The Low Sodium Cookbook (3 page)

The Institute of Medicine considers 1,500 mg per day to be an “adequate intake level” and 2,300 mg per day to be the “tolerable upper intake level” for healthy adults between the ages of nineteen and fifty.

Healthy adults ages fifty to seventy; individuals of any age who suffer from hypertension, diabetes, or chronic kidney disease; or individuals of any age who are African American should consume no more than 1,500 mg. Individuals who are over the age of seventy, whose calorie requirements are lower than those of younger adults, should limit their sodium to 1,200 mg per day.

When this book refers to a low-sodium diet, it means a diet with a maximum 1,500 mg of sodium per day. If you are older than seventy, you should reduce the sodium in your diet by another 300 mg per day.

How Do I Follow a Low-Sodium Diet?

Following a low-sodium diet may seem daunting, especially if you are used to eating out often or frequently rely on frozen meals or other processed foods for meals at home, at the office, or elsewhere. Rest assured, though, that following a low-sodium diet is easy to do, and it doesn’t mean that you have to give up all of your favorite foods. To the contrary, you may find that in your efforts to limit sodium, you’ll discover new, fresh, homemade, nutritious foods that are even more delicious and satisfying than fast-food burgers, frozen pizza, or takeout burritos.

Remember that most of the sodium in our diets comes not from salt that is added at the table, or even during cooking, but from processed foods. These include chips, pretzels, and other snack foods; canned soups and broths; canned stews and chili; frozen meals; jarred pasta sauces and condiments; and pickles, olives, capers, and other foods packed in brine. Also included in this high-sodium category are breads, cured meats, and cheese.

Since more than 75 percent of the sodium in our diets comes from prepared, processed, and restaurant foods, that’s a great place to start when looking to modify your diet. In a way, this is the easiest place to start, too, because the sodium content is listed right on the nutrition label of processed foods. Chain and fast-food restaurants are required to post nutritional information, including sodium content, on their menus. Many national restaurants also provide this information on their websites.

As you do your grocery shopping, get in the habit of reading labels. You may need to allow extra time to get your shopping done at first, but you’ll gain valuable knowledge about the sodium content of the foods you eat. A good rule of thumb when you do choose processed foods is to stick to those that contain 140 mg of sodium or less per serving. This is the level that is considered to be low in sodium.

Once you start reading labels, you may find that many of the foods you eat regularly are now off the menu, but don’t worry; you’ll find plenty of delicious and healthful options to take their place.

Limiting your diet to mostly fresh, whole, and natural foods can take a big bite out of your daily sodium level. Fresh, whole foods without seasoning or sauces, such as fruits and vegetables—even those that naturally contain sodium—always fall within the low-sodium category. Choosing these foods whenever possible is a great start.

Canned foods, on the other hand, are almost always processed with a lot of sodium, unless they are marked “low sodium” or “no salt added.” Of course, it’s always better to choose fresh foods (or even frozen) over canned, but switching from high-sodium foods to these lower-sodium options will help you make significant cuts in your dietary sodium. Instead of canned beans, buy dried beans, for instance. The drawback is that these usually need to be soaked overnight and then cooked for an hour or two, but you’ll cut the sodium by a ton.

Avoiding added salt, soy sauce, fish sauce, and other high-sodium sauces and condiments will go a long way toward reducing your sodium intake as well.

Cooking at home, from scratch, is the best way to make sure that you are sticking to your sodium limit, but restaurant dining and even fast foods aren’t out of the question completely. When you do dine in a restaurant, check the nutritional information, choose carefully, and, whenever possible, ask for your meal to be prepared with minimal added salt or salty condiments.

Tell your family, loved ones, friends, and coworkers—anyone you share meals with on a regular basis—about your new low-sodium diet. This will help you garner support and make sure that others aren’t inadvertently sabotaging your efforts when they cook for you. Who knows? You might even inspire others to join you in reducing sodium, or discover that someone you know is already on a low-sodium diet and might be able to share tips with you.

The goal is to keep your sodium intake to 1,500 mg or less per day. This means if you eat three meals and no snacks, you can have up to 500 mg per meal. However, be sure to count snacks, too. Many people like to limit the sodium of each meal to 350 mg and allow for two snacks per day with up to 225 mg of sodium.

When you embark on a low-sodium diet, it is extremely helpful to begin by tracking your sodium intake every day and at every meal. This is the best way to get a handle on how much sodium you’re getting and where you might be able to easily cut back.

While you might prefer to use an old-fashioned pen-and-paper tracking method, there are lots of tracking apps available online—some are made to be used from your desktop or laptop and others can be used right on your smartphone or tablet. These programs do most of the work for you. All you have to do is enter in what you ate. At the end of the day, you’ll be able to see exactly how much sodium you ate. This information can be quite valuable as you learn to make better choices.

Ten Tips for Reducing Sodium in Your Diet

1. Track your sodium intake every day and at every meal, at least until you become a savvy low-sodium dieter.
   
2. Choose fresh fruits and vegetables whenever possible. If fresh fruits and vegetables aren’t available, opt for frozen over canned, and choose packages labeled “fresh frozen” that contain only the fruit or vegetable without added sauces or seasonings.
   
3. If canned fruits or vegetables are your only option, choose those labeled “low sodium” or “no salt added.” Check the nutrition label as well.
   
4. When using canned foods (including fruits, vegetables, and beans), rinse the foods before using them. For canned tuna, buy no-salt-added varieties packed in water or oil.
   
5. Choose fresh, uncooked meats (steak, chicken, pork chops, etc.) over cured or processed meats (bacon, cooked ham, sausages, and deli meats like salami, pepperoni, or pastrami).
   
6. Steer clear of fermented or brined products (olives, sauerkraut, kimchi, capers, pickles, etc.) or use only very small quantities and rinse them well or soak them in water before using.
   
7. When cooking rice, pasta, beans, polenta, quinoa, couscous, or other starchy sides, omit the salt in the cooking water even if the package directions tell you to add it.
   
8. Limit the amount of cheese in your diet, and when you do eat cheese, look for lower-sodium versions.
   
9. Choose seasonings (spices, herbs, etc.) that do not contain any added salt or sodium. Garlic powder (not garlic salt), onion powder, cayenne or ground chipotle chilies and herbs like oregano, basil, rosemary, mint, and thyme add lots of flavor without boosting the sodium content of your meals.
   
10. Cook for yourself. Cooking at home, from scratch, using whole foods is the absolute best way to reduce the amount of sodium you consume.
    

CHAPTER THREE

High- and Low-Sodium Foods

Understanding Sodium Levels

As you get into the habit of researching the nutritional content of foods and reading nutritional labels, you’ll soon develop a keen sense of which foods to avoid. As a general rule, the more highly processed a food is, the more sodium it is likely to contain. Whole foods, on the other hand, those that you consume more or less in the form in which you find them in nature, tend to be lower in sodium.

Of course, there are exceptions to every rule, and some whole, natural, unprocessed foods—like mussels, for example—are high in sodium. Do a bit of research so that you can avoid such unexpected sources of sodium.

Everyday Foods and Beverages High in Sodium

Everyone may point a finger at the salt shaker, but most of the salt people consume is hidden in prepared and processed foods. Many of the foods highest in sodium are the obvious culprits: the ready-to-eat foods people buy at the supermarket or pick up at a drive-through window on the way home from work. Some of them, however, may surprise you.

Bread has been called—by both the Centers for Disease Control and Prevention (CDC) and the American Heart Association—the number-one biggest saboteur of the low-sodium diet. One slice may contain as much as 250 mg of sodium. And even low-sodium breads can derail efforts to curb sodium intake simply because people tend to eat a lot of it.

It probably doesn’t come as a big surprise that salami and ham are loaded with sodium, but even milder, “healthier” deli meats like roast turkey breast can deliver a shocking amount of sodium. In fact, a four-ounce serving of deli turkey may contain more than 1,000 mg of sodium, or two-thirds of your daily allotment. Put it between a couple of slices of bread and you’re done for the day. Don’t even think about adding cheese, mustard, or (gasp) pickles.

It may not be a big shocker that aged cheese—think salty blue cheese, sharp cheddar, and creamy Camembert—is high in sodium. But even mild cheeses that don’t taste terribly salty, like cottage cheese, can have as much as 450 mg of sodium per serving.

Doing your research, comparing similar products, and choosing carefully are crucial to following a low-sodium diet.
Take common types of cheese, for instance, which can vary dramatically in the amount of sodium they contain. Flavorful Swiss cheese contains a relatively low sodium level of 75 mg per ounce. Popular cheddar contains more than double that at 175 mg per ounce. And rich, salty blue cheese comes in at a whopping 400 mg per ounce.

Frozen meals are one of the most obvious culprits, with many delivering more than 800 mg per serving in their convenient heat-and-eat trays.

Canned soups, vegetables, and beans are more of the usual suspects, with some varieties containing as much as 900 mg per serving. Jarred spaghetti sauces, too, can top 550 mg per half-cup serving.

Condiments are sodium saboteurs, too. Compared to other foods, you may think that you consume so little of these sauces, marinades, and spreads that it’s easy to dismiss them when you’re adding up a meal’s sodium content. But some of these tasty touches pack a shocking amount of sodium in just a spoonful. Mustard, which is relatively low in sodium for a condiment, contains more than 150 mg of sodium per tablespoon. Teriyaki sauce, on the other hand, contains nearly 700 mg of sodium per tablespoon, while the same amount of soy sauce contains 1,000 mg. And watch out, because even low-sodium soy sauce is likely to have more than 500 mg of sodium per tablespoon.

Don’t be duped into thinking that prepared foods labeled “light,” “lean,” “low-fat,” or “low-calorie” are likely to be lower in sodium.
They’re not. In fact, when manufacturers cut the fat and calories in foods, they often increase the salt to make up for any loss of flavor.

Here are a few common foods and beverages and their sodium content:

• 1 medium orange: 0 mg
  
• 1 medium apple: 2 mg
  
• ½ cup broccoli: 15 mg
  
• 1 (12-ounce) can of cola: 30 mg
  
• 1 cup mineral water: 40 mg
  
• 1 cup low-fat plain yogurt: 160 mg
  
• 1 tablespoon ketchup: 190 mg
  
• 4 saltine crackers: 280 mg
  
• ½ cup cottage cheese: 425 mg
  
• 1 hot dog: 560 mg
  
• 1 fast-food cheeseburger: 600 mg
  
• 1 slice pepperoni pizza: 680 mg
  
• 1 cup canned soup: 800 mg
  
• 1 tablespoon soy sauce: 1,000 mg
  
• 1 bean and cheese burrito: 1,030 mg
  
• 1 frozen beef enchilada meal: 1,800 mg
  

Which Foods Should I Eat and Which Foods Should I Avoid?

Let’s start with the good news. There are plenty of nutritious, delicious, and low-sodium foods that you can and should eat to your heart’s content. Foremost among them are fresh fruits and vegetables, eaten raw or steamed, sautéed, or roasted and seasoned with fresh herbs, sodium-free spices, lemon juice, vinegar, or other low-sodium ingredients.

Tomatoes are a good-for-you, low-sodium food, full of heart-healthful potassium and magnesium, plus hefty doses of beta-carotene and vitamin C, and only about 10 mg of sodium per cup.
But make that a cup of canned tomato soup and the sodium level soars to 400 mg. Even worse, store-bought tomato juice registers more than 650 mg of sodium per cup. The worst offender? Store-bought tomato sauce, which delivers more than 1,000 mg of sodium per cup.

The number-one rule of low-sodium eating is to always choose food that is as close to the form in which it is found in nature as possible. For instance, fresh corn is better than frozen, frozen is better than canned, and canned corn kernels are better than canned corn chowder.