As of Tuesday, March 26, 2013
DEAR DOCTOR K: I’ve always enjoyed my food well-seasoned. Now my doctor wants me to cut down on my salt intake. Any suggestions?
DEAR READER: Salt (sodium chloride) is like many other things in our food: We need it, just not in the amounts we take in. For most of us, the salt in our diet is too much of a good thing.
Salt helps our nerves transmit impulses. Muscle fibers need salt to contract and relax. Sodium helps the body maintain a proper fluid balance. (Not to mention it makes our food taste good!) But it doesn’t take much sodium to accomplish any of these essential jobs. And consuming too much salt can put you at risk for high blood pressure, stroke and heart problems.
How can you cut down? Start by getting a sense of where the salt in your diet comes from. I’ve put a table on my website, AskDoctorK.com, that lists the top sources of sodium in the American diet. You might be surprised by how much salt there is in certain foods.
The most sodium-heavy foods we eat tend to be processed ones. So minimize the amount of foods that are salted, smoked or cured, such as cold cuts, bacon and cheese. The same goes for canned soups and vegetables, mixes for baked goods and other prepared foods that are high in salt. With packaged foods you get in the market, the Nutrition Source label tells you how much salt is in the food. With canned soups, for example, you’ll find that some have a lot less than others.
Replace processed foods with foods made from scratch. Eat more vegetables and fruits, which contain no added salt.
You may be skeptical, but it is entirely possible to wean yourself off a taste for salt. Your taste buds can easily adapt if you cut back a little at a time. Replace salt with herbs, spices and flavorings. Experiment with garlic, oregano, rosemary, curry, cinnamon and smoked paprika. Lemon juice and flavored vinegars, and fragrant oils such as sesame or walnut, offer a sodium-free taste boost. (But beware of store-bought sauces that tend to contain a lot of salt.)
When you eat out, if your food is being made to order, ask that it be made without salt. And ask for gravies or sauces (which tend to be loaded with salt) to be served on the side. If you’re eating in a chain restaurant, it may have a menu that tells you the amount of salt (and saturated fats, cholesterol and other nutrients) in each meal.
I know how hard it can be to cut down on salt. I once had a patient who arrived at the hospital in heart failure. She swore she was following her low-salt diet. As she was being wheeled to get a chest X-ray, I saw her pull a salami out of her purse and start eating it. When I asked her about it, she shrugged. “I love it, doctor,” she said. “At my age, I love it maybe more than life itself.”
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.