Despite longstanding dietary guidelines and industry reformulation initiatives, sodium consumption among U.S. adults continues to exceed recommended limits. A new study suggests a critical, and often overlooked, factor: sodium intake patterns and reduction efforts differ significantly across racial and ethnic groups.
Published in the Journal of the American Heart Association, the study analyzed pre-pandemic data from the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2020. It found that while foods such as pizza, chicken, and soup are among the leading sources of sodium across all groups, notable differences exist in how specific communities consume and manage sodium. For example, Asian American adults derive a substantial portion of their sodium intake from soy-based condiments, fried rice, and stir-fry sauces—items not commonly found among the top sources for other populations.
Behavioral patterns also varied. Black adults were the most likely to report receiving physician advice to reduce sodium and to be actively attempting to do so. Conversely, Asian American adults were the least likely to receive such guidance, yet reported the highest rates of salt use during food preparation while being least likely to use salt at the table—likely reflecting cultural cooking practices rather than consumption of industrially processed foods.
These insights challenge the effectiveness of uniform public health messaging. As lead author Jessica Cheng noted, sodium reduction strategies should be “culturally and linguistically tailored.” Educational tools such as the commonly promoted “Salty Six” (an infographic campaign focused on breads, pizza, sandwiches, cold cuts, soup, burritos and tacos as major sources of sodium) may not effectively address the specific dietary realities of all communities.
The study also raises important questions about the accuracy of current sodium intake assessments. Standard nutrient databases assume that all rice is cooked with added salt. This assumption does not align with common practices in many Asian American households. When the researchers adjusted for unsalted rice, the estimated sodium intake for Asian American adults dropped by more than 300 mg/day—altering conclusions about group-level dietary risks.
Looking ahead, sodium reduction strategies must evolve. While reformulating packaged foods remains important, it should be complemented by culturally responsive education, improved clinical communication, and more accurate methods of dietary surveillance that reflect cultural diversity.
Ultimately, addressing excess sodium (salt) intake is not only a nutritional challenge but a matter of health equity. This research underscores the importance of designing public health interventions that acknowledge and respect cultural variation in dietary patterns. Only then can national sodium reduction efforts be both effective and inclusive.
Coordinator at la Verneda-Sant Martí Learning Community and adjunct professor at the University of Barcelona