Sodium (Na)
Sodium
is an electrolyte whose primary function is the control of fluid balance in the
body. It controls the extracellular fluid and is essential for osmosis. Sodium
is also necessary to maintain the acid-base balance in the body. In addition,
it partici-pates in the transmission of nerve impulses essential for normal
muscle function.
Sources.The primary dietary source of sodium is table
salt (sodium chlo-ride), which is 40% sodium. (One teaspoon of table salt
contains 2,000 mg sodium.) It is also naturally available in animal foods. Salt
is typically added to commercially prepared foods because it enhances flavor
and helps to preserve some foods by controlling growth of microorganisms.
Fruits and vegetables contain little or no sodium. Drinking water contains
sodium but in varying amounts. “Softened” water has a much higher sodium
content than “hard,” or unsoftened, water.
Requirements.The DRI for sodium has been established at
1,500 mg,or 3,800 mg of salt. The UL for salt is 5,800 mg, with the majority of
men and women exceeding that limit.
Deficiency or Excess.Either deficiency or excess of sodium can
causeupsets in the body’s fluid balance. Although rare, a deficiency of sodium
can occur after severe vomiting, diarrhea, or heavy perspiration. In such
cases, dehydration can result. A sodium
deficiency also can upset the acid-base bal-ance in the body. Cells function
best in a neutral or slightly alkaline medium. If too much
acid is lost (which can happen during severe vomiting), tetany due to alkalosis may develop. If the
alkaline reserve is deficient as a result of starvation or faulty metabolism,
as in the case of diabetes, acidosis (too much acid) may
develop.
An excess of sodium is
a more common problem and may cause edema. This edema adds
pressure to artery walls that can cause hypertension. Thus, an excess of
sodium is frequently associated with cardiovascular conditions such as
hypertension and congestive heart failure. Certain groups have greater (or
lesser) reduction in blood pressure in response to reduced sodium intake. Those
with the greatest reductions in blood pressure have been termed saltsensitive, whereas those with little
or no reduction in blood pressure have beentermed salt resistant. Working with your cardiologist is the best way to
deter-mine which you are, sensitive or resistant. Depending on the diagnosis,
the diet order may be either a 3- to 4-gram (also called no-added salt, or NAS)
or a 1- to 2-gram sodium-restricted diet. A physician rarely prescribes a diet
of 1 gram of sodium because compliance is difficult.
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