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In the ongoing public health campaign to get people to cut back on sodium, foods such as chips, popcorn and pretzels have unfairly shouldered a heavy burden of blame.

As it turns out, we should have declared war on the sandwich.

Bread, rolls and deli meats are the top contributors of sodium to the average person's diet, according to a report released Tuesday by the U.S. Centers for Disease Control and Prevention. Bread and rolls account for more than 7 per cent of daily sodium consumption, while cold cuts and cured meats amount to about 5 per cent.

The report also found that almost two-thirds of sodium consumed comes from processed food purchased in stores, while 25 per cent comes from restaurant meals. The rest is added by consumers with a salt shaker.

CDC experts set out to analyze the top contributors of sodium to the American diet in order to help figure out where sodium reduction efforts could be most effective.

They determined that 10 foods, including bread, pizza, poultry (often injected with a sodium solution, according to the CDC), soup and pasta are responsible for nearly half of all sodium consumption. Number 10 on the list are savoury snacks, such as potato chips and pretzels, which account for only about 3 per cent of the sodium adults consume each day.

"Excess sodium increases blood pressure, which is a major risk factor for both heart disease and stroke as well as other health problems," said Thomas Frieden, director of the CDC, in a briefing with the media. "Reducing the sodium content of the 10 leading sodium sources by just 25 per cent would lower total dietary sodium by more than 10 per cent and prevent an estimated 28,000 deaths per year."

Although the report's conclusions are based on the U.S. population, they reflect patterns in Canada.

The average Canadian consumes about 3,400 milligrams of sodium a day, more than double the recommended amount of 1,500 milligrams and far above the maximum recommended amount of 2,300 milligrams, above which the risk of health problems starts to rise.

While salty snacks, such as potato chips, contribute to high sodium levels, health experts say the seemingly innocuous foods we consume larger amounts of on a daily basis, such as soups, sauces, bread and cereal, are the real issue.

Despite a national report from a federally-appointed working group that called for maximum limits on salt added to foods sold in Canada, little has been done to address the problem of excessive sodium intake.

Yoni Freedhoff, an expert on nutrition issues and medical director of the Bariatric Medical Institute in Ottawa, said there's no doubt high amounts of sodium consumption is a clear indication something is wrong with our diets.

But he wonders if sodium is the real villain, or if health problems result from regularly consuming processed foods with artificial ingredients and preservatives that also happen to contain plenty of salt.

"I think what we really need to be looking at is the quality of our diets as a whole," Dr. Freedhoff said. "I do wonder whether the bigger deal is to start buying foods without labels,…transforming raw ingredients into dinner."

Dr. Frieden at the CDC also highlighted the importance of consuming more fruits and vegetables in order to cut back on salt and improve overall health. But he also noted how difficult it can be for consumers to stick to low-sodium plans, given that even seemingly healthy foods, such as breakfast cereals, can pack a punch in terms of salt content. He urged consumers to read labels, compare brands and choose companies that have the least-salty products.

"I think the key here is to find lower-sodium options of the foods you love," Dr. Frieden said.

The top 10 sources of sodium in the average person's diet, according to the U.S. Centers for Disease Control and Prevention:

  • Bread and rolls
  • Cold cuts and cured meats
  • Pizza
  • Poultry (often injected with a sodium solution, according to the CDC)
  • Soups
  • Cheeseburgers and other prepared sandwiches
  • Cheese
  • Pasta dishes (such as spaghetti with meat sauce)
  • Meat dishes (such as meat loaf with tomato sauce)
  • Snacks (such as chips, pretzels and popcorn)