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!

Recipe feature time! My awesome husband made these amazing pork chops and they were probably the most delicious pork chops I have ever had. Smothered in mushrooms and surprisingly flavorful sauce (I had to ask him three times if he added extra salt to the sauce), these pork chops leftovers barely lasted 2 days. I would eat these almost every week if I could!

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.

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.

I know you are all just absolutely dying to know how I’ve been eating (note the heavy sarcasm font), so I thought I’d grace you with some sneak peeks of my heart healthy meals/snacks and the list of recommendations I’ll be following for the next 3 weeks.

Two days in to my Heart Healthy meal plan, my meals have been mostly enjoyable. My least favorites have been breakfast – too boring, too carby, and too lacking in protein. I’m starving by lunch, even with my morning snack. I have discovered two delicious recipes pictured above (Vietnamese Steak Sandwich, top left, and Warm Quinoa Salad with Edamame, bottom right)!

You can find the full page of recommendations from the American Heart Association here, but the quick gist is paraphrased below:

• Use up at least as many calories as you take in (I’m aiming to hit the activity recommendations of 150 minutes of physical activity per week).
• Eat a variety of foods from all the food groups.
• Eat fresh, frozen, or canned vegetables and fruits without added sauces, salt, or sugars.
• Choose fiber-rich whole grains for most grain servings.
• Eat a variety of fish at least twice a week.
• Eat poultry and fish without the skin. If you eat meat, choose the leanest cuts and prepare them without added saturated or trans fats.
• Select fat-free and 1% dairy products.
• Avoid foods containing partially hydrogenated vegetable oils.
• Reduce saturated fat to no more than 5-6 percent of total calories (in my case, 10-12 grams per day).
• Cut back on foods and beverages with added sugars.
• Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, eat less than 2400 mg sodium per day. Reducing even farther to 1500 mg per day may have an even greater effect on blood pressure.
• Drink alcohol in moderation. For women, limit to one drink per day and for men, two. And yes, those drinks have standard serving sizes.

As with any diet recommendations these guidelines have been a subject of hot debate in nutrition, but that’s a topic for another day.

Now here’s your turn to help me out: pretend you have just had a heart attack (I know, scary – but the good news? You made it!) and you are presented with the recommendations above to lower your risk of it happening again. What are your initial thoughts? Overwhelming? Easy? What the heck does any of that mean? I want to hear it.

If you had to follow these recommendations, what would your questions be? What would you want from your dietitian to make you feel confident in taking care of your heart? Commence to comment in 3, 2, 1…