CONTROLLING SALT AND SODIUM CONSUMPTION
Sodium helps regulate the balance of fluids in your body. When water builds up in your tissues (a common problem for PH patients), the volume of blood your heart has to pump also increases. One of the most effective ways of alleviating this condition is to reduce the amount of salt in your diet. If the edema is severe, however, or if it doesn’t respond to a low-salt diet, your doctor may recommend a low-sodium diet. A diet that is low in salt is not necessarily also low in sodium.
Research has shown that a low-salt diet will have a greater impact on your health if it is coupled with a diet rich in calcium, magnesium, potassium, and phosphorous.
Your taste for salt will decrease over time. Therefore, if you decrease your salt intake in steps, you will hardly notice its absence. You will even begin to notice how much more flavorful your food tastes.
Ways to cut back on salt
- Check labels. Much of the salt we consume each day comes from prepared and packaged foods. Read the labels of all prepared foods and look for low-salt versions.
- Break the habit. If you are in the habit of salting your food, stop before you shake! Many times, we might salt our food without thinking, or before we have even tasted a bite. Breaking the habit will help you feel better.
- Never add salt during cooking. It takes about ten times as much salt in cooking to achieve the flavor you’ll get when you add salt at the table. Let your family season to taste on their own plates.
- Build barriers! Put the tip of a toothpick into two holes in your saltshaker and break them off. Now when you use your shaker you will be getting less salt. Each day close off two more holes. When you close off all the holes, consider throwing out the shaker!
Some salty foods to avoid
In the produce aisle: Foods pickled or preserved in brine, such as olives, sauerkraut, pickles, pickled herring and pickled eggs; Pre-seasoned frozen vegetables; Most packaged and canned veggies
- In the kitchen: Seasonings that contain salt (you might be surprised!), such as coating sprays, garlic preps and baking mixes as well as meat seasonings and celery salt; Buttermilk
- For dinner: Most packaged and canned soups, stews, vegetable and pasta dinners; prepared meat products such as hot dogs, sausage, salami, dried beef, smoked meats, pre-cooked chicken breasts and rolls, cold cuts and canned meats; Breaded or battered foods, both fresh and frozen
- On the side: Condiments such as relish, ketchup, soy sauce and Worcestershire sauce are very salty. Find low-salt versions or replace these with flavorful herbs and veggies. Packaged/bottled sauces such as clam sauce, red spaghetti sauce and curry sauce are also often salty. Soup starters and bouillon have a lot of salt.
- During the day: Salted snack foods such as potato chips, corn chips, pretzels, crackers and salted nuts; Some instant breakfast drinks
Ways to cut back on sodium
Be vigilant. Read the labels of all prepared foods, as these are the source of most of the sodium in your diet. Many foods now have low sodium versions. Don’t be misled by “light” or “reduced sodium” labels. “Light” soy sauce has more than 500 mg of sodium per tablespoon!
- Do your math. Check the serving size on processed foods when adding up your sodium intake.
- Don’t forget your meds! Ask your physician or pharmacist about the sodium content of your prescriptions. Most medicines contain less than 5 mg of sodium per dose, but some contain up to 120 mg per dose.
Hidden sources of sodium
In the medicine cabinet: Mouthwashes and toothpastes; Some chewable antacid tablets; Aspirin (50 mg/tablet); Some prescription drugs (ask your pharmacist); Laxatives
- In the spice rack: Celery and parsley flakes
- In the fridge: Sauerkraut; Cheese; Milk; Cold cuts; Frankfurters
- In the pantry: Any salted crackers or chips; Canned tomato juice; Canned vegetables with added salt; Olives
Recommended sodium intake
Some PH doctors advise PAH patients to follow the American Heart Association (AHA)
guidelines when being conscious of salt and sodium. The AHA recommends that healthy adults reduce their sodium intake to no more than 2,400 milligrams per day. This is about 1 1/4 teaspoons of sodium chloride (salt). They further recommend that if you have heart failure, you reduce your sodium to 2,000 mg. Listings of the sodium content of various foods and other guidelines can be found on the AHA’s website
1/4 teaspoon salt = 500 mg sodium
1/2 teaspoon salt = 1,000 mg sodium
3/4 teaspoon salt = 1,500 mg sodium
1 teaspoon salt = 2,000 mg sodium
1 tsp baking soda = 1,000 mg sodium
Interpreting sodium content
Prepared foods must follow these FDA set guidelines when making claims on their labels. The amounts given below are for one serving, so you must read the label to determine the serving size.
- “Sodium-free” means less than 5 milligrams of sodium per serving
- “Very low sodium” means 35 milligrams or less per serving
- “Low sodium” means 140 milligrams or less per serving
- “Unsalted,” “no salt added” or “without added salt” mean exactly what they say: no salt is added to the food. These foods are not necessarily low in sodium, because some sodium may naturally be present in the ingredients.
- “Healthy” means less than 360 mg sodium per serving, or no more than 480 mg per meal for meal-type products.
Instead of seasoning your food with salt, try these substitutes
Rather than souring your food, Fresh or frozen lemon juice “brightens” the taste, pepping up everything from vegetables to chicken and fish
- Peppers: bell peppers, hot peppers, and freshly grated peppercorns - delicious varieties, lots of flavor.
- Garlic: fresh chopped garlic, dried garlic flakes, bottled garlic puree
- Fresh herbs: these are far superior to the store-bought variety and can grow in a windowsill garden - beauty and function!
- Potassium-containing salts (not potassium chloride, which is dangerous): available in most supermarkets, these salts have the benefit of acting as a potassium supplement, which may help you if your blood potassium levels are sometimes low. Some patients cannot take extra potassium and are put on low-potassium diets, so be sure to seek your doctor’s advice before you start using potassium-containing salts.
Consensus Statement on Sodium Restriction
The PHA Scientific Leadership Council has prepared recommendations on sodium intake for PH patients.
Sodium and Fluid Restriction: A Common Dietary Prescription
Martha Kingman, FNP-C, offers advice on managing a low-sodium diet in this Fall 2008 Pathlight
Sodium and Fluid Restriction: Eating Right During the Holidays
Martha’s Fall 2008 Pathlight
article continues with a few pointers on how to keep your diet in check through the holiday season.
Helpful Hints: Adopting a Low-Sodium Diet
This Fall 2007 Pathlight article contains a table listing salt seasoning alternatives for various foods.