Heart failure: Eating less salt

Sodium causes you to hold onto (retain) water, increases swelling in your legs, and makes it more difficult for your heart to pump. Eating too much sodium can even trigger sudden heart failure. Limiting sodium, a major component of salt, in your diet helps prevent your body from retaining extra fluid. Your doctor will talk with you about how much sodium you can have in your diet.

Test Your Knowledge

1. You need to limit the amount of sodium in your diet to:

   1. Usually less than 2 grams (g) per day.

      This answer is correct.

      Preferably, you should limit sodium to less than 2 g (2000 mg) per day. A single teaspoon of salt contains 2 g (2000 mg) of sodium.

   2. Usually more than 3 g per day.

      This answer is incorrect.

      Preferably, you should limit sodium to less than 2 g (2000 mg) per day. A single teaspoon of salt contains 2 g (2000 mg) of sodium.

Limiting sodium will make you feel better. Too much sodium makes it harder for your already-weakened heart to pump and can lead to sudden heart failure. Fluid may build up in your lungs-making it harder for you to breathe-and in your feet, ankles, legs, and belly (abdomen).

Test Your Knowledge

1. Limiting sodium in your diet:

   1. Helps decrease thirst.

      This answer is incorrect.

      Limiting sodium in your diet does not help decrease thirst; it will help prevent fluid from building up in your body. Also, it will actually help you feel better and may decrease your risk for being hospitalized because of severe heart failure. The correct answer is d.

   2. Helps you lose weight that is not caused by retaining water.

      This answer is incorrect.

      Limiting sodium in your diet does not help you lose weight that is not caused by retaining water; it will help prevent fluid from building up in your body. It will also help you feel better and may decrease your risk for being hospitalized because of severe heart failure. The correct answer is d.

   3. Helps flush your kidneys.

      This answer is incorrect.

      Limiting sodium in your diet does not help flush your kidneys; it will help prevent fluid from building up in your body. Also, it will help you feel better and may decrease your risk for being hospitalized because of severe heart failure. The correct answer is d.

   4. Helps prevent fluid buildup in your body.

      This answer is correct.

      Limiting sodium in your diet does help prevent fluid buildup in your body. Also, it will help you feel better and may decrease your risk for being hospitalized because of severe heart failure.

Ways to start limiting sodium in your diet

• Talk with a registered dietitian about how to make tasty, low-sodium meals.
• Use a general list of low-sodium "foods allowed" and high-sodium "foods to avoid." This is an easy method, although it may narrow your food choices.
• Count the milligrams (or grams) of sodium in the foods you eat. See counting milligrams of sodium method for help; if you have more sodium than your doctor prescribed, see which foods you could replace or eliminate. This allows you to be more flexible in your food choices. You will need to keep an accurate record of the amount of sodium you eat at each meal and snack. To keep track of your sodium intake throughout the day, use the sodium record (What is a PDF document?) .
• Eat fewer processed foods and foods from restaurants, including fast foods, because these foods are typically high in sodium and are the biggest source of sodium in our diets. Processed foods can include anything that is not fresh, such as canned vegetables and soups, packaged lunch meats, canned sauces, fast foods, chips, pizza, hot dogs, and softened water.
• Read food labels. Buy foods that are labeled "unsalted" (no salt used to process), "sodium-free" (less than 5 mg of sodium per serving), or low-sodium (less than 140 mg of sodium per serving). But reduced-sodium products may still contain too much sodium. Foods labeled "light sodium" contain less than 50% of the sodium in a comparable food.
• At restaurants, order foods with less salt. For tips on eating out and enjoying yourself on a low-salt diet, see:

  Low-salt diets: Eating out.

Finding hidden sodium

Salt (sodium) can be found in many substances that you might not suspect. Some nonprescription medicines and many canned and other processed foods contain sodium.

Check your food labels. Sodium can have many different names. Be careful about using products that have:

• Monosodium glutamate (MSG). Monosodium glutamate is frequently added to Chinese food.
• Sodium citrate.
• Sodium sulfite.
• Sodium caseinate.
• Sodium benzoate.
• Sodium hydroxide.
• Disodium phosphate.

Check your medicines. Sodium can be an ingredient in medicines.

• Prescription medicines. Talk with your doctor about whether the medicines you take contain salt.
• Nonprescription medicines. Many medicines that you can buy without a prescription contain sodium. Read the labels. If you are not sure whether a medicine contains sodium, talk with a pharmacist. Be sure to check with your doctor before taking any new nonprescription medicine.

When you cook your food, cut down on sodium:

• Use fresh or frozen foods whenever possible, instead of canned.
• Rinse canned vegetables, which removes some-but not all-of the salt.
• Flavor your food with garlic, lemon juice, onion, vinegar, herbs, and spices instead of salt. Don't use soy sauce, steak sauce, onion salt, garlic salt, mustard, or ketchup on your food. Make your own salad dressings, sauces, and ketchup without adding salt. When dining out, use vinegar and oil for salad dressing.
• Avoid extra salt. Do not cook with salt or add it to your food.
• Avoid water that has a naturally high sodium content or that has been treated with water softeners, which remove calcium and magnesium and add sodium. Call your local water company to find out the sodium content of your water supply. If you buy bottled water, read the label and choose a sodium-free brand.

If you are not well enough to cook for yourself

You may need to get some help with shopping and preparing food. Consider these options.

• Have family members or friends help you, or hire someone to help cook low-sodium meals.
• Check with your local senior nutrition program (often a health department or hospital in your area) to find out where meals are served and whether they offer a low-sodium option.
• Have meals delivered to your home. Most communities have a Meals on Wheels program. These programs provide one hot meal a day for older adults, delivered to their homes. Ask about the average sodium content of the meals they prepare. Be sure they know that you have to limit the amount of sodium in your diet.

Weighing yourself is an important part of staying healthy

You can tell when your body retains fluid by weighing yourself often, because your weight may increase by several pounds.

• Get an accurate scale and weigh yourself at about the same time each day. A good time to weigh yourself is first thing in the morning after you have gone to the bathroom and before you eat breakfast. Wear the same amount of clothing (or no clothes) each time you weigh yourself.
• Keep track of your weight.
• Call your doctor if you notice a sudden weight gain. Your doctor may tell you how much weight to watch for. But in general, call your doctor if you gain 3 lb (1.4 kg) or more in 2 to 3 days.
• Take your weight record with you to each doctor visit.

Test Your Knowledge

1. In general, the biggest source of sodium in our diets is:

   1. Salt added at the table.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not salt added at the table. Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About two-thirds of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

   2. Processed foods and foods from restaurants.

      This answer is correct.

      In general, the biggest source of sodium in our diets is processed foods and foods from restaurants. About three-fourths of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake.

   3. Salt added in cooking.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not salt added in cooking. Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About three-fourths of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

   4. Milk.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not milk. Milk has about 125 mg of sodium per 8 fl oz (237 mL). Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About three-fourths of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

2. Choose the food that is lowest in sodium (you may need to review the general list of foods allowed and foods to avoid):

   1. Fresh green beans

      This answer is correct.

      Fresh green beans have the least sodium. All the other foods have sodium added to them.

   2. Canned green beans

      This answer is incorrect.

      Canned green beans contain more sodium. Fresh green beans have the least sodium. The correct answer is a.

   3. Green bean casserole

      This answer is incorrect.

      Green bean casserole contains more sodium. Fresh green beans have the least sodium. The correct answer is a.

   4. Green beans served at a restaurant

      This answer is incorrect.

      Green beans served at a restaurant contain more sodium. Fresh green beans have the least sodium. The correct answer is a.

Now that you have read this information, you can begin to cut down on the sodium in your diet.

Talk with your health professional (heart specialist, family doctor, dietitian, or nurse)

If you would like more information on the sodium content of foods, how to limit sodium, or how to follow a diet for heart failure, the following resource is available:

Organization