Shaking up reduction of salt

Q: I’m confused about whether or not it makes sense to reduce salt if you want to protect your heart. Recent reports seem contradictory. Can you explain? Greg T., Myrtle Beach, South Carolina

A: I think you’re referring to two recent studies on sodium and heart health — one that said cutting sodium is very beneficial for preventing strokes in folks at high risk for stroke and the other that said reducing sodium intake didn’t reduce the risk that heart-related problems would send a person with heart failure to the ER or hospital.

The first study, published in Circulation, reconfirmed that switching to salt substitutes reduces stroke risk by 14% and found that doing so lowers health care costs significantly.

The second study, published in the Lancet, found that reducing sodium did improve heart failure patients’ quality of life by reducing symptoms of the disease, such as fluid retention and difficulty moving around and breathing. It also helps lower blood pressure. But it did not produce statistically meaningful differences in cardiovascularrelated admissions to hospital, cardiovascular-related emergency department visits and all-cause death. The study target for reduced sodium intake was 1,500 milligrams daily for 12 months — the participants’ median daily intake achieved 1,658 milligrams.

So ... if you’re at high risk for stroke — or have high blood pressure — reducing sodium intake is essential. If you have heart failure, discuss your target sodium intake with your doctor. And everyone — with diagnosed heart issues or not — should pay attention to the sodium content of prepared foods. One study found the biggest sodium bombs in sauces and spreads (1,283 milligrams sodium per 3-ounce serving) and processed meats (846 milligrams sodium per 3-ounce serving).

You can make your own salt substitutes using an almost infinite blend of herbs and spices to impart flavor and zip to any dish. Try my favorites: ancho and guajillo chili pepper sauce and harissa spice blend from my “What to Eat When Cookbook.”