Not sure if anyone noticed, but I haven't been here much over the last couple months. 4 weeks ago, after 5 long months of sickness & breathing issues (that we thought had to do with my asthma worsening), I was admitted to ICU for congestive heart failure... I've been restricted to a 1500 mg sodium/day or 500 mg sodium/meal. My hubby & I are overwhelmed with all the changes (not to mention doctor's visits), but we're trying hard to create dishes within these parameters. For now we've been eating very bland food like what they had given me at the hospital. Hoping to change that part (the "bland" part) to make it easier to stick with this way of eating long term...
Is anyone else in here on a sodium-restricted diet like this? If so, I would appreciate any suggestions, tips & tricks for buying goods &/or lowering sodium in family recipes. Also any suggestions for holiday recipes, esp. with Easter coming up this weekend, would also be wonderful... Normally we have ham on Easter, but apparently it's a no-no now...
Thanks in advance,
lizanne
Not a sodium restricted diet but I have tons of food allergies, most notably tomato, shellfish, peanut and egg. And I didn't always have food allergies, I developed these allergies as an adult. So trying to find substitutions and variations for favorite dishes has become kind of a second hobby lol.
I honestly would imagine trying to limit sodium intake would be like trying to avoid food allergens in a way. The hardest one to get used to not having was tomatoes. I've had to find alternatives to tomatoes in recipes that I had made for years with tomatoes. I can now make lasagna, spaghetti, chili mac and ketchup all tomato free. We've had company over and not told them that dinner was tomato free until after they ate it and they are amazed. I now have go-to substitutes for my allergy foods and it is a lot easier to just adapt any recipe to fit my dietary restrictions. It is possible to make great tasting food even when you have to meet some crazy dietary constraints.
Sometimes, you just have to come up with new traditions for holidays when traditional foods become a health concern. It's not any less Easter just because you are eating something other than ham. Find a dish within your dietary constraints that you like and have that instead.
Also try not to feel bad explaining to people that you can't eat just anything for health reasons. People have brought us food I couldn't eat and couldn't understand why I couldn't just pick out the parts I was allergic to or couldn't understand why I wouldn't eat their dish at a potluck because while they didn't put an egg in it, an ingredient they used has eggs in it. I'm sorry to have hurt their feelings but my health is more important, plain and simple.
Eating out fast food is difficult because they often fry every thing in the same oil so if they fry shrimp in the same oil they fry chicken and then I eat the chicken, things get bad in a hurry. For that and other reasons, we don't eat out hardly at all any more. It was a huge change when we first found out that my health problems were food allergies and we did crave fast food for a while but now (about 2 years later) fast food doesn't even taste good any more. You do get used to your new normal eventually, it just takes time.
I did notice you haven't been around lately, I'm sorry for what you had to go through but I'm glad you are back!
My hubby and I have to watch our sodium levels .... I have a secret of bringing back some of the zing that is missing when you can't have salt ... powdered mustard .... I use it in all my savory dishes now ... the bright yellow stuff in the bottles doesn't do it ...you have to have the powdered, fresher the better. Also ... after you are eating a lower/salt free diet a while your body will adjust and once it does you will not miss it but it takes a few weeks for that to happen. Hang on and it will become better. I hope your heart gets better soon ... did they give you a reason why ? high blood pressure? or something else that you can change by diet or medication ? .. you can try branching out re: your diet by eating whole foods, avoiding packaged and prepared foods like the plague. There is lots you can eat without it being bland as long as it hasn't been prepared first .. that is where most of our sodium comes from now.
@Jennifer: Thanks, and I know what you mean. For several years I had a severe reaction to dairy & couldn't eat any. It was a lot easier to adapt recipes with that than this sodium-restricted diet. I know in time it will get easier, when I can get some help about adapting recipes for this yet again that is... The hardest part is all the sodium in everything, including staples (such as canned tomatoes, jalapenos, baking powder, baking soda, milk, etc.) - things you never really noticed or accounted for. We mostly cook from scratch, but we do still use some canned goods & it's amazing how quickly the sodium mg's add up... We also live in a rural area - the grocery stores around here do not have a lot of selection, and the natural food stores are very small & also don't have a lot of selection so it's hard to find things. That's why any advice people could give me on products would be helpful - it will at least give me something to look for (or possibly suggest to store managers?)... I'm even making my own cereal now because of the high sodium levels...
@Susan: Powdered mustard......sounds like something to try!
I know what you mean about the body eventually adjusting - that happened to me when I was on a vegan kick many years ago (desserts & treats all of a sudden tasted too sweet). My hubby & I do cook from scratch, mostly whole foods but some canned 'staples.' - we rarely eat prepared/processed food meals. Our big problem is finding low-to-no sodium options for staples we often use in cooking (be it broth, diced tomatoes, tomato paste, chopped jalapenos, baking powder, baking soda, etc.).
About the heart/CHF... They don't know the cause right now so they labeled it "idiopathy" (the doc filling in for my PCP who is on leave said that's what they put down when they don't know the cause). The ICU doctor suspects it may have been caused by sleep apnea (I've had insomnia for several years now, which my PCP was aware of but did nothing about), even though I don't have the normal symptoms (like snoring, stopping breathing). She ran an oximetry study on me while I was in ICU & it showed I was only getting oxygen in the 80's, sometimes dipping into the 70's. IOW I'm oxygen-deprived. And she said there's been a lot of studies linking sleep apnea to CHF & that insomnia can be a symptom of CHF... Unfortunately health insurance co's don't accept that report as evidence, so she wrote up in her release notes that my PCP should refer me for a sleep study (she really feels I need a CPAP machine to avoid further complications). On the other hand the cardiologist said I have cardiomyopathy (based on the various tests they performed - including an echocardiogram), that I have an enlarged heart, and that I'm only pumping blood & removing fluids at 50% (not good). I lost 40 lbs. of fluid in the hospital, and have lost another 8 lbs. in fluids since being released. Oh, and you asked about blood pressure.......yeah, it's high & they have me on 2 different meds for that (one to lower the heart rate, and one to lower the blood pressure).
Am on a lot of different drugs now (some AM, some PM), and have to weigh myself daily & take my blood pressure daily - because there's very little difference, symptom-wise, between asthma & CHF (which is scary for me - I'm asthmatic). So the key to figuring out which problem I'm having is the weight (a gain of 3+ lbs/day or 5+ lbs/wk it's CHF) &/or swelling (if I'm having pitting edema).
Last night I couldn't sleep......stayed in bed anyhow, and my entire chest became soaked this morning. Sometimes that can happen with a bad asthma attack, but I wasn't having any breathing problems. And I wasn't swollen. And I haven't had the weight gain I mentioned earlier, so I don't know what's going on. My hubby thought my pulse was racing so he took my BP - it was within the rates it's been at since released. Anyhow we called my doctor's office, but they felt I didn't need to come in since my BP results & weight didn't look troublesome, but they urged me to discuss this with the cardiologist tomorrow (I have my first follow-up with him tomorrow, thankfully).
Right now I'm waiting to see if my health plan will approve me for Cardiac Rehab & at what Phase (that's something I will be starting soon I hope); I got approval to go back to the pool to do my aqua p/t (started back last week at 25% of my program - my chiropractor is very happy about this); and I finally got an interview scheduled for a sleep study (it's next Friday - I've been told they'll discuss sleep apnea & pulmonary issues with me). Still awaiting a list of approved "durable medical equipment" vendors from my care manager so I can buy those Granny support hose (yeah, I now have to wear compression socks, which stinks). My plan will pay for those if it's from their approved list.
I completely get what you mean about limited options and dietary restrictions making those options even more limited. We live in a rural area too. It's a 90 minute drive to anywhere with any kind of selection, 2.5 hours to a health food store. Ordering specialty things online is great. We order egg replacer online since we can't easily get it where we live. I bet you could find all kinds of low-to-no sodium items as well.
The more and more things we found out I was allergic to, the more and more I started cooking everything from scratch. I now can and preserve a lot of my own food stuffs. One of my go-to replacements for tomatoes is red bell peppers but they are expensive to buy pre-canned at the store. So I stock up when red peppers are on sale in the produce section and roast and can or freeze them myself. If you pureed them, roasted red bell peppers make great replacements for tomato paste and sauce (and you control how much salt goes in so that could help with your low sodium diet. Honestly, I don't add any salt at all just out of personal preference and everyone who has had my spaghetti and lasagna made with pureed bell peppers instead of tomato sauce didn't notice that I didn't add salt either)
It sounds like you've got a long road ahead of you but like you said, when you went on your vegan kick, sweets were too sweet and soon food prepared with salt will be too salty. I know we found both to be true when I had to start preparing more and more food from scratch. I hope you find more helpful suggestions from those who have had to go low sodium
Lizanne: Spices do a lovely job of adding flavor without salt. Mustard, garlic, ginger, cumin, fresh ground peppercorns, and chiles are some of my go-tos, along with citrus juices and balsamic vinegar. Plain grated horseradish in vinegar is another low-sodium way to add flavor. Many pre-mixed seasoning blends have salt in them, especially steak seasoning and marinades, but Chinese five-spice and garam masala don't. Neither do chili powder or original Mrs. Dash. Potassium chloride can work to help season those things that need it, too, but take it easy on that as well, since it can lead to hyperkalemia if you're taking ACE inhibitors, potassium-sparing diuretics, or have chronic kidney disease.
Chicken broth and such...yeah, Swanson's now makes an unsalted variety. Otherwise, if you roast a bird of some type, save the carcass and toss it in a pot with a couple quarts of water, add garlic and rosemary, and simmer it for a couple of hours, then freeze it in pint containers. One container is equivalent to a can of broth then, but doesn't have the sodium that even the low-salt canned stuff would.
I don't add much for extra salt on veggies, but I avoid canned foods as they've almost always got a lot of it. Plain frozen or fresh veggies are the better option, or unspiced blends. Steam-in-bag are usually pre-salted, so avoid those.
Meats: Pre-portioned meats and deli meats usually have a lot of added salt. Fish filets and family pack steaks and chops usually don't have much, if any. Buying large roasts and cutting your own steaks from them is often one of the most budget-friendly ways to avoid the additives. Sirloin steak comes in at 16mg/oz, and pork loin chops can come in similarly if they're not injected with a salt solution like many of the bigger corporations do these days. Plain salmon fillets are under 20mg/oz, too, which is pretty low for a salt-water fish.
Use unsalted butter, or heart-healthy oils like olive, avocado, or coconut. Cheese is almost always high in salt, so limit that, but you do have some options. Swiss is one of the lowest-sodium ones at 54mg/oz, while cream cheese comes in at 85. Whole-milk mozzarella is 105mg/oz, so you might be able to get away with a slice or two of pizza once every couple of weeks, provided the rest of the ingredients are similarly low-sodium. Coconut milk or plain Greek yogurt do a good job of making things creamy without adding a ton of sodium, too. Greek yogurt is about 10mg sodium to the ounce, while coconut milk comes in around half that.
That said, most people do need a certain amount of sodium to survive, and 1500mg is 3/4 of a teaspoon total throughout the day. If a dish needs a pinch of salt while you're cooking to make the flavors come alive, you can probably get away with that once during the day and still stay under your 1500mg limit.
I know you've got some other health issues and dietary restrictions, so please toss out anything I've said that doesn't work with your other limits, but hopefully there are some useful things in what I've said here. And feel better soon--I miss seeing your smiling face around here!
Thanks Holly...
Missed you, too.
We've been doing a lot of what you said already - we're trying to up our spice use, and we mostly use cold pressed olive oil & fresh veggies, occasionally using frozen. But I've never seen tomato stuff frozen, and we use a lot of tomatoes in dishes (be it crushed, diced or paste), so that's a struggle right now. We make a lot of Italian & Mexican meals (my family's faves) so I have to find a good solution to that... I already buy plain yogurt (not a fan of Greek, though occasionally we buy it); and I also buy coconut-almond milk to use in place of dairy since I'm lactose intolerant (which, unfortunately, has the same amount of sodium as reg. milk). I love cheese, so I'm struggling with that. If I can make a very low sodium meal I can have a small piece of cheese as a treat, which I've managed to do a couple times. The meat thing is something I'm just starting to learn about. I knew things like ham & corned beef were often soaked in brine (so those are out for me), but I wasn't aware of meat being injected with a salt solution - that's going to make it tough for me to figure things out - thank you for telling me about that.
Definitely something I'm going to have to talk to my hubby about & see what he thinks we can do. Maybe we'll have to look into buying a CSA share of an animal to avoid this?
About the medicines... They have me taking a generic form of lasix, and also potassium & magnesium (they said the lasix will cause you to "pee" those out). And yes, I am taking an ACE inhibitor - lisinopril. Also taking metroprolol (to bring heart rate down) - unsure if that falls into the ACE inhibitor category or not.
Easter has been hard to plan - trying to figure out an entire holiday meal that I can eat & my whole family can enjoy (and still stay within my sodium limits). Thinking of doing a stuffed pork loin (hopefully I can keep sodium level down with that), a potato dish, asparagus, roasted carrots, homemade apple sauce & deviled eggs as an appetizer. I found a cake recipe that looks pretty simple & has a raspberry sauce that you drizzle over it - it was very low sodium, so I'm leaning toward that or possibly carrot cake. If this somehow goes over my limit, I may end up having to take an extra lasix (something one of the ICU nurses told me I could do occasionally, in instances like this). Trying very hard not to do that, though, if I can help it.
The salt solution is commonly injected into pork and chicken to keep them from being dry when cooked more quickly. That said, not all companies do that, and they usually label it "injected with up to 10% of a solution of...", but it'll be in small print. Be sure to read it! A CSA share of a pig wouldn't be a bad idea, or a few chickens a month. Organic ones often aren't injected either, but they're far too expensive for my budget!
As far as tomatoes, I guess for now you'll need to buy fresh, and grow a bunch this summer that you can puree and freeze. Bell pepper strips don't freeze as well as I'd like, but they're still nice in the middle of winter when peppers are $1.39 each at the store!
I'm also going to remind you of something my rheumatologist told me when I mentioned having overdone it the previous weekend at a convention (too little sleep, some alcohol, not following my diet): "Part of living with a chronic illness is LIVING. Yes, you need to avoid flareups as much as possible, but quality of life is a factor too, so let yourself have a little fun once in a while. A mild flareup every few months won't shorten your life expectancy as much as being depressed because you never get to do anything fun." Choose your timing and check with your doctor, but you might be able to pick 4 things you miss most and have each once a year, in small portions, providing you follow the diet strictly the rest of the time. (Mine would be St. Pat's corned beef, bratwurst on the 4th, a salted-caramel apple in fall, and Christmas ham.)
Support hose ... I have been wearing them for several years .... didn't want to, fought against them but I am so glad I started .... they now look like regular knee socks and you can wear a pair of normal socks over top if you want when you wear slacks etc. My blood pressure has gone done so much ... I have a leaky heart valve so my BP is very hard to control ... I also had one of those open blood vessels on my leg that refuse to completely heal and probably would have ulcerated eventually ... it's gone !! .... it healed about a year after wearing the stockings because the blood wasn't pooling in the area. They also help with the arthritis in my feet, keeping the bones from spreading as much and massaging them as I walk. I'd fight now if you took those stockings away from me lol
@Holly: Sounds like you have a great rheumatologist - fantastic advice...
@Susan: Glad you like them - I'm still not there yet... So needless to say I was elated when my cardiologist told me at my follow-up visit last week that my legs were good & he doesn't think I need them. I still may get a couple pairs just in case though (from a "durable medical equipment" place so it's covered by my insurance) - this way if I need them I have one to wear while the other is being washed (which I don't have now & was a pain). He said there may be times that I will have swelling (esp. in summer), and to elevate my legs when that happens. I have noticed when I sit at the computer for long periods my legs do swell a bit, so I've been trying to make sure I get up more (as a preventative) and I elevate my legs at times as well. My main concern was during the summer - I usually go barefoot or wear my teva's, and I found those stockings make me so hot...
Back to doing the aqua physical therapy 3x/week, which is good. Not making as much progress I had hoped - my muscles have been fighting me. Hoping that changes in the near future as the pain has been intense & it's affecting my sleep. Because of my condition I can't take ibuprofen anymore (which was my go-to item when having pain or inflammation issues in the past), so ice & heat are my only options right now. Unfortunately it only helps short term. Got approval for Cardiac Rehab - now we're trying to work the scheduling out (on their end) because of my insomnia issues (which the sleep study doctor & ICU doctor believe may have caused my CHF). And I was told that I will be scheduled for a sleep study & they want to look at other issues also (not just the heart, but pulmonary issues). Hoping everything goes well & I get the help my body needs...
Even though it's been hard, I'm still keeping up with the low-sodium requirements (500 mg/meal, 1500/day). My hubby & I are not very good about meal planning, and often create meals on the fly, so that's been a hassle but we're getting by... So very thankful when we have leftovers, as then we don't have to do any meal calculations (for sodium) or come up with ideas... However I'm hoping for a little more variety in the future - we're just not there yet. Have had too much on our plate lately, so that's taken a backseat to everything else. Maybe I'll lose some weight with all this bland eating?
My trick for limiting the swelling ankles (due to inflammation from lupus flareups, in my case) has been to get a bigger desk and a high-back office chair that has solid loop arms that help support the weight when I lean back. (Here's an example of an inexpensive chair similar to what I'm talking about: http://www.amazon.com/HON-Executive-High-Back-Office-Computer/dp/B0046TRL0I)
I lean back and put the keyboard on my lap, using a solid board to support it and the mouse, and stretch my feet out on top of the desk. With the chair at the right height, it's the same position as if I were using a recliner as my desk chair. You might need to reinforce the front edge of the desk with something like a 2x4 if your desk is one of those assemble-it-yourself things, but it's an option that doesn't take a lot of changes to implement if you have a chair that'll let you do it.
It sounds like you're doing pretty well with adjusting to the new requirements. A quick google search will find you a lot of low-sodium recipes that might have more flavor. I enjoyed aquatherapy when I did it; it was great for rebuilding back strength and balance issues.
I eat low salt for health because I'm salt sensitive and it puts my BP through the roof and I don't like taking BP drugs if I can do it the natural way. Hang in there, your tastebuds will change with time.
I have found a great trick for getting low sodium bbq sauce without cooking it from scratch. Take a bottle of no salt added ketchup (costs $1.08 at Walmart). Add 1/4 cup of regular bottled barbeque sauce. I've done this to cut the sodium on BBQ sauce. If you can make it from scratch it's even better, but I found this works in a pinch.
Thanks for the tip, Merritt
I am not but probably should be.
Money is tight, really tight and we don't always eat the greatest.
Several meals a month are usually processed foods and I hate it.
Lizanne, I must have been having my major health issues about the same time as you! I was coming off of some medications for my Fibromyalgia with a brand new dr cause we moved, and even though we discussed concerns over weaning off the med, I had a horrible reaction. She was taking me off of the med to try another med for insomnia, but I came off too quickly...tapered down over 2.5 weeks in Feb, and I went into extreme sleep deprivation. Ended up my hubby had to call my parents at 1 am Feb 29th cause I still wasn't sleeping and my mom who used to be a nurse, said call the ambulance, cause she's got to have immediate medical care. I had only a total of 9 hrs of sleep for the week and 2 days prior to that. Ambulance and hospital tried giving me sedatives to knock me out, but I'm also highly allergic to many meds...including ones they gave me at the hospital and on release. Needless to say the sedatives really didn't work either! Still haven't found any good solutions for sleep or pain. Proper sleep is SO IMPORTANT! I was in for 4 days with chest xrays, Cat scans, spinal taps etc...- for a while they thought it might be meningitis as the tests were inconclusive, etc.
BP & heart rate: I've take Atenolol for years for BP and racing heart rate, it might be one that they can try with you, if the other doesn't slow down your heart rate.
I've always cooked low-sodium, as both parents growing up had to restrict sodium in diet due to BP. Check your library for cook books, they could be a good source of recipes. Like the others said spices are your new best friend! Broth is easy to make and freeze. You may want to invest in some good freezer containers and a deep freezer, if you don't already have these, but you may have them already cause you live rural. We're in the same boat, 1:40 away from any real grocery store. (Even the ambulance took 1:15 to get me to the hospital, as our roads are very windy and hilly.)
You may need to find other things for breakfast, make your own oatmeal mix with spices, farm fresh eggs with pepper...farm fresh are more flavorful. Toast etc, instead of cereals.
How did the sleep study go? We just had to go to a health sharing plan because of self-employment for insurance, and still don't know what if any they will help us on for the medical bills, but I know the frustrations of insurance red-tape.
Make-A-Mix recipe books are great resources for doing ahead and convenience. You can make alot of your own dry mix or freezer mixes to keep the convenience factor in cooking. Also Once A Month Cookbook is another great one, so you're not eating processed meals. You may still have to adapt some of the recipes, low-sodium alternatives etc, but can do a lot of the prep work all at once the day after a major shopping trip to "town".
Praying you continue healing and the entire family adjusts.
Oh, don't know if you just really like cottage cheese, but one of the tricks my mom has used for years is to "wash" it to get rid of the majority of the salt. I won't recommend doing this until you have cleaned your palette, and notice how really salty things are.
To wash, just put extra water in the container, or another tall container with the cottage cheese, and stir....then drain off the milky liquids, repeat several times, then sample some of the cottage cheese...you should notice a big difference. Again, not sure what the salt content would be exactly, but eventually you'll be able to tell that it's down to acceptable limits.
Also, I've noticed that I think it was the chicken bullion granules had a much lower sodium as compared to the cubes. Not as low as the low sodium cubes, but close. It was several yrs ago, so don't hold me to it, and I can't tell you the brand, but check the labels when you're in a good store. Seems like the cubes were about 1200 regular, the low sodium cubes around 500 or 600 (that may have been servings, and remember that it's going into a whole pot of soup or whatever) plus the low sodium cubes were at the time MUCH MORE EXPENSIVE. The granules though were around 700 for the equivalent...so again close to the low-sodium alternatives, but not as expensive per serving. Also I only used them to have on hand as a quick alternative, or to add a little to "enrich" a homemade broth or stock.