Here’s more proof that skipping the salt shaker and processed foods with high sodium, along with adding potassium-rich foods, can lessen your risk for a heart attack.

In a large-scale study of more than 10,000 adults with accurate sodium measurements from individuals, researchers from Harvard T.H. Chan School of Public Health reaffirmed that lower sodium consumption and higher potassium intake is linked with lower risk of cardiovascular disease in most people.

The study was published in the New England Journal of Medicine in November 2021.

Researchers decided to conduct the study because past research had used less-than-ideal methods to assess sodium and got mixed results — with some studies showing both low and high sodium diets linked to cardiovascular disease.

This study measured excretion of sodium and potassium in participants’ urine — the most accurate way possible to measure intake.

Researchers calculated that each daily increment of 1,000 milligrams in sodium excretion was associated with an 18% higher cardiovascular risk and each daily increment of 1,000 milligrams in potassium excretion was associated with an 18% lower risk.

Most of us consume far more sodium than the recommended 2,300 milligrams of sodium per day, not from the salt shaker, but from packaged foods and restaurant meals.

On the other hand, we don’t get enough potassium, found in fruits, vegetables and legumes.

Too much sodium in the bloodstream pulls water into the vessels, increasing the volume of blood flowing through them. That can lead to high blood pressure and an increased risk of heart attack and stroke. Potassium helps lower blood pressure by lessening the effects of sodium.

The researchers examined data from 10,709 generally healthy adults who were an average of 52 years old. They were participants in six different studies across the United States and Europe.

Their sodium and potassium levels were measured with at least two 24-hour urine samples, meaning all urine produced in a full day, which is considered the optimal method.

During an average follow-up of 8.8 years, there were 571 cardiovascular disease events such as a heart attack or stroke. The researchers found that higher sodium levels, lower potassium levels and higher sodium-to-potassium ratio were all associated with higher risk.

After adjusting for other cardiovascular risk factors such as age, smoking status, cholesterol and diabetes, participants with the highest levels of sodium in the urine (an average of about 4,700 milligrams) were 60% more likely to have a cardiovascular event than those with the lowest sodium levels (about 2,200 milligrams).

Those with the highest levels of potassium (about 3,500 milligrams) had a 31% lower risk of cardiovascular events than those with the lowest levels (about 1,750 milligrams).

The bottom line: Cook at home where you can control your sodium intake, and opt for fruits, veggies and whole grains, skipping the more processed foods. Your heart will thank you.


Q: Are best-by-dates or use-by-dates required by law on all food products?

A: No, except for infant formula. Infant formula is required to have use-by product dating and it should be honored to ensure the nutrients are at peak quality.

For all other foods, use-by or best-by dates are included voluntarily to tell consumers about peak quality, but it doesn’t necessarily mean the food should be thrown out past the date.

Use a first-in, first-out system when storing canned or packaged shelf-stable items. Keep the older dates in front so you’ll use them first. If you use a product past its use-by or best-by dates, the quality may be affected but, in most cases, they are still safe to use.

The dates refer to freshness and peak quality. The exception is food that can spoil, such as dairy products or meat.

Slow-Cooked Southwest Chicken

Here in the Midwest, I tend to use my slow cooker year-round. I’d rather be outside grilling, but this is the season where spring can’t decide if it’s really going to show up or just wait another week or two.

Here’s a recipe for slow-cooked southwest chicken with a boost of fiber from the addition of black beans. It’s from Taste of Home’s Skinny Slow Cooker. To lower the sodium, use no-salt-added black beans and chicken broth.


» 3 cans (15 ounces each) black beans, rinsed and drained

» 1 can (14.5 ounces) reduced-sodium chicken broth

» 1 can (14.5 ounces) diced tomatoes with mild green chilies, undrained

» ½ pound boneless, skinless chicken breast

» 1 jar (8 ounces) chunky salsa

» 1 cup frozen corn

» 1 tablespoon dried parsley flakes

» 1 teaspoon ground cumin

» ¼ teaspoon pepper

» 3 cups hot, cooked brown rice


In a 2- to 3-quart slow cooker, combine beans, broth, tomatoes, chicken, salsa, corn and seasonings. Cover and cook on low for 6-8 hours. Shred chicken with two forks and return to the slow cooker: heat through.

Serve with rice. Optional: add a dollop of low-fat sour cream or Greek yogurt and sprinkle with cilantro.


Serves 6 (1 cup chicken mixture and ½ cup rice)

Per serving: 320 calories; 19 grams protein; 56 grams carbohydrates; 1 gram fat; 21 milligrams cholesterol; 8 grams fiber; 873 milligrams sodium

— Charlyn Fargo Ware is a registered dietitian with SIU School of Medicine in Springfield, Illinois. Contact her at, or follow her on Twitter: @NutritionRd, or click here for additional columns. The opinions expressed are her own.

Charlyn Fargo Ware

Charlyn Fargo Ware

Charlyn Fargo Ware is a registered dietitian with SIU School of Medicine in Springfield, Illinois. Contact her at, and follow her on Twitter: @NutritionRd. The opinions expressed are her own.