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Sodium Restriction

We all need to consume some sodium every day to help our bodies function properly. But certain medical conditions, including heart failure, require a decreased intake of this nutrient.

Sodium can act like a sponge in our bodies, causing extra fluid to build up in the blood and body tissues. This extra fluid creates more work for the heart. It also can make symptoms such as high blood pressure and fluid buildup around the ankles and in the abdomen much worse.

A low sodium diet can help to decrease fluid buildup in the body.

Limit your sodium intake to 2 grams, or 2,000 milligrams (mg), per day.

Much of our sodium intake comes from table salt. Here are the approximate amounts of sodium in a given amount of table salt:

  • One shake of a salt shaker = 200 mg sodium
  • 1/4 teaspoon salt = 575 mg sodium
  • 1/2 teaspoon salt = 1,150 mg sodium
  • 3/4 teaspoon salt = 1,725 mg sodium
  • 1 teaspoon salt = 2,300 mg sodium

There are many things you can do to reduce the amount of sodium in your diet.

1. Avoid adding salt to food at the table or while cooking.

2. Avoid commercially prepared and packaged foods whenever possible.

  • Frozen entrees, pizzas, and boxed pasta/macaroni and cheese; rice, noodle, and stuffing mixes with seasoning packets

3. Limit intake of highly processed or salty snacks.

  • Crackers, chips, pretzels, popcorn, nuts, cheeses

4. Limit canned foods.

  • Canned vegetables, beans, soups, sauces, gravy mixes, and salted fish

5. Stay away from fast food items.

  • Chinese food, French fries

6. Use sauces, gravies, and condiments sparingly.

  • Soy sauce, teriyaki sauce, steak sauce, Worcestershire sauce, salad dressings, ketchup, barbeque sauce, hot sauce, pickles, and olives.

7. Limit processed deli meats and cheeses.

  • Ham, bacon, sausage, cold cuts, hot dogs

8. Limit beverages that are high in sodium.

  • Tomato juice and vegetable juice cocktail

9. Be aware that baking powder and baking soda contain sodium too.

10. Read all nutrition labels carefully for sodium content. Pay special attention to serving size and servings per container.

11. Seek out lower sodium versions of traditionally high sodium items by looking for the following phrases on food labels:

  • Sodium-free: almost no sodium
  • Very low-sodium: 35 mg or less in each serving
  • Low-sodium: 140 mg or less in each serving
  • Reduced sodium: look for percentage
  • Unsalted, no salt added or without added salt

Most people with heart failure must limit their daily sodium intake to less than 2,000 milligrams (mg) per day.

In order to stick to your limit, you’ll need to know how much sodium is in the foods you eat. This information can be found on packaged food labels.

When evaluating the label for sodium content, pay special attention to serving size and servings per container. The amount of sodium listed is per serving—not for the whole package. If you eat more or less than what the manufacturer considers one serving, you’ll have to do the math.

Let’s use this food label as an example:

Serving size = 1 cup

Servings per container = 2

Sodium = 470 mg

If you eat the entire container (2 cups) of this food, you will have consumed

470 mg x 2 = 940 milligrams of sodium

Another number on the nutrition label that can be misleading is the percent of daily value (% DV). When it comes to sodium, this percentage is based on 2,400 mg a day, not your goal of 2,000 mg. That means the sodium in a serving is actually a higher percentage of your daily limit than what is listed on the label.

Try to select meals that have 600 mg or less sodium per serving and snacks that have 200 mg or less sodium per serving.

This table will help you find foods to choose and avoid in major food categories.

Ask plenty of questions. You are paying to eat out so do not hesitate to ask about how items are prepared. Whenever possible, ask for your choices to be made without salt.

Avoid any entree or side dish with cream, cheese, or seasoned sauces. Request items plain or if necessary, with sauces/dressings on the side.

Keep it simple. Choose grilled, baked, or broiled fish, poultry, or meats.

For dessert, try fresh fruit.

When cutting down on the amount of salt (sodium) in your diet, you may be tempted to reach for a salt substitute. You’ll find many varieties of salt substitute in the spice aisle in your local grocery store. But if you have heart failure, you’ll need to exercise some caution.

Some salt substitutes are a harmless mixtures of dried herbs. But others contain potassium, a mineral that can be dangerous for people with heart failure.

Potassium is essential in helping your body control the electrical balance of your heart as well. But too much potassium can cause dangerous heartbeat irregularities and even sudden death. Some of the drugs you may be taking for heart failure can upset the balance of this mineral in your body. For example, ACE inhibitors, angiotensin-receptor blockers, and aldosterone blockers can cause your body to hold on to excessive levels of this mineral.

Before you reach for the salt-substitute, check with your doctor to make sure it’s safe for you to use.