It's open season on salt.
The latest studies point at sodium — 40 percent of table salt — as a top food villain, looming large in processed foods.
It's estimated that Americans consume 3,000 to 5,000 milligrams of sodium per day — far more than the USDA's recommended daily limit of 2,400 milligrams, about 1 teaspoon of table salt.
Excessive sodium intake has been linked to high blood pressure, which can lead to heart disease and other chronic conditions.
"Reducing sodium chloride ... can lead to lowering heart attacks, strokes, kidney failure and chronic kidney diseases," says Dr. Tom Rifai of St. Joseph Mercy Hospital Oakland in Pontiac, Mich. "And there can be more benefits beyond that."
Studies have found that cutting back on sodium could have a profound impact on Americans' health and their health care costs.
For example, in a study published last month in the New England Journal of Medicine, researchers at the University of California at San Francisco found that if Americans reduced sodium by 3 grams per day, it could prevent up to 120,000 new cases of heart disease and up to 66,000 strokes a year.
But cutting back on sodium goes far beyond the salt shaker, which shares only a pinch of the blame. While more lower-sodium products are becoming available, the majority of Americans' sodium intake — more than 75 percent, according to health policy research company Rand — comes from processed foods and restaurant meals. Think condiments, processed meats, canned products such as soups and some canned vegetables.
"As much as you can cut back, the better," says Rifai, who directs a nutritional and weight management program. "We are too much of a salt and food toxic world."
Darlene Zimmerman, registered dietitian for Henry Ford Health System, teaches classes on heart-healthy food choices.
During a class about dining out, Zimmerman created a sample meal from an Italian restaurant chain — and the sodium added up quickly.
Using the restaurant's nutritional information, she showed that a serving of salad without a bread stick, an entree and slice of cheesecake contained nearly 6,000 milligrams of sodium.
"One of the comments I always hear is that people say they don't use the salt shaker anymore and don't add it to cooking," says Zimmerman. "The shaker doesn't have much of an impact."