Sodium And Diabetes

Sodium in the diet is considered by most nutritionists to be a serious health concern for anyone, including healthy people. Increasing use of sodium, which is most commonly found in the form of table salt, is used in seemingly everything that is processed from candies and baked goods through to meats, cheeses and vegetables. Some foods are obviously salty to the taste and can easily be identified as containing high levels of sodium. These tend to be high in carbohydrates as well, particularly starches, and include snack foods such as potato chips, pretzels and fast food items. Other foods such as pickles, baked goods, processed foods, fast foods, condiments, canned foods and processed meats are also very high in total sodium content even though they may not initially taste as salty.

Sodium Facts

Sodium is a naturally occurring chemical element that is considered essential for humans, animals and even some plants. In the body sodium acts to help retain fluids in the cells, allow transport of fluids across cell membranes and to allow electrical impulses that control muscle and nerve impulses to be transmitted through the body. These are essential for muscle contraction and relaxation as well as to allow the brain and nervous system to communicate and coordinate all body actions and functions.

In total, the human body contains an approximate total weight of 1.3 grams of sodium. Of this most is found within the fluids of the body and a smaller amount found in the bones. Sodium can be lost through filtration by the kidneys and some of the excess sodium that humans consume is eliminated in the urine. To keep sodium levels balanced and at optimal levels an adult needs to consume some sodium per day, which is available in cooking and table salt.  The average American consumes about 3, 436 milligrams of sodium per day with the Food and Drug Administration recommending a daily intake of 1,500 milligrams or 1.5 grams. 1

The average adult eating a regular diet will consume in excess of 5000 milligrams, which is more than triple the recommended daily intake. This excess of sodium in the blood puts additional pressure on the kidneys, impacts the fluid transportation in the body and increases blood pressure leading to hypertension and increased risk of heart attack, stroke and cardiovascular disease. Recent research also includes that increased sodium levels are associated with cancer.  In Japanese studies, it was found that the sodium was more likely to be problematic for cancer if it was found in salted foods as opposed to salt that was used cooking or table salt. However, table and cooking salt use posed a higher risk of developing cardiovascular disease.2

Type 1 Diabetes And Sodium

Individuals with type 1 diabetes may be at particular risk of elevated levels of sodium in the diet and consequently in the body. In recent research the link between high levels of sodium consumption, all-cause mortality and the end-stage renal disease in type 1 diabetics was examined. The researchers identified 2, 807 individuals with type 1 diabetes that did not have end-stage renal disease diagnosed between the years 1998 and 2002. After 10 years it was found that there were 217 deaths with highest representation in those with high urinary sodium excretion and very low urinary sodium excretion. The conclusion of the researchers was that for some people high sodium intake was independently related to all-cause mortality and end-stage renal disease but not in all patients. 3 They further recommended additional study to see what factors impacted the effects of sodium in patients with type 1 diabetes.

Type 2 Diabetes and Sodium

Hypertension is found in approximately 50% of all people with type 2 diabetes, although all individuals with type 2 diabetes are insulin resistant. Determining the relationship between the development and hypertension and insulin resistance is not a direct link but may be found through the development of increased peptides and specific plasma concentration that could trigger insulin resistance in the cells. This increased activity is noted when healthy individuals consume high sodium level diets for a short period of time during studies. 4

This study, as others, indicates that hypertension is clearly associated with increased sodium consumption, weight gain, and decreased urinary nitrate excretion. This in turn will lead to increased salt and water retention that further increases the blood pressure, leading to increased risk of kidney disease and cardiovascular problems.

Diet Choices To Lower Sodium Intake 

Lowering sodium intake in the typical diet is not as easy as it may seem. Sodium or salt is found in literally all cooked or processed foods, even in some beverages. Foods prepared in restaurants or fast food outlets can be particularly high in sodium but still not appear to be salty to the taste.

Cutting sodium out of the diet starts with avoiding adding extra salt at the table. Instead try using non-sodium spice mixes to add flavor. Avoid using butter and margarine that can also be very high in sodium and add “hidden” sodium to the foods. High sodium foods such as a pickles, sauerkraut, condiments and dressings should be avoided. Many companies now market low sodium options that allow you to enjoy the flavor without all the salt.

Using fresh or fresh frozen vegetables as opposed to canned or processed vegetables can dramatically help in reducing your sodium intake. Canned or preserved foods use salt as a bacterial inhibitor that will increase sodium consumed dramatically. Reading the labels and looking for both the sodium levels as well as the ingredient list for the food product is essential to determine if it is really a low or reduced sodium item.

Finally it is essential to learn what foods contain sodium. Breads, cookies, pastries, cakes and other sweets typically contain some sodium. While it is not as much as can be found in savory foods combined with the calories, fats and carbohydrates these foods can be devastating to a food plan.

References

1 Americans Consume Too Much Sodium (Salt). (n.d.). Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/features/dsSodium/

2 Takachi, R., Inoue, M., Shimazu, T., et al. (2010). Consumption of sodium and salted foods in relation to cancer and cardiovascular disease: the Japan Public Health Center–based Prospective Study. American Journal of Clinical Nutrition , 456-464.

3 Thomas, M. C., Moran, J., Forsblom, C., et al. (2011). The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 Diabetes. Diabetes Care , 861-866.

4 Reaven, G. M. (2011). Relationships Among Insulin Resistance, Type 2 Diabetes, Essential Hypertension, and Cardiovascular Disease: Similarities and Differences. The Journal of Clinical Hypertension , 238-243.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.