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My standard disclaimer, from my writing on reproductive issues.
Current daily recommended intake of sodium is 2400 mg/day (a little more than a teaspoon). Surprisingly enough, most people consume more than that. Typical low sodium recommendations are designed to get daily sodium intake to or below 2000 mg/day. U.S. recommendations assume that adults need a fairly significant amount of sodium per day (1200-1500 being mentioned often) and therefore do not recommend arbitrary lowering sodium.
Once upon a time, the medical community attempted to deal with high blood pressure and related issues that occurred in association with pregnancy by insisting that pregnant women with high blood pressure adhere to an extremely low sodium diet. This turned out to be a (sometimes lethally) bad idea.
Rather than get into the pros and cons of reducing sodium, I'm just going to describe how to reduce sodium. Specifically, how I have been reducing sodium.
If you are drinking "softened" water, or water from a well in the salt belt, you may be getting a lot of sodium in your drinking water (viz. a hundred or more milligrams sodium/day). As far as I have been able to determine, Pitcher-based water filters such as Brita will not filter out sodium. A reverse osmosis filtration system will remove sodium, which would give you at least one option beyond bottled water.
Some medications contain sodium. Check your label inserts and/or the PDR or a reputable online source and discuss with your doctor.
Read labels: avoid anything where the number of milligrams is larger than the number of calories. If you had a teeny tiny amount of soy sauce on a large amount of otherwise unsalted fresh vegetables and rice cooked without salt, obviously, you can calculate that over all the food, rather than just the soy sauce.
Avoid eating out. It has gotten easier to find current, accurate nutritional breakdowns for chain restaurants, because most of them are now satisfying disclosure requirements through their websites. Researching your choices is worth doing, but likely to depress you. Independent restaurants won't have them at all, although they may be willing to work with you to find the best choice, this will be time consuming and not particularly effective.
Salt preserves food. If a food has acquired any kind of shelf life, it has probably also acquired sodium along the way. Fresh foods tend to be low(er) in sodium, as do frozen whole foods. Other preservatives, such as sodium benzoate, are not table salt, but also contain sodium.
Salt enhances the flavor of foods. MSG, which is not table salt, but which contains sodium, also enhances the flavor of foods. If you reduce the sodium content of your food, you will notice a difference in taste and, in general, it will be a disappointment. Over time, your palate will adjust. Also, with the high-impact of salt and MSG removed from your diet, you may discover a lot of flavors you weren't noticing before, which might in turn cause you to eat fresher, better prepared foods. Low sodium bread, in particular, can be a huge, disappointing shock. I recently bought a Nutrimill and started milling my own grains; the improvement in flavor was stunning.
If your local markets aren't coming through for you, Healthy Heart Market might have something useful for you.
Condiments There is at least one no salt added mustard on the market (Westbrae Stoneground No Salt Added). There are ketchups that replace some or all of the sodium with potassium, although I have been unable to adjust to this taste. Mayonnaise is generally (although not always) low in sodium, at least relative to calories. Salad dressings are often extremely high in sodium; oil and vinegar or lemon juice are extremely low in sodium. Pickles and relish are highly variable. Mt. Olive makes a comparatively low-sodium sweet relish. B&G makes a no-salt sweet relish. Hot sauce is often depressingly high in sodium; sometimes I sprinkle powdered chipotle or New Mexico chili instead.
Ezekiel Bread Ezekiel breads are named after a verse in Ezekiel. This can be off-putting to the non-religious. They are made from a combination of grains and legumes that have not been ground as fine as flour, so they are coarse and dense. They tend to be comparatively low-calorie, high-fiber, contain complete protein and are often (although not always) low sodium. They are often, but not always, kept in the freezer section. They are an acquired taste, but a taste worth acquiring.
No Sodium Baking Powder and "Soda" Ener-G makes a baking "soda" that contains no sodium. Featherweight makes a baking powder that contains no sodium (and no aluminum). If you buy these, you can make your own, (nearly) no sodium baked goodies.
Sea Salt, Kosher Salt In general, because of the other mineral content, sea salt has less (sometimes half) the sodium of regular salt. Kosher salt measures by volume less than ordinary table salt because of the grain size. You can also buy "salt" that is part or all potassium chloride, altho this flavor is recognizable and not entirely safe.
Soy Sauce Even "reduced or low" sodium soy sauces have shockingly high sodium levels (the lowest I've found is Angostura, which is 300+ mg/Tablespoon). Use extremely sparingly when unavoidable. Many other Asian condiments are similarly high in sodium.
Spice Blends Chili powder often means a mix of powdered chilis, cumin, black pepper, garlic, salt, etc. Sometimes a lot of salt. Make your own. Watch out also for lemon pepper and similar blends. A good spice shop will have blends with no sodium or you can assemble your own.
Deli Meats These are all high in sodium, but some are worse than others. Try to go when it isn't too busy and ask help in choosing the lowest sodium, or roast your own bird/beast/etc.
AVOID BRINED POULTRY! Goddess only knows why this particular technique took off, but it really sucks. It took a perfectly reasonable sodium food (poultry) and turned it into something lethal. Obviously, Butterball is a non-starter. Look for labels.
Choose Fats and Oils Carefully Unsalted butter rather than salted, unsalted shortening (Spectrum makes an unsalted, organic solid shortening; high in saturated fat and therefore it should probably not be your only choice, at least you're separating hazards). I prefer to use oils. Margarines and spreads tend to be particularly bad. While a lot of recipes for baked goods specify butter or margarine, you can often adjust the recipe. When replacing a solid fat with a liquid oil, remember to reduce the oil by 1/4 to 1/3, and change the mixing technique. Recipes that call for creaming butters and sugars together can be adjusted to instead emulsify the egg and oil together, then add the sugar to the emulsion. Recipes without eggs can be more difficult or impossible to modify, particularly pastry or pastry like things (pie crusts, croissants, etc.). Many French sauces cannot be translated successfully to use anything other than butter.
Cheese I don't know a lot about cheese, because I'm allergic to milk products. Some are really salty. Read labels.
Peanut Butter There are low and no-sodium peanut butters out there. You will have to stir them to re-integrate the separated oil (because they are also "natural"), and I recommend keeping them in the refrigerator.
Snack/Energy bars There are low/no sodium bars out there (Larabar), but a lot of the big names (Clif, Power) meet the mg <= cal principle.
Soup/Stock Health Valley makes a few no salt added soups that taste good to me but are often hard to find. They also make some low sodium broths (chicken and beef). Shelton's makes a very low sodium broth as well. It's quite simple to make your own chicken broth which, as long as you got unbrined/unsalted chicken and didn't add any sodium of your own, should be as low or lower and taste even better.
It's what everyone keeps saying: a diet of whole foods, minimally processed. It's nice if they are fresh (fresh dried beans cook more reliably than old dried beans, even), but from a sodium perspective, frozen and canned are the same as fresh as long as no sodium gets added in the process. I read that sodium used to be commonly added to frozen vegetables; it is less common now. Sodium is pervasive in canned goods, but there are some no salt added choices (Bionaturae and Muir Glen both make no salt added canned tomato products, as do some of the conventional brands; Eden Organics makes a wide range of no salt added canned beans; Trader Joe's has some no salt added options including a jarred tomato sauce that I find much tastier than Eden's).
IOM presentation "FDA Regulation of Salt and Sodium".
If by some bizarre chance you manage to really drop your sodium levels to the floor and at the same time forced yourself to drink a lot more water than your natural thirst would lead you to do, you risk hyponatremia. Try not to do that.
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Copyright Rebecca Allen, 2002.
Created January 5, 2008 Updated June 2, 2013