Low Sodium – Cleveland Clinic

According to the Centers for Disease Control and Prevention (CDC), about 6.2 million adults in this country are living with heart failure. This condition occurs when your heart doesn’t pump enough blood or oxygen to help other parts of your body.

While health conditions like diabetes, high blood pressure, coronary artery disease and obesity can increase your risk for heart failure, smoking, drinking heavily, not exercising and eating a diet heavy in saturated fat, sodium and cholesterol can as well.

Registered dietician Anna Taylor, RD, explains how sodium, in particular, affects your heart health and provides a list of low-sodium foods to work into your daily meal plans.

How sodium affects heart health

Sodium is a mineral and it’s naturally found in foods. But it’s added to processed foods, too. While sodium helps keep a normal balance of fluid in your body, those living with heart failure need to follow a low-sodium diet because it helps control symptoms and can prevent other heart problems.

“A low-sodium diet can help control blood volume and blood pressure. Excess sodium intake can lead to fluid retention,” explains Taylor. “Since people with heart failure often suffer from volume overload (which can overwork the heart), a diet low in sodium can help lessen fluid retention, meaning the heart doesn’t have to work so hard.”

High blood pressure can increase your risk for stroke, kidney disease and heart disease, like heart failure. Following a low-sodium diet can help improve blood pressure control, which can reduce your risk of these diseases from developing or worsening.

Why do I need to limit my sodium?

Limiting sodium in your diet can help minimize the amount of extra fluid around your heart and lungs and in your legs. Extra fluid in your body makes your heart work harder and can increase your blood pressure.

Keep in mind that salt and sodium aren’t the same things, though. Salt is a combination of sodium and chloride, and a teaspoon of salt equals 2,300 milligrams (mg) of sodium. While sea salt and kosher salt are less processed than ordinary table salt, they aren’t low in sodium. The amount of sodium is about the same for table salt and sea salt.

How much sodium is allowed for a heart-healthy diet?

Your healthcare provider may suggest sticking between 1,500 mg to 2,000 mg of sodium per day. If you’re wondering how you can start cutting down on sodium, try taking the salt shaker off the table, as 1 teaspoon of table salt equals 2,300 mg of sodium.

Also, remember that processed food has a lot of sodium. The majority of sodium in the average American’s diet is from processed foods and convenience foods. The salt shaker is just the tip of the iceberg. So skip the drive-thru and start cooking with fresh ingredients at home. And when you do eat at a restaurant, look for simply prepared foods — the more processed the food is, the more likely it’s high in sodium.

“Look for a baked potato instead of mashed,” says Taylor. “Choose a side salad instead of vegetable soup, since commercial broths are typically 800 mg of sodium per 1 cup. And ask the waiter to skip that bread basket — 1 roll typically contains more than 150 mg of sodium.”

And as you’re adjusting to the changes in your diet, it might help to keep a record of how much sodium you’re eating every day. You can write it down or use a meal tracking app to make things easier.

How to read food labels

Food labels are standardized by the U.S. government’s National Labeling and Education Act (NLEA). If you look at the food label below, you’ll notice that there’s a section that tells you how much sodium is in a serving of food. Pay attention to the following:

A. The sodium content is listed on the food label per serving size.

B. Ignore the % daily value and focus on the amount of mg sodium per serving.

You might also notice that some products are labeled “Low sodium” or “No sodium.” Low sodium means that food has 140 mg or less of sodium per serving. No sodium means that food has less than 5 mg of sodium per serving.

Important nutrition guidelines for a heart-healthy diet

Following a heart-healthy diet made up of high-fiber, low-cholesterol and low-sodium foods can help you maintain or reach a healthy body weight. Foods like fruits, vegetables, beans (legumes) and whole-grain foods also help with digestion and controlling glucose (sugar) levels.

Use fresh ingredients and/or foods with no salt added whenever possible. Fresh fruit, vegetables, meat, poultry and fish are low-sodium foods.

Most frozen vegetables are good alternatives to fresh vegetables. Canned or frozen fruits are acceptable as well. When you’re grocery shopping, choose no-salt-added canned vegetables or rinse canned vegetables before they’re cooked — this will remove a small amount of sodium in the product.

“Unless they have an added sauce or flavor, frozen vegetables rarely have added sodium, making them just as healthy an option as fresh vegetables,” says Taylor. “They are also an economical choice, since they don’t go bad as quickly as fresh produce does.”

For those favorite family recipes, try making healthy swaps for ingredients that are high in saturated fat, sodium and cholesterol and cut down on the amount of salt you add. Salt can be removed from any recipe except those that contain yeast. If you’re worried about not having enough flavor, add fresh herbs and aromatics like leeks, onions, celery, carrots, ginger, garlic, lemon or peppercorns.

Cut down on convenience

Avoid convenience foods such as canned soups, pasta and rice mixes, frozen dinners, instant cereal, puddings and gravy sauce mixes.

If you must choose frozen entrees, select those that contain 600 mg or less of sodium. However, limit these items to one per day. Check the Nutrition Facts label on the package for sodium content.

Avoid canned, cured or smoked meats and items like deli meats.

Sodium guidelines

When selecting foods to eat throughout the day, you want to pay close attention to the number of servings you’re having, while keeping in mind portion control. Here’s a list of foods broken down by food type and the sodium guidelines for each to achieve a good low-sodium diet:

Protein: Choose 2-3 servings per day

• 2-3 ounces of fresh or frozen fish, shellfish, meat (beef, veal, lamb, pork) or poultry.
• 1/2 cup cooked dried beans or peas.
• 1/2 cup low-sodium canned fish (like salmon or tuna).
• 1 egg (no more than three whole eggs per week).

Dairy products: Choose 2 or more servings per day

• 1-1/2 ounces of low-sodium cheese.
• 1 cup milk (nonfat or 1% recommended).
• 1/2 cup low-sodium cottage cheese.
• 1 cup unsweetened soy milk, almond milk or oat milk.

Vegetables and fruits: Choose 5 or more servings per day

• 1/2 cup fresh whole, chopped, cooked, frozen or canned fruit.
• 1/2 cup chopped, cooked, frozen or no-salt-added canned vegetables.
• 1 cup raw leafy vegetables.

Bread and grains: Choose 6 or more servings per day

• Low-sodium whole-grain breads, rolls, bagels and cereals (1 serving = 1 slice bread, 1 small roll, 1/2 bagel, 1/2 English muffin or a 4-inch pita).
• 1/2 cup whole-wheat pasta (noodles, spaghetti, macaroni).
• 1/2 cup brown rice.
• Low-sodium whole-grain crackers (read label for serving size).
• 3 cups low-sodium popcorn.

Fats, oils and condiments (use sparingly)

• Olive oil, canola oil and avocado oil.
• Avocado.
• Unsalted nuts.
• Tub margarines.
• No-salt-added broths.
• Low-sodium salad dressing.
• Homemade gravy without salt.
• Low-sodium ketchup.
• Mustard.
• Low-sodium sauce mixes.

Free foods

• Lemon juice.
• Vinegar.
• Herbs and spices without salt.

Low-sodium diet sample menu

To pull it all together, here’s an example of what a low-sodium diet meal plan might look like in one day for anyone who’s living with heart failure:

Breakfast

• 1 cup fresh fruit.
• 1 slice of whole-wheat bread.
• An egg white omelet made with 1/2 cup egg whites, veggies (mushrooms, bell pepper and onion) and 2 tablespoons shredded low-sodium cheese.

Lunch

• 3 ounces grilled salmon.
• 2-3 cups salad or assorted veggies.
• 1 tablespoon low-sodium dressing.
• 1/2 cup berries.
• 2 tablespoons salt-free slivered almonds.

Dinner

• Grilled chicken.
• Boiled red skin potatoes.
• Steamed fresh vegetables.
• Tossed salad and low-sodium dressing.
• Fresh melon.

Snacks

• 1 cup fresh fruit.
• 1/4 cup unsalted nuts.

Note: For a diet in which you consume 2,000 mg of sodium per day, a sample plan might involve eating 500 mg at breakfast, 250 mg for snacks twice daily, 500 mg for lunch and 500 mg for dinner.

“It takes about three to six weeks for your tastebuds to start to adjust and stop missing the salt so much,” notes Taylor. “Stick with it and allow your body to get used to your new food choices. Instead of focusing on all the foods to avoid, focus on all the healthy foods you should be eating. Your grocery cart should look like you just came from the farmers market — full of actual foods, not just products.”