Even though the term “heart failure” sounds incurable and fatal, most patients with heart failure are still able to live long and healthy lives. The key to heart failure management is early diagnosis and treatment, including lifestyle changes.
The treatment of heart failure is complex and individualized to each and every patient. However, there are standard treatment guidelines all heart failure patients should make a part of their daily lives. These guidelines are designed to prevent the symptoms of heart failure and reduce the chances of being admitted to the hospital. One such treatment guideline is dietary salt restriction or a “low-salt” diet.
How much salt do I eat?
Salt is sodium chloride (NaCl). It is the sodium in salt that is the main concern, and the terms “salt” and “sodium” are typically used interchangeably. Increased dietary salt is associated with high blood pressure and contributes to the development of cardiovascular disease. Currently, the generally recommended amount of salt is between 1,500 and 2,300 mg per day. The strictest of all expert groups, the American Heart Association, currently recommends a sodium intake of less than 1,500 mg per day for the entire US population! Despite these recommendations, most people consume 3,400 mg of salt per day, over twice the daily recommended amount. Nearly 80% of our sodium intake comes from processed or restaurant foods. Here is a small list of some common foods and the average salt content:
Big Mac = 970 mg
Quarter Pounder with Cheese = 1,100 mg
Large French Fries = 350 mg
Large Diet Coke (30 fl oz) = 35 mg
Canned Green Beans (1 can) = 1,400 mg
One Slice of Bread (1 oz, typical) = 100-200 mg, remember this is just ONE slice!
Believe it or not, bread is one of the largest contributors of salt in the Western diet, and bread doesn’t even taste salty! Think, how much salt must be in the foods that actually taste salty? The answer is, a lot!
Another shocking revelation is the average amount of salt in a typical restaurant meal: about 2,200 mg! Salt is sneaky—very sneaky—but because it makes food taste better and keeps customers coming back for more, food manufacturers and restaurants continue to pile it on.
How does salt affect heart failure?
Wherever salt goes, water follows. When you consume excess salt, the sodium makes its way into your blood stream. One of the ways your body responds is by allowing extra water into the blood stream to dilute the sodium. Your blood vessels are only so large, and the increase in blood volume creates a high-pressure environment. The increased volume of blood pushes against your blood vessels and heart, making it more difficult for your heart to effectively move blood through the body. When doctors say “high blood pressure,” this is the state they are describing.
To make matters worse, normal sodium balance is often altered in heart failure. Many heart failure patients experience something called “low ejection fraction,” meaning the heart does not pump out or “eject” enough blood with each heartbeat. The body thinks it needs to increase blood volume to compensate for the heart’s low output, so now you have a double whammy. First, your body allows extra water into the blood stream to dilute the sodium; then it allows even MORE water in to compensate for the heart’s low output, despite the body already being volume overloaded! Reducing salt intake is one of the best ways to break this vicious cycle of sodium and water retention.
What is the bottom line?
Most experts strongly recommend less than 2,000 mg of salt per day for patients with heart failure. An amount of salt less than 2,000 mg per day can be difficult to achieve, however, you can accomplish this goal by following these simple steps:
- Beware of foods that do not taste salty but have a high salt content, such as bread, cheese, and soup.
- Don’t add salt either at the table or during food preparation at home.
- Rinse canned foods to wash off some of the salt.
- Avoid packaged foods when you can.If you do eat packaged foods, check the label for the amount of
- At restaurants, ask your server which foods are prepared without added salt.
- Always consider salt-free substitutes.
- Use a calorie and nutrition tracking app such as MyFitnessPal to help monitor your daily salt intake
Growing accustomed to a low-salt diet takes time and determination, but be encouraged: the changes you are making are well worth the effort! If you stay committed, you will reap the benefits of a longer, healthier life. Take control of your health! Your heart will thank you for it.