Lower-Sodium Food Choices

8/16/2019 Lower-Sodium Food Choices

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Lower-Sodium Food ChoicesPatients with chronic kidney disease (CKD) need to limit the salt (sodium) in their diet.

Many people think that they are following a low-sodium diet if they do not use the salt

shaker. However, only about 10% of the salt in our diets comes from the salt shaker. The

rest comes from salt that is already in foods (for example, in processed and restaurant

foods).

When you have chronic kidney disease, the recommended limit for sodium is 1,500 to

2,000 milligrams (mg) a day.

Reading Food LabelsReading food labels can help you eat less salt.

• First, look at the serving size listed at the top of the Nutrition Facts. The information

for the rest of the Nutrition Facts is for this serving size. Remember that you might eat

a larger or smaller portion.

• In the Nutrition Facts, the percentage of the Daily

Value (% DV) for sodium helps you know whether

the food is low or high in sodium.

3 5% DV or less is low.

3 20% DV or more is high.

• The Nutrition Facts also lists the milligrams (mg)

of sodium in one serving. You can see how this

amount might fit in your daily limit of 1,500 to

2,000 mg.

• Some food packaging also features claims about

the sodium/salt content. Here is what the labeling

terms mean:

3 Sodium free means 5 mg of sodium or less per serving.

3 Very low sodium means 35 mg of sodium or less per serving.

3 Low sodium means 140 mg of sodium or less per serving.

3 Reduced sodium means the product has at least 25% less sodium than the original

version of the product. Note that a reduced-sodium product can still contain a large

amount of salt.

3 Unsalted or no salt added means that no salt was added to the food during

processing. Note that these terms do not mean the product is sodium-free.

Copyright © 2015 Academy of Nutr ition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for

patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of

Nutrition and Dietetics.

Note for People

Who Need to Limit

Potassium in Their Diet

Manufacturers often add

salt substitutes that contain

potassium to low-sodium

foods. If you need to limit

potassium, read Nutrition

Facts labels and ingredients

lists and choose foodswithout the added potassium.


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Guidelines for Choosing Lower-Sodium FoodsBread, Crackers, Popcorn, and Chips

What to Know

• Most regular breads and rolls have 90 to 190 mg of sodium per slice or roll.

• Baking powder biscuits and ready-to-bake biscuits and rolls canhave 150 to 700 mg of sodium per piece.

• Salted crackers, chips, popcorn, and many other salted crunchy

snacks can have 150 to 250 mg of sodium per ounce.

What to Do

• Buy or bake salt-free bread.

• Limit the total amount of bread you eat. Make half sandwiches or open-face

sandwiches to cut down on the amount of bread you eat.

• Look for unsalted, low-sodium, or “hint of salt” crackers, chips, popcorn, and

other snacks.

Cereals

What to Know

• Ready-to-eat cereals contain varying amounts of sodium.

• Instant hot cereals (oatmeal, grits, or cream of wheat) often contain added salt.

What to Do• Check labels on ready-to-eat and instant cereals, and choose

products with lower sodium levels.

• Choose regular or quick-cook oatmeal, grits, or other hot cereals

instead of instant products that have sodium added to them.

• Make your own flavored cereals by adding fresh or frozen

berries, sugar, or sugar substitute to low-sodium or no-sodium

cereals.





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Cheese

What to Know

• Most cheeses are high in phosphorus as well as sodium. Your registered dietitian

nutritionist (RDN) may give you a guide for limiting the amount you eat.

• Swiss cheese, ricotta, and cream cheese are lower in sodium than most other cheeses.

• Cottage cheese is very high in sodium.

• Processed cheeses (such as American cheese, Velveeta, and Kraft Singles) have the

highest amounts of sodium and phosphorus and are not recommended.

What to Do

• If you like cheese, use it as a garnish. Small amounts of Swiss

cheese, ricotta, brie, cheddar cheese, farmer’s cheese, goat

cheese, Monterey Jack, mozzarella, or parmesan can be added

to salads or other dishes.

• Limit cottage cheese to no more than ¼ cup per day. In

recipes that call for cottage cheese, try ricotta instead.

Condiments and Cooking Sauces

What to Know

• Many condiments and cooking ingredients add sodium to the diet.

• Cooking wine has salt added to it.

• Dry mixes for gravies, soups, or other sauces usually have salt added.

• Salad dressings can be especially high in sodium.

What to Do

• Check the sodium information on the Nutrition Facts labels

on your condiments and seasonings.

• Consider buying products that are lower in sodium.

• Use very small amounts of high-sodium condiments and

sauces—the less you use, the less sodium you eat.

• Make salad dressings at home, using oil and vinegar and

salt-free seasonings.





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• Be familiar with the condiments that are highest in sodium. These include:

3 Soy sauce: 920 to 1,315 mg of sodium in 1 tablespoon

3 Reduced-sodium soy sauce: Approximately 500 mg of sodium in 1 tablespoon

3 Teriyaki sauce: 390 to 690 mg of sodium in 1 tablespoon

3 Packaged marinades: 340 to 610 mg of sodium in 1 tablespoon

• Also learn which condiments tend to be lowest in sodium, phosphorus, and potassium.

These include:

3 Barbecue sauce: 265 to 450 mg of sodium in 2 tablespoons

3 Hot sauce: 124 mg of sodium in 1 teaspoon

3 Olives: 350 mg of sodium in two queen-size olives

3 Worcestershire sauce: 165 to 180 mg of sodium in 1 tablespoon

3 Yellow mustard: 80 to 170 mg of sodium in 1 tablespoon

3 Dijon mustard: 120 to 360 mg of sodium in 1 tablespoon

3 Ketchup: 320 to 420 mg of sodium in 2 tablespoons

3 Chili sauce: 230 mg of sodium in 1 tablespoon

3 Dill pickles: 591 mg of sodium in half of a 4-inch pickle; 306 mg of sodium in 1 spear

Convenience Foods

What to Know

• Convenience foods are often very high in sodium. Examples include:3 Canned baked beans

3 Bread stuffing mixes

3 Hamburger, tuna, and macaroni and cheese mixes

3 Seasoned mixes for rice, pasta, and potatoes

3 Canned dinners, such as chili and stew

3 Pasta sauces in jars or cans

3 Frozen egg and muffin breakfast sandwiches

3 Seasoning packets for meals made in slow cookers

3 Gravy and sauce mixes





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What to Do

• Make meals from scratch, using unprocessed ingredients

as much as possible.

• If you wish to use a particular type of convenience food,

compare labels on different products and choose the one

with the lowest sodium.

• Look for products that have reduced sodium.

• Eat only a small portion of a higher-sodium food.

Fast Food

What to Know

• Fast-food restaurants are noted for the high sodium content of their foods.

• Even those fast foods that are promoted to be “healthy” foods can have

high sodium levels.

• Portion sizes make a difference.

What to Do

• Look up the sodium content of your favorite fast foods using an online nutrition

database or the company’s nutrition information. Choose the foods that are lowest in

sodium. For example, at a sandwich place:

3 Leave off the cheese, pickles, olives, and high-sodium dressing.

3 Choose vegetables and a meat that are lower in sodium.

3 Have a smaller sandwich to reduce the sodium.

• Choose plain salads that have low amounts of sodium. Be careful to check the sodium

content of salad dressings, and remember that adding meats or chicken adds sodium.

Frozen Foods

What to Know

• A frozen entrée can contain up to an entire day’s amount of sodium in one serving.

What to Do

• Read labels and choose meals with 600 mg of sodium or less. Healthy Choice offersseveral frozen meals that meet this goal. The smaller packages of Lean Cuisine, Weight

Watchers, and Smart Ones may also be options.

• Consider making your own “frozen entrées” by making large batches of food and

freezing them in meal-sized portions.





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FruitsWhat to Know

• All fruits are low in sodium.

What to Do

• If you are limiting potassium, use the Making Choices food lists to guide your choices of fruits.

• If you are not limiting potassium, enjoy a variety of fruits.

Meats, Poultry, and SeafoodWhat to Know

• Cured meats (such as ham, bacon, sausage, pepperoni, hot dogs, corned beef,

pastrami, and bratwurst) are high in sodium and are not recommended.

• Fresh, canned or frozen poultry, seafood, or meats can have high amounts of sodium

if they are “enhanced” with a salt solution or broth. Check the Nutrition Facts label tolearn the sodium content.

• Meats, poultry, and seafood that are breaded or seasoned are high in sodium.

• For information on deli meats and tuna, refer to the Sandwich Fillings section, later in

this handout.

What to Do

• Buy plain meat, fish, or poultry that are not enhanced. Many

meats now have Nutrition Facts labels. Read labels and look for

meats with 201 mg of sodium or less per serving.

• Season meat yourself, using salt-free herbs and spices.

(See suggestions later in this handout.)

• Make your own salt-free breading.

Milk and YogurtWhat to Know

• Milk and yogurt naturally contain sodium.

• Milk and yogurt are good sources of protein and calcium. However,

they are high in phosphorus and potassium, and you might need tolimit them.

What to Do

• Follow your RDN’s recommendations about how much milk and

yogurt to include in your diet.





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Pizza

What to Know

• Pizza is usually made with many high-sodium ingredients, including the sauce, the

cheese, and toppings such as olives, pepperoni, sausage, and Canadian bacon.

What to Do

• Homemade is best! Use a low-sodium sauce, vegetables,

and/or ground beef and a small amount of mozzarella

cheese.

• If you are limiting potassium, keep in mind that all tomato

sauces are high in potassium.

• If you are having pizza that is not homemade, choose just

one slice, and fill out the rest of the meal with a vegetable

salad or other foods that are not high in sodium.

Sandwich Fillings

What to Know

• Deli meats—even turkey, chicken, and beef—are often very high in sodium.

• Tuna is usually packed with salt, whether it is canned or packaged in oil or water.

What to Do

• Make sandwiches with chicken, turkey, or beef that you

have previously cooked without added salt.

• Read Nutrition Facts labels on packaged deli meats, and

look for products with no more than 480 mg of sodium

per 2-ounce serving. Most delis now carry lower-sodium

meats, but ask the clerk to check the label for you.

Note: If you are limiting potassium, check to see whether

potassium was added to replace the sodium.

• Look for lower-sodium canned or packaged tuna.

• Make an unsalted egg or egg salad sandwich.

• Use small amounts of unsalted peanut butter (no more than 2 tablespoons per day).Peanut butter is higher in phosphorus and protein.





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Vegetables

What to Know

• Regular canned vegetables have salt added to them.

• Draining and rinsing salted canned vegetables removes some, but not all, of the salt.

• Some frozen vegetables have sauces added to them that make them high in sodium.

• Canned tomato juice and vegetable juices are high in sodium.

What to Do

• Look for “no salt added” canned vegetables.

• Buy fresh or frozen vegetables without sauces or added salt.

• Tomato-based vegetable juices come in lower-sodium varieties. Keep in mind that the

tomatoes in the juices make them high in potassium.

Seasoning Without SaltFood without salt does not have to be food without flavor. You can build a spice cupboard

with a collection of dried herbs, ground spices, and salt-free seasoning blends. Also,

consider growing your own herbs in a garden or in pots on a deck or sunny window sill.

The following chart offers some good seasoning substitutes to use instead of salt. You

can use each seasoning individually or combine them for more complex flavors.

Note: Avoid using salt substitutes that contain potassium.

Salt-Free Seasoning Ideas

Food Suggested Seasonings

Beef Basil, bay leaf, chives, cloves, cumin, garlic, hot pepper, marjoram, onion,

rosemary, savory, thyme

Fish Basil, curry powder, dill, fennel, garlic, paprika, parsley, tarragon, thyme

Lamb Basil, garlic, marjoram, onion, oregano, rosemary, thyme

Pork Coriander, cumin, fruits and juices, garlic, ginger, hot pepper, onion, pepper,

sage, savory, thyme

Poultry Basil, fruits and juices, garlic, ginger, onion, oregano, rosemary, sage, savory,

tarragon

Eggs Caraway, chervil, chili powder, dill weed, marjoram, oregano, savory, tarragon




Continued on next page


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Salt-Free Seasoning Ideas (continued)

Food Suggested Seasonings

Soup Bay leaf, celery, marjoram, onion, parsley, rosemary, savory, tarragon

Cheese Basil, chives, curry, dill, fennel, garlic, marjoram, oregano, parsley, sage, thyme

Fruits Allspice, anise, cinnamon, cloves, coriander, ginger, mint, nutmeg

Tomato sauce Basil, bay leaf, celery, garlic, marjoram, onion, oregano, parsley, pepper

Vegetables Basil, chives, dill, marjoram, mint, onion, parsley, pepper, tarragon, thyme

How to Use Herbs When Cooking

• Steaks and chops: Before cooking, pierce the meat with a fork, brush the steak or chop

with oil, and then sprinkle with herbs. Or, sprinkle herbs on meat while cooking.

• Roasts: Make slits in the raw meat and insert sprigs of herbs before roasting, orsprinkle herbs on the meat toward the end of the roasting time.

• Burgers, meatloaf, or stuffing: Add herbs to the mixture before cooking.

• Vegetables, sauces, and gravies: Moisten herbs with little water or oil. Let stand for

30 minutes and then add the herbs and soaking liquid to the food while it cooks.

• Soups and stews: Add herbs during last half hour of cooking.

Using Strong or Dominant Seasonings

• Strong herbs and spices include bay leaf, cardamom,curry, ginger, hot peppers, mustard, pepper, rosemary, and sage.

• Use these seasonings with care because their flavors

stand out.

3 In general, use 1 teaspoon of a strong dried herb or

spice to flavor 6 servings.

3 Fresh herbs will not be as strong as dried. You can

use a larger amount

of fresh herbs.





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Using Medium-Strength Seasonings

• Examples of medium-strength seasonings include basil, celery leaves, celery seed,

cumin, dill, fennel, garlic, marjoram, mint, oregano, savory, tarragon, thyme,

and turmeric.

• In general, use about 1 to 2 teaspoons of a dried medium-strength herb to flavor

6 servings.

Using Delicate Herbs

• Delicate herbs can be used in large quantities and combine well

with most other herbs and spices.

• Examples of delicate herbs include chervil, chives, and parsley.

Flavoring Foods with Liquids

• Cook fish, pork, and poultry in low-potassium fruit juices, with low-potassium fruit

or dried fruit added, or with a touch of lemon.

• Cook any meat in wine. Don’t use cooking wine. It has salt added.

• Cook meat and vegetables together.

Copyright © 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for



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Lower-Sodium Food Choices