Sodium and Heart Failure
What is sodium?
Sodium, or salt, is a natural mineral found in foods and within the body. Most foods contain a small amount of sodium. This includes fresh fruits, vegetables, meats, and seafood. We need sodium to live, but most people take in more than they need.
Why do I need to limit sodium?
Salt attracts fluid. Eating too much sodium can increase your blood pressure. Excess sodium also causes the body to retain extra fluid (edema), which makes your heart work harder.
What’s my limit?
The usual limits for a sodium-restricted diet are between 1,500 and 2,000 milligrams (mg) per day. Your doctor will tell you the exact amount you can have. This amount cannot be “saved” over several days – it is the amount you can have in one day. Your doctor may change this limit based on your specific needs.
Being able to read a food label is one of the most important steps in starting your low-sodium diet. Eating a diet filled with fresh foods is best, but some frozen foods are often good choices.
To read the label, look at the amount of sodium (listed in mg) and the serving size. Many foods are packaged with more than one serving, so be sure to look at how many servings are in a package and how much sodium is in each serving.
It is easiest to follow a low-sodium diet when you start with low-sodium foods, such as:
- Fresh or frozen fruits, vegetables, beef, poultry, pork, and seafood that do not have sauces
- Unsalted snacks, like pretzels and nuts
- Oats and cereals that have less than 140mg sodium per serving
You can still enjoy some foods that have higher levels of sodium. But, be careful when eating the following:
- Cured meats (hot dogs, sausage, bacon, ham, beef jerky)
- Canned meats (tuna, chicken, salmon, sardines)
- Canned soups (even ‘reduced’ or ‘low’ sodium soups)
- Canned and some frozen vegetables
- Dairy products (some cheeses, yogurt)
- Frozen entrées (those with more than 600mg per serving)
- Pickled foods (pickles, banana peppers, okra, pigs feet)
- Condiments (ketchup, barbeque sauce, mayonnaise, salad dressings, marinades)
Tracking Sodium & Fluid Intake
It helps to keep track of how much sodium you have every day. You can do this by simply writing it down on paper or in a notepad.
Some smart phones have applications that allow you to track sodium intake.
Some patients with heart failure need to limit their fluid intake because too much can affect their condition. Ask you doctor about how much fluid you can have.
Why limit fluid intake?
Drinking too much fluid puts more stress on your heart and can cause swelling or edema, weight gain, and shortness of breath.
What counts as a fluid?
Foods liquid at room temperature:
- All beverages
- Ice cream
Fluid Tracking Tips
There are two easy ways to track your fluid intake using a water pitcher or 2 liter soda pop bottle:
- Fill the container with 2 liters (2000 cc) of water (or whatever your limit is for the day). Each time you drink/eat fluid, take the same amount of fluid out of the container. When the container is empty, you will know you have had your fluid limit for the day.
- Start with an empty container. Each time you have a fluid, put the same amount into the container. When the container is full (to your fluid limit amount), you will know you have reached your fluid limit for the day.
Shopping & Cooking Tips
- Plan ahead
- Some grocery stores employ dietitians that will help you shop and choose low-sodium foods.
- Make a grocery list so you know what to buy before you go shopping.
- Shop the perimeter of the store, where most fresh and frozen foods are found.
- Choose fresh or frozen foods
- Fresh foods have the least amount of sodium. Frozen foods are often very low in sodium if they are not precooked, seasoned, covered in a gravy or sauce, or injected with a saline or salt solution (often poultry).
- Use sodium free seasonings such as:
- Mrs. Dash®
- Mom’s Gourmet® spice blends
- Onion powder
- Garlic powder
- Chili powder
- Black pepper
Some good resources for low-sodium recipes are:
- American Heart Association Low-Salt Cookbook
- Cleveland Clinic Heart Healthy Recipe Corner
- American Heart Association: Heart.org
- Difficult, but not impossible! Follow these tips:
- Appetizers - Avoid soups and broths
- Salads - Avoid pickles, cured meats, cheeses, and salted nuts. Order salad dressing on the side or use a sodium-free dressing like oil and vinegar.
- Main Courses - Choose items that are grilled, baked, broiled or roasted. Ask that food be prepared without butter, salt, MSG, or dressings. Order condiments, sauces and dressings on the side. Avoid buffets!
- Use your resources
- Ask your server for nutrition information
- Research the restaurant’s website and check the menu before dining out
- Use these websites:
- Healthydiningfinder.com – Sodium savvy entrees
What’s the difference between iodized, sea and kosher salts?
- Iodized, or table salt, is mined from salt deposits and is processed to produce small, uniform granules.
- Sea salt is produced from evaporated salt water and often contains minerals. It varies in coarseness.
- Kosher salt is similar to table salt but with larger granules. All forms of salt contain the same amount of sodium by weight. It is safest to avoid added salt completely. However, it should not be removed from baked goods, as it is needed for dough or breads to rise. Kosher salt contains 1/3 less sodium by volume, and substituting volume for volume will reduce the sodium content of recipes (exchange 1 tsp of table salt for 1 tsp of kosher salt). You can enjoy some of your favorite baked goods with less sodium.
Can I rinse my canned or high-sodium foods?
Rinsing foods removes some sodium, but we do not know exactly how much. It is safer to choose low-sodium foods.