Sodium for Health and Performance

By Elliot Fisher MS, ATC, CSCS, PES

Sodium has a bad reputation in the health and wellness community for being related to high blood pressure and heart disease.  It’s common for people with hypertension or heart disease to be recommended by their physician to reduce sodium intake. The RDA for sodium is only set at 2300 mg, which is not very high and very easy to go over.  These recommendations have been long standing but newer research has shown evidence of improved health outcomes with slightly higher sodium intakes.  

Heart Health

Cardiovascular disease is the number one cause of death in America.(1)  It’s pertinent that we make sure our diets and lifestyles are conducive to maintaining heart health.  Sodium consumption is poor for heart health because it increases water retention which can cause increased pressure on arteries raising blood pressure.  When blood pressure is high it damages the arterial walls and as the walls repair with cholesterol, blockages begin to form.  

A meta analysis done in 2014 showed increased mortality rates with low and high sodium intake.(2)  This meta analysis showed the lowest mortality rates with a consumption of 2645 mg – 4945 mg of sodium/day.  This is in conflict with the current recommendations of lower sodium intake.  

Sodium consumption likely does not have any mechanisms of heart disease outside of raising blood pressure.  If you are consuming more sodium than recommended and blood pressure is controlled there is little negative effect.  One other factor for blood pressure is potassium intake. Potassium is another electrolyte consumed in the diet (usually less than the recommended 4700 mg/day).  Potassium helps the body get rid of extra water helping control blood pressure. It is suggested that the sodium:potassium ratio is more important for hypertension than sodium intake alone.(3) 


Nutrition plays an important role in sport performance.  One thing coaches and trainers harp on is to make sure their athletes drink enough water to stay hydrated.  There is good evidence showing dehydration decreases sport performance.(4) Strength, endurance, and technical skills can all decline with dehydration.  In strength sports it’s recommended to consume a lot of sodium to help increase performance.(5) Sodium helps the body hold onto water. It also helps increase fluid retention in the muscles, helps facilitate muscle contraction, and raises blood volume.  All of these factors help increase performance.  

Practical Application

If you have any cardiovascular disease, dyslipidemia, hypertension, or other conditions consult your doctor before adding more sodium to your diet.  When consuming sodium make sure to monitor your blood pressure to make sure it is around 120/80 (or slightly lower). Salt foods to taste, and take a ½ tsp of salt about a half hour before working out to get a performance benefit.  If you are monitoring your intake, shoot for between 3-5 grams as the study showed that dose had the lowest mortality rate. Consult your physician before consuming more sodium than that. Also make sure to eat high potassium foods such as: potatoes, bananas, beans, lean meats and dairy.  


  2. Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014). Compared with usual sodium intake, low-and excessive-sodium diets are associated with increased mortality: a meta-analysis. American journal of hypertension, 27(9), 1129-1137.
  3. Yang, Q., Liu, T., Kuklina, E. V., Flanders, W. D., Hong, Y., Gillespie, C., … & Hu, F. B. (2011). Sodium and potassium intake and mortality among US adults: prospective data from the Third National Health and Nutrition Examination Survey. Archives of internal medicine, 171(13), 1183-1191.
  4. Cheuvront, S. N., & Kenefick, R. W. (2011). Dehydration: physiology, assessment, and performance effects. Comprehensive Physiology, 4(1), 257-285.
  5. Efferding S,McCune D.  (2019). The Vertical Diet and Peak Performance 3.0.


Comments are closed.