Cutting Down on Salt
Limiting sodium — which we get through salt, baking powder, baking soda and other substances in foods we eat — is one of the most important things that people with heart failure can do. Sodium makes the body hold on to fluid. To pump the added fluid, the heart has to work harder. People with heart failure shouldn't put this extra strain on their hearts.
Also, too much salt can worsen symptoms like swelling and shortness of breath and cause weight gain. If those symptoms become severe, the person may need to be admitted to the hospital.
Physicians often recommend keeping salt intake below 2,300 milligrams (mg) per day for most people. However, for people with heart failure, recommended sodium intake is no more than 2,000 mg per day. Most people eat considerably more than this, so it's likely that a person with congestive heart failure will need to find ways to cut down on salt. Since most salt intake comes from eating and drink prepared and packaged foods, reading food labels to determine how much sodium is in a food or beverage is a great start to lowering sodium intake.
Here are some other tried-and-true strategies for reducing sodium intake. Start small and gradually work up to bigger changes. (We've tried to arrange the strategies that way.)
Tips on table salt
* Take the salt shaker off the table.
* Cook without salt.
* Discuss using salt substitutes with your doctor.
Limiting salt when you cook
* Avoid any seasonings that taste salty, including:
o bouillon cubes
o cooking sherry or cooking wine
o chili sauce
o meat tenderizer
o seasoned salts
o soy sauce
o steak sauce
o tamari
o Worcestershire sauce
* Instead, try cooking with low-salt seasonings, such as lemon juice, vinegar and herbs.
* Drain and rinse canned foods before preparing them to remove some of the salt.
* Substitute fresh fruits and vegetables and other low-sodium foods for canned and processed foods. Use canned vegetables with no salt added. Select brown rice or plain white instead of flavored rice (such as chicken- or beef-flavored, or any rice that comes with a packet of powdered seasoning).
Avoiding high-sodium foods
This recommendation is probably the hardest to follow, because so many convenience foods (like packaged meals and soups) and snacks (potato chips and popcorn) are high in sodium. But most of us take in more sodium through these foods than by using table salt. That's why it's essential to cut back and eventually eliminate them. The foods below are usually high in sodium (but read the labels, because some may be available in a low-salt or unsalted form):
* Canned soups and dry soup mixes
* Canned meats and fish (buy water-packed tuna or salmon instead)
* Ham, bacon and sausage
* Salted nuts and peanut butter
* Instant cooked cereals
* Salted butter and margarine
* Processed meats, such as deli items and hot dogs
* Prepared mixes (pancake, muffin, cornbread, etc.)
* Prepackaged frozen dinners (unless one serving has less than 400 mg of sodium)
* Preseasoned mixes (tacos, chili, rices, sauces, gravies, etc.)
* Snack foods (pretzels, potato chips, olives, cheeses, pickles)
* Salad dressings
* Fast food
Choosing low-sodium alternatives
* Read food labels to check salt content (listed as "sodium"). Start with what's in the cabinet right now, so you can stop buying any high-sodium foods.
* People with heart failure should watch out for the various forms of sodium (for example, sodium alginate, sodium sulfite, sodium caseinate, disodium phosphate, sodium benzoate, sodium hydroxide, monosodium glutamate or MSG, sodium citrate).
* Check your medicine cabinet. People with heart failure should avoid headache or heartburn medicines that contain sodium carbonate or bicarbonate.
* Look for canned vegetables labeled with “no salt added.” Look for "low-salt" or "low-sodium" labels on cans and packages. This label isn't allowed on the can or package unless the food has 140 milligrams or less sodium per serving. However, it's still important to read the label to see exactly how much it does contain. The less salt, the better!
