What's Your Low Sodium Program?


Nutritional Label

I think everyone approaches going low sodium differently. It definitely is not a "one size fits all" proposition. The way I see it, you’re the only one who understands your likes and dislikes, your schedule, your cooking abilities, your finances, what’s available in grocery stores nearby, and what you’re willing to do in order to eat lower sodium. Everyone has different skills, tastes, and levels of motivation. What works for you may not work for others. You are the only one who can develop a lower sodium routine  and regimen that fits your unique personality. You can glean ideas and inspiration from a lot of sources, but everything you do needs to satisfy you and you alone. After all, it's YOUR low sodium program.


Here’s my story:

About ten years ago, my husband spent over a week in ICU. He was horribly weak and diagnosed with congestive heart failure, an irregular heartbeat, an enlarged heart, and a massive fluid buildup in his lungs. Before coming home, he was prescribed a regimen of several drugs to stabilize his condition and told to restrict his daily sodium intake to about 2,000 mg daily or less.

I immediately began researching low sodium living – shopping, cooking, and eating. I spent hours pouring over product labels in the grocery store, bought cookbooks, and signed up for online newsletters. I gleaned a lot of good information but was not sold on tracking the sodium content of every item in every recipe. For me, a recipe was basically a guideline or inspiration. I learned to cook the way my mother and grandmother did – a pinch of this, a spoonful of that – no exact recipes. I would call it “ad lib” cooking. I mainly adjusted and adapted recipe ideas, very rarely ever following a recipe as written. Most main dishes –  from spaghetti sauce to meatloaf to tuna casserole to beef stew to split pea soup – I just winged, not even glancing at an official recipe. I was (and still am) an avid experimenter and fiddler. So detailed tracking of sodium in recipes didn’t really fit with my cooking style. What to do?

Early on, for my purposes, I identified four (4) food groups:

Minimally Processed Foods
Minimally Processed Foods
For example, meat, fish, and poultry naturally contain sodium. But there’s nothing I can do to a pound of raw ground beef that will lower its sodium content. To use a hackneyed saying, “It is what it is.” All I can do is to make sure I don’t add any more sodium, either in the form of salt or high sodium products. I also can make sure that I don’t accidentally purchase “enhanced” pork, turkey, chicken, or seafood. The same basic principle applies to vegetables. They all contain pre-existing sodium, and there’s nothing I can really do about it. But I can avoid using salt and high sodium products when I prepare them. And I can avoid vegetables frozen with salt. Ditto for minimally processed grains like brown rice, bulgur wheat, rolled oats, etc.

NSA Products
No-Salt-Added Products
I look for products that don’t have any additional sodium in the form of salt. From canned tomatoes to potato chips to frozen corn to instant mashed potato flakes to chicken broth to puffed corn cereal to spice blends. The products don’t necessarily have to be labeled as NSA or geared to a low sodium diet. But if there is a NSA version of something, that’s what I buy. However, I read the labels carefully just in case some hidden salt appears. Many times I also determine that even if I made the product myself, I wouldn’t be able to end up with a significantly lower sodium count. (Good examples are NSA canned tomato products and NSA broths.)

Low Sodium Products
Low Sodium Products
When we first started out, there weren’t many low sodium products available in local grocery stores. But things have changed quite a bit. Now there are a lot of NSA/loso options. But not all supposedly loso products are helpful. A good example is so-called low sodium chicken broth. One-third less sodium than regular sounds good, but the reality is that it’s a whopping 570 mg of sodium per cup. That’s still a lot!

So, often times, dealing with loso products is tricky. That’s where careful label reading comes in. I’ve actually come across certain loso products that are higher in sodium than their regular salted counterparts. Portion control is also important. Generally speaking, however, if a NSA version is not available, I’ll choose products that  are labeled as reduced sodium.

Regular Salted Products
Regular Salted Products
These are products that are neither NSA or loso. I try to find the products with the lowest sodium content and use them wisely. Careful label reading is important because the amount of sodium can be all over the place when it comes to a particular product or even within a particular brand. For example, marinara sauces at my local grocery store range from a low of 380 mg sodium per half cup to a high of 560 mg. So, if I couldn’t find a NSA/loso version, I’d purchase the 380 mg jar and add a can of readily available NSA tomato sauce to lower the sodium content a bit. This is another situation where portion control is important.

So what’s my low sodium program?

First of all, I don’t add salt to what I prepare. (The only exception is for yeast breads where I reduce the salt by 50% - 75%.) I know it may seem heretical, but I don't bother calculating the sodium for basic foods like unadulterated meat, poultry, fish, vegetables, and grains. There's nothing I can do to lower their naturally inherent sodium content. I can control portioning, preparation, and some ingredients but not the raw materials. So I don’t track minimally processed foods.

I apply a similar principle to NSA products. Even if I made homemade versions, I doubt that I could get them significantly lower in sodium than what is offered in grocery stores. I check the nutritional label and usually determine that the sodium amount per serving is negligible. So I don’t track most NSA products.

 Checking Sodium Content

Instead, I try to provide a diet with lots of fresh meats, fruits, vegetables, and whole grains — foods that have undergone minimal processing.  If available, I always choose no salt added products. And I choose lower sodium or regular sodium products carefully. Those last two classifications are my focus.

For example, when I make chili for dinner I don’t attempt to calculate the sodium content. After all, it’s filled with minimally processed or NSA ingredients: meat, onions, garlic, salt free chili blend, and cumin simmered in NSA beef broth (sometimes I may add NSA tomatoes or corn). Thickening is water and masa. The only significant sodium comes from the possible toppings ﹘ cubed avocado, chopped onion, chopped tomato, chopped jalapeno, chopped cilantro, pico de gallo, shredded cheese, or sour cream. For me, the chopped vegetables don’t count at all. Pico de gallo can be made at home or purchased without any salt added too. Sour cream is pretty low in sodium, about 15 – 25 mg sodium for 2 tablespoons. So the only ingredient worth worrying about is the cheese (175 mg sodium for 1 oz. of shredded cheddar), and it could be eliminated altogether. I don’t calculate the sodium level of my homemade chili because everything is either minimally processed or NSA except for the optional cheese topping. As far as I’m concerned, that one ingredient is the only thing I need to monitor.

That’s my program in a nutshell. It’s been ten years, but I really haven’t changed my cooking style. I still pretty much “wing” it when it comes to main dishes. I use recipes mainly for inspiration, more as jumping off points. I don’t fret about the sodium content of basic ingredients like meat, vegetables, and grains. I choose NSA products when possible. I choose low sodium products carefully by reading labels. and I do the same for products that are not NSA/low sodium. I watch portions, and I adjust and modify recipes and ingredients as needed in order to produce tasty yet low sodium dishes.

This blog reflects my approach to cooking. I’ve found that sharing low sodium recipes complete with detailed nutritional information is difficult because of the variables involved. Not everyone has access to the same low sodium/no salt products. So what I make with ingredients available to me may not be the same as what someone else makes. For instance, I make lasagna with a creamy layer using NSA cottage cheese. But if that particular product wasn’t available locally, I wouldn't advise anyone to follow my example.

This is what works for me, but it may not work for you. As I’ve often said before, everyone is different. So it should be no surprise that everyone approaches low sodium living differently. What’s your low sodium program? What’s your unique strategy?

In case you need some help developing your own personalized low sodium program, here are some online sources:

Sodium Dietary Guidelines from the CDC - Centers for Disease Control and Prevention

Dietary Guidelines from USDA - United States Department of Agriculture

SuperTracker from USDA - United States Department of Agriculture

Sodium and Your Health from AHA - American Heart Association



4 comments:

Mary said...

This is my program: If salt is listed in the ingredients, it stays on the shelf. Here is a recipe I love, since it's not only low sodium, it's "paleo" and low carb:

Joe's Special:

1 lb NSA ground turkey or beef
1 square package frozen chopped spinach, thawed and drained or squeezed
3 eggs, mixed with a fork or egg substitute equivalent
2 cloves garlic, finely chopped
1 yellow onion, chopped

Saute garlic and onion in as little oil as you like until translucent; add turkey. Saute until turkey is cooked, then add spinach and mix. When well heated, add eggs and mix again until eggs are just cooked.

You can use some Mrs Dash, and if you want to add a small amount of sodium, use some tabasco. A little bit more sodium, sprinkle servings with finely shredded parmesan cheese and/or ketchup. Kids love it with ketchup.

shambo said...

Mary, thanks for your comment. Your recipe sounds really good. It's a breakfast standard in most restaurants in my area. I love egg dishes with a sprinkling of Tabasco or a bit of ketchup on the side. Thanks again.

shambo said...

Candy Wathen has left a new comment on your post "What's Your Low Sodium Program?":

I was diagnosed with diastolic heart failure about two years ago. I already ate fairly healthy and love to cook, so that has been a huge asset for me. I remember staying up all night one night researching what stores carried low sodium versions of foods I liked. I found one store with a low sodium cottage cheese, which I have not found anywhere else, even online. About 90% of the changes I made can be boiled down to just a few items that I eat often. (1) I started making my own breakfast sausage. I just use 1 lb ground turkey (although you could use beef or pork or any combination), and add 1 tsp sage, 1/2 tsp garlic powder, 1/2 tsp onion powder, 1/4 tsp cumin, red pepper flakes, tarragon, oregano, and pepper to taste. Mix it together with your hands in a medium bowl, fry it up (I cook it 4 minutes per side) until browned well. It makes 8 patties, which I freeze in a ziploc bag. Then every morning I heat one patty in the microwave for 40 seconds. (2) I bought a bread machine and started making my own bread. That was good, but after I had done that awhile I found an Ezekial 4:9 low sodium bread with 0 mg of sodium per slice, so I use that sometimes. Even so, being able to make hamburger buns and yeast rolls with almost 0 sodium has been a HUGE help, since processed bread in the store has SO MUCH sodium! (3) I used to love ordering carry out from a Chinese restaurant. I thought I would have to give up Chinese food forever. But I found a recipe for a "soy sauce substitute that is amazing and has way less than 50 mg of sodium per serving. The recipe for that is 3/4 cup rice vinegar, 1 clove garlic, pureed or very finely chopped, 3 Tbsp Grandma's Molasses, 3 tsp onion powder. Shake all the ingredients together in a small glass jar, and store in the refrigerator. This works perfectly in every Chinese dish I have made! I have to give full credit to Donald Gazzinga and his book "The No Salt, Lowest Sodium Cookbook". You probably know about that already, but if anyone does not, it is amazing. I only eat 700-800 mg of sodium a day, and was able to discontinue almost all the medications I was prescribed when I was first diagnosed in the hospital. This website is a GREAT addition to the resources I use, and I am so happy I found you! Thanks for all the work you have put into gathering and sharing this information!

HobbitGirl said...

I just found this site. Thank you! I was diagnosed last October with enlarged heart, cardiomyopathy and left branch bundle block. I now have an ICD pacemaker in my chest. I was put on several different meds and 2 diuretics. I had to go on a low salt/sodium diet with no more than 2000mg per day. I worked really hard to keep it under 1500mg a day. More than that and my lungs rattle at night.

This has been an extremely difficult journey for me. I am, or rather was, a savory salty snacker No more! AARRGGH!! It has been extremely difficult to change my diet. There are times I do not enjoy eating because food tastes bland. Going out to eat with friends is depressing! I have had no one to complain to or talk to about this.

The English muffins I used to eat have decided to change. Their sodium content from before was 110mg. Now their new recipe has increased that to 210!!! All other brands are that or higher. Hence my search for homemade English muffin recipes and my landing on your site. Thank you for your effort to help your husband and in turn, helping others like us!