Health authorities have long been warning Americans to slash the sodium in our diets. Yet with restaurant meals and processed foods growing in popularity, the low-sodium diet remains elusive. Many of us are consuming more sodium than ever -- and not just from the salt shaker.
In fact, 3/4 of the sodium in our diets comes from processed foods, says Columbia University researcher Wahida Karmally, DrPH, RD. And the watchdog group Center for Science in the Public Interest found that 85 out of 102 meals at popular restaurant chains contained more than a full day's worth of sodium. Some of the meals had four days’ worth of sodium.
Consuming too much sodium is serious business because it's a risk factor for high blood pressure. High blood pressure, in turn, can lead to stroke and heart disease.
Most U.S. adults consume the equivalent of 1 1/2 teaspoons of salt or 3,400 milligrams of sodium each day. That's over twice the daily recommendation of 1,500 milligrams of sodium.
And the American Medical Association has called for food manufacturers to reduce sodium in foods by 50% over the next 10 years.
So how do you go about moving toward a more low-sodium lifestyle? One of the best places to start, experts say, is with restaurant meals.
How to Follow a Low-Sodium Diet When Eating Out
Since even unprocessed foods like milk have small amounts of sodium, it’s tough to figure out exactly how much sodium you're consuming. Eating out makes things even more difficult since it's hard to know how foods were prepared.
Some the worst restaurant offenders are fast-food outlets and so-called "fast casual" restaurants, says Sarah Krieger, MPH, RD, a personal chef and spokeswoman for the Academy of Nutrition and Dietetics (formerly the American Dietetic Association).
"Fast-food and fast-casual restaurants have little control over the food because they simply assemble it" rather than cooking from scratch, she says. "So it is harder to request less sodium, other than checking the web site or asking for a brochure in search of lower-sodium options."
Asian restaurants like Japanese, Thai, and Chinese also tend to serve high-sodium cuisine, since they use lots of sauces, chicken stock, and soups. Likewise, Italian restaurants often rely on high-sodium canned tomato products for their red sauces and use plenty of sodium-laden cheese.
If these are some of your favorite restaurants, Krieger suggests ordering foods as plain as possible and using portion control.
"Ordering wisely and keeping your portions reasonable, like one slice of plain or vegetable pizza and a salad, allows you to scale back on sodium as well as fat and calories," she says.
Krieger also offers these 10 tips to help trim the sodium when dining out:
1. Ask lots of questions to learn as much as you can about the preparation of each food; even a baked potato may be rolled in salt before cooking. Ask about spices, rubs, marinades, and finishing sauces, all of which can be loaded with sodium.
2. Frequent locally-owned restaurants where most foods are cooked to order. It may be easier for such restaurants to accommodate requests for less salt.
3. Skip the sauce on your entree, or ask that it be served on the side. For taste without all the sodium, just dip your fork into the sauce, then use it to spear your food. (This helps control calories and fat as well as sodium.)
4. Pass on casseroles and stick to basic foods that are grilled, baked, or roasted.
5. Salsa and ketchup may be low in calories and fat but high in sodium, so use them sparingly.
6. Taste your food before salting and use the salt shaker sparingly.
7. Bring along your own low-sodium spice mix, like Mrs. Dash, to flavor your food.
8. Round out your meal with simply prepared fruits and vegetables, which are naturally low in sodium. Ask for steamed vegetables with no sauce, and use a squeeze of lemon to brighten the flavor.
9. Go easy on the cheese, olives, deli meat, and croutons in your salad, and ask for salad dressings on the side.
10. Order sorbet or fruit for dessert.
Tips for Eating Low Sodium at Home
While this might not be the advice many of us are looking for, Krieger recommends eating out only once a week, for the sake of your wallet and your health.
"When you eat out, you tend to eat more calories and have less control over the ingredients," she says. "So why not get back into the kitchen, preparing more fresh foods, fewer processed foods, and slash the sodium by using flavorful ingredients?"
A few of her favorite high-flavor, low sodium ingredients are roasted garlic, caramelized onion, fresh herbs, citrus, wine, fruit juices, and homemade chicken stock.
She also makes it a point to buy seasonal produce.
"When fruits and vegetables are in peak season, they taste delicious without any additions, so taste the tomato before you automatically add the salt," Krieger says. "And whenever you do need salt, add it at the end of cooking so you can taste it."
Avoid buying processed foods at the grocery store, but when you do, check labels to select the ones that contain the least sodium. Foods likely to be highest in sodium include:
• Canned foods (other than fruits)
• Frozen entrees and pizzas
• Frozen vegetables with sauces
• Deli, cured, and processed meats (like ham, hot dogs, and sausages)
• Crackers, chips, and nuts
• Instant puddings
• Some breads, cookies, cakes and cereals