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Lower-Sodium Food Choices

Patients with chronic kidney disease (CKD) need to limit the salt (sodium) in their diet.
Many people think that they are following a low-sodium diet if they do not use the salt
shaker. However, only about 10% of the salt in our diets comes from the salt shaker. The
rest comes from salt that is already in foods (for example, in processed and restaurant
foods).
When you have chronic kidney disease, the recommended limit for sodium is 1,500 to
2,000 milligrams (mg) a day.

Reading Food Labels


Reading food labels can help you eat less salt.
First, look at the serving size listed at the top of the Nutrition Facts. The information
for the rest of the Nutrition Facts is for this serving size. Remember that you might eat
a larger or smaller portion.
In the Nutrition Facts, the percentage of the Daily
Value (% DV) for sodium helps you know whether
the food is low or high in sodium.

3 5% DV or less is low.
3 20% DV or more is high.
The Nutrition Facts also lists the milligrams (mg)
of sodium in one serving. You can see how this
amount might fit in your daily limit of 1,500 to
2,000 mg.
Some food packaging also features claims about
the sodium/salt content. Here is what the labeling
terms mean:

Note for People


Who Need to Limit
Potassium in Their Diet
Manufacturers often add
salt substitutes that contain
potassium to low-sodium
foods. If you need to limit
potassium, read Nutrition
Facts labels and ingredients
lists and choose foods
without the added potassium.

3 Sodium free means 5 mg of sodium or less per serving.


3 Very low sodium means 35 mg of sodium or less per serving.
3 Low sodium means 140 mg of sodium or less per serving.
3 Reduced sodium means the product has at least 25% less sodium than the original
version of the product. Note that a reduced-sodium product can still contain a large
amount of salt.

3 Unsalted or no salt added means that no salt was added to the food during
processing. Note that these terms do not mean the product is sodium-free.

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patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
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Guidelines for Choosing Lower-Sodium Foods


Bread, Crackers, Popcorn, and Chips
What to Know
Most regular breads and rolls have 90 to 190 mg of sodium per slice or roll.
Baking powder biscuits and ready-to-bake biscuits and rolls can
have 150 to 700 mg of sodium per piece.
Salted crackers, chips, popcorn, and many other salted crunchy
snacks can have 150 to 250 mg of sodium per ounce.

What to Do
Buy or bake salt-free bread.
Limit the total amount of bread you eat. Make half sandwiches or open-face
sandwiches to cut down on the amount of bread you eat.
Look for unsalted, low-sodium, or hint of salt crackers, chips, popcorn, and
other snacks.

Cereals
What to Know
Ready-to-eat cereals contain varying amounts of sodium.
Instant hot cereals (oatmeal, grits, or cream of wheat) often contain added salt.

What to Do
Check labels on ready-to-eat and instant cereals, and choose
products with lower sodium levels.
Choose regular or quick-cook oatmeal, grits, or other hot cereals
instead of instant products that have sodium added to them.
Make your own flavored cereals by adding fresh or frozen
berries, sugar, or sugar substitute to low-sodium or no-sodium
cereals.

Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Cheese
What to Know
Most cheeses are high in phosphorus as well as sodium. Your registered dietitian
nutritionist (RDN) may give you a guide for limiting the amount you eat.
Swiss cheese, ricotta, and cream cheese are lower in sodium than most other cheeses.
Cottage cheese is very high in sodium.
Processed cheeses (such as American cheese, Velveeta, and Kraft Singles) have the
highest amounts of sodium and phosphorus and are not recommended.

What to Do
If you like cheese, use it as a garnish. Small amounts of Swiss
cheese, ricotta, brie, cheddar cheese, farmers cheese, goat
cheese, Monterey Jack, mozzarella, or parmesan can be added
to salads or other dishes.
Limit cottage cheese to no more than cup per day. In
recipes that call for cottage cheese, try ricotta instead.

Condiments and Cooking Sauces


What to Know
Many condiments and cooking ingredients add sodium to the diet.
Cooking wine has salt added to it.
Dry mixes for gravies, soups, or other sauces usually have salt added.
Salad dressings can be especially high in sodium.

What to Do
Check the sodium information on the Nutrition Facts labels
on your condiments and seasonings.
Consider buying products that are lower in sodium.
Use very small amounts of high-sodium condiments and
saucesthe less you use, the less sodium you eat.
Make salad dressings at home, using oil and vinegar and
salt-free seasonings.

Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Be familiar with the condiments that are highest in sodium. These include:

3 Soy sauce: 920 to 1,315 mg of sodium in 1 tablespoon


3 Reduced-sodium soy sauce: Approximately 500 mg of sodium in 1 tablespoon
3 Teriyaki sauce: 390 to 690 mg of sodium in 1 tablespoon
3 Packaged marinades: 340 to 610 mg of sodium in 1 tablespoon
Also learn which condiments tend to be lowest in sodium, phosphorus, and potassium.
These include:

3 Barbecue sauce: 265 to 450 mg of sodium in 2 tablespoons


3 Hot sauce: 124 mg of sodium in 1 teaspoon
3 Olives: 350 mg of sodium in two queen-size olives
3 Worcestershire sauce: 165 to 180 mg of sodium in 1 tablespoon
3 Yellow mustard: 80 to 170 mg of sodium in 1 tablespoon
3 Dijon mustard: 120 to 360 mg of sodium in 1 tablespoon
3 Ketchup: 320 to 420 mg of sodium in 2 tablespoons
3 Chili sauce: 230 mg of sodium in 1 tablespoon
3 Dill pickles: 591 mg of sodium in half of a 4-inch pickle; 306 mg of sodium in 1 spear
Convenience Foods
What to Know
Convenience foods are often very high in sodium. Examples include:

3 Canned baked beans


3 Bread stuffing mixes
3 Hamburger, tuna, and macaroni and cheese mixes
3 Seasoned mixes for rice, pasta, and potatoes
3 Canned dinners, such as chili and stew
3 Pasta sauces in jars or cans
3 Frozen egg and muffin breakfast sandwiches
3 Seasoning packets for meals made in slow cookers
3 Gravy and sauce mixes

Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

What to Do
Make meals from scratch, using unprocessed ingredients
as much as possible.
If you wish to use a particular type of convenience food,
compare labels on different products and choose the one
with the lowest sodium.
Look for products that have reduced sodium.
Eat only a small portion of a higher-sodium food.

Fast Food
What to Know
Fast-food restaurants are noted for the high sodium content of their foods.
Even those fast foods that are promoted to be healthy foods can have
high sodium levels.
Portion sizes make a difference.

What to Do
Look up the sodium content of your favorite fast foods using an online nutrition
database or the companys nutrition information. Choose the foods that are lowest in
sodium. For example, at a sandwich place:

3 Leave off the cheese, pickles, olives, and high-sodium dressing.


3 Choose vegetables and a meat that are lower in sodium.
3 Have a smaller sandwich to reduce the sodium.
Choose plain salads that have low amounts of sodium. Be careful to check the sodium
content of salad dressings, and remember that adding meats or chicken adds sodium.

Frozen Foods
What to Know
A frozen entre can contain up to an entire days amount of sodium in one serving.

What to Do
Read labels and choose meals with 600 mg of sodium or less. Healthy Choice offers
several frozen meals that meet this goal. The smaller packages of Lean Cuisine, Weight
Watchers, and Smart Ones may also be options.
Consider making your own frozen entres by making large batches of food and
freezing them in meal-sized portions.
Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Fruits
What to Know
All fruits are low in sodium.

What to Do
If you are limiting potassium, use the Making Choices
food lists to guide your choices of fruits.
If you are not limiting potassium, enjoy a variety of fruits.

Meats, Poultry, and Seafood


What to Know
Cured meats (such as ham, bacon, sausage, pepperoni, hot dogs, corned beef,
pastrami, and bratwurst) are high in sodium and are not recommended.
Fresh, canned or frozen poultry, seafood, or meats can have high amounts of sodium
if they are enhanced with a salt solution or broth. Check the Nutrition Facts label to
learn the sodium content.
Meats, poultry, and seafood that are breaded or seasoned are high in sodium.
For information on deli meats and tuna, refer to the Sandwich Fillings section, later in
this handout.

What to Do
Buy plain meat, fish, or poultry that are not enhanced. Many
meats now have Nutrition Facts labels. Read labels and look for
meats with 201 mg of sodium or less per serving.
Season meat yourself, using salt-free herbs and spices.
(See suggestions later in this handout.)
Make your own salt-free breading.

Milk and Yogurt


What to Know
Milk and yogurt naturally contain sodium.
Milk and yogurt are good sources of protein and calcium. However,
they are high in phosphorus and potassium, and you might need to
limit them.

What to Do
Follow your RDNs recommendations about how much milk and
yogurt to include in your diet.
Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Pizza
What to Know
Pizza is usually made with many high-sodium ingredients, including the sauce, the
cheese, and toppings such as olives, pepperoni, sausage, and Canadian bacon.

What to Do
Homemade is best! Use a low-sodium sauce, vegetables,
and/or ground beef and a small amount of mozzarella
cheese.
If you are limiting potassium, keep in mind that all tomato
sauces are high in potassium.
If you are having pizza that is not homemade, choose just
one slice, and fill out the rest of the meal with a vegetable
salad or other foods that are not high in sodium.

Sandwich Fillings
What to Know
Deli meatseven turkey, chicken, and beefare often very high in sodium.
Tuna is usually packed with salt, whether it is canned or packaged in oil or water.

What to Do
Make sandwiches with chicken, turkey, or beef that you
have previously cooked without added salt.
Read Nutrition Facts labels on packaged deli meats, and
look for products with no more than 480 mg of sodium
per 2-ounce serving. Most delis now carry lower-sodium
meats, but ask the clerk to check the label for you.
Note: If you are limiting potassium, check to see whether
potassium was added to replace the sodium.
Look for lower-sodium canned or packaged tuna.
Make an unsalted egg or egg salad sandwich.
Use small amounts of unsalted peanut butter (no more than 2 tablespoons per day).
Peanut butter is higher in phosphorus and protein.

Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Seasonings
What to Know
Many mixed seasonings and seasoning packets have large amounts of salt added to them.
Lemon pepper and chili powder sometimes contain salt.

What to Do
Read the Nutrition Facts label and ingredients list on seasonings. Look for herbs and
spices that do not have added salt.
Choose garlic powder in place of garlic salt, and choose onion powder in place of onion
salt. Or, use fresh chopped garlic, onion, or bell peppers to season foods.
Try different flavored vinegars, such as cider, balsamic, champagne, or unseasoned
rice vinegar.
Make your own seasoning mixes. For example, to make a seasoning for tacos, combine:
2 teaspoons chili powder, 1 teaspoons paprika, 1 teaspoons ground cumin,
1 teaspoon onion powder, teaspoon garlic powder, and a dash of cayenne pepper.
Look for a salt-free seasoning blend. Some options include:

3 Chef Paul Prudhommes No Salt, No Sugar Magic Seasoning Blend


3 McCormicks Perfect Pinch salt-free blends
3 Mrs. Dash salt-free blends
3 Mrs. Dash salt-free marinades
3 Store-brand salt-free blends without added potassium
Soups
What to Know
Several brands of soups now have reduced-sodium or lower-sodium varieties.
However, these soups often have higher amounts of potassium.

What to Do
Make homemade soup using unsalted or reduced-salt broth, stock,
or bouillon (without added potassium) and unsalted vegetables.

3 If you are limiting potassium, you may need to choose


low-potassium vegetables for your soup.

3 Use no salt added canned vegetables in your recipe.


If you are limiting potassium, be sure to check labels on
packaged soups and avoid products with added potassium.
Copyright 2015 Academy of Nutrition and Dietetics. www.eatright.org. All rights reserved. This handout may be distributed for
patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Vegetables
What to Know
Regular canned vegetables have salt added to them.
Draining and rinsing salted canned vegetables removes some, but not all, of the salt.
Some frozen vegetables have sauces added to them that make them high in sodium.
Canned tomato juice and vegetable juices are high in sodium.

What to Do
Look for no salt added canned vegetables.
Buy fresh or frozen vegetables without sauces or added salt.
Tomato-based vegetable juices come in lower-sodium varieties. Keep in mind that the
tomatoes in the juices make them high in potassium.

Seasoning Without Salt


Food without salt does not have to be food without flavor. You can build a spice cupboard
with a collection of dried herbs, ground spices, and salt-free seasoning blends. Also,
consider growing your own herbs in a garden or in pots on a deck or sunny window sill.
The following chart offers some good seasoning substitutes to use instead of salt. You
can use each seasoning individually or combine them for more complex flavors.
Note: Avoid using salt substitutes that contain potassium.

Salt-Free Seasoning Ideas


Food

Suggested Seasonings

Beef

Basil, bay leaf, chives, cloves, cumin, garlic, hot pepper, marjoram, onion,
rosemary, savory, thyme

Fish

Basil, curry powder, dill, fennel, garlic, paprika, parsley, tarragon, thyme

Lamb

Basil, garlic, marjoram, onion, oregano, rosemary, thyme

Pork

Coriander, cumin, fruits and juices, garlic, ginger, hot pepper, onion, pepper,
sage, savory, thyme

Poultry

Basil, fruits and juices, garlic, ginger, onion, oregano, rosemary, sage, savory,
tarragon

Eggs

Caraway, chervil, chili powder, dill weed, marjoram, oregano, savory, tarragon
Continued on next page

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patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

Salt-Free Seasoning Ideas (continued)


Food

Suggested Seasonings

Soup

Bay leaf, celery, marjoram, onion, parsley, rosemary, savory, tarragon

Cheese

Basil, chives, curry, dill, fennel, garlic, marjoram, oregano, parsley, sage, thyme

Fruits

Allspice, anise, cinnamon, cloves, coriander, ginger, mint, nutmeg

Tomato sauce

Basil, bay leaf, celery, garlic, marjoram, onion, oregano, parsley, pepper

Vegetables

Basil, chives, dill, marjoram, mint, onion, parsley, pepper, tarragon, thyme

How to Use Herbs When Cooking


Steaks and chops: Before cooking, pierce the meat with a fork, brush the steak or chop
with oil, and then sprinkle with herbs. Or, sprinkle herbs on meat while cooking.
Roasts: Make slits in the raw meat and insert sprigs of herbs before roasting, or
sprinkle herbs on the meat toward the end of the roasting time.
Burgers, meatloaf, or stuffing: Add herbs to the mixture before cooking.
Vegetables, sauces, and gravies: Moisten herbs with little water or oil. Let stand for
30 minutes and then add the herbs and soaking liquid to the food while it cooks.
Soups and stews: Add herbs during last half hour of cooking.

Using Strong or Dominant Seasonings


Strong herbs and spices include bay leaf, cardamom,
curry, ginger, hot peppers, mustard, pepper, rosemary, and sage.
Use these seasonings with care because their flavors
stand out.

3 In general, use 1 teaspoon of a strong dried herb or


spice to flavor 6 servings.

3 Fresh herbs will not be as strong as dried. You can


use a larger amount
of fresh herbs.

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patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
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Using Medium-Strength Seasonings


Examples of medium-strength seasonings include basil, celery leaves, celery seed,
cumin, dill, fennel, garlic, marjoram, mint, oregano, savory, tarragon, thyme,
and turmeric.
In general, use about 1 to 2 teaspoons of a dried medium-strength herb to flavor
6 servings.

Using Delicate Herbs


Delicate herbs can be used in large quantities and combine well
with most other herbs and spices.
Examples of delicate herbs include chervil, chives, and parsley.

Flavoring Foods with Liquids


Cook fish, pork, and poultry in low-potassium fruit juices, with low-potassium fruit
or dried fruit added, or with a touch of lemon.
Cook any meat in wine. Dont use cooking wine. It has salt added.
Cook meat and vegetables together.

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patient education. Mention of product names in this publication does not constitute endorsement by the authors or the Academy of
Nutrition and Dietetics.

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