If you haven't already started on a program to cut the added sodium and saturated fats out of your life, you can start today. If you'll check your refrigerator now, and you find any of the following in it, then it may be the time to adjust your lifestyle.
For higher than acceptable added sodium check for bottled salad dressings, mustards, seasoned rice vinegar, ketchup, sauces, dairy products and brined chicken or pork.
For saturated fats check for high-fat milk, cream, cheeses, ice cream or yogurt, butter, margarine and/or sour cream. Beef steaks, roasts, ham, pork roasts, pork chops, fowl with skin and fat still attached provide high saturated fats as well. To find exact nutrient data you can visit megaheart.com/sodium_all_about.html
You will most likely want to eat smaller portions than you are consuming today. Especially change to very lean meats (95% fat free ground beef for instance), lean loins like pork tenderloin (that hasn't been brined) and fish. Lots of Pacific Wild Salmon for good omega-3 (1.28 grams fatty acids (FA) per 3-ounce serving), or Pacific Jack Mackerel (about 1.372 grams per 3-ounce serving), or fresh Pacific herring (1.6 grams per 3-ounce serving). White fish generally has no omega-3 fatty acids except for Greenland halibut (.938 g), swordfish (.701 g), shark (.833 g), and bluefin tuna has (1.103 g), Yellow fin has only (.207 g). Red Snapper has a low amount, at around .3 grams per 3-ounce serving. You can find other fish ratings at megaheart.com/sodium_all_about.html
Replace those high fat dairy products with nonfat or low-fat and for cheese, always low fat with the lowest sodium available such as no- salt-added (NSA). NSA low-fat cheese is difficult to find so if buying regular no salt added cheese, just use one-half of what you'd normally use. Yogurt products have yet to show up with lowered sodium, simply because milk itself has from 103 milligrams of sodium up to 150 mg per cup. According to the USDA, milk with vitamin A added contains 102.9 mg of sodium.
Unfortunately "diet" foods, or those with their fat content lowered often use more salt to kick up the flavor and shelf-life. Consequently, when we strive to cut out those saturated fats and trans fatty acids, we get an automatic up-tick in sodium.
To keep your sodium low, change your portions of each of these foods smaller. For instance, instead of the 6 to 8-ounce container of low fat yogurt, buy the 4-ounce container (or just eat half of one of the larger containers).
When it comes to butter, buy the unsalted version, but better yet, get rid of the butter habit and use extra virgin olive oil instead. (It's okay to use unsalted butter sparingly, like when baking a special treat, but try to get rid of the habit of using it every day.) If you like the flavor of olive oil you'll love the switch - and olive oil is much healthier. If you don't have a weight problem from consuming butter or oil, you can spread olive oil on a piece of toast or bread instead of using butter.
The best dietary protection for your heart is that you become persistent in taking care of what you eat. Once you've adapted to the new levels of food intake, lowered sodium and lowered fat, you'll find it easy to manage and you'll find yourself much healthier. But please do remember to continue exercising. A walk of 30 to 45 minutes a day is all you need for basic care. If you can walk more than that a day, then you'll be much better off.
What about bread?
Flour is high in calories but very low in sodium (2.5 mg per cup). Flour is also high in carbohydrates (95.4 g per cup), something diabetics are aware of. On the commercial side, diabetics have found a friend in Ezekial bread products. Ezekial 4:9 grain bread has 15 grams of carbohydrates and 75 mg of sodium per slice. Both are acceptable levels for a sandwich or piece of toast. Ezekial is made without flour, but instead with whole grains and lots of fiber. Diabetics can subtract the fiber count from the carbohydrate count to figure their daily "choices" or exchanges, but should be cautious about overdoing it since the sodium is rated at a level much higher than homemade bread.
Sometimes it's not the bread itself that affects our fat, sodium, or calorie intake. Nutritionists sometimes refer to a slice of bread as a "carrier." In other words, it's what we put on the bread before we eat it, such as butter, jam, peanut butter, burger meat, or as an overloaded sandwich, etc., that adds on the calories and sodium.
Homemade bread is often the best bread you can find for low sodium. (There are local brands that offer no-salt bread. If you have a Trader Joe's near you, they have an excellent high grain no-salt bread.)
With homemade bread you are also able to control the fat content somewhat by using flaxseed meal to replace some or all of the oil in the bread, and for lowering carbohydrates you can replace sugar with Malted Barley Flour or Splenda. Diabetics also get to subtract the fiber count from the carbohydrate count when balancing their day. Oil is used in bread to keep it soft and rich. Megaheart.com has developed some very low carbohydrate bread that is also under 5 mg of sodium per slice. Experimenting with other low sodium recipes is also doable and often rewarding.
Each of the Web based recipes at Megaheart.com includes data for Omega-3, Omega-6 and trans fatty acids along with carbohydrates, sugars, calories and other important nutrient information.
How Do We Know What Manufacturers Put Into Their Food?
The best help we have are the FDA food labels mandated to go on all commercial products. Unfortunately, many locally baked products do not carry these labels, but in some states they must provide the data if you request it. Additionally, some meat products, packaged "in-store" by markets, don't have FDA labels affixed. In these cases, ask for the nutrient data. In many states the meat market or supplier must provide this data to you. It is particularly important now since many meat processors are brining fowl and pork before selling it to you. This can raise the sodium levels in chickens and pork products as much as 100 mg per ounce.
Read all labels, even if you think you know what's in a product. We are still shocked sometimes by what we read - and often return items we intended to buy - back to the shelf.
Make sure you check the serving size on the FDA labels when you read them. A classic example of how these are managed is the salt container in the store. The FDA label usually will display that the salt you are looking at has 290 mg sodium per serving. When you check the serving size you'll see that the number is for 1/8th teaspoon. Multiply the sodium level by 8 and you have a teaspoon of salt at 2,320 mg .
It's always best to check anything you're buying in a can, package or frozen food section. Read the label to make sure you're getting what you think you're getting.
Read The Ingredients As Well
The ingredients become important to us when we're trying to protect our health. Two words that will stop us from buying anything are "partially hydrogenated." This refers to the oil used in the product and that's also important. Oils that are considered most damaging to our vascular system and to hour hearts are partially hydrogenated palm kernel, palm, coconut, and cottonseed. But all oils are considered not healthy if they are partially hydrogenated. We don't want to start a controversy here, but we think whoever is making Girl Scout cookies should wake up. And products from some of the weight watching companies need to change their ways as well.
Margarine is not an acceptable food either for fat content or for sodium levels. Even Benecol is listed on our "don't use" list since the sodium level is "through the roof." It was a good idea for trans fatty acids control, but not good for low-sodium eating.
Partially hydrogenated oils raise the LDL cholesterol (the bad one) and lower the HDL cholesterol (the good one). This action is caused by the trans-fatty acids produced by the partially hydrogenated oils.
New "No Trans Fats" products are arriving. Check the nutrient data closely and the ingredients before purchasing. Some might say "fractionlized" for the oil used. Look out especially for the calories and sodium levels. These are liable to be higher. Once again, if you have a hankering to use them, just use lower portions.
Is There Anything Safe To Eat?
Yes. We believe a diet of mostly fresh fruits and vegetables, or at least five servings a day is a very healthy way to live. (Also recommended by the National Institute of Health (NIH), and The American Dietetic Association.)
If you're healthy, alter your lifestyle today to fit into a program of fresh food, very lean meats and high fiber. Research has shown this cuts your chances of a stroke or heart attack.
For low-sodium eaters who must also cut calories, a typical breakfast might contain a very low sodium cereal like shredded wheat, a half cup of nonfat milk with vitamin A for the cereal, and fresh fruit added to the cereal. We don't recommend adding sugar but if you must sweeten it, try some Splenda.
Lunch can be a high fiber choice, but if you have to travel or work, why not order a steamed vegetable platter? Or a salad (with oil and vinegar or just plain lemon juice dressing). Ask the waiter or chef to use water without salt and to not butter or salt the vegetables. Also make sure they agree to steam any steamed foods in plain water, no salt added.
Dinner can consist of a variety of choices. A high fiber dinner for instance could be made from Eden Organic's No Salt Added kidney (or pinto) beans, cooked with Grandma's Chili Powder (one of the only chili powders that doesn't contain salt) and maybe some 95% lean burger meat, chopped onions, cayenne pepper and other flavors you like.
What you want to do is to eat the fresh fruits and vegetables and some whole grain, either in cereal or in your bread. This lifestyle, with soluble fiber, is healthy and it can help to lower your cholesterol levels to where they need to be. (Megaheart.com has a terrific whole-grain, high fiber bread recipe.)
Can I Go Out And Party It Up Sometimes?
You don't have to be a party pooper. But you should keep an eye out at any party for the "good stuff." Watch for the fresh vegetable platter, and enjoy the meal but be careful about what is served. If it's chicken, look out. Odds are it will be a brined chicken. Lean beef is rarely served in restaurants or at group parties so if you are served beef, check for fat and trim it off if you can. Look out for the added salt in almost everything that is prepared, cooked or that comes from a commercial caterer.
Can I Snack?
Sure. We do that all the time. I love Trader Joe's Calimyrna figs(also known as Californian). Other neat and healthy snacks are organic carrots (small mini size), bananas, oranges, apples (each with less than 1 mg of sodium). Candy or "sweets" are out. Read the labels and the ingredients. After seeing what's going into your commercially produced and packaged snack, you may never return to them.
Unsalted peanuts are also a favorite of mine. No more than an ounce a day according to the dietitians and other experts (about ¼ cup). But an ounce is plenty and you can exchange the peanuts for unsalted walnuts, pecans, or almonds. We buy the large bags at Costco and put them into airtight containers, or we freeze them. Nuts freeze well.
What About Fish?
There is a photograph at Jon's Place (www.chfpatients.com) of me holding a 32 pound wild salmon that I caught off Ft. Bragg, California. I cut it into many servings and froze it with the special freezing recipe you'll find in The No Salt, Lowest Sodium Cookbook. We barbecue it, bake it, or grill it and of course share it with family and friends. It's the best of the omega-3 fatty acid providers, and omega-3 fatty acids are what we are searching for. Also good for the omega-3 are mackerel and herring. Halibut, Sole, Orange Roughy, and Lingcod have no Omega-3 fatty acids.
A Megaheart.com visitor asked me about Fish Oil supplements. Yes, they are worth it if you don't like fish, but only if you get the oil in gel capsules that do not contain "tocopherols" or "Vitamin E" as part of the gel capsule. (Tocopherols are vitamin E.) Vitamin E supplements, it has been discovered, can lead to heart disease. But first, before starting any supplements, consult with your doctor. Make sure they don't interact or interfere with what you're already taking.
Are There Other Ways To Keep Cholesterol Low?
The National Institutes for Health (NIH) has information about phytosterols. Here is a quote from that site:
Phytosterols are cholesterol-like molecules found in all plant foods, with the highest concentrations occurring in vegetable oils. They are absorbed only in trace amounts but inhibit the absorption of intestinal cholesterol including recirculating endogenous biliary cholesterol, a key step in cholesterol elimination. Natural dietary intake varies from about 167-437 mg/day.
This article goes on to say that it's much better to get phytosterols naturally than with supplements or as additives to other foods. You read this section at:
NIH Phytosterol Study.
Anything Else I Can Do To Help With Low Sodium and My Heart?
Yes. Exercise. Get off the couch as they say. Turn off the TV and go outside and walk, or if you're healthy jog, bike or hit the gym. If you're healthy, you need a good 45 minutes of aerobic exercise a day (brisk walking, riding or gym work). If you can't do 45 minutes, start at 15 and work up. If you're already in heart failure, walk, walk, walk at the pace you can, but do it. Work your way up to more distance and time as you can. You'll find that you get much better.
There is another simple, at-your-desk or in-your-house exercise you might want to try. It was taught to me by a man who scored some of my industrial films during my career. His mother was a dancer who taught him to stand, suck in his abdomen and hold it, then let it out and do it again. In other words, work out his abdomen using his breathing while doing it. This practice exercised both his lungs and his abdomen. It's something you can do anytime of the day, and more than a few times each day. After a few months you should notice a positive change in your breathing and your strength.