My Care Team has put me on Sodium (Salt) Restriction. What do I do now?

Sodium Restriction for Patient with Pulmonary Vascular Disease/Pulmonary Hypertension or other heart conditions (congestive heart failure/CHF)

The American Heart Association recommends a daily sodium intake of 2400 mg or less for the American population and 2000 milligrams (mg) or less for patients with heart failure. Many American take in nearly 6000 mg of sodium each day. The general recommendation for patients with PAH should follow the guidelines of the American Heart Association, that is an intake of less than 2000 mg per day (see http://www.americanheart.org ). In patients with right heart failure, their physician may recommend a more restricted sodium intake.

The first step one can take to lower sodium intake is to stop using the salt shaker entirely when cooking, baking, or eating a meal. Another effective way to lower one's sodium intake is to minimize the consumption of processed foods. Processed foods are those that are prepared commercially including most canned, frozen, commercially baked, and dry foods. One should try to eat foods that are more natural, unprocessed (such as fresh fruit and vegetables, meat, and poultry), or home-cooked (from scratch) rather than commercially-prepared meals.

When buying processed foods, one should look for the following comments on the nutrition label: "low sodium", "sodium-free", "no salt added", and "unsalted". Low sodium indicates that the food has 140 mg or less per serving, very low sodium indicates the food has 35 mg or less per serving and sodium-free indicates that the food has less than 5 mg of sodium per serving. When shopping, it is important to take into account not only the milligrams of sodium per serving but also the size of the serving. The percent daily value of sodium listed on a food label is based on a 2400 mg of sodium allowance over an entire day. It is also important not to be misled by "light" labels. Many low-fat or fat-free foods are high in sodium. Also reduced sodium doesn't mean much if a product is high in sodium to begin with. For example "light soy sauce" still contains over 500 mg of sodium per tablespoon. A listing of sodium content of food and guidelines for various levels of sodium restricted diets can be found on the American Heart Association web site.

The use of low-salt substitutes should be discussed with one's physician. Many of these substitutes are high in potassium and may not be advisable for patients with kidney problems or those who are taking potassium-sparing diuretics (i.e., spironolactone). A number of other herbs and spices can be substituted for salt and salt substitutes to enhance flavor. These include basil, bay leaves, chives, curry powder, dill, garlic, ginger, dry mustard, nutmeg, onion, parsley, rosemary, sage, savory, thyme, and turmeric.