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Salt has always been of high importance to the human race. Salt has been used as a preservative for burial and was even traded pound for pound with gold. The fascination with salt lies in its chemical makeup, mainly sodium. Salt is also composed of iodine and chloride. Surprisingly enough, 75% of our sodium intake comes not from the salt shaker, but from processed foods and restaurant foods1. Salt enhances flavor and it preserves food. Our body needs sodium to function properly but too much is not good for most of us and many of us who have a congenital heart defect need to make a conscious effort to reduce our sodium intake.

How Does Sodium Affect Our Body

The Good – Sodium helps to regulate fluids by letting the body know when it is time to replenish or dispose of water. In addition, sodium maintains nerve transmissions and muscle contraction – functions vital for our survival. Unfortunately, that is where the good ends.

Sodium plays a key role in balancing the fluid levels in our body. It signals the kidneys to retain or get rid of water. Higher sodium levels interfere with this delicate process and lead to fluid retention for those at risk. The result – less fluid removed from the body which can lead to higher blood pressure or symptoms from retained fluid such as difficulty breathing or swelling in the belly or legs. The liver can get congested in certain patients, such as those who have had a Fontan operation, and create issues there as well.

The recommended daily intake of sodium for congenital heart patients depends on many factors. Those with normal kidney, heart, and liver function can do fine with up to <3000mg/ day. Those with poor kidney, heart, or liver dysfunction, or hypertension might need as little as 1500mg/ day. Simply put, if you need a diuretic or blood pressure med you should stay on the low end. If you don’t, you can probably consume more. This seems very achievable until you start to consider that almost everything you put into your body contains sodium, sometimes from the most unlikely sources.

Let’s consider breakfast. You realize it is the most important meal of the day. You are trying to eating right. You understand that you need a fair amount of protein and a low amount of carbohydrates but you are in a hurry. So you stop at Starbucks on the way to the office and grab the usual weekday breakfast. A Sprouted Grain Vegan Bagel. After all, it has only 280 calories, only 1.5 grams of fat, 9 grams of fiber, and 12 grams of protein. That is healthy except it has 620 milligrams3 of sodium and your green tea has 10milligrams of sodium. In total 630 mg of sodium to start your day. You theorize that is okay, “I was planning on having a salad at lunch.” The Roasted Beet, Quinoa, and Citrus salad from Panera has 660 mg of sodium4. So half way into your day and long before dinner, you have consumed 1290 milligrams of sodium. What’s for dinner?

What’s the big deal? So what if I go over once in a while? What’s the harm? Truth be told it probably isn’t harmful if you go over by a little bit occasionally. Missing the mark every day by a large margin is a concern and if we don’t track it the chances are far greater that will happen.

How can you effectively reduce your sodium intake and more importantly have food that still tastes good?

  • Track it. Look at the labels and the sodium content. Everything in a grocery store should have a nutritional information panel. CHECK THE SERVING SIZE. Remember, there may be more in the container than what is considered a serving size. I.e.: a dill pickle has about 550 mg sodium. Depending on the brand there may be 22 servings in the jar. As it turns out the serving size is half a pickle. It is easy to get fooled.

  • A good rule of thumb is the more fresh foods in your diet the better.

  • Processed and canned foods have high amounts of sodium for preservation and cost effective production. Salt is a large source of sodium and a cheap way to season food when compared to other spices. Canned vegetable such as corn, beans, peas, and others should be drained and rinsed.

  • Look for items marked “Low Sodium” when choosing tomato paste or canned tomatoes, vegetable, beef, fish, and chicken stock.

  • When doing Asian night at home use low sodium soy sauce and teriyaki sauce.

  • Use other spices to enhance flavors of meats such as Mrs. Dash’s. Chicken and pork pair nicely with Rosemary and Thyme.

  • Use salt sparingly with other spices. A ¼ teaspoon of salt has 590 mg of sodium5 but paired with oregano, parsley, onion, garlic, cumin and pepper it will flavor an entire 8 serving pot of chili.

  • Using dried beans instead of already cooked beans avoids sodium all together. A little planning allows soaking them overnight. Spice can be added using Jalapeño peppers and chili powder.

  • When eating out ask for your dressing on the side and forego the blackening spice on meats. Some bread is okay but it is a large source of sodium.

  • Consider baking your own bread. Fresh baked bread can be sliced and frozen in individual slice servings to keep it fresh.

  • If you are going for wings, ask for them plain and get the sauce on the side. Try getting baked if possible.

Here are some common foods and their sodium content*


FoodServing SizeSodium ContentFoodServing SizeSodium Content
Kroger Low Sodium Ketchup1 Tblsp70 mgJif Peanut Butter2 Tblsp135 mg
Kroger Lite Soy Sauce1 Tblsp530 mgApple Jacks1 Cup150 mg
Kroger Reduced Sodium Chicken Stock1 Cup570 mgCostco 2% Reduced Fat Milk1 Cup125 mg
Franks Red Hot Sauce1 Tsp190 mgBusch Chili Beans½ Cup450 mg
Wish-Bone 1000 Island Drsg2 Tblsp340 mgGoya Kidney Beans½ Cup350 mg
Sunshine Cheez-It Crackers27 Crackers230 mgKraft Shake n Bake for Pork1/8 Packet190 mg
Orville Redenbachers Microwaved Single Serving Butter Popcorn1 Bag320 mgKen’s Steakhouse Lite Balsamic Vinaigrette2 Tblsp310 mg
Tones Crushed Red Pepper¼ Tsp0 mgMcCormick Black Pepper1 Tblsp0 mg
Mrs. Dash’s Extra Spicy Blend1 Tsp0 mgChik-Fil-A Original Chicken Sandwich1 Sand1370 mg
Mc Donald’s Quarter Pounder w/ Cheese1 Sand1090 mgTaco Bel Nachos BellGrande1 Plate1290 mg

Footnotes – 1, 2American Heart Association, 3Starbucks Nutritional Information, 4Panera Bread and Bakery Nutritional Information, 5Morton Salt Nutritional Information Panel

*Brand Name is listed – Sodium may vary by brand. All information comes from the Nutrition Information Panel

©2017 Georgia Adult Congenital Hearts

Content reviewed for medical accuracy by Dr. Wendy M. Book and Cam Hebson – Emory Adult Congenital Heart Center