The Low Sodium Cookbook (2 page)

Changing your eating habits isn’t easy, but this book will serve as a guide to small changes you can make in your habits to see big improvements. It will provide plenty of guidance on what to eat once you’ve eliminated the problem foods from your day-to-day menu.

Part I
examines what sodium is and how it affects people’s bodies and health, who should adopt a low-sodium diet, and what the health benefits of such a diet are. Guidelines will spell out what constitutes a low-sodium diet, offer tips for reducing sodium, and examine which foods are high in sodium and which are not.

A chapter on low-sodium eating will provide tips for shopping and cooking, reading food labels, and eating out without overdosing on salt. Finally, an outline detailing a two-week meal plan is included that will serve as a guide to get you started on your new way of eating.

Part II
provides more than one hundred recipes for low-sodium dishes, including breakfasts, snacks, appetizers, condiments and sauces, soups, stews, salads, meat and poultry entrées, fish and seafood entrées, and tantalizing desserts. This book focuses on providing recipes for common favorite dishes and comfort foods to help you feel satisfied and fulfilled by your new diet, not deprived.

By reading this book, you’ll learn:

• Simple tricks to easily reduce sodium in your diet
  
• How to recognize foods that contain “sneaky” or hidden sodium
  
• How to shop for low-sodium foods
  
• What foods contain health-enhancing vitamins, minerals, and other nutrients
  
• How to cook your favorite dishes with less sodium
  

Remember that even a small reduction in your sodium intake can have a significant effect on your health, and making small changes at every meal can add up to big results.

PART ONE

Understanding the Low-Sodium Diet

Chapter One
The Benefits of a Low-Sodium Diet

Chapter Two
Low-Sodium Dietary Guidelines

Chapter Three
High- and Low-Sodium Foods

Chapter Four
Low-Sodium Eating

Chapter Five
A 14-Day Low-Sodium Meal Plan

CHAPTER ONE

The Benefits of a Low-Sodium Diet

Why Choose a Low-Sodium Diet?

The simple answer is that you should choose a low-sodium diet because it could save your life.

The more complicated answer is that too much sodium in the diet can exacerbate certain conditions, especially high blood pressure, which puts undue pressure on your arteries, heart, kidneys, and other organs. It can make life uncomfortable, causing headaches, fatigue, shortness of breath, chest pain, and other unpleasant symptoms. And it also increases your risk of serious, even life-threatening illnesses, including diabetes, cancer, heart failure, respiratory failure, and osteoporosis.

When you have too much sodium in your system, it causes excess fluid to be held in the body, which puts added pressure on the circulatory system by increasing the force of blood against the artery walls. When this force is too strong, the pressure becomes burdensome to the heart and other organs. Therefore, consuming too much sodium increases your risk of cardiovascular diseases like hypertension, heart failure, and stroke. And this excessive pressure on the arterial walls can damage not just the heart but other organs and tissues, making you more susceptible to osteoporosis, stomach cancer, and kidney disease.

Chances are that you are embarking on a low-sodium diet not by choice but by necessity or because your doctor strongly advised that you cut your sodium intake to improve your health.

If you’ve been advised to adopt a low-sodium diet due to hypertension, you are not alone. Hypertension affects almost one out of every three people in the United States and is one of the leading causes of heart disease. Hypertension is often referred to as a “silent killer,” because many sufferers aren’t even aware that they have high blood pressure.

While sodium isn’t the sole cause of high blood pressure—lack of exercise, obesity, and genetic factors are also culprits—cutting back on high-sodium foods is a simple way to significantly lower your risk of high blood pressure and its negative effects on the body.

What Is Sodium?

In its most basic form, sodium is a mineral that is found in nature, including in natural, unprocessed foods and in drinking water. Table salt is a compound of two minerals, sodium (40 percent) and chloride (60 percent). Sea salt, kosher salt, and other salts used to season food are also sodium chloride.

Much maligned as a dietary evil, sodium is actually one of the minerals most crucial for the healthy function of our bodies. It helps to regulate water balance, control muscle and nerve function, metabolize food, and keep our circulation running properly. Our bodies also need it to help regulate fluid levels and blood pressure. Ironically this last characteristic is where excess sodium in the diet often leads to problems when it causes our bodies to hang on to excess fluid, increasing the force of the blood on our artery walls and organs to dangerous levels. There is a fine balance between the right amount of sodium in our bodies and too much, which causes problems.

Many doctors recommend that patients who suffer from certain ailments, such as high blood pressure or edema—or are at high risk for developing such conditions—take pains to reduce the levels of sodium in their diets.

What Is a Low-Sodium Diet?

A low-sodium diet is one that limits the amount of sodium a person ingests, and it is often used to treat or prevent hypertension and other conditions.

The average American diet includes as much as 3,400 mg of sodium per day, which is twice the healthful level for most people. In fact, a sodium level no higher than 1,500 mg per day is recommended as a low-sodium diet.

Most of the sodium in our diet comes from table salt, or sodium chloride. Although sodium does occur naturally in unprocessed foods, the levels are low enough that these foods provide the quantities our bodies actually need, as opposed to the exorbitant levels found in many processed foods and even in home-cooked foods that incorporate large amounts of table salt.

There are two primary reasons that our diets have evolved to contain such high levels of sodium. The first is, of course, that salt is tasty and adds pleasant flavor to foods. This effect is intensified when salt is combined with fat and sugar, creating an even more dangerous combination. People’s taste buds have become accustomed to saltier and saltier foods so that foods with little or no added salt, even if they contain naturally high levels of sodium, may taste bland.

The second reason sodium levels in our diets have skyrocketed is that salt is often used as an additive in processed foods, either to preserve or otherwise enhance them. It is added to many foods to inhibit the growth of food-borne pathogens and increase shelf life. It is also used to bind, stabilize, and enhance the color of many processed foods. This is why so many canned foods contain such extremely high levels of sodium, even when they don’t taste particularly salty.

Reducing dietary sodium can be challenging since more than 75 percent of the sodium in a typical American’s diet comes from processed or prepared foods, not salt used to season foods at the table or even during cooking. Becoming a savvy consumer and learning to scrutinize nutrition labels is the best way to identify the hidden sodium found in packaged foods.

There are even foods that don’t come with labels, such as grains and meats, that are suspect. Their sodium levels might be low compared to highly processed foods, but their sodium content significantly contributes to our diets simply because people tend to eat so many servings of them in a day. A single slice of sandwich bread, for instance, may contain as much as 250 mg of sodium; a typical serving of dark-meat chicken may contain more than 450 mg of sodium.

With this in mind, it’s easy to see how sodium quickly adds up, even if you eat a healthful diet of mostly homemade foods. And, of course, the problem is exacerbated the more you rely on prepared, highly processed, and fast foods.

It’s good to remember that the main sources of sodium in our diets are:

• Certain condiments, such as soy sauce, steak sauce, and ketchup
  
• Cured meats, including cold cuts, bacon, and smoked fish
  
• Natural sources, including grains, vegetables, milk, cheese, meat, and shellfish
  
• Prepared foods, such as fast food and frozen meals
  
• Processed foods, such as canned soups, cereal, crackers, chips, bread, and jarred sauces
  
• Table salt, added to restaurant-prepared and home-cooked meals and at the table
  

On the most basic level, a low-sodium diet is one that includes less than 1,500 mg of sodium per day. This usually means strictly limiting processed foods and fast food and unnecessary added salt in recipes or at the table. It also means limiting some naturally high-sodium foods such as cheese, bacon, bread, cured meats and fish, and certain types of shellfish.

Who Should Follow a Low-Sodium Diet?

Low-sodium diets are most commonly recommended for people who suffer from or are at high risk of developing hypertension (high blood pressure) or heart disease, but anyone who suffers from hypertrophy, osteoporosis, kidney stones, renal failure, edema, shortness of breath, respiratory failure, gastric ulcers, or certain types of cancer is a prime candidate for a low-sodium diet.

If you have high or borderline high blood pressure, reducing your sodium intake can lower it. And if you are taking medication for high blood pressure, that’s all the more reason you should adopt a low-sodium diet as it can enhance the effectiveness of the medication.

Some research has found that African Americans are more sensitive to sodium than others, which may be the reason that the African American population has a higher rate of high blood pressure. As a result, the Food and Drug Administration (FDA) includes African Americans of any age in the group of people who should limit sodium to 1,500 mg per day.

Even people with normal blood pressure can benefit from switching to a low-sodium diet, which will gradually lower their blood pressure, too, and decrease their risk of heart disease. And moderate sodium intake has been associated with numerous other health benefits, such as a reduced risk of dying from a stroke, reversal of heart enlargement, and a reduced risk of kidney stones and osteoporosis.

People with kidney problems should also limit their sodium intake. The kidneys help prevent sodium buildup in the body. Consuming more sodium than your kidneys can flush out can lead to swelling, spikes in blood pressure, breathing difficulties, and a buildup of fluid around the heart and lungs. Therefore, according to the National Kidney Foundation, if your kidneys are damaged or not functioning optimally, it’s necessary to adopt a low-sodium diet.

The opposite but incredibly rare problem, sodium deficiency, can lead to a condition called hyponatremia, which may cause fatigue, seizures, muscle spasms, confusion, and coma.
While following a low-sodium diet does slightly increase your risk of developing hyponatremia, it is extremely rare for a low-sodium diet to cause it. More often it is the result of certain medical conditions, vomiting, diarrhea, drinking excessive fluid (especially water), excessive sweating, or the use of certain medications.

Health Benefits of a Low-Sodium Diet

Following a low-sodium diet has many health benefits. First and foremost, of course, is reducing blood pressure, which in turn lowers the risk of heart attack and stroke.

While many hypertension sufferers don’t even realize they have a problem until they go to the doctor, some people may experience bothersome symptoms such as severe headaches, fatigue, confusion, vision problems, chest pain, shortness of breath, or irregular heartbeat. All of these symptoms may be alleviated through a blood pressure–reducing low-sodium diet. In fact, when sodium intake is reduced, most people experience a drop in blood pressure within a few days to a few weeks.

An added benefit of a low-sodium diet is that it may help you drop unwanted pounds, which incidentally, can contribute to high blood pressure. If you currently eat more than the recommended daily maximum of sodium, it may be causing you to retain water, which can mean that you’re carrying unnecessary weight. In fact, an excess of just 400 mg of sodium in your body can be responsible for an added two pounds of fluid. Drinking plenty of water can flush out excess sodium, causing those extra pounds to drop off, but unless you reduce your sodium intake, they will just pile right back on as the bloat returns.

In addition to raising blood pressure, sodium can cause your body to lose calcium, which weakens the bones over time and can lead to osteoporosis. Getting the recommended dose of calcium every day can help to offset the bone loss caused by a high-sodium diet, but reducing your salt intake goes right to the source, preventing a problem before it arises.

CHAPTER TWO

Low-Sodium Dietary Guidelines

How Much Sodium Is Too Much?

Opinions on the optimal level of sodium intake vary depending on who you ask, but the most reputable sources all agree on the minimum and maximum dietary levels of sodium for a healthful diet.

The average American consumes nearly 3,000 mg more of sodium each day that their body simply doesn’t need. Our bodies actually need very little sodium to function optimally. A mere 500 mg of sodium is enough to keep our bodies running along smoothly. Therefore, reducing your sodium intake with a low-sodium diet has benefits no matter what your health condition.

Dietary Recommendations

As far as the upper limit of sodium in the diet, authoritative bodies such as the Institute of Medicine, the FDA, and the U.S. Department of Agriculture (USDA) all agree that even healthy adults should eat no more than 2,300 mg of sodium per day.