Low-Sodium Diet: Pros, Cons, And More

Written by Ahmed Zayed Helmy, MD, on November 25, 2020

We see more and more people that are living by the guidelines of a low-sodium diet. While some are doing that for obvious health-related reasons, others see it as a chance to improve their overall health. But is sodium the enemy to our health? Are there any unwanted effects that you should expect? And what foods should you avoid? We will answer all of these questions and more in the next couple of minutes.

What is the low-sodium diet?

Sodium is one of the essential minerals that our body needs to survive (1). This mineral is involved in multiple bodily functions such as regulating the blood pressure levels, fluids, electrolyte balance, and much more. It is up to our kidneys to regulate the sodium levels according to the concentration of every bodily fluid that there is in the body (2).

Veggies, fruits, and poultry are some of the best natural sources of sodium, no matter how little sodium they carry within them. Animal-based products, too, contain sodium as well, although in much higher amounts (3). However, table salt remains to be the main source of sodium. This is where things often go wrong.

Did you know that the average American eats up to five or more teaspoons of salt each day? Did you also know that this is around 20 times more than what our body really needs? You may be surprised but our body only needs as little as ¼ teaspoon of salt to survive. Doctors recommend eating less than 2,000 mg of sodium per day (4).

Eating too much salt is a continuous risk factor for several health issues. A high-sodium diet can raise your blood pressure levels. It can also cause fluid retention, thus leading to swelling of the legs and feet (5). Many other health issues may follow as well.

A low-sodium diet, as the term suggests, is a diet plan that restricts eating too much sodium. To do that, it limits high-sodium foods and beverages. Patients usually restrict or completely avoid these kinds of foods and drinks. Instead, it introduces you to the world of healthy eating and low-sodium foods and drinks that are both tasty and beneficial for your health.

Who is recommended to follow a low-sodium diet?

Patients with Heart Disease

A low-sodium diet is within the standard treatment plan for those with any heart issues, especially heart failure. Patients with heart failure struggle with a declining kidney function. This may lead to sodium and water retention. If the patient continues eating a high-sodium diet, this may lead to fluid overload. In this case, symptoms such as swelling of the legs and feet, fatigue, and shortness of breath take place (6).

Patients with mild heart failure are recommended to limit their salt intake to less than 3,000 mg per day. Those with moderate to severe heart failure are recommended for consuming no more than 2,000 mg per day (7). However, there are divided opinions on the topic. While some consider a low-sodium diet to be the key for heart failure patients, others disagree. There is proof that consuming less than 2,500 mg of sodium per day increases the risk of death or hospitalization in those with heart failure (8). Knowing this, it is up to your doctor to decide what is best for you, considering your overall health status and medical history.

Patients with High Blood Pressure

High blood pressure is a serious health issue, one that poses as a potential risk factor for several complications including heart disease and stroke (9). Recently, research has confirmed that a high-sodium diet is highly associated with high blood pressure. A recent study has shown that patients who had the highest urinary sodium excretion also had the highest blood pressure levels (10).

Patients with Kidney Disease

We mentioned the kidneys being the organs that regulate the sodium levels in the body. Whenever any type of kidney disease is present, it compromises kidney function. That being said, the kidneys are unable to properly regulate the sodium levels in the body. In this case, it is expected that the sodium and fluid levels become too high, thus leading to further kidney damage (11). All patients with kidney disease are highly recommended to intake no more than 2,000 mg of sodium daily (12).

What Are the Benefits of A Low-Sodium Diet?

Research shows that restricting sodium can help reduce the risk of some of the most common health issues. In the following, we will share three important health benefits that a low-sodium diet has to offer.

It lowers blood pressure levels – A 2015 review showed that following a low-sodium diet has a positive effect on one’s high blood pressure levels (13). The salt-restriction had the greatest effects on those with severely high blood pressure levels.
It reduces cancer risk – Eating too much salt may expose you to several types of cancer. A review of 76 studies shows that five grams of salt per day increased the risk of stomach cancer by as much as 12% (14). On the other hand, eating a diet that is low in high-sodium and processed foods is strongly linked to a lower risk of stomach cancer (15).
It improves overall diet quality – A low-sodium diet restricts eating processed foods. Processed foods are often the source of empty calories, unhealthy fats, and way too many carbs. That being said, the elimination of these foods will not only reduce your salt intake but also improve the overall quality of your diet.
It may induce weight loss;
It prevents heart disease and stroke

Are There Any Possible Side Effects?

Consuming less than 2,500 mg salt per day is associated with a significantly higher risk of death or hospitalization (16);
Low sodium intake, too, threatens your heart health;
Consuming too little salt can potentially increase cholesterol and triglycerides levels (17);
A low sodium diet may lead to insulin resistance;
An extremely low intake of sodium has been linked to hyponatremia.

Which Low-Sodium Foods Should You Eat?

Fruits and veggies

Any fresh fruits that you like such as watermelon, apples, oranges, bananas, etc.;
Any fresh veggies that you enjoy eating such as bell peppers, broccoli, carrots, spinach, etc.;
Frozen fruits and veggies without added sauce and/or butter;
Canned fruits and veggies that are low in sodium and no added salt;
Low-sodium vegetable juice;
Dried fruits with no added sugars.

Whole-grain foods

Whole grains including brown rice, barley, or quinoa;
Whole-wheat or whole-grain pasta and couscous;
Whole-grain breakfast cereal and oatmeal with no added salt;
Unsalted popcorn and other low-sodium snacks;
Whole-grain bread and tortillas.

Protein

Fresh and frozen fish and shellfish;
Fresh and frozen chicken and turkey breast without skin or marinade;
Lean beef and pork;
Eggs – whole eggs and egg whites;
Canned low-sodium or no salt added beans;
Dried beans and peas including beans, chickpeas, lentils;
Unsalted nuts and seeds.

Dairy products

Fat-free and low-fat milk;
Fat-free and low-fat yogurt;
Low-sodium cheese;
Soymilk;
Unsalted butter.

Dressing and condiments

Vegetable oil such as canola, peanut, olive, sunflower, etc.;
Vinegar;
Low-sodium and no added salt ketchup;
Low-sodium salsa.

Seasonings

Fresh and dried herbs and spices;
Lemon/lime juice;
Fresh and dried ginger.

High-Sodium Foods to Avoid

Any type of fast-food including pizza, burgers, French fries, chicken fingers, etc.;
High-sodium snacks such as salted nuts, salted crackers, salted potato chips, salted pretzels, etc.;
Microwave dinners such as frozen pizza, frozen meat, etc.;
Any type of processed, smoked, cured, and canned meat, fish, and poultry such as hot dogs, bacon, lunch meats, ham, sardines, anchovies, etc.;
High-sodium canned veggies, pasta, meats, and fish;
High-sodium canned and packaged soups;
Baking mixes including pancake and cake mixes;
Boxed meals such as mac and cheese, rice meals, etc.;
High-sodium sauces and condiments including gravy, soy sauce, salad dressings, etc.;
Pickled veggies including sauerkraut, olives, and pickles;
High-sodium dairy products including salted butter, cottage cheese, buttermilk, etc.;
Regular vegetable juice;
Seasonings such as salt and salt blends.

More Low-Sodium Diet Tips

Making so many changes all at once can be quite difficult and overwhelming. The last thing that we would like to do is to endanger your mental health. To make this process easier for you and even a bit fun, we recommend the following low-sodium diet tips.

1. Write a Shopping List

Now that you know which foods you should avoid, it is time to write your shopping list. Put all of the allowed foods there and go on a shopping trip. Eating healthy will be easier if you have these healthy foods at your side. It is impossible to make a salad if all that you buy are snacks and microwave dinners. Be smart about what you put in your shopping cart, and with that in your body as well.

2. Make Time for Cooking

Did you know that eating outside is considered to be the leading contributor to high-sodium intake? Research published in Circulation showed that commercial and restaurant food accounted for as much as 70.9% of the total sodium intake. (18). Ask yourself this – How often do you eat out? Do you have the habit of eating take-out for dinner and lunch? Do not feel guilty because this is exactly what most of us are doing right now. It is what our busy schedules have led to. Today, we rarely have the time to use that beautiful kitchen of ours just because we are stuck at work and feeling too tired when we come back home.

But, have you heard about meal-prepping? This can be your savior. Or even waking up half an hour earlier than usual can give you enough time to make a tasty breakfast and lunch for work. Cooking at home gives us the unique opportunity to actually control what goes into our food, including the amount of salt. A 2017 study showed that those who cooked at home have a better diet quality and less body fat as compared to those who did not (19). Do not underestimate your cooking skills and try to keep things interesting by trying out new and fun recipes. Who would think that cooking can be so much fun?

3. Use More Fresh Produce

Make the effort to use more fresh produce in your cooking. Add fruits and veggies to your every meal, including snacks. Prepare a fresh side salad to go with your lunch and use fruits and veggies to invent new snacks.

4. Experiment with the World of Spices

Salt, pepper, and cinnamon are the usual spices found in everyone’s kitchen. So why not take the time to explore beyond that? Look for low-sodium recipes that offer you the opportunity to explore the world of spices. As soon as you try adding some fresh herbs, you will never go back to using plain salt. And how about replacing salt with fresh lemon juice, for a change?

5. Be Smart About Snacking

Snacking is a part of our everyday life. Snacks take care of our hunger in between meals and give us the much-needed energy boost in the middle of the day. But, then again, we often snack on sweets, chocolate, baked goods, and salty snacks to curve our hunger. One tip that we could give you is to replace your old snacks. Instead, buy some fresh fruits and veggies, unsalted nuts, unsalted peanut butter, and try preparing low-sodium snacks that you can enjoy.

6. Make A Homemade Salad Dressing

No one likes eating salad without any dressing. Even a pinch of salt can make a major difference. We are meant to enjoy our salad. That is the only way we will keep coming back for more. What you may not know is that store-bought salad dressings are often filled with too many unhealthy fats and sodium. Our tip would be to prepare homemade salad dressings from scratch. Use lemon juice, lime juice, veggie oils, fresh herbs, and honey to make your very own salad dressing. Keep experimenting until you find your favorite one.

Conclusion

The low-sodium diet is among one of the most popular diet plans. But unlike most diet plans, this one is tailored to benefit your health, rather than helping you lose weight. Today, we discussed both the benefits and the unwanted effects of following a low-sodium diet. We also explained who would benefit the most and what foods you should and should not be eating. Hopefully, this will be enough for you to decide for or against the low-sodium diet.