After a diagnosis of heart failure, "reduce salt intake" is one of the first pieces of advice doctors offer. Sodium contributes to fluid retention, and too much sodium is one of the most common triggers for exacerbation. For this reason, doctors recommend that those with heart failure limit salt intake to 1,500 to 2,000 milligrams of sodium per day.
But how to do that? Start by following recommendations for managing diet for heart failure. Putting away the salt shaker helps, as does learning to cook with other flavors, such as garlic, citrus, and herbs. However, many people find it's much harder than they expected to reduce sodium intake, and the culprit is often hidden salt. Here's a list of some of the biggest "salt traps" to avoid.
1. The Condiment Shelf
Many people are surprised to discover that many salad dressings, sauces, dips, and condiments such as ketchup, mustard, and relish rely on high sodium content to achieve a concentrated flavor. Soy sauce, for example, has about 1,160 milligrams of sodium per tablespoon, while ordinary chicken bouillon has about 1,100 milligrams per packet. But while bouillon and soy sauce taste recognizably salty, this is not true of many other condiments. Your taste buds may not recognize the flavor as salty despite high quantities of sodium. Some examples:
- Italian salad dressing: 430 milligrams in 2 tablespoons
- Spaghetti sauce: 850 milligrams in a half-cup
- Alfredo pasta sauce: 1,080 milligrams in a half-cup
- Pickle relish: 240 milligrams in 1 tablespoon
- Sun-dried tomatoes: 1,050 milligrams per cup
2. Cheese and other Dairy products
Salt is used in the making and preserving of many cheeses and cheese products, yet often we don't think of them as salty. Rich, piquant cheeses like blue cheese, gorgonzola, and Roquefort are among the saltiest, all of them coming in between 350 and 500 milligrams per serving. Cheese spreads and dips often have as much as 500 milligrams of salt per serving, as can good old cheddar cheese. Parmesan, Romano, feta, and many of the other cheeses used in cooking are high in salt.
Milk itself has 120 milligrams of sodium per half-cup serving; choose buttermilk or chocolate milk instead and the level rises to150 milligrams. And a half-cup serving of a low-fat cottage cheese has twice as much sodium (360 milligrams) as a serving of potato chips.
3. Canned soups, Stews, and Vegetables
The Campbell Soup Company made headlines recently by putting the sodium back into some of the company's canned soups that had previously had the salt content reduced. The reason? Consumers weren't buying the products because they didn't taste as good -- and therein lies the problem.
Many flavors of canned soup, from home-style chicken to simple tomato, contain 700-1,300 milligrams of sodium per serving. French onion soup is one of the worst, with 1,300 mg per serving. Canned beef stew and chili both have 1,000 to 1,200 milligrams per serving, and vegetable soups, like minestrone and split pea, contain 800-1,000 milligrams per serving. It's also important to realize that a serving is often just half a cup, much less than the average person eats at a sitting.
One last surprise lurks in some types of canned vegetables. One can of kidney beans contains 440 milligrams of sodium, and canned tomatoes with spices added ("Italian style," for instance) can contain up to 600 milligrams of sodium per half cup.
4. Breakfast cereals
Store-bought breakfast cereals vary widely in salt content, so read labels carefully. Some of the most popular brands -- including Chex, Total, and Wheaties -- contain between 250 and 300 milligrams of sodium in a one-cup serving, though many people eat double that much at breakfast. And beware the "healthy" label; some of the highest-sodium cereals are those we consider healthiest, such as raisin bran. Kellogg's Raisin Bran has 340 milligrams per cup; instant oatmeal has as much as 350 milligrams per three-fourths cup serving, depending on the flavor.
5. Baked goods and Bake mixes
A bagel might not taste particularly salty, but one bagel can contain 500-700 milligrams of sodium, depending on the size and flavor, while one piece of whole-wheat pita bread has 340 milligrams of sodium. Baked goods made with white flour aren't necessarily worse than those made with whole wheat; one slice of whole-wheat bread contains 132 milligrams of sodium, and a sandwich doubles that.
Sweet baked goods can be loaded with hidden salt. One doughnut contains close to 300 milligrams of sodium, and a blueberry muffin is close behind at 250 milligrams. But an even bigger surprise lurks in baking mixes: One box of self-rising cornmeal contains a startling 1,860 milligrams of sodium, or 440 milligrams per one 3-tablespoon serving; a single corn muffin made from a mix has 400 milligrams of sodium; and one slice of yellow cake made from a mix has 220 milligrams of sodium.