How to Lower Sodium in Your Diet

This handout is about sodium () and how What is the difference between salt and to lower the amount in your diet. sodium? Sodium is a component of salt. Table salt, How much sodium is needed by the body? also known as , is 40% Our body needs about 500 mg (milligrams) sodium and 60% chloride by weight. One or about ¼ teaspoon (tsp) of sodium daily. teaspoon of salt weighs about 6 grams and This amount helps the body to: contains ~2300 mg sodium and ~3700 mg of • Send nerve impulses (signals). chloride. • Contract and relax muscles. • Keep water and mineral balance. 2300 mg sodium = 1 tsp salt 1,725 mg sodium = ¾ tsp salt Most people eat about 3400 mg of sodium in 1,150 mg sodium = ½ tsp salt their diet each day. This is much higher than 575 mg sodium = ¼ tsp salt needed. Keep sodium (salt) intake to less than 2000 mg per day or the amount your What other besides salt have high medical team suggests. sodium? Most (70%) of the sodium in the diet comes Why lower sodium (salt) in your diet? from eating packaged and prepared foods. Eating too much sodium can increase your Sodium is added to these foods during risk of high blood pressure. This can lead to manufacturing. Most canned soups, lunch heart disease and stroke. Excess salt in the meats, frozen dinners, and many meals eaten diet can: at restaurants also are very high in sodium. • Increase water retention. This causes, puffiness, bloating, and weight gain. Why is sodium added in processed foods? • Increase your risk for: Because it adds flavor and acts as a binder o Stroke and stabilizer in . Adding salt preserves o the food and prevents bacteria from o High blood pressure growing. This way it can last for months. o Enlarged heart muscle Foods like meats, baked foods and grains o Kidney disease and stones may not salty but still have a lot of o Headaches sodium. o Osteoporosis Highest sources of sodium come from: Lowering salt helps to: • Pizza made with pepperoni or • Lower your blood pressure. sausage. • Reduce puffiness, bloating and help • Cold cuts, cured meats, sausages, in weight loss. cheese. • Reduce the strain on your heart. • Canned soups and other canned • Reduce shortness of breath. goods. • Allow your medicines to work better. • Burritos and tacos – made with these toppings (sauces, cheese, salsa, tortilla chips). • Convenience foods.

How much daily sodium should I have? 3. Note the serving size on the nutrition Aim for no more than 2000 mg of sodium or facts label. Eating more than what is the goal set by your doctor. The American listed as 1 serving means eating more Heart Association suggests you limit sodium sodium. In the example below, one intake to 1500 mg a day if you have high serving is 1 cup which gives 470 mg blood pressure. To start, cut down on your sodium. The package has 2 servings. daily sodium intake by 1000 mg. This will If you eat the whole package, you help improve heart health and blood will eat 940 mg sodium (470 mg + pressure. You can then move towards a goal 470 mg). of 2000 mg or less.

How can one start cutting back salt? Start tracking sodium in the diet by: 1. Read the nutrition facts label. The amount of sodium per serving is listed in milligrams (or mg).

2. Read the ingredients list. Look for words like “sodium,” “salt” and “soda.” These mean salt is added in other forms which may not be added in the total amount listed on the 4. Look for these sodium-related terms label. on food packages. • Sodium-free: Less than 5 mg of sodium per serving and has no added salt • Very low sodium: 35 mg or less per serving • Low sodium: 140 mg or Some ingredients to watch out for include: less/serving • Sodium attached to any of these: • Reduced (or less) sodium: At nitrate; citrate; bicarbonate; chloride; least 25% less sodium per diacetate; erythorbate; glutamate; serving than the original lactate; lauryl sulfate; metabisulfite; product phosphate. • Monosodium glutamate (MSG) or sodium benzoate • Disodium guanylate (GMP) • Disodium inosinate (IMP) • • Himalayan pink salt; ; rock salt; Salt; • Trisodium phosphate

Strategies When Shopping for Food like the taste of lower-sodium foods, try Compare labels. Choose the product with combining it in equal parts with a regular the lowest amount of sodium (per serving). version of the same food. Try this with Different brands of the same food can have broths, soups and tomato-based pasta different sodium levels. sauces.

Pick fresh and frozen poultry. Read the Cook pasta, rice and hot cereal without salt. labels and look at the fine print on the Grill, braise, roast, sear and sauté to bring packaging for terms like “broth,” “saline” or out natural flavors. “sodium solution.” These words mean that salt has been injected in them. Include foods that are high in like sweet potatoes, potatoes, greens, tomatoes Select condiments with care. For example, and lower-sodium tomato sauce, white , bottled salad dressings, dips, beans, kidney beans, nonfat yogurt, oranges, ketchup, jarred salsas, capers, mustard, bananas and cantaloupe. Potassium helps pickles, olives and relish can be very high in counter the effects of sodium and may help sodium. Look for a reduced- or lower- lower your blood pressure. sodium version. At restaurants: Get canned vegetables labeled “no salt • Ask for your dish to be made without added” and frozen vegetables without salty salt or less salt. sauces. • Add freshly ground black pepper or squeeze fresh lemon or lime, Get products with the American Heart especially on fish, chicken and Association’s Heart-Check mark. vegetable dishes to boost flavor. • Avoid foods with these words: pickled, brined, barbecued, cured, smoked, broth, au jus, soy sauce, miso or teriyaki sauce. They are very high in sodium. • Order foods that are steamed, baked, grilled, poached or roasted as these Preparing Food have less sodium. Use onions, garlic, herbs, spices, citrus • Control portion sizes. Ask if smaller juices and vinegars to add flavor. Check out portions are available. Share the recipes at American Heart Association meal with a friend or ask for a to-go website. Use herbs and spices in place of all box when you order and place half or some salt. the meal in the box to eat later. When you cut calories, you cut Drain and rinse canned beans and peas (like sodium. chickpeas, kidney beans, etc.) and • Chain restaurants with 20 or more vegetables if “no added salt” or “low- locations give nutrition information sodium” is not available. that lists sodium content. Some restaurants post this on a website Combine lower-sodium versions of food and/or share upon request. with regular-sodium versions. If you don’t

What if food bland? Change Salty Ways in 21 Days The natural flavor of food is enhanced with less salt, especially when you use cooking Week 1: Breads and Rolls / Cold Cuts techniques and flavorful ingredients listed and Cured Meats above. Over time, your taste buds will • Look for lower sodium items. adjust. • Track sodium intake. • Track how much sodium you've cut. Salt Substitutes There are many salt substitutes. Some Week 2: Pizza / Poultry: replace some or all of the sodium with • Get pizzas with less cheese and potassium. With certain medical conditions meats. (like kidney disease) and medications, salt • Add veggies to your pizza. substitutes can affects potassium levels. Talk • Use fresh poultry rather than fried, with your healthcare team about whether a canned or processed. salt substitute is right for you. Some examples of salt substitutes are listed below. Week 3

The products with an asterisk (*) have high Soups / Sandwiches: amounts of potassium (1 tsp has more than • One cup of chicken noodle soup can 1500 mg). None of these should not be used have up to 940 mg of sodium. by anyone with kidney disease. • Check labels and try lower sodium ® • Spike Salt Free foods. • Veg-It® ® • Use lower sodium meats, cheeses • *Adolph’s Sodium Free Tenderizer and condiments and plenty of ® • Accent Low Sodium Seasoning vegetables to build a healthy ® • Salt Sense sandwich. • Pleasoning Mini-Mini Salt® • *Morton Lite Salt® Herbs, Spices and Seasonings: Add • * Substitute® Flavor Without the Salt • *No Salt® or *Nu-Salt® • Lemon/lime juice, citrus zest • Lawry’s Seasoned Pepper® Are sea salt, kosher salt, and Himalayan • Dry mustard salt healthier than table salt? • Scallions, onions, shallots Kosher or sea enhance taste, texture • Vinegar and color. All of these contain same amount Onion and garlic powder of sodium as regular salt. Sea salt and other • salts may have trace levels of minerals like • Fresh garlic ® magnesium, potassium and calcium. We get • Tabasco Sauce these from other healthy foods and don’t • Dried horseradish need it from salt. • Celery powder • Fresh or dried herbs • Flavored pan sprays • Molly McButter® • Pepper (white/black) • Fresh hot peppers and hot sauces

General Tips Foods Moderate in Sodium (35-140 Foods vary in sodium content. Always mg/serving) check labels. Try to select foods with low or moderate sodium. Portion size makes a Bread, Cereal, Rice, Pasta difference in sodium amounts. • Bread, biscuits, muffins, pancakes, baked goods, crackers without salt, Foods Low in Sodium (0-35 g/serving): some ready to eat cereals Vegetables Bread, Cereal, Rice, Pasta • Fresh or plain frozen vegetables: All • Puffed wheat and rice cooked with less than 1/8 tsp salt • Shredded wheat, Slow cook hot Fruits cereal cooked without salt • Dried fruits • Rice, pasta, noodles cooked without Dairy products salt • Milk, yogurt, cheese, ice cream, Vegetables puddings • Fresh vegetables Meat, Poultry, Fish/seafood, Dried Beans, • Frozen vegetables without any Eggs, Nuts sauces • Fresh meat, poultry, fish (check • Canned if no salt added label) • Any cooked without salt • Peanut butter Fruits • Frozen fish fillets • Fresh, frozen, or canned fruit and • Fresh shrimp fruit juice • Low or reduced sodium tuna Dairy Products • Reduced sodium deli meats • Low-sodium cheese Fats and Oils Meat, Poultry, Fish, Dried Beans, Eggs, • Butter, tub margarine, Mayonnaise Nuts • Most salted nuts • Eggs Sweets • Unsalted peanut butter • Cakes, cookies • Beans, peas & lentils (cooked dry • Pies, doughnuts, pastries without salt). • Cocoa Fats and Oils • Ice cream • Oils, nuts (lightly salted) • Low sodium salad dressings (oil and Foods High in Sodium (140 mg or more vinegar) /serving) Sweets • Honey, jam, jelly, gelatin, hard Bread, cereal, rice, pasta candies, sherbet. • Many ready to eat cereals, instant hot • Carbonated soft drinks, -free cereals crackers, breads, and snack powdered drink mixes foods, Miscellaneous • Noodle mixes, instant potatoes, • Coffee, tea, Vinegar stuffing

Vegetables Who to Call • Canned vegetables, pickles, If you are a UW Health patient and have more sauerkraut questions please contact UW Health at one of • Regular tomato or V-8® juices the phone numbers listed below. You can also Dairy products visit our website at www.uwhealth.org/nutrition. Nutrition clinics for UW Hospital and American • Cottage cheese, buttermilk Family Children’s Hospital can be reached at: Meat, Poultry, Fish, Dried Beans, Eggs, (608) 890-5500. Nuts • Bacon, ham, Canadian bacon Nutrition clinics for UW Medical Foundation • Canned fish and meat can be reached at: (608) 287-2770. • Corned beef, dried beef • Frankfurters/brats, hotdogs, sausage • Deli meats, breaded shrimp • Veggie burgers and soy products that resemble meat • Smoked fish • Some fresh meats injected with sodium solution (pork, chicken) • Rinsed canned beans Fats and Oils • Bacon drippings, gravies • Most salad dressings Sweets • Cream pies Miscellaneous • Canned soup, marinades • BBQ sauce, chili sauce • Soy Sauce, mustard, ketchup

• Seasoned salts

• Frozen entrees • Broth/ bouillon • Olives, steak sauce

Spanish version is #180s

Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright 7/2020. University of Wisconsin Hospital and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department of Nursing. HF#180