Most people with Chronic Kidney Disease (CKD) are likely consuming much more salt than they realize because it is "hidden" from both their eyes and taste buds. Have you ever wondered why you have elevated blood pressure or gained too much weight between dialysis treatments, but believe you are doing a "good job" of eliminating salt and salty foods from your diet? Well, chances are you may need to reconsider.
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Many individuals with CKD who say that they eat no salt or follow a low sodium renal diet actually consume a significant daily dose of salt, it just does not come from the salt shaker. Much of the salt consumed by CKD patients comes from packaged foods and restaurants. However, you do not need to be alarmed because there are actions you can take to correct this issue:
- Read the Nutrition Facts Label to see how much sodium is in the foods you are considering. Check the label for lower sodium choices and compare sodium in different brands of foods such as frozen meals, packaged soups, breads, dressings/sauces, and snack foods. Choose the lowest sodium products available and if you eat canned vegetables then select low sodium or no-salt-added. Also, rinse canned foods, such as tuna, vegetables, and fruits before eating them. This removes some of the sodium. The %DV tells you whether a food contributes a little or a lot to your total daily diet. 5%DV (120 mg) or less of sodium per serving is considered low in the general population while 20%DV (480 mg) or more of sodium per serving is high. Verify with your Dietician that YOU can abide by these general guidelines.
- Prepare your own food when you can. Choose to buy and eat fresh fruits from local Farmer's Markets and freshly cut meat from butcher (fish and poultry are more kidney friendly). Fresh foods are generally lower in sodium. Remember to use herbs and spices instead of salt to add flavor to your foods. Try rosemary, oregano, basil, curry powder, cayenne pepper, ginger, fresh garlic or garlic powder (not garlic salt), black or red pepper and no-salt seasoning blends.
- “Unsalt” your snacks. Choose unsalted snack products, that are marked “low sodium” or “no-salt-added” or even have a fresh fruit/vegetable instead. Be aware that sodium in ketchup, salad dressings, and seasoning packets can add up so try to purchase no-salt-added ketchup, add oil and vinegar to a salad rather than bottled salad dressings, and use only a small amount of seasoning from flavoring packets instead of the entire packet.
- Speak up at restaurants. Ask to see the nutrition information in restaurants and choose a lower-sodium option. Ask for your meal to be prepared without salt and request that sauces and salad dressings be served “on the side,” then use less of them. You can also reduce your portion size because less food means less sodium! For example, ask the server to put half of your meal in a take-out container before it comes to your table or split an entrée with a dinner companion.
Sodium levels have not dropped much in packaged and restaurant foods over the last few years. In fact according to new (2013) research published by JAMA Internal Medicine the average sodium content in 402 packaged foods only decreased 3.5 percent between 2005 and 2011 and 78 items found in chain restaurants increased in sodium during that same time frame by 2.6 percent. This is a serious matter as researchers have stated that excess sodium intake which is mostly obtained from dietary salt, may lead to the deaths of 2.3 million people across the world annually, and we can speculate a significant impact in the CKD Community specifically. The American Heart Association has suggested that eating too much salt may be the culprit for high blood pressure in one-third of Americans and may cause retention of fluid in the body which puts more stress on the heart, increasing the risk for stroke, heart failure, osteoporosis and stomach cancer.
Certain beverages such as energy drinks tend to have high amounts of sodium in them. Do not try to use salt substitutes as they have large amounts of potassium and can disrupt your health in other ways. KidneyBuzz.com recommends that you simply talk to your Dietician to discuss further means for you to reduce sodium in a manageable fashion given your personal habits.
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Jacobson,, Michael F., PhD. et. al. "Changes in Sodium Levels in Processed and Restaurant Foods, 2005 to 2011." Jamanetwork.com. JAMA Internal Medicine
"Sodium in Your Diet: Using the Nutrition Facts Label to Reduce Your Intake." Food Facts. FDA, U.S. Food and Drug Administration
"Sodium Levels in Packaged and Restaurant Foods Have Not Fallen Much, Study Finds." CBSNews. CBS Interactive