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A Doctor's Word: Take Food without a Grain of Salt

New America Media, Commentary, Erin Marcus, M.D. Posted: Mar 15, 2010

Editors Note: In this column, Dr. Erin Marcus talks about the harm of high-sodium diets and how to reduce salt intake in a healthy way. Dr. Marcus is associate professor of clinical medicine at the University of Miami Miller School of Medicine. A Doctor's Word is supported by a grant from the Ford Foundation.

Its hard for Cassandra Mathieu to describe her mothers cooking without mentioning the salt shaker.

I remember my mother used to cook with seasoning salt, garlic salt, every kind of salt you can imagine, she said recently. We grew up on salt.

Cassandra grew up fixing food the same way, adding generous amounts of salt to dishes she prepared and to her food at the table. At age 42, she discovered her blood pressure was extremely high 167 over 101, a level so far above the normal reading of 120 over 80 that she was going to need two medications to control it.

As her doctor handed her the prescriptions for the blood pressure pills, he also gave her some advice: Stop the salt.

Her doctor was advising her to lower her salt intake because it contains sodium, an element that raises blood pressure and can damage the blood vessels. Left untreated, high blood pressure often leads to stroke, heart disease, kidney failure, and a host of other problems. People often become more sensitive to the effects of sodium as they get older. African Americans are often especially sensitive to sodiums effects, as are people who are obese, who have kidney disease and who have blood sugar problems.

Our bodies only need about 180 milligrams of sodium daily, but the average American consumes nearly 20 times that about 3,400 milligrams. The U.S. Centers for Disease Control recommends that people with high blood pressure, everyone older than 40, and African Americans take in no more than 1,500 milligrams of sodium daily, or no more than 2/3 of a teaspoon of table salt. (For everyone else, they recommend limiting sodium to less than 2,300 milligrams daily).

These recommendations are tough to follow, especially since most packaged foods contain a lot of sodium and most of us are used to eating lots of it beginning in childhood. But contrary to what many may think, low sodium foods can be tasty and inexpensive. Below are some tips from Cassandra on how to reduce salt. She now works as a nutrition educator for the University of Floridas Extension Service, as well as several dieticians.

1. Your taste buds will adapt to a low-sodium diet, even though its tough at first. When you first start making these changes, you find yourself looking up at the salt shaker when youre eating, said Cassandra, who has cut down the number of blood pressure pills she takes from two to one as a result of avoiding sodium. But all of a sudden, it got to where I dont have to do that. Now it just comes natural.

2. Avoid canned and other processed foods. Only a very small amount of the sodium we take in is from salt that we add at the table or in the kitchen; 80 percent is from processed food. The best way to follow a low-sodium diet is to buy fresh food and to cook it yourself. The message people get is, dont salt your food, and thats the least important, dietician Sheah Rarback said. Its not just the food, its the processing. Even processed foods that dont taste salty, like bread and cottage cheese, have lots of sodium. Rarback and others recommend buying a crock-pot for cooking if you dont have good access to a kitchen.

If you absolutely have to use canned vegetables, try to rinse them off with water.

3. Look at nutrition labels. The Food and Drug Administration has advice on how to read them.

Remember that the amount of sodium reported on the label is for a certain portion size, not for the entire can or box. The label for one popular brand of soup lists the sodium thats in just one cup which is about half of what many people would consider a real serving.

Read labels on uncooked chicken, too, because many companies inject chicken with salt to plump it up and help preserve it.

4. If fresh fruits and vegetables arent an option, consider frozen vegetables and fruits. Frozen vegetables in sauce and frozen dinners do have a lot of sodium, but plain frozen peas and carrots usually dont.

5. Dont believe it when a product says its low salt or low sodium.

6. Avoid restaurants, which really sneak in the salt. Sad to say, but none of the dieticians I spoke with could come up with any chain restaurants that serve low-sodium dishes. Were living in a convenience society, and the convenience of someone else cooking for us or preparing our food is killing us, dietician Roniece Weaver said. (If you arent convinced, look at McDonald's nutrition facts.

Cassandra makes lunch at home and packs it.

7. Learn to cook with herbs and spices, and be willing to try new things. Cassandra uses chopped up garlic, lemon juice, and olive oil to season food. Lorna Shelton-Beck, a dietician at the Franklin C. Fetter Family Health Center in Charleston, SC, advises people to add a new fruit or vegetable every week.

8. If you have been eating a high-sodium diet for a long time, you may need to take it slow as you cut back. Dietician Roniece Weaver says she often has people reduce their sodium intake by half for about a week or so, and then gradually taper it more over the course of a month.

9. Check out low-sodium recipes on the internet. Some useful sites include Hebni Nutrition, the Hypertension Initiatives DASH diet page , and the Latino Nutrition Coalition.

10. Try to find a buddy, or a support group at a local church or health center. Its good to have someone to share it with, Lorna Shelton-Beck said.

Related Articles:

A Doctor's Word--Tips from Al on Managing Diabetes

A Doctors Word--Prevent Diabetes with Diet and Exercise

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