Understanding the Low Sodium Diet, According to A Registered Dietitian Nutritionist

Sodium is a mineral and electrolyte that your body needs for several important functions. However, many Americans consume too much, which can be detrimental to health.

A low sodium diet is often recommended for people with certain health conditions, such as high blood pressure or kidney disease.

What Is a Low-Sodium Diet?

A low-sodium diet is a specialty diet that limits how much sodium you consume daily.

It can often help manage health issues like high blood pressure, heart disease, and kidney disease.

Your body needs sodium for fluid balance and nerve and muscle function. In foods, sodium helps enhance flavors and textures and is also used for preservation.

However, many people consume more sodium than they should.

Sodium is highly prevalent in processed foods, such as packaged snacks, deli meats, condiments, salad dressings, and breads. On a low-sodium diet, you eat fewer processed foods and more minimally processed or fresh foods, like fruits, vegetables, and fresh meats.

How Much Sodium Is in a Low-Sodium Diet?

Americans consume an average of 2,000 to 5,000 milligrams (mg) of sodium per day, which is well above the recommended intake.

The Dietary Guidelines for Americans recommends that adults consume no more than 2,300 mg of sodium per day. The percent daily value (%DV) for sodium is also 2,300 mg per day.

For some people on a low-sodium diet, a maximum daily sodium intake of 2,300 mg may be beneficial. However, some may need to cut their daily sodium intake to no more than 1,500 mg.

A healthcare provider can help you determine the right sodium goals for your specific health needs. For example, a person with very high blood pressure (hypertension) may need to reduce their sodium intake further than a person with moderately high blood pressure.

Benefits of a Low-Sodium Diet

A low-sodium diet has many potential health benefits and may help treat various health conditions.

• Blood pressure: Many studies suggest reducing sodium intake lowers blood pressure. One study included middle-aged and older adults with varying blood pressure statuses, ranging from normal to untreated high blood pressure. Participants consumed either a high- or a low-sodium diet for one week before switching to the other diet protocol. Compared to the high-sodium diet, the low-sodium diet significantly reduced blood pressure after just one week, regardless of blood pressure status.
• Heart health: High blood pressure is a risk factor for heart disease and other heart health issues. Some research shows that reducing sodium intake may help prevent heart failure due to the diet’s effects on blood pressure. However, researchers have yet to agree on optimal sodium intake for better heart health outcomes because some people may be more sensitive to sodium than others.
• Kidney health: Your kidneys help maintain normal sodium levels in your body, but this can become difficult when sodium levels are high. This can be especially problematic for people with kidney disease. According to one meta-analysis, a low sodium diet may help prevent end-stage renal disease (ESRD) in people with chronic kidney disease (CKD). Researchers believe that the effects of a low-sodium diet on blood pressure play a significant role in slowing the progression of CKD.
• Diabetes: A low-sodium diet may help prevent diabetes. One study found an association between high sodium intake and diabetes. According to the study, the risk of diabetes increases by 1.2 times for every 1,000 mg increase in sodium consumption. However, more research is necessary to determine whether a low-sodium diet may help manage diabetes for those who already have it. Results are mixed as to whether a low sodium diet helps with metrics like blood sugar levels and insulin sensitivity.
• Reduced stroke risk: Evidence suggests that high sodium intake may increase the risk of stroke. The Northern Manhattan Study, a large-scale, multiethnic study on stroke risk, found that people who consumed less than 1,500 mg of sodium per day had the lowest risk of stroke. Study participants who consumed 4,000 mg of sodium or more per day had the highest risk of stroke.
• Bone health: Sodium affects calcium balance, essential to bone health. Research shows that high sodium intake may lead to excess calcium excretion, resulting in bone loss and an increased risk of osteoporosis. However, sodium intake may only affect bone health in this way if calcium intake is low.
• Reduced fluid retention: Consuming too much sodium may cause your body to hold on to extra fluid, which can be a risk factor for high blood pressure. Water follows sodium in your body, so excess sodium in your body may lead to excess water retention. Various studies have found that reducing sodium intake helps reduce fluid retention.
• Weight management: Some research suggests that following a low-sodium diet may help with weight management. In one study, people who followed a low-sodium diet for two months saw reductions in body weight and body mass index (BMI). However, these reductions may have been due to fluid loss rather than loss of fat mass.

Guidelines for Starting a Low-Sodium Diet

You’ll need to take a few steps to start a low-sodium diet.

• Meet with a healthcare provider: Meeting with a healthcare provider before starting a low-sodium diet is essential. A healthcare provider can help you determine whether a low-sodium diet is necessary for you. They can also help you learn how much sodium you should consume each day to stay healthy.
• Know your sodium limit: How much sodium you consume daily while on a low-sodium diet will depend on your health needs. In many cases, 2,300 mg of sodium is recommended for a low-sodium diet. However, some people may need to limit their sodium intake even more. Of course, you will still need to consume some sodium because it’s a vital nutrient.
• Learn to read nutrition labels: When you know your sodium limit, you’ll also need to know how to read nutrition labels. When reading a nutrition label, look at both the serving size and the percent daily value (%DV) for sodium in one serving. Knowing that a food is low-sodium if it has 140 mg or less per serving is also helpful.
• Ease into your new way of eating: It is typically best to take your time and ease into a new way of eating. Doing so will give you and your body time to adjust to these changes. Easing into a low-sodium diet can also help you avoid the stress that often comes with change.

Tips for Reducing Sodium Intake

There is more than one way to reduce sodium intake, and following a few simple tips can help you get started.

• Start at the grocery store: When shopping for low-sodium foods, look for unprocessed or minimally processed foods. Fresh fruits, vegetables, and meats are lower in sodium than ultra-processed foods, like packaged snacks, deli meats, and frozen meals. When purchasing packaged foods, look for ones that are low in sodium (140 mg or less per serving).
• Limit or avoid salt shakers: You can reduce your sodium intake by using the salt shaker less often. To do so, use fresh herbs or other seasonings instead of salt when cooking at home and avoid adding extra salt to restaurant dishes.
• Be careful with condiments: Condiments and salad dressings are notoriously high in sodium. Fortunately, some low- or no-sodium options are available at the grocery store. Some people also enjoy making their own condiments and salad dressings that contain less sodium than commercial ones.
• Make more of your own food: When you cook at home, you get to control how much sodium is added to your food. At restaurants, however, you give up this control.
• Choose low-sodium snacks: Although many packaged snacks are high in sodium, low-sodium options are available. When purchasing snacks, look for ones that contain little to no sodium, like salt-free nuts and chips. Fresh fruits and vegetables are another salt-free snack option.

Low-Sodium Foods to Try

Sodium may be a popular food ingredient, but many delicious foods contain little to no sodium. These include the following:

• Fresh fruits and vegetables
• Frozen fruits and vegetables (no sauce or seasonings added)
• Unsalted canned vegetables
• Minimally processed whole grains (quinoa, brown rice, pasta, etc.)
• Oats
• Unsalted or low-sodium snacks (popcorn, chips, nuts, pretzels, etc.)
• Fresh or frozen fish, poultry, or lean beef or pork
• Dried beans and lentils
• Eggs
• Yogurt
• Low sodium cheese
• Unsalted butter
• Cow’s milk or low-sodium milk alternatives (soy, almond, oat, etc.)

High-Sodium Foods to Limit or Avoid

Limiting or avoiding high-sodium foods is just as crucial as choosing low-sodium foods when on a low-sodium diet. Foods that are often high in sodium include the following:

• Enriched breads, rolls, and buns
• Deli meats
• Cured meats
• Soup
• Pizza
• Savory packaged snacks
• Frozen meals and snacks
• Cheese
• Burgers
• Baked goods (cookies, brownies, cakes, etc.)
• Breakfast meats (bacon, sausage, etc.)
• Chicken nuggets

Potential Side Effects and Risks

Although a low-sodium diet is generally considered safe, some potential risks are associated with it, including:

• Hyponatremia: Hyponatremia, or low sodium levels in your blood, may occur if you don’t consume enough sodium. Symptoms of hyponatremia include confusion, fatigue, headache, digestive issues, and muscle weakness. If left untreated, hyponatremia can become serious and even lead to death. Hyponatremia can also be a side effect of medication use, like medications for anxiety and depression and more. If you’re on medication and also on a low-sodium diet, check with your healthcare provider and a registered dietitian nutritionist for further guidance to avoid side effects.
• Insulin resistance: Some research shows that a low-sodium diet may lead to insulin resistance. According to one review, low sodium intake (less than 2,300 mg per day) may change the nerve signals needed for insulin to work properly. However, study results are conflicting, so more research is necessary.
• Heart health: A low-sodium diet can benefit heart health in those who need it. Yet, restricting sodium too much may hurt your heart. In some studies, a low-sodium diet has been associated with an increased risk of death in people with heart failure. Other studies have found that following a low-sodium diet may increase total cholesterol and triglycerides.
• Brain health: Too little sodium in your blood may lead to changes in your brain. In one study of older adults, lower sodium intake was linked to worse cognitive function (memory, learning, reasoning, etc.). Additionally, hyponatremia may cause confusion in some people.

Limiting your sodium intake too much, especially if you’re healthy, may increase your risk of adverse events. Talk with a healthcare provider to learn how to limit sodium safely if necessary.

Summary

Sodium is an electrolyte and an essential nutrient that your body needs to perform specific tasks. However, consuming too much sodium may cause problems.

Your healthcare provider may recommend a low-sodium diet if you have certain health conditions, such as high blood pressure or kidney disease.

There are many ways to reduce your sodium intake. In general, ultra-processed foods are high in sodium, and unprocessed or minimally processed foods are lower in sodium.

A low-sodium diet has some potential downsides. If it has been recommended to you, talk with a healthcare provider about how to follow it safely.