Limiting sodium can be a bit tricky at first. Most of the flavor we enjoy in food comes from one of three things: sugar, fat, or salt. Our palates just love the tasty stuff. And the more of it we eat, the more we need in order to experience the same pleasurable taste sensation. Sound kind of like addiction to you? Ehhhhh-xactly.

Besides flavor, sodium is also used as a preservative in many foods and often foods that don’t even taste salty, which can be confusing for some people just learning about limiting sodium.

Anyway, it is possible to decrease sodium intake without eating tasteless cardboard. I promise! There are several ways to increase flavor and leave the sodium out:

• Herbs and spices: These are the best! Natural, delicious, and many are anti-inflammatory. Find a bulk section (like Winco) or grow your own for the best value. Check out the chart below from the Academy of Nutrition and Dietetics for tips on matching herbs and spices to the food you’re making tonight:
  

  Food Item	Flavorings
  Beef	Basil, bay leaf, caraway, curry, dill, dry mustard, garlic, grape jelly, green pepper, mace, marjoram, mushrooms, nutmeg, onion, parsley, pepper, rosemary, sage
  Chicken	Basil, cloves, cranberries, mace, mushrooms, nutmeg, oregano, paprika, parsley, pineapple, saffron, sage, savory, tarragon, thyme, tomato, turmeric
  Egg	Chervil, curry, dill, dry mustard, green pepper, lemon juice, marjoram, mushrooms, paprika, pepper, tarragon, tomato, turmeric
  Fish	Basil, bay leaf, chervil, curry, dill, dry mustard, green pepper, lemon juice, marjoram, mushrooms, paprika, pepper, tarragon, tomato, turmeric
  Lamb	Cloves, curry, dill, garlic, mace, mint, mint jelly, onion, oregano, parsley, pineapple, rosemary, tarragon, thyme
  Pork	Applesauce, basil, caraway, chives, cloves, garlic, onions, rosemary, thyme
  Vegetables	Basil, dill, garlic, ginger, lemon juice, mace, marjoram, nutmeg, onion, tarragon, tomato, salt-free salad dressing, vinegar
  Desserts	Allspice, anise, cinnamon, cloves, ginger, mace, nutmeg, vanilla extract

• Pre-made spice mixes: If you aren’t big on growing or buying herbs yourself, you can get a little help from sodium-free spice mix products like Mrs. Dash. The Mrs. Dash line has several pre-made spice mixes like Caribbean Citrus, Italian Medley, or Steak Grilling seasonings, all made without salt. I personally have only tried the original and I like it, especially on fish. I have several patients who have tried other flavors with success!
• Lite salt/salt substitutes: These are usually made with potassium chloride as opposed to sodium chloride (table salt) to decrease intakes of sodium. I use it at home and in recipes and the taste is similar enough I don’t notice it. Be aware: people with kidney disease or who are on certain diuretic blood pressure medications should not use salt substitutes because their bodies can not clear potassium as well as others. Ask your doctor before switching to salt substitute if you have any of these concerns.

Lastly, be patient! Your tastes will adjust to the point where they will enjoy the flavors of food with less salt, but it does take time. Most of my patients say that after 4-6 weeks of limiting sodium, the high-sodium foods they used to eat taste way too salty for them! You can do it!

Today was my last day on the heart healthy diet. I learned a lot nutritionally and psychologically in the last few weeks. I’ve summarized my take-aways into 4 main points:

1. Limiting sodium was (mostly) easier than I expected. At first, things are a little bland and it seems like there are a lot of things you “can’t have,” but over time I saw that I had several days well under 2,400 mg so I started adding a sprinkle of salt to bland food and found I did have a little room to add some sodium. You do also get used to needing less salt for flavor. I learned some tricks for adding flavor without salt, too. Be careful, though, because certain foods can blow almost your entire sodium budget in one fell swoop…*cough* seafood fettuccini *cough*.
2. Limiting saturated fat was quite a bit harder than I expected. Those saturated fat grams are sneaky little suckers! I went into the heart healthy diet assuming sodium would be my biggest challenge and I quickly learned that saturated fat was much more difficult to keep within my 12 gram per day limit. Saturated fat is primarily from animal sources like butter, lard, dairy fat, and meat fat. The way I generally teach people to limit saturated fat is to eat oil-based spreads (instead of butter), low-fat or nonfat dairy, and lean meats and fish. I figured since I mostly eat that way I wouldn’t have to worry much about saturated fat on this diet. I was wrong! More often than not, halfway through the day I would check my saturated fat consumption and find it well over halfway through the budget. I now know that if patients are committed to limiting their saturated fat within recommendations, they probably need more specific guidelines and tips to keep that in check.
3. Having dietary “restrictions” is a nasty mind game. It makes your inner petulant toddler come out: What do you mean I can’t have it? I want it! Suddenly I want lots of it! It’s a tricky thing to navigate when educating people about how to properly care for their bodies and live a life worth living.
4. Fish is expensive. Very expensive. And I rarely get 2-3 servings per week. Unless you’re eating tuna all the time, getting in 2-3 servings per week racks up the grocery budget awfully quick-like.

Overall, I pretty much broke even on every outcome I was measuring, which didn’t really surprise me because I wasn’t eating in a drastically different way from how I normally eat. I did much better this week on my own than I did last because I made a more concerted effort to keep my saturated fat down.

So that about wraps up my experience on the heart healthy diet. What diet will I be doing next?

Well, folks…week 2 is done! And unfortunately, I have become an incubus of the common cold as of yesterday. Goodie. In light of my crummy cough and angry sore throat I have resorted primarily to applesauce, soup, and nonfat frozen yogurt as my primary sustenance for the time being, but I still stayed within my nutrition goals while sick.

I was surprised to notice that I had a hard time meeting my saturated fat goal while on my own this week – I never went over on my sodium, believe it or not – but I was over on my saturated fat 3 out of 7 days. I’ll have to make a more concerted effort to watch that this week.

https://www.youtube.com/watch?v=Uw-SF5C2iHM

Living a healthy lifestyle of any kind – heart healthy or otherwise – can be daunting! It can sometimes feel like you should never eat those foods you love so much or that you’ll never enjoy food again. Not so! Check out this video I made to help you navigate a happy heart-healthy lifestyle.

heart healthy low sodium eating

Why is it that the Heart Healthy diet recommendations limit sodium? It’s highly unfortunate, as sodium is ever so tasty in many applications including (but not limited to) flavorful broths, crunchy kettle chips, and spicy sausage. Those are just a few of my personal high-sodium loves. Limiting sodium is tough for me because I can really go to town on the stuff. I’m not big on sweets – I can stay away from candies and pastries for the most part but put me near a good cracker with sharp cheese or salty chip and you have to fend me off with a stick. Limiting sodium can be a challenge. So what’s the benefit of doing it?

Research studies have shown that a lower sodium or sodium chloride (table salt) intake was associated with significantly lower blood pressure in adults with normal, slightly elevated, or high blood pressure. In most studies, “high sodium intakes” ranged from 2400-4800 mg per day while “low sodium intakes” ranged from 440 (holy low sodium!) to 2640 mg per day (Some study examples: Bray, 2004; Coruzzi, 2001; Geleijnese, 2003; He, 2004). You may wonder why sodium makes a difference in blood pressure. You are wondering, aren’t you? Of course you are.

Well surprise, surprise, it’s complicated! Bodies are complicated. The primary explanation is due to sodium’s role in directing how much fluid the body holds on to. Generally I explain it this way: Sodium and water are friends. Wherever sodium goes, water goes too – linked arm-in-arm with charged chemical attractions (oo la la!). So when we eat a lot of sodium (hello, pizza binge), our body holds on to a lot of water to hang out with it (hello, puffy bloat body). Some people notice the extra water because their feet, ankles, face, or belly swell with it. Some people can’t even tell it’s on board.

Either way, all this extra water has to move around the body to get filtered and whatnot. Guess whose job it is to move it? Your heart! Poor heart is pumping blood through the hoses of your veins and you’ve just increased the volume he has to move. His best response is to create more pressure to push all that extra fluid around to get rid of it. So, he pumps even harder and your blood pressure rises. That’s rough on him, as well as all of your hoses because in some places in your body (like your eyes and kidneys for example), your body has leeeeetle, tiny hoses that don’t respond well to pressure. Think fire hose pressure in your little green garden hose. Not a good match.

The goal of the Heart Healthy diet in limiting sodium is to keep blood pressure within healthy ranges for your heart and blood vessels. Now, as with everything in the realm of nutrition, there is debate about this. A few studies have recently been published that throw some doubt into the mix about the role of sodium in blood pressure regulation.

One such study by NutriNet-Santé found that sodium intake alone was not related to an increase in blood pressure, but rather found that the ratio of sodium intake to potassium intake was a much stronger predictor. Potassium is known as a helpful regulator of high blood pressure and foods high in potassium (like fruits and vegetables) are commonly promoted in diets recommended to lower blood pressure. Interestingly, I’ve been having a heck of a time meeting my potassium goals on this diet. More fruit! More vegetables!

There have been other studies that have suggested a notion of “salt responders” – people whose blood pressure is affected by their sodium intakes vs. others whose is not.

More research to come I hope! But overall, that’s a quick look at why we watch sodium as a contributor in the realm of promoting strong, healthy, not overworked hearts. Come back soon for ideas on how to cut sodium without sacrificing flavor (and joy)!

Yesterday I completed my first week of the Heart Healthy diet, which also means I’m off the meal plan today (yay!). Overall, I’m not finding this way of eating too difficult, though the meal plan certainly could have added more sodium-free and low saturated fat flavoring methods to certain dishes to reduce their blah factor (here’s lookin’ at you, plain cooked pearled barley). For the most part, this is the way I typically eat, though I am a big salt lover. There have been a couple of notable differences:

I’ve definitely upped my fish intake, which is a great healthful change. My fiber intake has also increased,  and my digestive system took note, veered off of the approved course, made adjustments, and returned to the regularly scheduled program. Fear not – we are back on track.

I’m looking forward to doing Heart Healthy on my own for the next two weeks and experimenting with sodium-free ways to flavor things. Check out the table below to see how my last week went.

Now on to the next week! Check out this tiny pile of groceries to go with all my meal plan leftovers!

I made them with whole wheat sandwich rolls – they were delicious!

Recipe feature time! By far my husband’s favorite recipe from the Heart Healthy meal plan so far, these tasty sandwiches hail from a recipe from Eating Well. My husband said even other firefighters at work were enviously ogling this veggie-laden sammich.

The sandwiches are pretty high in sodium (likely one reason they are so delectable), so I was a little surprised to see them on the Heart Healthy meal plan, though the plan did keep me low enough for the rest of the day to keep me under my daily sodium recommendation of 2400 mg per day.

Heart-Healthy Tip: Use half the fish sauce and replace it with apple cider vinegar in the marinade to cut the sodium by 353 mg per serving.

The meat is flavorful and tender, the veggies are crisp and zesty. Give ’em a try – the full recipe is here!

One sandwich has 373 calories, 9 g fat, 8 g fiber, 858 mg sodium (505 mg with the heart-healthy modification), and 2 g saturated fat.