Sodium and Your CKD Diet: How to Spice Up Your Cooking

What is sodium?

Sodium is a mineral found naturally in foods and is the major part of table salt.

What are the effects of eating too much sodium?

When your kidneys are not healthy, extra sodium and fluid build up in your body. This can cause swollen ankles, puffiness, a rise in blood pressure, shortness of breath, and/or fluid around your heart and lungs. See the following table for suggestions on how to reduce sodium in your diet.

LIMIT THE AMOUNT OF…	FOOD TO LIMIT BECAUSE OF THEIR HIGH SODIUM CONTENT	ACCEPTABLE SUBSITUTES
SALT & SALT SEASONINGS	Table salt Seasoning salt Garlic salt Onion salt Celery salt Lemon pepper Lite salt Meat tenderizer Bouillon cubes Flavor enhancers	Fresh garlic, fresh onion, garlic powder, onion powder, black pepper, lemon juice, low-sodium/salt-free seasoning blends, vinegar
SALTY FOODS	High Sodium Sauces such as: Barbecue sauce Steak Sauce Soy sauce Teryaki sauce Oyster sauce Salted Snacks such as: Crackers Potato chips Corn chips Pretzels Tortilla chips Nuts Popcorn Sunflower seeds	Homemade or low-sodium sauces and salad dressings; vinegar; dry mustard; unsalted popcorn, pretzels, tortilla or corn chips
CURED FOODS	Ham Salt pork Bacon Sauerkraut Pickles, pickle relish Lox & Herring Olives	Fresh beef, veal, pork, poultry, fish, eggs
LUNCHEON MEATS	Hot Dogs Cold cuts, deli meats Pastrami Sausage Corned beef Spam	Low-salt deli meats
PROCESSED FOODS	Buttermilk Cheese Canned: Soups Tomato products Vegetable juices Canned vegetables Convenience Foods such as: TV Dinners Canned raviolis Chili Macaroni & Cheese Spaghetti Commercial mixes Frozen prepared foods Fast foods	Natural cheese (1-2 oz per week) Homemade or low-sodium soups, canned food without added salt Homemade casseroles without added salt, made with fresh or raw vegetables, fresh meat, rice, pasta, or unsalted canned vegetables

Why do I need to limit my sodium intake?

Some salt or sodium is needed for body water balance. But when your kidneys lose the ability to control sodium and water balance, you may experience the following:

• thirst
• fluid gain
• high blood pressure
• discomfort during dialysis

By using less sodium in your diet, you can control these problems.

Hints to keep your sodium intake down

• Cook with herbs and spices instead of salt. (Refer to “Spice Up Your Cooking” section for further suggestions.)
• Read food labels and choose those foods low in sodium.
• Avoid salt substitutes and specialty low-sodium foods made with salt substitutes because they are high in potassium.
• When eating out, ask for meat or fish without salt. Ask for gravy or sauce on the side; these may contain large amounts of salt and should be used in small amounts.
• Limit use of canned, processed and frozen foods.

Some information about reading labels

• Understanding the terms:
• Sodium Free - Only a trivial amount of sodium per serving.
• Very Low Sodium - 35 mg or less per serving.
• Low Sodium - 140 mg or less per serving.
• Reduced Sodium - Foods in which the level of sodium is reduced by 25%.
• Light or Lite in Sodium - Foods in which the sodium is reduced by at least 50%.

• Simple rule of thumb: If salt is listed in the first five ingredients, the item is probably too high in sodium to use.

All food labels now have milligrams (mg) of sodium listed. Follow these steps when reading the sodium information on the label:

1. Know how much sodium you are allowed each day. Remember that there are 1000 milligrams (mg) in 1 gram. For example, if your diet prescription is 2 grams of sodium, your limit is 2000 milligrams per day. Consider the sodium value or other food to be eaten during the day.
2. Look at the package label. Check the serving size. Nutrition values are expressed per serving. How does this compare to your total daily allowance? If the sodium level is 500 mg or more per serving, the item is not a good choice.
3. Compare labels of similar products. Select the lowest sodium level for the same serving size.

How to Spice Up Your Cooking

Giving up salt does not mean giving up flavor. Learn to season your food with herbs and spices. Be creative and experiment for a new and exciting flavor.

What kinds of spices and herbs should I use instead of salt to add flavor?

Try the following spices with the foods listed.

Allspice:

Use with beef, fish, beets, cabbage, carrots, peas, fruit.

Basil:

Use with beef, pork, most vegetables.

Bay Leaf:

Use with beef, pork, most vegetables.

Caraway:

Use with beef, pork, green beans, cauliflower, cabbage, beets, asparagus, and in dips and marinades.

Cardamom:

Use with fruit and in baked goods.

Curry:

Use with beef, chicken, pork, fish, green beans, carrots and in marinades.

Dill:

Use with beef, chicken, green beans, cabbage, carrots, peas and in dips.

Ginger:

Use with beef, chicken, pork, green beans, cauliflower and eggplant.

Marjoram:

Use with beef, chicken, pork, green beans, cauliflower and eggplant.

Rosemary:

Use with chicken, pork, cauliflower, peas and in marinades.

Thyme:

Use with beef, chicken, pork, fish, green beans, beets and carrots.

Sage:

Use with chicken, pork, eggplant and in dressing.

Tarragon:

Use with fish, chicken, asparagus, beets, cabbage, cauliflower and in marinades.

Tips for cooking with herbs and spices

• Purchase spices and herbs in small amounts. When they sit on the shelf for years they lose their flavor.
• Use no more than ¼ teaspoon of dried spice (¾ of fresh) per pound of meat.
• Add ground spices to food about 15 minutes before the end of the cooking period.
• Add whole spices to food at least one hour before the end of the cooking period.
• Combine herbs with oil or butter, set for 30 minutes to bring out their flavor, then brush on foods while they cook, or brush meat with oil and sprinkle herbs one hour before cooking.
• Crush dried herbs before adding to foods.

Can I use salt substitutes?

Caution! If you are told to limit potassium in your diet, be very cautious about using salt substitutes because most of them contain some form of potassium. Check with your doctor or dietitian before using and salt substitute.

Here are some seasoning recipes:

When using the following seasoning recipes, make sure to blend well. Place in a shaker.

American Favorite Blend 5 tsp. onion powder (not onion salt) 1 Tbsp. garlic powder 1 Tbsp. paprika 1 Tbsp. dry mustard 1 tsp. thyme ½ tsp. white pepper ½ tsp. celery seeds Yield: about ¼ cup (Health Education Assc. Inc., Glenside, PA)	Savory Seasoning 1 ¼ tsp. celery seed 2 Tbsp. crushed marjoram 2 Tbsp. crushed savory 2 Tbsp. crushed thyme 1 Tbsp. crushed basil Yield: about ½ cup (Nutrition: The Art of Good Eating, Seattle, WA)
Spicy Seasoning 3 Tbsp. celery seed 1 Tbsp. onion powder 1 tsp. garlic powder 2 Tbsp. crushed oregano 1 Tbsp. crushed thyme 1 ½ tsp. ground bay leaf 1 ½ tsp. black pepper 1 ½ tsp. ground cloves Yield: about ½ cup (Nutrition: The Art of Good Eating, Seattle, WA)	Savory Seasoning Savory Blend 1 tsp. chili powder 2 tsp. ground oregano 2 tsp. black pepper 1 Tbsp. garlic powder 6 Tbsp. onion powder 2 Tbsp. dry mustard 3 Tbsp. paprika 3 Tbsp. poultry seasoning Yield: about ¾ cup (South Carolina Dept. of Health and Environmental Services)

Experiment and create your own seasoning containing those spices that you like.