Tame Salt Intake

Stick to a Daily Sodium Allowance

The recommended daily intake of sodium for healthy adults is 1500 mg. If you’re African American or older than 51, it’s only 1300 mg. It may sound like a lot but it’s surprising how quickly your meals can add up to your daily allowance. Statistics Canada reports that 85% of Canadian men and 60% of Canadian women aged 19-70 have sodium intakes exceeding the recommended upper limit beyond which health risks increase.  “Treat sodium like it’s money and you’re on a budget,” says Marilyn Tanner-Blasiar, R.D., L.D., a spokesperson for the Academy of Nutrition and Dietetics. “Let’s say 2300mg is the equivalent of 23 dollars. If you ‘spend’ 1000 mg, or 10 dollars, on chicken soup at lunch, your budget is over half gone.” Better to divvy it up more sensibly, trying not to exceed 600 mg of sodium per meal and snacks.

Cut Back on Everyday Culprits

More than 40 percent of our sodium intake comes from food most of us eat every day, according to a recent report from the Centers for Disease Control (CDC). The biggest offenders: bread, lunch meat such as deli ham or turkey, pizza, chicken soup, cheeseburgers and other sandwiches, cheese, pasta dishes, meat dishes such as meat loaf, and snack foods such as potato chips (including canned tomato sauce), pretzels and popcorn. To sidestep these sodium traps, compare nutrition labels on your favorite foods because different brands vary in sodium content. You should also look for no- or low-sodium labels, says Christine Gerbstadt, M.D., R.D., spokesperson for the Academy of Nutrition and Dietetics. Replace pre-packaged canned food wherever you can with lower-sodium alternatives like dried beans and frozen vegetables.

Learn to Find Hidden Salt Content on Food Labels

While there’s sodium in almost everything, the amount of sodium in things like condiments can be shocking. When you read a food’s ingredients, salt (sodium chloride) isn’t the only thing you should be looking for. There are other sodium-containing compounds such as monosodium glutamate (MSG), sodium nitrate or nitrite and sodium alginate, which will up the total sodium count. One tablespoon of soy sauce has 920 mg of sodium; even labeled “low sodium” has 575 mg of sodium. Other big offenders include teriyaki sauce (690 mg per tablespoon), tomato sauce (640 mg per half cup) and barbecue sauce (420 mg per two tablespoons). “If you overdo it at one meal, make sure you make low-sodium choices the rest of the day,” says Tanner-Blasiar. Also, low-fat doesn’t mean low-sodium — when food companies take out fat, they often replace it with salt to boost flavor.

Learn to Love Other Spices

Instead of adding salt, and spices to kick up the flavor in your food, like garlic, basil, cumin, chili peppers, rosemary, ginger or cinnamon. You can also try flavored vinegars, such as fig, pear and cranberry. Because premixed blends of spices often contain salt, come up with your own favorite blends of dried spices and keep them in a shaker instead of putting the salt on the table, says Gerbstadt.

Know What to Order When Eating Out

Stick to restaurants where your food is cooked to order rather than chain-type eateries where food may be prepackaged (like soup, gravy or even crab cakes). Choose simple items without gravies or sauces and ask for them to be prepared without salt. Order the baked potato instead of the mashed potatoes, but don’t eat the skin, which has likely been oiled and salted before baking. Add a salad to fill up on greens, but keep dressings on the side since they’re often loaded with sodium. Request that grilled entrees, like fish and chicken, be cooked without salt.

Watch Portion Size

You may think you’re doing fine because you only had a few handfuls of salty snacks, like pretzels or chips. But check out the label for serving size. One ounce of potato chips is 170mg of sodium; but that’s just 15 chips. “If you are going to indulge, measure out your portion so you don’t overdo it,” says Tanner-Blasiar. “It’s very easy to eat mindlessly and go overboard on portions.” And you’ll be cutting down on fat and calories, too.

Give Your Taste Buds Time to Adapt

Your taste for salt is acquired, so it will take some to get used to a lower-sodium diet. “When you first cut back, food may taste a little bland,” says Gerbstadt. “It’s simply that you’ve lost sight of how food naturally tastes.” Decrease your salt intake gradually, and after a few weeks, you probably won’t even miss it.

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Hyponatremia

What is hyponatraemia?
Although we’re often urged to cut down on salt in our diet, salt or sodium is essential for many of the body’s functions including fluid balance, blood pressure management and the nervous system.

Hyponatraemia is a low level of sodium or salt in the blood. Symptoms are not usually very specific and can include changes to a person’s mental state, headache, nausea and vomiting, tiredness, muscle spasms and seizures.

Hyponatraemia may be caused by drinking too much water, for example during strenuous exercise, without adequate replacement of sodium.

It may also be due to a loss of sodium and body fluid.

Severe hyponatraemia can lead to coma and can be fatal.

Treatment of hyponatraemia involves intravenous fluid and electrolyte replacement, medicine to manage the symptoms of hyponatraemia, as well as any treatments for any underlying cause.

What causes hyponatraemia?
A low sodium level in the blood may result from excess water or fluid in the body, diluting the normal amount of sodium so that the concentration appears low. This type of hyponatraemia can be the result of chronic conditions such as kidney failure (when excess fluid cannot be efficiently excreted) and congestive heart failure, in which excess fluid accumulates in the body. SIADH (syndrome of inappropriate anti-diuretic hormone) is a disease whereby the body produces too much anti-diuretic hormone (ADH), resulting in retention of water in the body.

Hyponatraemia can also result when sodium is lost from the body or when both sodium and fluid are lost from the body – for example, during prolonged sweating and severe vomiting or diarrhoea.

Medical conditions that can sometimes be associated with hyponatraemia are adrenal insufficiency, hypothyroidism, and cirrhosis of the liver. The eating disorder anorexia can also cause a sodium imbalance.

Some medicines can lower blood sodium levels. Examples of these include diuretics (water tablets), desmopressin, and sulfonylureas.

What are the symptoms of hyponatremia (low blood sodium)?
When sodium levels in the body are low, water tends to enter cells, causing them to swell. When this occurs in the brain, it is referred to as cerebral oedema. Cerebral oedema is particularly dangerous because the brain is confined in the skull without room for expansion, and the swelling can lead to brain damage as the pressure increases within the skull.

In chronic hyponatraemia, in which the blood sodium levels drop gradually over time, symptoms are typically less severe than with acute hyponatraemia (a sudden drop in blood sodium level). Symptoms can be very nonspecific and can include:
Headache
Confusion or altered mental state
Seizures
Decreased consciousness which can proceed to coma and death.

Other possible symptoms include:
Restlessness
Muscle spasms or cramps
Weakness, and tiredness

Nausea and vomiting may accompany any of the symptoms.

How is hyponatraemia diagnosed?

The symptoms of hyponatraemia are not specific, so a blood test measuring the sodium level is needed to confirm the diagnosis of hyponatraemia. Sometimes the medical history (such as prolonged vomiting or excessive sweating) will help a doctor with the diagnosis. In other cases, further blood tests, urine tests, and imaging studies may be needed in order to determine the exact cause of the hyponatraemia.

How is hyponatraemia treated?
Mild chronic hyponatraemia may not require treatment other than adjustments in diet, lifestyle or medication. For severe or acute hyponatraemia, treatment often involves intravenous (IV or drip) fluids and electrolytes. In this case medication is often needed to treat the underlying cause of the hyponatraemia as well as medication to manage the accompanying symptoms.

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