How Sodium Affects Health (and What About Electrolyte Drinks?)

Sodium affects health in many ways.

Few people in the world get inadequate sodium. Most Americans consume much more sodium than they need. Some tribes in South America do quite well on less than 500 mg of sodium per day, despite very active daily lives. There is over 900 mg of sodium in a tablespoon of soy sauce. You could easily survive on that, unless you are a serious athlete. There are a few medical conditions that benefit from the consumption of more sodium, but Americans consume double or triple the recommended amount. I will discuss recommendations below.

Serious athletes and those likely to become significantly dehydrated, perhaps hiking in Montana, may benefit from a moderate to high level of sodium consumption. Still, typical people, even those who regularly work out, do not benefit from adding sodium to their diet. Unless you’ve been sweating like crazy, water is fine and much less expensive. To make it worse, most packaged food and some electrolyte drinks have more sodium than is healthy.

First, I want to remind you of a common error. Sodium is only part of salt. Most recommendations by major groups and nearly all product labels list sodium, not salt. You should think of the amount of sodium you are taking in because that is what your physician is thinking about. I discuss this in The Six Rules for a Longer, Healthier Life.

Excess sodium has risks. Most people know about the effect of excessive alcohol consumption on blood pressure. Elevated blood pressure (hypertension) is a significant risk factor for heart attack, heart failure, and stroke. Decreasing your sodium intake will likely lower your blood pressure. Until fairly recently, it was thought that dietary sodium only mattered for people who already had blood pressure or other heart problems. That is not the case.

Not only does a high-sodium diet increase blood pressure, which can increase the risk of heart disease, but sodium intake also has direct effects on the risk of cardiovascular disease. Increasing your sodium intake independently increases the risk of death. If you’re not worried about dying, perhaps you will consider that more sodium in your diet increases the risk of stroke.

The American Heart Association recommends “no more than 2,300 mg a day and an optimal goal of no more than 1,500 mg a day for most adults“. Other organizations recommend less than 2000 mg, and lower limits if the individual already has conditions worsened by elevations of blood pressure. 1500mg is a low limit, but it can be done. See my earlier post and my book. (Don’t be fooled by blood tests for sodium {Na.} Blood levels don’t reflect the quantity of sodium in your blood or body, just concentration or dilution.)

Most of the sodium we eat is in processed foods and food prepared by others. When you cook at home, you can control how much salt you eat. Pay close attention to anything in a can or box. I mentioned soy sauce, but some brands of cottage cheese add 500 mg of sodium to a 1/2 cup serving.

I want to mention electrolyte drinks and especially powdered mixes. A standard bottle of Gatorade has 380 mg of sodium. This is not a huge amount by itself, but since for most people it is unnecessary, I don’t recommend it. Liquid I.V., a powdered mix, has at least 500mg per package. LMNT usually has 1000 mg per stick. Since they are sometimes sugar-free, some people feel they can drink several of these drinks a day. Again, most people don’t benefit much from this type of hydration compared to water, so most of their effects are negative.

The reason I am singling out electrolyte drinks is that people drink them, thinking they are helping their health. Perhaps they are, but not significantly. Yet, like everything else, electrolyte drinks have risks. Too much sodium consumption in this country is a significant problem and part of the reason that ultraprocessed food is harmful. I am not saying you shouldn’t drink electrolyte mixes. I try to avoid saying anyone should or should not do something. The question is, are they worth the money and the risks? This applies to everything. There is nothing wrong with doing something that carries a risk. Just do it with intent.