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Sodium and Diabetes 101

The hidden sources of dietary salt

When the topic is healthy eating, lightening up on sodium is high on the priority list, as the American Diabetes Association (“The Association”) recommends. The average American takes in about 3,400 mg of sodium per day, even though The Association guidelines recommend that people living with diabetes have 2,300 mg sodium or less per day, which is the amount of sodium in single teaspoon of salt! (For those living with diabetes and hypertension – high blood pressure – the recommendation is to aim for 1,500 mg or less per day.) But many people don’t add significant amounts of salt to their food, and might well wonder where all that sodium comes from. So let’s start at the beginning.

Sodium is an essential nutrient that helps regulate body fluids and keep muscles and nerves functioning properly, but eating minute amounts daily is usually enough. In addition, people often think of salt and sodium as synonymous, but they’re not; table salt contains 40 percent sodium and 60 percent of another mineral, chloride.

Perhaps surprisingly, the salt added in cooking or at the table usually makes up only a small percentage of an individual’s daily sodium consumption. Even fresh foods without any additives, such as fruits, vegetables, and milk contain some sodium. However, the main source, as much as 75 percent, of all this dietary sodium is processed food, as manufacturers add it for a variety of purposes, from curing meats to enhancing flavors and retaining a product’s moisture.

Another surprise that I and other experts have found is that for many people, their biggest  source of sodium isn’t that super salty pickle or drizzles of soy sauce at Asian restaurants, it’s actually the moderate sodium count in foods they eat day in and day out. The American Heart Association recently called a handful of these commonly eaten foods – bread, processed poultry products, cold cuts, pizza, soups and sandwiches – The Salty Six. Suddenly, that low-sodium-sounding deli sandwich isn’t looking so good.

Now you may wonder where limiting sodium should rank on your nutrition priority list. Good question! I encourage people I counsel to focus first on the priorities that will get them the biggest bang for their efforts. Your nutrition priorities should also take into account your diabetes and related health concerns. There’s not just one answer for everyone living with diabetes. You may want to ask your health care providers this question to get a specific answer for you.

For most people with diabetes, getting and keeping their blood sugar under control is a high priority. To accomplish this, most people need to control portions carefully and monitor their carbohydrate counts. Many people may also need to shed a few pounds. Portion control along with lightening up on fats in and on foods can help. Here’s one more surprise about sodium – just by eating fewer calories each day, you’ll eat less sodium because it’s in so many foods. So to cut down on sodium simply, I suggest you try out a few of these tasty sodium-reducing tips.

  • Prepare more home-cooked meals from fresh foods naturally low in sodium.
  • Limit packaged, canned, and frozen foods with sauces, seasonings, and gravies.
  • Buy frozen vegetables without sauces and seasonings or low-sodium canned vegetables.
  • Make your own salad dressing by the batch. Mix together a healthy oil and one of many flavorful vinegars. Use a tasty mustard to blend the ingredients together. Then add your preference of herbs, spices, garlic, and/or pepper. A few drops of vegetable or fruit juice can vary the flavors, as well.
  • Shake less salt when you prepare foods or at the table. I suggest you keep the saltshaker off the table to minimize temptation.
  • Cook with herbs, spices, lemon, lime, other fruit juices, and vinegars to enhance the flavor of foods instead of adding salt.
  • Observe the sodium count of packaged foods by using the Nutrition Facts labels. Sodium is a mandatory nutrient on most labels and it’s listed per serving of the food. If you want to buy the food, consider how it will fit into your meal plan within your sodium goal. Consider the lower sodium versions of some foods, like soups, canned vegetables, and prepared meals. To be labeled “low-sodium,” a food must contain less than 140 milligrams per serving.
  • Limit restaurant meals, especially fast food hamburgers or sandwiches with cold cuts. Opt for a salad, carrots, or apple slices rather than chips or French fries. Split and share.
  • At restaurants where food is cooked to order, request that no salt is added to your foods. Limit high sodium foods and ingredients. Then, don’t sprinkle salt at the table.

Hope Warshaw, MMSc, RD, CDE*, is the author of several best-selling books published by the American Diabetes Association, including Diabetes Meal Planning Made Easy and Guide to Healthy Restaurant Eating. She’s a frequent contributor to Diabetic Living magazine. Warshaw is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2013 The DX: The Diabetes Experience

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