proceed with caution.
By Andrew Del-Colle

5 Saltiest Nachos
On The Border Grande Fajita Chicken Nachos (appetizer)
5,180 milligrams (mg) sodium
1,540 calories
85 grams (g) fat

Even if you share this appetizer with a friend, you'll have eaten an entire day's worth of sodium before the entrees arrive.

4 Saltiest Steak Meal
Claim Jumper Country Fried Steak
6,157 mg sodium
2,288 calories
66 g fat

Southern staples like these have enough salt in the batter to deice your driveway.

3 Saltiest Breakfast
Perkins Southern Fried Chicken Biscuit Platter
6,680 mg sodium
1,860 calories
86 g fat

Call it the inflated-portion effect: This meal consists of two fried-chicken breakfast sandwiches, with eggs, bacon, and hash browns on the side.

2 Saltiest Burger
Chili's Jalapeno Smokehouse Bacon Burger
6,710 mg sodium
2,140 calories
139 g fat

Bacon, Cheddar, and tortilla strips create a trio of saltiness.

1 Saltiest Food in America
P.F. Chang's Double Pan-Fried Noodles with Pork
7,900 mg sodium
1,652 calories
84 g fat

This abomination packs more than 3 days' worth of sodium into one pile of noodles.