Wednesday, December 17, 2008

How to Follow a Low-Sodium Diet

If you have really decided to follow a low-sodium diet, the first thing to do is to get new pots, pans, and dishes just for you. Unfortunately, simply washing pots and pans in which high-salt meals have been prepared will not remove all the sodium. Some salt adheres to ceramic, metal, or Teflon waiting to be released by acids from high-potassium foods. In my observations in Latin American medical clinics (run by doctors with mainstream, legitimate credentials), I have seen visible differences in symptoms in people on our plan who failed to use their own, clean pots, pans, and serving ware exclusively for low-sodium diet. Having two sets of dishes also reminds your family that you must only consume low-sodium foods.

The nature of salts to “stick” to kitchen utensils makes it very difficult to find truly low-sodium meals in restaurants, and even if you could find low-sodium frozen foods, their sodium content would be suspect. Sodium that does not come from the foods from which the meal is prepared can nonetheless wind up in what you eat, so it’s a good idea to eat at ordinary restaurants—even if you order your meal prepared without salt—no more than once a week, and not at all if you have had a heart attack in the last six weeks, if you have a racing pulse or sinus tachycardia, or if you have angina, cardiomyopathy, or severe hypertension (160/110 or higher). By 2010 there may be a certification program through which restaurants and other food providers can assure you that their meals are truly low-sodium. Until that time, become a low-salt gourmet at home!

As a rule, a truly low-sodium diet only includes foods that contain less than one-tenth percent sodium by weight. That means 1 mg of salt in every 100 g of food, or if you are reading a typical label, 1 mg of salt or less for every 3 ounces of food in the package. Dr. Sodi’s definition of acceptable sodium content was just 1 mg of sodium per 100 mg of product, or 1 g of sodium per 100 g of product. That means if the food comes in a 100 g (3-1/2 oz) serving, it should not contain more than one gram of sodium. More sodium that 1 g per 100 g, and you should not eat.

Certain foods will always contain too much sodium. These include:

Any food preserved with sodium benzoate, such as commercial bread
Bacon, ham, and sausage
Barbecue
Beer
Beets, celery, and spinach
Cheeses of all kinds
Dried fruit preserved with sodium benzoate is acceptable if it is washed (making it, of course, no longer dry)
Egg whites and egg substitutes (egg yolks are acceptable)
Mineral water
Nuts and peanuts unless unsalted and labeled 1 mg of sodium or less
Popcorn unless specifically labeled 1 mg of sodium or less
Prepared cakes, cookies, crackers, and chips
Prepared foods (mixes) of any kind
Ready-to-eat breakfast cereals and breakfast bars
Soft drinks unless they contain less than 1 mg of sodium
All drugs containing sodium, such as aspirin (sodium salicylate) and fizzy drinks for indigestion (sodium bicarbonate)

I do not say you should never, ever eat even the tiniest portion of these foods—unless you feel you would be unable to stop at a very small portion. If you count all your sodium mg, you could have a portion—a very small portion—containing up to 300 mg of sodium, provided you do not eat any other sodium-rich foods on the same day.

What can you eat? Any food that is very low in sodium, not just labeled “low sodium,” but actually containing only 1 mg of sodium or less in a 100 g serving. Here are some examples:

Rice
Tortillas
Unsalted crackers
Butter (up to 2 tablespoons a day)
Egg yolks, which are low-sodium, but not egg whites or egg substitutes
Milk (up to 2 glasses a day)

Chicken
Lamb
Pork (as long as it is not cured)
Red snapper
Sea bass
Steak
Veal
White fish

Eat up to a 6-ounce (185 g) portion of any one meat daily. If you keep kosher or hallal, eat only meats not treated with salt. (In Judaism, an allowance is made for eating foods for health.) Do not eat smoked fish, dried fish, salted fish, fish sauce or oyster sauce (even if used in a “dash” to flavor an Asian dish), canned fish, or shellfish in general.

It has been suggested that following a low-sodium, high-potassium, adequate hydration diet could lead to decreased intakes of iron, magnesium, calcium, and vitamin B6, largely due to decreased consumption of meat and fish. When this proposition was tested, in a study by Korhonen, Järvinen, Sarkkinen and Uusitupa at Finland’s University of Kuopio, no reduction in overall consumption of these nutrients during low-sodium diets was found.

Any kind of fresh fruit in any quantity, and any quantity of fresh or fresh from concentrate fruit juices of any kind. Up to five pieces of dried fruit (apricots, prunes, raisins, and dates are most useful to complement this diet) or 2 ounces of raisins daily, rinsed in water if preserved with sodium benzoate.

Artichoke
Avocado
Beans and lentils
Cabbage
Carrots
Cauliflower
Green beans
Lettuce
Potatoes
Radish
Turnips
In any quantity.

Olive oil, enough for frying or salad dressings

Herbs and spices
Vinegar
In any quantity

Any food combined with a sodium preservative (BHA, BHT, sodium benzoate)is forbidden.

Along with consuming drastically less sodium, it is a good idea to consume more water, 2 liters (8 cups) a day, although fruit and acceptable vegetable juices (remember, V-8 contains beet juice) may count toward the total. Once you have gone to the trouble of purging sodium from your diet, make sure your kidneys can purge sodium from your system. Do not drink water treated with a home water softener—it contains massive amounts of salt—and do not drink municipal water that contains more than 1 mg of sodium per liter.

You don’t have to overdo. Two liters of water is eight cups, or four American glasses, or four 500 ml bottles of water a day. More water, however, doesn’t hurt. There is some confusion about the eight cups = eight glasses. In Europe, this would be the case. In the United States eight cups is about four glasses, Americans drinking from larger glasses.

This recommendation may be less water than you already drink. It is more water, however, than most cardiologists would recommend if you asked them. Doctors sometimes write orders to restrict water consumption to 800 ml (800 cc), about a cup and three-fifths, a day. This may be appropriate in the intensive care unit but it is not appropriate at home.

Read about weight loss and water weight.

No comments:

Post a Comment