Heart Failure and a Low-Sodium Diet: What to Know

Medically Reviewed by James Beckerman, MD, FACC on November 05, 2022
5 min read

One way you can improve heart failure symptoms? Eat less salt.

Sodium, a key mineral in salt, helps your body keep the right amount of fluid in your bloodstream. When you eat a lot of it, your blood vessels take in more water. That raises blood pressure. It also makes heart failure symptoms worse, like the fluid buildup, weight gain, bloating, and swelling that happen when your heart doesn’t pump as well as it should.

To help keep your condition under control, you need to be careful to get the right amount of sodium in your diet.

If you’re living with congestive heart failure, it’s best if you limit the sodium in your diet to less than 1,500 milligrams a day. That’s far less than the amount that most Americans eat -- 3,400 milligrams.

You may not realize it, but it’s likely that more than 70% of the sodium in your diet comes from packaged foods and meals cooked in restaurants. Buying fresh foods and cooking at home are some of the best ways to cut back.

Some foods you don’t think of as salty, like bread or cookies, can have a surprising amount of sodium. Before you buy a food, check the packaging to know how much sodium it has.

The Nutrition Facts panel lists the milligrams of sodium in one serving of that food, as well as the daily value (DV) -- the percentage of the daily recommended amount of that nutrient -- that you get from a serving. If you’re trying to eat less salt, it’s a good idea to buy foods with 5% DV or less of sodium.

Also, check out the ingredients list. If you see the words “salt,” “soda,” or “sodium” in any form, the item has sodium in it.

A few other terms on food packaging can give you a clue about its sodium content:

Sodium-free: The food has less than 5 milligrams of sodium per serving.

Very low sodium: It has less than 35 milligrams of sodium in a serving.

Less (or reduced) sodium: The food has at least 25% less sodium in a serving than usual.

Light in sodium: There’s at least 50% less sodium per serving than usual.

Grocery store shelves are packed with plenty of low-salt choices that can help you build a heart-healthy diet. Here’s how to shop for the essentials:

Fruits and vegetables. You can buy them fresh or frozen, but choose the ones without added butter, sauces, or seasonings.

Meat. Processed meats like bacon, lunchmeat, hot dogs, sausage, salami, and ham are high in sodium. So are meats that are smoked, cured, or canned. Instead, buy fresh or frozen fish, chicken, beef, or pork that you can cook and season yourself. Some raw meats have sodium added as part of their packing process. If there’s a Nutrition Facts label, look for a DV of 5% sodium or less.

Beans. You can buy dried beans to cook at home so you can control how much salt goes in. If you buy them in a can, look for those with no salt added. Rinse them off before you eat them to remove extra sodium.

Cereals. Oatmeal and shredded wheat are healthy choices. Choose the plain kinds, you can dress them up with fruit or nuts before you eat them. If you buy cold cereals, look for ones with 5% DV sodium or less on the Nutrition Facts label.

Pasta, rice, and other grains. Skip the pre-seasoned kinds and go for whole grains, like brown or wild rice, quinoa, whole wheat pasta, or couscous.

Snacks. Good bets include unsalted popcorn, crackers, pretzels, and nuts.

Dairy foods. Milk, yogurt, and many other dairy products are naturally low in salt. When it comes to cheese and butter, look for low- or no-salt options.

Dressings and condiments. Store-bought versions of salsa, salad dressing, soy sauce, and other condiments can be super salty. The best bet is to make your own at home. If you buy premade, look for low- or no-sodium versions. And watch your portion sizes. Some store-bought items like ketchup aren’t too bad if you stick to a tablespoon or so.

A few other ways to cut back on the salt you eat:

  • Use herbs and spices to season your food: You can add great flavor to your meals without ever lifting the saltshaker. Try citrus juice or zest, black or red pepper, allspice, ginger, cardamom, dill, curry, sage, or rosemary. You may not even miss the salt.
  • Be careful with light salts: Some salt substitutes have table salt in them. If you use these items too much, you’ll still take in too much sodium. Most of them also have potassium chloride, which can cause problems for people with heart failure.
  • Track your sodium levels daily: You can download worksheets online to help you track, or just keep notes on your smartphone or with a pencil and paper.
  • Take it slow: It takes about 6 to 8 weeks to get used to eating less salt. Make small changes every day, and be patient with yourself.

Though cooking at home is a good way to control the amount of sodium in your food, you’ll still want to have a meal out from time to time. There are some good ways to stick to your low-salt goals when you go out:

  • Ask if the restaurant has a separate low-sodium menu.
  • Ask for your food to be prepared without added salt or MSG.
  • Instead of fried foods, go for items that are steamed, grilled, broiled, baked, roasted, or poached.
  • Request olive oil and vinegar instead of salad dressing.
  • Skip the breadbasket or ask for whole-grain breads, rolls, or breadsticks.
  • Choose appetizers with lots of fruits and veggies. Avoid those with heavy sauces or butter.
  • Enjoy sorbet, sherbet, meringues, or plain cake with fruit puree for dessert.
  • Order a fruit salad, tossed greens, or spinach salad without added cheese or meat.

Sodium isn’t the only part of your diet to keep in mind:

  • Eat a variety of foods. This will help make sure you get all the nutrients you need.
  • Include high-fiber foods like vegetables, beans, whole-grain foods, bran, and fresh fruit in your diet. Fiber helps move food along your digestive tract, controls blood sugar levels, and may reduce the level of cholesterol in your blood. You should have 25 to 35 grams of fiber each day.
  • Cut back on alcohol. It can affect your heart rate and make your heart failure worse.
  • Talk to your doctor about how much fluid you should be drinking each day. Have less (including soup) if you have shortness of breath or notice swelling.