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Understanding Sodium And Sodium Restricted Diets
Broward County > Parks > Extension Education > Nutrition > Understanding Sodium And Sodium Restricted Diets

Low sodium, low salt, sodium free, salt free, no added salt, restricted sodium. What do all these terms really mean? The media has bombarded us with warnings about the hazards of consuming too much salt. An entire industry to produce low and reduced sodium products has been created.

Sodium is a naturally occurring mineral that is present in most foods and is often used as an additive in food processing and preparation. It is an essential mineral that has many important functions within the body. Sodium plays a vital role in fluid balance and maintenance of blood pressure.

Sodium in the diet, mainly in the form of salt, is also known as sodium chloride. Salt is a mixture of 40% sodium and 60% chloride; therefore, the words "sodium" and "salt" are not the same. It is estimated that the human body requires 500 mg of sodium per day.

The sodium controlled diet is used to treat many medical conditions including hypertension, congestive heart failure, cirrhosis of the liver, kidney disease, and other fluid- or sodium-retaining conditions.

The average American diet contains up to 6500 mg of sodium per day. The American Heart Association recommends consumption of no more than 3000 mg per day. Most Americans are consuming much greater amounts of sodium than required by the body. The term “low sodium diet” is quite non-specific and often causes confusion for a lot of people. Many people ask, “How low is low?”

Sodium restrictions cover a wide range and can be mild, moderate, or severe. A mild restriction is approximately 3000 – 4000 mg per day. In healthcare facilities, this type of restriction is referred to as a “No Added Salt” or “NAS” diet. A moderate restriction is approximately 2000 mg per day and a severe restriction is approximately 500 mg per day. Physicians prescribe sodium levels dependant on medical conditions.

The most important part of following a sodium restricted diet is to read food labels. Table 1 defines terminology used on food labels. It is important to become familiar with the many different sources of sodium in food besides salt. Some of the common sources of sodium include monosodium glutamate (MSG), baking powder, baking soda, brine, sodium nitrate, sodium citrate, and di-sodium phosphate. It is also important to be aware that some medications contain sodium. Table 2 lists some common medications and their sodium content.

There are many tips for following a sodium controlled diet. The first step is to eliminate the salt shaker and develop a taste for other seasonings. The use of the salt shaker is often just a learned habit; many people do not even taste their food before adding salt. Commercially available salt substitutes are widely used to replace the salt shaker. However, caution should be used because salt substitutes often contain large amounts of potassium which may also be restricted in some medical conditions such as renal disease. More desirable replacements for salt include herb mixtures, lemon wedges, lime wedges and fresh seasonings such as garlic and onions. A typical herb blend contains a mixture of basil, thyme, parsley, cloves, ground mace, black pepper, dried savory, cayenne pepper, and ground nutmeg. Many people have never even tasted these flavors so experimenting with them is encouraged.

Certain foods are known to be high in sodium and should be avoided. Canned foods often contain large amounts of sodium as a preservative. Fresh and frozen foods are preferred over canned foods for this reason. If canned foods are to be used, look for low sodium products. Read the labels. Condiments are another group of foods that contain large amounts of sodium. Traditional Ketchup, BBQ sauce, soy sauce, salad dressings, and steak sauce are all high in sodium. Cured and salted meats should be avoided. This includes ham, bologna, hot dogs, bacon, sausages, herring, anchovies, and sardines. Milk contains approximately 120 mg of sodium per eight ounce glass and may be limited to one glass per day on very restrictive physician prescribed diets.

Using fresh foods instead of canned and processed foods, reading food labels, learning to enjoy the natural taste of food rather than using the salt shaker, and developing an awareness of how much sodium is consumed daily are all recommended. The sodium controlled diet is an important part of therapy for many medical conditions. Most people will agree that it is easier and more cost-effective to follow a sensible sodium controlled meal plan rather than to take additional medications and undergo additional costly medical procedures.

Table 1 . Terms used on Food Labels
Term Definition
Sodium Free Less than 5 mg of sodium per serving
Very Low Sodium 35 mg or less of sodium per serving
Low Sodium 140 mg or less of sodium per serving
Reduced Sodium 75% less sodium than the original version of the product
No Added Salt/Unsalted No salt was added during processing (this does not mean that the product is low in sodium)