Patient education: Low-sodium diet (The Basics)

What is sodium? — Sodium is the main ingredient in table salt. It is also found in lots of foods. The body needs a very small amount of sodium to work normally, but most people eat much more sodium than their body needs.

Who should eat less sodium? — Nearly everyone eats too much sodium. The average American takes in 3400 milligrams of sodium each day. Experts say that most people should have no more than 2300 milligrams a day.

Some people with certain health conditions should follow a low-sodium diet. Ask your doctor how much sodium you should have.

Why should I eat less sodium? — Reducing the amount of sodium you eat can have lots of health benefits:

●It can lower your blood pressure. This means it can help lower your risk of stroke, heart attack, kidney damage, and lots of other health problems.

●It can reduce the amount of fluid in your body, which means that your heart doesn't have to work as hard

●It can keep the kidneys from having to work too hard. This is especially important in people who have kidney disease.

●It can reduce swelling in the ankles and belly, which can be uncomfortable and make it hard to move

●It can lower the chances of forming kidney stones

●It can help keep your bones strong

Which foods have the most sodium? — Processed foods have the most sodium. These foods usually come in cans, boxes, jars, and bags. They tend to have a lot of sodium even if they don't taste salty. In fact, many sweet foods have a lot of sodium in them. The only way to know for sure how much sodium you are eating is to check the label (figure 1).

Here are some examples of foods that often have too much sodium:

●Canned soups

●Rice and noodle mixes

●Sauces, dressings, and condiments (such as ketchup and mustard)

●Pre-made frozen meals (also called "TV dinners")

●Deli meats, hot dogs, and cheeses

●Smoked, cured, or pickled foods

●Salted snack foods and nuts

●Restaurant meals

What should I do to reduce the amount of sodium in my diet? — Many people think eating a low-sodium diet just means not adding salt to their food. But this is not true. Not adding salt at the table or when cooking will help a little. But almost all of the sodium you eat is already in the food you buy at the grocery store or at restaurants (figure 2).

Here are some tips to help you eat less sodium:

●Avoid processed foods when possible. This is the most important thing you can do to eat less sodium. Processed foods include most foods that are sold in cans, boxes, jars, and bags.

●Instead of buying pre-made, processed foods, buy fresh or fresh-frozen fruits and vegetables. ("Fresh-frozen" means the food is frozen without anything added to it.)

●Buy meats, fish, chicken, and turkey that are fresh instead of canned or sold at the deli counter. (Meats sold at the deli counter are high in sodium.)

●Try to eat at restaurants less often

●When possible, try to make meals from scratch at home using fresh ingredients

●If you do need to buy canned or packaged foods, choose ones that are labeled "sodium-free" or "very low sodium" (table 1). Or choose foods that have less than 400 milligrams of sodium in each serving. The amount of sodium in each serving appears on the nutrition label that is printed on canned or packaged foods (figure 1).

The table has some examples of foods to avoid and foods to choose instead (table 2).

Whatever changes you make, make them slowly. Choose 1 thing to do differently, and do that for a while. If you can keep doing that change easily, add another change. For instance, if you usually eat green beans from a can, try buying fresh or fresh-frozen green beans and cooking them at home without adding salt. If that works for you, keep doing it. Then choose another thing to change.

If you try making a change and it doesn't work right away, don't give up. See if you can reduce sodium in other ways. The important thing is to take small steps and to keep doing the changes that work for you.

Can I still eat out at restaurants sometimes? — One of best ways to limit your sodium is to only eat out at restaurants every once in a while. When you do eat out, try to choose places that offer healthier choices and fresh ingredients.

No matter where you eat, when choosing what to order:

●Ask your server if your meal can be made without salt

●Avoid foods that come with sauces or dips

●Choose plain grilled meats or fish and steamed vegetables

●Ask for oil and vinegar for your salad, rather than dressing

●If a meal you really want has more sodium than you should have, consider saving half of it to eat another day

What if food just does not taste as good without sodium? — Starting a low-sodium diet can be hard. The good news is your taste buds can get used to having less sodium. But you have to give them some time to adjust.

It can also help to try other ways to add flavor to your foods. Try things like herbs, spices, lemon juice, and vinegar.

What about salt substitutes? — Flavoring your food with a salt substitute is a good way to reduce how much salt you eat. But check with your doctor or nurse before trying this. Some salt substitutes can be dangerous if you have certain health problems or take certain medicines.

Do medicines have sodium? — Yes, some medicines have sodium. If you are buying medicines you can get without a prescription, look to see how much sodium they have. Avoid products that have "sodium carbonate" or "sodium bicarbonate" unless your doctor prescribes them. (Sodium bicarbonate is baking soda.)

More on this topic

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Patient education: Diet for people with nondialysis chronic kidney disease (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Stroke (The Basics)
Patient education: Kidney stone diet (The Basics)
Patient education: Diet for adults with cirrhosis (The Basics)

Patient education: Low-sodium diet (Beyond the Basics)