Eating a restricted sodium diet

[1992casey]

I've been trying to help a family member with a reduced sodium diet. It's not an easy task. The first thing that becomes obvious is that it's pretty wild how really, really bad many foods are.

 

One really obvious thing is to not add salt at the table and to avoid it if at all possible while cooking. A teaspoon contains more sodium than anyone at any age is supposed to consume in a day.

 

Some of the basics that one learns right away are that processed foods suck, bread sucks, and restaurant food sucks. It seems that processed foods should basically be eliminated. With bread, it looks like one should look for the lowest sodium alternative and limit its consumption. Restaurants apparently need to be avoided as much as possible.

 

I feel like I've made quite a bit of progress, but there's still a long way to go. When I buy something, I check the sodium content on all competing alternatives and go with the lowest. Often, I'll come home and say "This isn't too bad, but I think we can do better."

 

One thing I've noticed is that a product's definition of a "serving" is often ludicrous. You have to look at the amount of product that's likely to be eaten and go from that.

 

I'm hoping that people here have suggestions that they can share, e.g. products that are reasonable alternatives and where they can be purchased, easy recipes, what to do when you're forced to eat at a restaurant, etc. I have a few specific products that I've found that I'll come back and post later.

[DuWayne Steurer]

About 6 years ago I went to a low sodium diet. The USDA recommended daily allowance is 2000 mg, but any dietician will tell you in reality you should stay below 1500 mg. The USDA value is at 2000, because if you buy boxed or canned food and eat 3 meals a day, it's almost impossible to stay below 2000 mg. Sad.

 

Casey, it sounds like you know most of the basics already. Most processed foods are a no-go. Canned food, for the most part, is simply off limits. Even stuff that is labelled as "low sodium" is still outrageously high in actual sodium content. Bread, as you've found out, can be high. Most store bought breads will have 150 mg or more of sodium, per single slice. If you have a person who needs to eat low sodium, and REALLY wants to eat bread, make home made bread. There's TONS of good recipes online for low or no-sodium bread.

 

And, yeah, just get used to finding different ways to season your food. Stay away from salt substitutes. I will say this though, in time, if the person in question really sticks to the low/no sodium diet, eventually extra salty/too salty food will start to have a distaste to it, to the point where it will be undesirable.

 

One thing that really works for me is I love spicy/hot foods. I have a great selection in my house of seasonings that don't have salt in them, or have very low sodium content.

 

Also, even things you wouldn't associate salt with, read labels. A 20 ounce bottle of mountain dew, for example, has 140 mg of sodium in it, and that's fairly low sodium for a soda.

 

Restaurants is a tough one. You simply can't control how much salt goes in what you cook. If there are restaurants this person frequents, you may want to ask the management (if they're available) if they can provide some reasonable estimate of salt content, or, simply limit how often they eat out.

 

For recipes..........google really is your friend. I could sit here and list a bunch of things, but you know what you like more than I do. If you want to make, for example, lasagna, just google low-sodium lasagna, and you'll find plenty of examples of what you want, and plenty of varieties.

[mothershipconnection]

One really obvious thing is to not add salt at the table and to avoid it if at all possible while cooking. A teaspoon contains more sodium than anyone at any age is supposed to consume in a day.

 

I'm sure you're onto this already, but the salt shaker contributes only a small amount of our sodium intake (unless you just dump it on). Most of it's already in the stuff you buy. Processed food, as you mentioned, is a complete disaster for those who can't handle lots of sodium.

 

My wife has to be on a low sodium diet due to cochlear hydrops, and fortunately, she's a good cook. We've scrapped almost all convenience foods and make most things from fresh ingredients. The real key is an herb garden. I built 3ft x 6 feet of raised garden boxes in my yard that I use to grow 3 kinds of basil, rosemary, thai peppers, oregano, 2 kinds of parsley, spearmint, chives, green onions, cilantro, and dill. The herbs allow you to pack in tons of flavor without adding a bunch of sodium. When they need to be trimmed and grow faster than we can consume them, I dry or freeze the excess to last through the winter.

[1992casey]

Tonight I made up a recipe tonight that my mom used to make. In its original form, it would have been fairly high in sodium. I skipped the 2 teaspoons of salt and did some substitutions:

 

• Herb-Ox® Sodium Free Beef Bullion (available at Sendik's) for the standard beef bullion cube
  
• No Salt Added Canned Corn (available in a lot of places) for the standard can of corn
  
• No Salt Added Diced Tomatoes (available in a lot of places) for the standard can of diced tomatoes

 

I thought the net result was bland, but the patient was OK with it. (I didn't mention that I had conscientiously reduced the sodium from the original recipe.) With the leftovers, I might try adding more of the spices called for (chili powder, black pepper). Or in this particular recipe, I could always add cayenne (which definitely becomes noticeable once one uses enough).

 

Apparently it's common to put potassium into products where sodium is removed or reduced. The Herb-Ox® Bouillon falls into this category. Depending on the individual, additional potassium could be good, bad, or irrelevant.

 

Most of the medical gurus have told us to try to stick to 1500mg in a day as the limit, although some have said 1500–2000. 2000mg would be a huge improvement for a lot of people, though. I'd bet that many people routinely consume 5000mg or more in a typical day.

 

So far, with restaurant food, the only thing I can think of is to not take home the leftovers and to be extremely conscientious about skipping sodium during the rest of the day.

 

I'm not a great cook, so substitutions don't come natural to me. I don't necessarily know which herbs and spices are appropriate to a particular dish, nor do I know how much to use.

 

Some stuff is kind of surprising. We "fit in" BLTs recently. The bread was worse than the bacon. Mayonnaise is something I'm working on making better. If someone has a recommendation, I'd be glad to hear it.

 

One trick that I hear people use is to eat open faced sandwiches. That's be a pretty sloppy option in some cases, though.

[nate82]

Corn Tortillas only have about 15mg of salt and you can use those as a sandwich wrap compared to 100+ in bread.

[rwa12]

Try adding different seasonings to Greek Yogurt to reduce mayo. I use it for my chicken salad. It's a pretty good canvas to do whatever you want with. You don't get the exact mayo experience, but I find it a suitable alternative. Make a spread out of it with some curry, or garlic. Or use it to cut the amount of mayo you use. I don't know about the sodium level in greek yogurt, but for the other health categories, it trumps mayo in just about every way.

[LouisEly]

Here's an interesting website:

 

http://nutritiondata.self.com/

 

Lots of good stuff here. One thing I like is that it has a drop-down menu for portion size that will automatically adjust the nutritional information for different portions. For example, for butter you can select a pat, a tablespoon, an ounce, or a stick, and it will change the fat/calories/sodium/etc. automatically to the total for that amount. It has nutritional information for many restaurants, but mostly national chain fast-food. It also has a calculator to adjust your nutritonal needs where you can enter your gender/age/height/weight/lifestyle (sedentary, active, very active, etc.) and adjust accordingly. For example, based on my height/weight/age/lifestyle, my daily energy expenditure is ~4100 calories. A 2500 calorie diet is not something I can sustain for more than a couple of days.

 

If you are a very active athlete who exercises and sweats a lot, you do need to increase your sodium intake a little above USRDA. As for flavor, one thing I like to season/marinate/flavor my food with is lime juice. Just about anything sauteed in lime juice tastes better (including asparagus, beet leaves, spinach), and it adds no sodium.

[Baldkin]

Mrs Dash is your friend, for quick, easy way to add flavor to almost anything.

[logan82]

Penzey's has a lot of salt free seasonings. Price wise they are not to far out of line with your regular store bought seasonings.

[hawing]

There are no particular sodium restrictions in my household (knock on wood), but my S.O. is diabetic, and for him carbs are the big deal. One source we've found useful, especially when eating away from home, is Calorie King (http://www.calorieking.com/, available online, or in book/Kindle form. It gives nutritional information for all kinds of foods and restaurant menu items - and it's not limited to national brands (Milio's Sandwiches is included, and I think they are just regional).

 

We consult it for carb counts, but sodium content is there too. I downloaded the Kindle version to an older iPod touch that we don't use for anything else, just to have it when we need it.

[1992casey]

Thanks for all the great suggestions. I'll definitely spend some time on the website that LouisEly recommends, especially for evaluating recipies. And I'll grab the Kindle book that hawing has mentioned.

 

Someone mentioned Penzey's to me previously, but I forgot the name of the place, so I'm glad that logan82 brought that up. I see that there's a location that's very convenient for me.

 

And I'm glad that Baldkin mentioned Mrs. Dash. I had seen those products mentioned, but they kind of slipped my mind. I see that besides being sodium-free, their products aren't loaded with garbage. Because this is a widely recognized brand, I'd bet on the products being easy to find.

 

nate82's corn tortilla suggestion is a good one. The idea definitely appeals to me, but this person is set in his ways and may take some convincing. I may come up with something that'll appeal to him, though.

 

I'm also intrigued by rwa12's Greek Yogurt suggestion. I'm not sure that I'll be able to get this person to smear it on a sandwich, but I'm definitely going to try it in chicken or potato salad.

 

Going back to what RoCoBrewfan says about the taste of salt becoming undesirable, I definitely think that lightly salted potato chips taste better than the "standard" product.

 

And LouisEly makes a good point about times where sodium can be beneficial in situations where you might be encountering with dehydration. If you're dealing with diarrhea, for instance, and there isn't a lot of appetite to begin with, a can of Campbell's Chicken Noodle soup might be appropriate and would fit within one's daily limit. On most days, however, that'd be a total waste as you'd rather allocate your sodium intake to something else.

[logan82]

If you are going to go to Penzey's I recommend signing up for their catalog. You get one every other month and it usually has a coupon for a free 1/4 cup jar of some seasoning or other. You usually have to buy something but usually only $10 at most.

[LouisEly]

Sounds like you're trying to take care of an older family member. I know how challenging that can be. My grandmother was in the hospital recently, has high blood pressure, and she said when they served her a meal with a lettuce salad, "They didn't give me any salt to put on my lettuce - how can you eat lettuce without any salt?" My grandmother doesn't like taking vitamins because of the size of the tablets and has had issues with diarrhea, so I bought her liquid vitamins two years ago. I've stopped asking her if she needs more because she doesn't use them.

[1992casey]

Yeah, it's an older family member. His main symptom is edema (fluid retention). The reduced sodium diet seems to be helping to control that.

 

I stopped adding salt at the table years ago when my grandmother complained that she couldn't taste anything after she was told to do that. I decided that I didn't want to end up having that happen, so I may as well get used to not adding salt.

 

This family member has never added salt at the table, so that's a huge plus. His issue is some of the other junk he likes to eat, so I help him "budget it in" here and there.

 

The big pain is that many things that you want to do work against each other. What's good for the heart is bad for the kidneys (and vice versa), so that has to be balanced. And with food, if you're dealing with cholesterol, you'll find that lower fat alternatives tend to have more sodium than the non-reduced fat versions. I go for aggressively controlling the salt and using common sense with cholesterol.

[hawing]

Not fully on topic, but the observation above that once you get used to eating less sodium, you really notice the most salty foods resonated with me. When I went to college, I didn't bring a salt shaker. I wasn't consciously trying to eat less salt, just didn't bring one. By the time I was out of college, I was used to going without for most foods, and some foods are just plain too salty for me now. Our household now has salt and pepper shakers, but we hardly ever refill them.

 

Except for corn on the cob. I still salt corn on the cob.

[1992casey]

I put pepper on corn on the cob. At home, the pepper comes from a grinder rather than a shaker, but I'm not too snooty to use a shaker when that's the available option.

[logan82]

I don't add anything to corn on the cob. We don't have a salt shaker in our house. The only salt added gets added when a dish is made. Of course we probably counteract that with to many processed foods.

[1992casey]

I can easily eat corn on the cob without the pepper.

 

I mentioned that a lot of products list serving sizes that are ridiculously small. I see that Tabasco Sauce is the opposite. A "serving" is one teaspoon, which is a heck of a lot of Tabasco for most people.

 

A teaspoon of Tabasco has 30mg of sodium; I see potential for using it since you get mass quantities of flavor with a small quantity. The main issue I see is that the flavor is so distinctive that if one used it too often, things would taste the same and become boring.

 

Logan, I bet a lot of people out there add salt to their processed foods, so you're probably still ahead of a good segment of the population.

[1992casey]

The doctor says that eating a brat at a Brewers' game contributes to "quality of life."

 

Actually, I estimate that a brat on a bun with a squirt of Koop's mustard (but no sauerkraut) amounts to about 1000mg, or 2/3 of a heart patient's daily maximum. There's room if you budget for it.

 

The other night, we brought salad dressing to a restaurant. Based on the server's reaction, it was obvious that she had seen that done before. I think that in the future, we may bring ketchup too.

 

Butter and margarine are a drag. The amount of sodium is OK when you're sticking to one "serving." But it adds up fast when you use it normally at the table. There's unsalted butter and no-salt margarine, but they come in sticks, and sticks tend to be higher in fat than softened alternatives.

 

I made some soft margarine from no-salt sticks. To do this, use two sticks of no-salt margarine, a quarter cup of skim milk, and whip using a hand mixer with a whisk attachment. Aside from being messy, it's an easy process. I covered as much of the bowl as possible with a paper towel to keep stuff from flying everywhere. I can't imagine keeping this very long, so I tried freezing some. I just thawed the frozen container, but I haven't tried using it.

 

You use less product if it's softened because whipping adds air and it's easier to spread. Sodium is a non-factor because the skim milk adds a total of about 30mg to the entire 16 tablespoon batch (plus the volume benefit you get from whipping).

 

I picked up liquid squirt margarine, which advertises 0mg sodium and no fat. However, the 0mg sodium is asterisked; 5 squirts would have 15mg. And it actually took 25–30 squirts to cover a piece of toast. That's better sodium-wise than store-bought soft margarine, but given that it's a pain in the butt to use, I'd be surprised if I bought it again. Plus, the stuff isn't cheap.

[rondoman]

http://chriskresser.com/shaking-up-the-salt-myth-the-dangers-of-salt-restriction

 

I dont know if this applies to your situation but salt restriction has actually shown to cause more issues. Too little salt can be as bad as too much.

 

 

Multiple studies show that salt restriction causes adverse effects on health:

 

Increased LDL and Triglycerides: In a massive review, low sodium diets were found to cause an increase in LDL (the “bad” cholesterol) by 4.6% and an increase in triglycerides by 5.9% (12).

 

Insulin resistance: In one study, just 7 days on a low sodium diet increased insulin resistance, a leading cause of obesity, diabetes and metabolic syndrome (13).

 

Type II Diabetes: A study found that in patients with type II diabetes, less sodium was associated with an increased risk of death (14).

 

Hyponatremia: In athletes, a low sodium intake can cause hyponatremia, a sodium deficiency which can be very dangerous (15).

[DHonks]

I've never gotten why some people douse their food with salt. The only thing I've ever salted was Culvers french fries, and that's because they ALWAYS need it.

[1992casey]

Interesting stuff, rondoman. The information you linked to certainly bucks the majority opinion. Then again, the doctor's background is far from traditional.

 

In our particular case, the doctor says not to be concerned about a daily minimum. He probably figures that it's pretty easy to stumble into an amount that's adequate for this person.

 

Edema (fluid retention) has been under control since aggressively cutting back sodium; it was completely out of control before that. It's possible that the oral medication might be having a positive effect, but I don't think it's doing a bit of good. The only way to be able to tell for sure is to experiment with cutting back on the drug. The doctor has given the go-ahead to try that.

[mothershipconnection]

Then again, the doctor's background is far from traditional.

 

An acupuncture practitioner is less of a "doctor" than a PhD in Chinese Literature (as they don't have a doctorate or medical training). If your doctor advises something and you're unsure, the solution is a second opinion from another doctor.

[rondoman]

http://blogs.laweekly.com/squidink/2013/05/low-sodium_diet_may_actually_b.php

 

 

There's actually plenty of info that suggests too little salt is harmful.

[1992casey]

The Institute of Medicine study linked to in the message above would certainly be a good topic for discussion with one's doctors.

 

As one ages, quality of life increasingly becomes the focus. Being able to eat one's favorite foods certainly contributes to one's quality of life. Addressing an obnoxious symptom also contributes to life quality. Fluid retention is uncomfortable, can cause shortness of breath, and can make it difficult to wear shoes.

 

So it's a trade-off. Because reducing sodium seems to really help with fluid retention, it makes sense to do it. Reducing fluid would trump eating what pleases you or considering the possible benefits of not reducing sodium at all.

 

On the other hand, blood pressure is simply a risk issue as it doesn't have symptoms. If this were the only issue, we'd probably be less inclined to be dealing with diet. And there'd be more room to debate the benefits of sodium (or the lack thereof) in one's diet.

 

Anyway, here are some "no salt added" spaghetti sauces:

 

[list-sp]

• Eden Organic Spaghetti Sauce (no salt added)… available at Outpost… about $4.50 per jar
  
• Walnut Acres Pasta Sauces (no salt added)… comes in Tomato & Basil, Marinara & Herbs, Olive Oil & Garlic… available at Whole Foods… about $7.00 per jar

[/list-sp]

I haven't decided which one tastes the best. A side by side comparison might be necessary.

 

And here's a really tasty low sodium waffle recipe:

 

• Whole Wheat Waffles

 

The key to the sodium content in the waffles is the Hain Featherweight Baking Powder (no sodium). It's allegedly available in Milwaukee, but I haven't found it. I ordered some from Amazon.

 

Baking power and baking soda are the main reasons that baked goods have very high sodium content. No sodium baking powder can (allegedly) be substituted for regular baking powder in any recipe. No sodium baking soda alternative can be substituted for baking soda, but the amount should be doubled. I haven't done anything with baking soda yet.

 

By the way, the waffles are really, really good. If you're not watching sodium and want to try them with regular baking powder, I'd recommend them just for the taste.

 

Most pancake syrups are really high in sodium. "Real" maple syrup has only a trace. I've noticed that some maple syrups add potassium. I don't know what purpose it serves; maybe it's a preservative.

 

Previously, I mentioned that I had made up some soft margarine from no sodium sticks but that I didn't know what happened after it was frozen. It turns out that it thaws just fine, so you can make up a bunch of it and save on the mess factor. I did notice that it's hard to get the milk to blend. Before putting it into containers, I've been scooping the portions onto a plate first. That avoids a puddle of milk in the container once you actually put it to use.