Excessive intake of sodium through added salt can contribute to high blood pressure (hypertension), which can then increase the risk of developing heart disease, stroke, and kidney disease. Too much dietary sodium can also negatively impact bone health because excessive sodium increases the amount of calcium your body loses through urination.

And not all salts are created equal. Iodized salt, for example, is a good thing, especially during pregnancy. Iodine is extremely important for fetal brain development as well as your normal cell metabolism and thyroid function (see Getting enough Iodine? Myself? My baby? My child? for more information). The salt added to processed foods is rarely iodized, and most of the more popular “gourmet” salts (sea salt, kosher salt, Himalayan sea salt, etc.) salts are also usually non-iodized.

The abundance of ready-made, packaged, processed and shelf-stable foods has led to an overabundance of sodium in the typical American diet. Salt has many aliases (sodium chloride (salt), sodium benzoate, sodium phosphate) and manufacturers add salt to maximize taste and flavor and to extend shelf life.

So how much sodium should you be ingesting to promote your best health? For adults, the World Health Organization recommends a maximum of 2,000 milligrams of sodium per day, whereas the U.S. Centers for Disease Control recommends a limit of 2,300 milligrams per day. The American Heart Association recommends no more than 2300 milligrams per day but says the ideal limit is no more than 1500 milligrams per day for most people. These recommendations remain the same before, during and after pregnancy and breastfeeding (and note that while pre-eclampsia during pregnancy is a form of high blood pressure, salt intake is not associated with causing, preventing, or treating pre-eclampsia).

The variations in limits are based in part on your medical profile, and ethnicity. Those with high blood pressure, diabetes, or chronic kidney disease and those of African-American descent should limit their daily intake to 1,500 milligrams of sodium per day. This means that you should only be having the equivalent of 1 small teaspoon or less of salt per day!

For babies ages 6-12 months and who are eating solid foods, the recommended sodium limit is approximately 370 milligrams per day. Be sure to avoid adding salt to your baby’s food or incorporating processed foods in your baby’s diet at this age as excess sodium is particularly hard on a baby’s immature kidneys.

Given sodium’s unhealthful reputation, many packaged food items have “nutrient claims” about sodium. Here are some translations of those different salt-related claims you can find on labels:

• “Sodium free” or “Salt Free” means the product does not exceed 5 milligrams of sodium per serving
• “Low sodium” means the product does not exceed 140 milligrams of sodium per serving
• “No salt added” or “Unsalted” does not mean the item is free of all sodium
• “Reduced sodium” means the product contains 25% sodium less than its original formulation. So if a high sodium product originally contained 1,000 milligrams of sodium, its “reduced sodium” version could still contain 750 milligrams – that’s almost half of a day’s worth of sodium!

The bottom line: always read food labels, especially the amount of sodium per serving size to keep your daily sodium intake in check.

What to Do

Stick to fresh whole foods to ensure you stay within the recommended daily sodium limit of 2,000-2,3000 milligrams per day.

Fruits, veggies, legumes, whole grains, fresh meats, chicken, and fish are great choices. Frozen fruits and veggies are also great choices, provided the only ingredient is the fruit or veggie itself.

If you buy canned or tetra packed beans, rinse the beans before you eat or cook with them to significantly decrease the amount of added sodium.

Prepare more food at home

Cooking at home, or even simply making your own soups, tomato sauces, and salad dressings will make a positive impact towards controlling your sodium consumption and limiting your processed food intake.

When preparing soup at home, make it in bulk to freeze and have easy access for subsequent meals.

For an easy salad dressing, simply mix olive oil and your favorite vinegar (like balsamic). Or try this delicious Honey-Tahini dressing recipe:

• 1/2 cup lemon juice
• 1/3 cup extra-virgin olive oil
• 1/3 cup tahini (if store-bought, the only ingredient on the label should be sesame seeds!)
• 2 tablespoons 100% maple syrup (you can substitute honey here, but only if your baby is over the age of 1 as honey ingestion poses a risk of exposure to botulism in children under the age of 1)
• 2 cloves garlic, minced
• 1/2 teaspoon salt
• Freshly ground pepper, to taste

Whisk all ingredients together and store in an airtight container or jar.

Makes approximately 1 ¼ cups

Nutritional information:

Serving size =1 Tablespoon

66 calories; 6 g fat (1 g sat, 4 g mono); 0 mg cholesterol; 3 g carbohydrates; 1 g protein; 0 g fiber; 60.5 mg sodium; 28 mg potassium

Limit foods known to be high in sodium

Below are many common high-sodium foods.

• Anchovies, olives, pickles, and sauerkraut
• Anything in a can
• Bread and rolls (while bread itself isn’t always glaringly high in sodium, because it is often incorporated frequently throughout the day and consumed in large portion sizes, the sodium content really adds up)
• Cereals
• Certain cheese varieties (check the labels!)
• Chickens injected with a high-sodium flavoring solution used to increase flavor and juiciness (it bears repeating, check the label!)
• Chips, crackers and most store-bought “snack” foods
• Cured, processed, and smoked meats (“cold cuts”)
• Meats like bacon, sausage and hot dogs
• Packaged spice blends (look for ones that are sodium-free)
• Pastas
• Pre-made broths, stocks, and soup bouillon cubes (again, look for no-salt added or low-sodium varieties)
• Pre-prepared frozen meals and foods
• Processed kids’ snacks including crackers and cereals
• Ready-made baked goods or cake mixes
• Salted margarine or butter
• Salted nuts
• Some cottage cheese varieties
• Store-bought marinades, sauces, and dressings (like BBQ sauce, MSG, soy sauce and Worcestershire sauce)
• Tomato juice

Be mindful of the salt shaker

No need to add salt, especially if you are already consuming processed items or high sodium foods. If you do add salt, use an iodized salt to help meet your increased iodine needs during pregnancy to promote healthy fetal brain development. Remember, the sodium in processed foods is rarely iodized, providing yet another reason to limit your intake.

When cooking, add salt sparingly and as the final step or replace it with other flavorful seasonings

If you’ve grown accustomed to adding a lot of salt to your dishes, slowly wean yourself off by replacing the salt with other natural flavors. Pepper, garlic, paprika, cumin, turmeric, curry powder, herbs like thyme, basil, rosemary, mint, and sage, along with fresh squeezed lemon juice are all delicious choices. Like breaking any habit, adjusting to a lower-salt taste may take some time.

Avoid salt pitfalls when dining out

Order steamed, grilled, baked, boiled, or broiled menu items as these methods of preparation tend to require less salt. And don’t be afraid to communicate with your server – request no added salt with your meal and ask about the sodium content. As always, limit your own added table salt and avoid high-sodium culprits like condiments, dressings, sauces, and cheese.

Check the labels of store-bought packaged foods

Always read food labels to keep an eye on sodium content by serving size. Different brands of the same foods may have different sodium levels, so do a comparison to make the best decision for you.

Did you know that food labels list their ingredients in descending order, starting with the ingredient with the highest amount? This means you should avoid foods that list salt or salt derivatives (baking soda, baking powder, sodium benzoate, sodium nitrate, sodium sorbate, etc.) near the top of the list of ingredients.

Incorporate potassium-rich foods in your diet to help counter the effects of excessive sodium

Not only does your body need far more potassium while pregnant (approximately 4,700 milligrams per day) and breastfeeding (approximately 5,100 milligrams per day) than sodium, but eating potassium-rich foods will also help relax blood vessels and decrease blood pressure to counteract the negative impact of excessive sodium.

Incorporate potassium-rich beet greens, swiss chard, avocado, tomatoes, and bananas in your diet to support your heart health.

Increase your sodium intake if you are very physically active or live in a hotter climate

You may have to compensate for lost sodium through sweat if you are regularly physically active for over an hour per day or if you live in a more tropical climate (and, in both cases, if your diet is also low in high-sodium processed foods). Warning signs of low sodium can include headache, confusion, and muscle spasms. Speak with your healthcare provider if you have any concerns.

Don’t forget about taste imprinting!

Your food choices while pregnant and breastfeeding will impact your baby’s healthy eating habits and attitude surrounding food for years to come. Keep your sodium intake within the recommended levels while pregnant and breastfeeding to help your baby’s development of future healthy flavor preferences. And when you start introducing solid foods to your baby, avoid processed foods or adding salt to the food you make for your little one. Instead, offer fresh whole foods and get him off to a healthy start.