Published by PMR of NY & CT
Most of the salt you eat never comes out of your saltshaker. It's already in the bread, soup, deli meat and restaurant meals that fill a typical week. That's why a low sodium diet is less about willpower at the table and more about knowing where sodium hides and choosing foods made with less of it.
Cutting back can help lower blood pressure and is a healthy goal for most adults. Here's how much sodium to aim for, how to read labels and how to keep food flavorful.
How much sodium is allowed on a low sodium diet?
The Dietary Guidelines for Americans recommend keeping sodium intake under 2,300 mg a day, about the amount in one teaspoon of table salt. The American Heart Association sets an optimal goal of 1,500 mg a day for most adults and notes that cutting back by even 1,000 mg a day can improve blood pressure.
Your own target may be different. If you have heart failure, kidney disease or liver disease, your doctor may set a specific number that fits your condition and medicines. Some people, such as those with certain types of low blood pressure, are told not to restrict salt at all. Follow the plan your own doctor gives you.
One more detail: labels list sodium, not salt. Table salt is about 40% sodium by weight, so the two numbers aren't interchangeable.
Common high sodium foods
Packaged and restaurant foods supply most of the sodium Americans eat. Common sources include:
- Bread, rolls, bagels and tortillas
- Pizza and sandwiches
- Deli meats, bacon, hot dogs and other cured meats
- Canned and boxed soups and broths
- Burritos, tacos and frozen dinners
- Processed cheese and cheese sauces
- Soy sauce, bottled dressings, marinades and condiments
- Chips, pretzels, salted nuts and crackers
Bread rarely tastes salty, but it adds up because it shows up at so many meals.
How to read the Nutrition Facts label
The label on the back of the package is your best tool on a low sodium diet. Check three things:
- Serving size. The sodium listed is for one serving, and many packages hold two or more.
- Milligrams of sodium. Compare similar products, since brands of the same soup or bread can differ a lot.
- Percent Daily Value. As a rule of thumb from the FDA, 5% or less is low and 20% or more is high.
Front-of-package claims have set meanings, too. "Low sodium" means 140 mg or less per serving. "Reduced sodium" means at least 25% less than the regular version, which can still be a lot. "No salt added" means none was added during processing, but the food may still contain natural sodium.
Cooking and eating out with less salt
Small, steady changes tend to stick best:
- Cook more meals at home, where you control the salt.
- Build flavor with garlic, onion, herbs, spices, citrus juice and zest, vinegar and a little black pepper or chili.
- Choose fresh or plain frozen vegetables, and rinse canned beans and vegetables before using them.
- Buy plain fresh meat, poultry and fish rather than marinated, breaded or "enhanced" versions.
- Taste food before salting it, and keep the shaker off the table.
- At restaurants, ask for sauces and dressings on the side, and share or box up half of large portions.
Your taste for salt often adjusts after a few weeks of eating less of it.
Be careful with salt substitutes. Many replace sodium with potassium, which can be risky if you have kidney disease or take certain heart or blood pressure medicines, so ask your doctor before using one.
When to get medical advice first
People who sweat heavily for long stretches, such as endurance athletes or outdoor workers in the heat, lose more sodium and may need a different plan. Ask your doctor or a clinician experienced in sports medicine and performance how to balance training with your health goals.
Talk with your doctor before making big changes if you take water pills (diuretics) or other blood pressure medicines, or have heart, kidney or liver disease. With heart failure, call promptly if your weight climbs quickly over a few days.
Call 911 for chest pain, severe shortness of breath, fainting, or signs of stroke such as face drooping, arm weakness or slurred speech.
Frequently asked questions
Is sea salt healthier than table salt?
Not in any way that matters for your health. Sea salt, kosher salt and pink Himalayan salt contain about the same amount of sodium as table salt by weight. Larger flakes mean a teaspoon may hold a little less, but it's easy to use more. Iodized table salt is also a key source of iodine, so if you switch, make sure dairy, eggs or seafood fill that gap.
Can you eat too little sodium?
It's uncommon from food alone, because sodium is in so many foods. Low blood sodium, called hyponatremia, usually comes from a medical condition, certain medicines such as some diuretics, or drinking very large amounts of water during long endurance events. Symptoms can include headache, nausea, confusion and muscle cramps. If you follow a strict limit, your doctor will check your levels.
Does cutting salt help with swelling?
It can. Sodium makes your body hold onto water, so eating less of it can ease fluid buildup, especially for people with heart failure, kidney disease or liver disease, who often take water pills as well. New swelling should still be checked by a doctor. Swelling in one leg with pain, warmth or redness may be a blood clot and needs medical care right away.
Request an appointment at PMR
Your primary care doctor, cardiologist or a registered dietitian can set the right sodium target for you. If pain or an injury is keeping you from the regular activity that also helps blood pressure, Physical Medicine & Rehabilitation of NY & CT (PMR) can help. Explore physical therapy at PMR or request an appointment, and our team will contact you to schedule your visit.
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