Some of the conditions that require a sodium-restricted diet are High Blood Pressure, Congestive Heart Failure, Pulmonary Hypertension, Renal Disease, and some hepatic diseases.
Most experts believe it would be prudent for everyone to cut back on their salt intake, but it's especially important for elderly Americans, African-Americans, and Native Americans for whom the rate of diabetes is already in higher evidence. This puts them at greater risk of hypertension. Pregnant women at risk for toxemia should also restrict their sodium intake. Sodium-controlled diets may also enhance the effectiveness of some medications.
The estimated average daily intake of sodium in the American diet ranges from 4 to 5.8 grams a day. The American Heart Association recommends no more than 3 grams (3,000 mgs) and the National Heart, Lung and Blood Institute recommends no more than 3.3 grams. So, if your doctor prescribes a diet that has a ceiling of 2,000 to 2400 (2.0 - 2.4 grams) of sodium, you will need to make some fairly dramatic lifestyle changes. [1]
Although Americans love their salty foods like chips, French fries, popcorn, and tacos, most are not aware of the pervasiveness of sodium hidden in the ingredients of many other foods – like bread and rolls, pizza crust, tortilla shells, canned vegetables, and deli meats. Canned soups, frozen dinners, Chinese foods, hot dogs, canned tuna, Ramen noodles…the list is seemingly endless of the everyday, popular items Americans consume regularly that take them over the healthy limit of sodium.
What About Restaurant Menus and Fast Food?
Fast foods and most restaurant menus are particularly difficult to gauge, as nutrition content is often unavailable – or if available, does not include sodium content. Nutrition information is usually limited to calories and fat (including trans fat) content.
According to "The 20 Saltiest Foods in America" by Lauren Murrow of Men's Health Magazine, some of the nation's restaurant chains disguise the lack of flavor and fresh ingredients by overloading their entrees and appetizers with enough salt to preserve a horse. Examples include "Denny's honey smoked ham, slice – 1700 mgs salt, Hardee's 2/3 lb Monster Thickburger - 2,770 mg sodium, Chili's Guiltless Grill Chicken Platter - 2,780 mg sodium, [and] Arby's Sausage Gravy Biscuit - 3,754 mg sodium, (gravy alone has 2600 mgs of salt!)" [2]
Water supplies may also carry hidden sodium content. You may need to contact your municipality's Water Department for this information. Water softeners may add large amounts of sodium to the water; sodium content of softened water may range between 7 and 220 mgs per quart. Distilled water may be used for cooking and drinking when your water supply contains more than 120 mgs of sodium per quart. [3]
How to Adapt Cooking Methods
While the prospect of cutting so much sodium from the daily menu may seem daunting, it is much easier today than it was even ten years ago. There are a wide array of salt substitutes, salt-free herbs and spices with which to enhance the flavors of foods cooked at home. Fresh vegetables can be prepared with unsalted butter, and salads tossed with a small amount of olive oil and vinegar.
Become a Diligent Label Reader
There are both national and local store brands of canned vegetables, beans, tomato products, soup stocks, and condiments that are made without salt. Some condiments are naturally salt-free, like black pepper, but it's also possible to find mustards, ketchup, salsa, and syrups that are very low in sodium or have none at all.
Low Sodium Menu Guidelines
These are some foods to avoid:
- MSG
- sea salt
- garlic salt
- onion salt
- rock salt
- Kosher salt
- pickles
- soy sauce
- olives
- Worcester and steak sauce
Beverages such as tea, coffee, and reconstituted fruit juice, should be prepared with water that has been checked for sodium content. Mineral water or carbonated beverages usually contain some sodium, so check the labels.
Dairy products in themselves are low in sodium, but may have added sodium in preparation. Cheese, however, is quite often a difficult food to include in a low-sodium diet. The harder or more aged a cheese, the higher the sodium content. Stick with Swiss cheese (50-60 mgs per ounce) and some mozzarella, provolone, and cheeses labeled as low-sodium. Reduced-fat cheese is not necessarily reduced-sodium! Cottage cheese must be labeled low-salt, as it is not naturally a low-sodium item.
Products labeled "organic", generally speaking, tend to be lower in sodium than their non-organic equivalents. Beware, however, of "sea salt" which is often marketed as being lower in sodium content than regular salt. This is not true – the sodium content is roughly the same.
You must become an avid, devoted, and diligent label-reader.
Sources:
[1] "Sodium-Restricted Diet". W.B.Saunders and Company, 1998 medical tear-sheet
[2] "The 20 Saltiest Foods in America" by Lauren Murrow, Men's Health Magazine, accessed on MSNBC.com, April 25, 2008
[3] "Sodium-Restricted Diet". W.B.Saunders and Company, 1998 medical tear-sheet
