What is a low sodium diet

Low sodium diet is generally considered to be between 1,500 to 2,300 milligrams of sodium per day ¹. 1,500 milligrams (mg) sodium lowers blood pressure even further than 2,300 mg sodium daily. Societies with a low-sodium diet have been observed to have a relatively low prevalence of hypertension ² and dietary sodium reduction could reduce blood pressure in not only hypertensive but also normotensive and prehypertensive individuals ³. A research study that follows over time groups of individuals investigating the effects of sodium intake on cardiovascular mortality have shown positive associations between dietary sodium intake and the risk of stroke ⁴ and coronary heart disease ⁵. If you have high blood pressure or heart, liver, or kidney problems, your health care provider may suggest you lower your sodium intake. Even people with normal blood pressure will have lower and healthier blood pressure if they lower how much salt they eat. Table salt is a combination by weight of about 40 percent sodium and 60 percent chloride. A single teaspoon of table salt, which is a combination of sodium and chloride, has 2,325 milligrams (mg) of sodium. To convert sodium to salt, you need to multiply the sodium amount by 2.5. For example, 1 gram (1,000 milligrams) of sodium per 100 g is 2.5 grams of salt per 100g.

Here are the approximate amounts of sodium in a given amount of table salt:

• 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

The American Heart Association recommends no more than 2,300 milligrams (mg) of sodium a day (equal to about 6g of salt or a teaspoon of salt) and moving toward an ideal limit of no more than 1,500 mg per day for most adults. Because average American eats so much excess sodium, even cutting back by 1,000 milligrams a day can significantly improve your blood pressure and heart health. And remember, more than 70 percent of the sodium Americans eat comes from packaged, prepared and restaurant foods — not the salt shaker.

People get most of the sodium in their diet from canned, prepared, and packaged foods. Fast food and restaurant meals also are very high in sodium. If you’re on a low sodium diet because of high blood pressure, heart failure, kidney or liver problems, your doctor will probably limit your sodium to less than 1,500 milligrams (mg) a day. This limit counts all the sodium in prepared and packaged foods and any salt you add to your food.

Dietary sodium is measured in milligrams (mg). Your health care provider may tell you to eat no more than 2,300 mg a day when you have these conditions. For some people, 1,500 mg a day is an even better goal.

Insufficient sodium intake isn’t a public health problem in the United States. The guideline to reduce sodium to 1,500 mg doesn’t apply to people who lose big amounts of sodium in sweat, like competitive athletes, and workers exposed to major heat stress, such as foundry workers and fire fighters, or to those directed otherwise by their healthcare provider. If you have a medical conditions or other special dietary needs or restrictions, you should follow the advice of a qualified healthcare professional.

On average, Americans eat more than 3,400 milligrams of sodium each day — much more than the American Heart Association and other health organizations recommend. Most of people are likely underestimating how much sodium they eat, if they can estimate it at all. One study found that one-third of adults surveyed couldn’t estimate how much sodium they ate, and more than half thought they were eating less than 2,000 mg sodium a day.

Keeping sodium in check is part of following an overall healthy eating pattern. The American Heart Association diet emphasizes fruits, vegetables, whole grains, legumes, nuts, plant-based protein, lean animal protein and fish. Replace processed meats, refined carbohydrates and sweetened beverages with healthier options. Eating this way should help you limit your sodium as well as harmful fats.

Avoid high-sodium foods

Avoid eating:

• Smoked, cured, salted, and canned meat, fish, and poultry.
• Ham, bacon, hot dogs, and luncheon meats.
• Regular, hard, and processed cheese and regular peanut butter.
• Crackers with salted tops, and other salted snack foods such as pretzels, chips, and salted popcorn.
• Frozen prepared meals, unless labelled low-sodium.
• Canned and dried soups, broths, and bouillon, unless labelled sodium-free or low-sodium.
• Canned vegetables, unless labelled sodium-free or low sodium.
• French fries, pizza, tacos, and other fast foods.
• Pickles, olives, ketchup, and other condiments, especially soy sauce, unless labelled sodium-free or low-sodium.

The body needs only a small amount of sodium (less than 500 milligrams of sodium per day) to function properly. That’s a mere smidgen — the amount in less than ¼ teaspoon. Very few people come close to eating less than that amount. Plus, healthy kidneys are great at retaining the sodium that your body needs. There’s no reliable evidence that eating less than 1,500 mg per day of sodium is a risk for the general population. There is some evidence that it could be harmful to certain patients with congestive heart failure.

Too much sodium in your diet can be bad for you. Too much sodium causes your body to hold on to extra water. This can raise your blood pressure and force your heart and kidneys to work harder. In very serious cases, this could cause you to be put in the hospital. It might even be life-threatening. By limiting sodium, you will feel better and lower your risk of serious problems. If you have high blood pressure or heart failure, you may be asked to limit the amount of salt you eat every day.

Is sea salt or kosher salt healthier than table salt?

Foodies and chefs may prefer kosher or sea salts for their taste, texture or color. But table salt, kosher salt and most sea salts all contain about 40 percent sodium by weight. Even though sea salt may have some trace levels of minerals like magnesium, potassium and calcium, the amounts are tiny and you can get them from other healthy foods.

Some varieties of sea salt may have less sodium than table salt. You can check the Nutrition Facts label to compare how a given sea salt compares to table salt, which has about 575 mg sodium per ¼ teaspoon.

How much sodium in a low sodium diet?

Low sodium diet is generally considered to be between 1,500 to 2,300 milligrams of sodium per day ¹. 1,500 milligrams (mg) sodium lowers blood pressure even further than 2,300 mg sodium daily. Because up to 75 percent of the sodium you consume is hidden in processed foods, by paying close attention to food labels when you shop, you can consume less sodium. It’s much more difficult to limit sodium when it’s already added before it’s bought. Going for less-processed foods and making more meals at home are great ways to help control the sodium you eat. Watch for the words “soda” and “sodium” and the symbol “Na” on labels, which mean sodium compounds are present. Sodium is found naturally in many foods. But processed foods account for most of the salt and sodium that Americans consume. Processed foods that are high in salt include regular canned vegetables and soups, frozen dinners, lunch meats, instant and ready-to-eat cereals, and salty chips and other snacks. Use food labels to help you choose products that are low in sodium. As you read food labels, you may be surprised that many foods contain sodium, including baking soda, soy sauce, monosodium glutamate (MSG), seasoned salts, and some antacids.

The top six sodium sources in the U.S. diet include:

1. Breads and Rolls
2. Pizza
3. Sandwiches
4. Cold Cuts and Cured Meats
5. Soup
6. Burritos and Tacos

That’s a pretty surprising list. Some of these don’t even taste salty. Keep in mind that different brands and restaurants may make versions of the same foods with different sodium levels. Compare labels and choose the product with the lowest amount of sodium you can find in your store.

Here are some examples of ingredients that contain sodium:

• Disodium guanylate (GMP)
• Disodium inosinate (IMP)
• Fleur de sel
• Himalayan pink salt
• Kosher salt
• Monosodium glutamate (MSG)
• Rock salt
• Salt
• Sea salt
• Sodium bicarbonate
• Sodium nitrate
• Sodium citrate
• Sodium chloride
• Sodium diacetate
• Sodium erythorbate
• Sodium glutamate
• Sodium lactate
• Sodium lauryl Sulfate
• Sodium metabisulfite
• Sodium phosphate
• Trisodium phosphate

Eating a variety of foods every day can help you limit salt. Try to eat a balanced diet.

Buy fresh vegetables and fruits whenever possible. They are naturally low in salt. Canned foods often contain salt to preserve the color of the food and keep it looking fresh. For this reason, it is better to buy fresh foods. Also buy:

• Fresh meats, chicken or turkey, and fish
• Fresh or frozen vegetables and fruits

Tips for lowering sodium when shopping, cooking, and eating out

Shopping

• Read food labels, and choose items that are lower in sodium and salt, particularly for convenience foods and condiments.*
• Choose fresh poultry, fish, and lean meats instead of cured food such as bacon and ham.
• Choose fresh or frozen versus canned fruits and vegetables.
• Avoid food with added salt, such as pickles, pickled vegetables, olives, and sauerkraut.
• Avoid instant or flavored rice and pasta.

Look for these words on food labels: 

• Sodium-free – Less than 5 milligrams of sodium per serving and contains no sodium chloride
• Very low sodium – 35 milligrams or less per serving
• Low sodium – 140 milligrams or less per serving
• Reduced (or less) sodium – At least 25 percent less sodium per serving than the usual sodium level
• Light (for sodium-reduced products) – If the food is “low calorie” and “low fat” and sodium is reduced by at least 50 percent per serving
• Light in sodium – If sodium is reduced by at least 50 percent per serving

Check all labels for how much salt foods contain per serving.

Ingredients are listed in order of the amount the food contains. Avoid foods that list salt near the top of the list of ingredients. A product with less than 100 mg of salt per serving is good.

Buy foods that are labelled “unsalted” (no salt added), “sodium-free” (less than 5 mg of sodium per serving), or “low-sodium” (140 mg or less of sodium per serving). Foods labelled “reduced sodium” and “lightly salted” may still have too much sodium. Be sure to read the label to see how much sodium you are getting.
Buy fresh vegetables, or frozen vegetables without added sauces. Buy low-sodium versions of canned vegetables, soups, and other canned goods.

Remember: Sodium levels vary in the same foods depending on the brand or restaurant.

Salty foods to watch out for:

• Sausages
• Bacon
• Ham
• Pastries
• Pizza
• Cheese
• Crisps
• Salted nuts
• Gravy
• Brown sauce
• Soy sauce
• Mustard and ketchup

Stay away from foods that are always high in salt. Some common ones are:

• Processed foods, such as cured or smoked meats, bacon, hot dogs, sausage, bologna, ham, and salami
• Anchovies, olives, pickles, and sauerkraut
• Soy and Worcestershire sauces, tomato and other vegetable juices, and most cheeses
• Many bottled salad dressings and salad dressing mixes
• Most snack foods, such as chips, crackers, and others

When you cook, replace salt with other seasonings. Pepper, garlic, herbs, and lemon are good choices. Avoid packaged spice blends. They often contain salt.

Use garlic and onion powder, not garlic and onion salt. DO NOT eat foods with monosodium glutamate (MSG).

When you go out to eat, stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese. If you think the restaurant might use MSG, ask them not to add it to your order.

Use oil and vinegar on salads. Add fresh or dried herbs. Eat fresh fruit or sorbet for dessert, when you have dessert. Take the salt shaker off your table. Replace it with a salt-free seasoning mix.

Ask your provider or pharmacist what antacids and laxatives contain little or no salt, if you need these medicines. Some have a lot of salt in them.

Home water softeners add salt to water. If you have one, limit how much tap water you drink. Drink bottled water instead.

Ask your provider if a salt substitute is safe for you. Many contain a lot of potassium. This may be harmful if you have certain medical conditions or if you are taking certain medicines. However, if extra potassium in your diet would not be harmful to you, a salt substitute is a good way to lower the amount of sodium in your diet.

Shop for lower salt foods

When shopping for food, you can take steps to cut your salt intake:

• Compare nutrition labels on food packaging when buying everyday items. You can really cut your salt intake by checking the label and choosing the pizza, ketchup or breakfast cereal that’s lower in salt. Try choosing 1 food a week to check and swap when you’re food shopping.
• Go for reduced-salt unsmoked back bacon. Cured meats and fish can be high in salt, so try to eat these less often.
• Buy tinned vegetables without added salt. Do the same with tinned pulses.
• Watch out for the salt content in ready-made pasta sauces. Tomato-based sauces are often lower in salt than cheesy sauces or those containing olives, bacon or ham.
• For healthier snacks, choose fruit or vegetables such as carrot or celery sticks. If you are going to have crisps or crackers, check the label and choose the ones lower in salt. Don’t forget to check the fat and sugars content, too.
• Go easy on soy sauce, mustard, pickles, mayonnaise and other table sauces, as these can all be high in salt.

Cook with less salt

Many people add salt to food when they’re cooking. But there are lots of ways to add flavor to your cooking without using any salt.

Check out these salt alternatives:

• Use black pepper as seasoning instead of salt. Try it on pasta, scrambled egg, pizza, fish and soup.
• Add fresh herbs and spices to pasta dishes, vegetables and meat. Try garlic, ginger, chilli and lime in stir fries.
• Make your own stock and gravy instead of using cubes or granules, or look out for reduced-salt products.
• Try baking or roasting vegetables such as red peppers, tomatoes, courgettes, fennel, parsnips and squash to bring out their flavour.
• Make sauces using ripe tomatoes and garlic.

Eating out

If you’re eating in a restaurant or cafe, or ordering a takeaway, you can still eat less salt by making smart choices of lower-salt foods.

• Pizza: choose vegetable or chicken toppings instead of pepperoni, bacon or extra cheese.
• Pasta dishes: choose one with a tomato sauce with vegetables or chicken, rather than bacon, cheese or sausage.
• Burgers: avoid toppings that can be high in salt, such as bacon, cheese and barbecue sauce, and opt for salad instead.
• Chinese or Indian meal: go for plain rice. It’s lower in salt than pilau or egg fried rice.
• Sandwiches: instead of ham or cheddar cheese, go for fillings such as chicken, egg, mozzarella, or vegetables like avocado or roasted peppers. And try having salad and reduced-fat mayonnaise instead of pickle or mustard, which are usually higher in salt.
• Breakfast: instead of a full English breakfast, go for a poached egg on toast with mushrooms and grilled tomatoes. If you do have meat, have either bacon or a sausage, but not both.
• Salad: ask for dressings or sauces on the side, so you only have as much as you need. Some dressings and sauces can be high in salt and fat.

Foods that contain salt

Some foods are almost always high in salt because of the way they are made.

Other foods, such as bread and breakfast cereals, can contribute a lot of salt to our diet. But that’s not because these foods are always high in salt – it’s because we eat a lot of them.

High-salt foods

The following foods are almost always high in salt. To cut down on salt, eat them less often and have smaller amounts:

• anchovies
• bacon
• cheese
• gravy granules
• ham
• olives
• pickles
• prawns
• salami
• salted and dry-roasted nuts
• salt fish
• smoked meat and fish
• soy sauce
• stock cubes
• yeast extract

Foods that can be high in salt

In the following foods, the salt content can vary widely between different brands or varieties.

That means you can cut down on salt by comparing brands and choosing the one that is lower in salt. Nutrition labels can help you do this.

These foods include:

• bread products such as crumpets, bagels and ciabatta
• pasta sauces
• crisps
• pizza
• ready meals
• soup
• sandwiches
• sausages
• tomato ketchup, mayonnaise and other sauces
• breakfast cereals

Soluble vitamin supplements and painkillers

If you routinely take an effervescent (dissolvable) vitamin supplement, or take effervescent painkillers when necessary, it’s worth remembering that these can contain up to 1g salt per tablet. You may therefore wish to consider changing to a non-effervescent tablet, particularly if you have been advised to watch or reduce your salt intake.

Why is there so much sodium in the food supply?

Sodium plays many roles on your plate. Adding flavor is probably its most well-known function. It can also be used as a preservative to keep food safe, enhance a food’s color or give it a firmer texture. For example, sodium in the form of baking soda (sodium bicarbonate) is used to help bread and other baked goods rise. Even though sodium plays a key role in many foods, more salt is often added than is necessary.

Unfortunately, more than 70% of the sodium we eat is hidden. The good news is that momentum to lower sodium is building. Many food companies and some restaurants are tweaking their recipes to cut the sodium.

Benefits of low sodium diet

Eating less sodium can reduce your risk for high blood pressure and bloating,and stave off other effects of too much salt. And did you know that reducing sodium in the food supply could save money and lives?

One estimate suggested that if Americans moved to an average intake of 1,500 mg/day sodium, it could result in a 25.6 percent overall decrease in blood pressure and an estimated $26.2 billion in health care savings.

Another estimate projected that achieving this goal would reduce deaths from cardiovascular disease by anywhere from 500,000 to nearly 1.2 million over the next 10 years.

Sodium is a mineral that’s essential for life. It’s regulated by your kidneys, and it helps control your body’s fluid balance. It also helps send nerve impulses and affects muscle function.

When there’s extra sodium in your bloodstream, it pulls water into your blood vessels, increasing the total amount (volume) of blood inside them. With more blood flowing through your blood vessels, blood pressure increases. It’s like turning up the water supply to a garden hose — the pressure in the hose increases as more water is blasted through it.

Over time, high blood pressure may overstretch or injure the blood vessel walls and speed the build-up of gunky plaque that can block blood flow. The added pressure tires out the heart by forcing it to work harder to pump blood through the body. And the extra water in your body can lead to bloating and weight gain.

High blood pressure is known as the “silent killer” because its symptoms are not always obvious. It’s one of the major risk factors for heart disease, the No. 1 killer worldwide. Almost no one gets a free pass. Ninety percent of American adults are expected to develop high blood pressure over their lifetimes.

Did you know that sodium can affect your blood pressure even more dramatically if you’re sensitive to salt? Recent science explains that certain factors may influence how your blood pressure changes when you eat salt, such as:

• Age
• Weight
• Race/ethnicity
• Gender
• Some medical conditions (like diabetes or chronic kidney disease)

Even if you don’t already have high blood pressure, eating less sodium can help blunt the rise in blood pressure that occurs with age. It can also reduce your risk of heart attack, heart failure, stroke, kidney disease, osteoporosis, stomach cancer and even headaches.

What can I eat on a low sodium diet

DASH or Dietary Approaches to Stop Hypertension, with a low-sodium diet has the potential to lower blood pressure as well as or better than many anti-hypertension medications ⁶.

DASH is a flexible and balanced eating plan that helps create a heart-healthy eating style for life.

The DASH eating plan requires no special foods and instead provides daily and weekly nutritional goals. This plan recommends:

• Eating vegetables, fruits, and whole grains
• Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
• Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils
• Limiting sugar-sweetened beverages and sweets.

The DASH eating plan is just one key part of a heart-healthy lifestyle, and combining it with other lifestyle changes such as physical activity can help you control your blood pressure and LDL “bad” cholesterol for life.

To help prevent and control high blood pressure:

• Be physically active.
• Maintain a healthy weight.
• Limit alcohol intake.
• Manage and cope with stress.

Other lifestyle changes can improve your overall health, such as:

• If you smoke, quit.
• Get plenty of sleep.

Low sodium diet plan

When following the DASH eating plan, it is important to choose foods that are:

• Low in saturated and trans fats
• Rich in potassium, calcium, magnesium, fiber, and protein
• Lower in sodium

Based on these recommendations, the following table shows examples of daily and weekly servings that meet DASH eating plan.

Table 1. Daily and Weekly DASH Eating Plan Goals for a 2,000-Calorie-a-Day Diet

Footnote: *1,500 milligrams (mg) sodium lowers blood pressure even further than 2,300 mg sodium daily.

Table 2. DASH Eating Plan—Number of Food Servings by Calorie Level

Footnote:

(a) Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

(b) For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

(c) Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

(d) The DASH eating plan has a sodium limit of either 2,300 mg or 1,500 mg per day

Table 3. DASH Eating Plan—Serving Sizes, Examples, and Significance

Footnote:

(a) Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

(b) Serving sizes vary between ½ cup and 1¼ cups, depending on cereal type. Check the product’s Nutrition Facts label.

(c) For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

(d) Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

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