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SALT REDUCED DIET

What is a Salt Reduced Diet ?

People vary a great deal in the amount of salt they eat. The main ingredient of common salt is sodium. Like most other elements, the amount of sodium is measured in millimoles (mmol). From all the food and extras that we consume, most people eat well above 200 mmol of sodium each day. Although everybody needs salt in small amounts to stay healthy, research suggests that on average we consume ten times more salt than the body needs. There are three types of low salt diets. A "no added salt" diet provides 80 to 100 mmol of the element sodium each day. A "low salt" diet contains 40 to 60 mmol of sodium each day. There is also a highly restrictive "very low salt" diet containing about 20 mmol of sodium each day.

What is it a Salt Reduced Diet used for ?

A "no added salt" diet is recommended for the treatment of most people with high blood pressure. High blood pressure helps to cause strokes, heart attack and kidney damage. A "low salt diet" and the "very low salt diet" are usually only used under medical supervision, with intake of fluids usually being restricted as well. These diets are used in the treatment of people who are finding it difficult to rid their body of excessive water. This happens when either the heart, the kidneys or the liver are not functioning properly.

How does a Salt Reduced Diet work ?

The intake of sodium (salt) is closely tied to the amount of water that the body can handle. The more salt we eat, the more water tends to be kept "on board". A totally healthy body has remarkable control systems. Even if a lot of salt is eaten, the kidney can get rid of the extra salt that the body does not need by passing it out through the urine. However, if the control systems fail (as in kidney, heart and liver disease), the body will retain both salt and water, sometimes causing blood pressure to rise. If more severe, the body can swell with fluid. This is called oedema. If the fluid collects inside the abdomen, it is called ascites.

What does the diet involve ?

NO ADDED SALT DIET In people at risk of blood pressure problems, salty foods can make blood pressure worse. Cutting down the salt intake may help to reduce this problem. There are three important points to remember: Only use a pinch of salt in cooking . Do not add salt at the table or to cooked food. Avoid very salty foods such as tinned meat, bacon, cured meats, ham, sausages, meat pastes or pates, smoked fish, tinned fish in brine or tomato sauce, shellfish, limit hard cheese to 125 g (4 oz) per week, salty savoury biscuits, tinned vegetables in brine or with added salt, tinned and packet soups, Oxo, Marmite, Bovril, stock cubes, gravy powder/ granules, soya sauce, monosodium glutamate and salted or flavoured nuts and crisps. There are many alternatives to use instead: all fresh and frozen meat, fresh unsmoked fish, tinned fish in oil or water, milk, eggs, cream, yoghurts, cottage cheese, bread, biscuits, rice, pasta, all animal and vegetable fats and oils, all fruits, all fresh or frozen vegetables, tea, coffee, squash, fizzy drinks, fruit juice, home made soups without salt, unsalted crisps and nuts (look for crisps with a separate salt sachet but don't use the sachet!).

LOW SALT DIET Firstly, you will need to follow all the above suggestions. In addition, you should limit milk intake to half a pint a day and bread intake to three slices a day. Breakfast cereals must be free from added salt, use only Shredded Wheat or Sugar Puffs. No salt should be used in cooking or at the table. Salt free butter or margarine must be used. Medicines containing sodium should also be avoided. These include effervescent (fizzy) tablets, laxatives, and some stomach settlers. Also watch your intake of gravy salts, baking powder, bicarbonate of soda and ketchups. Keep other processed, dried or packaged foods to a minimum.

VERY LOW SALT DIET You will need to follow everyone of the above suggestions. In addition, you will need to restrict your salt intake further by using salt free bread only. Remember that this diet is very restrictive and should only be used under medical supervision.

What to watch out for in a Salt Reduced Diet

All diets should avoid so-called "Lo Salt" as this still contains some sodium. There are salt substitutes available, for example Ruthmol (Cantassium) which is obtained through your doctor or dietitian. This contains potassium rather than sodium and the taste is a little different. Better still, try using extra herbs and spices, garlic, lemon or black pepper to improve the taste of your food.

What if a Salt Reduced Diet is not followed ?

With high blood pressure, not following the diet could mean having either to start on blood pressure tablets or at least needing higher doses than would otherwise be necessary. However there are many other things which affect blood pressure such as stress, obesity, lifestyle and underlying medical conditions. There is ongoing medical research and discussion into just how important a role salt plays in blood pressure problems. When there is serious fluid overload, drugs called diuretics are used: without salt restriction they are often far less effective, and oedema and ascites may be much slower to settle.