Putting down the saltshaker is just the first step....
Experts agree that a low-sodium diet can decrease the risk of heart disease, migraines, diabetes, and osteoporosis.
But to significantly reduce the salt in your diet, you must learn how to spot the hidden
sodium in frozen foods, canned goods, and popular recipes.
Fully revised and updated using the latest medical research, Cooking Without a Grain of Salt
is a nutrition guide and cookbook all in one. It's filled with useful tips on how to limit sodium without sacrificing flavor--as well as savory recipes that will help you put your healthy, low-salt lifestyle into action.
From Stuffed Mushrooms and Double Corn Biscuits to Pork Medallions in Pesto, Grilled Tuna with Salsa, and Pasta Primavera, Cooking Without a Grain of Salt
lets you enjoy all the dishes you love while forming healthy eating habits for years to come..
The Role Of Sodium: Nutritional Background
Sodium is a mineral basic and necessary to animal and plant life, and salt (sodium chloride) has been used as a seasoning since ancient times. But medical consensus tells us that excess sodium can cause us all eventual harm. The kidneys are the organs that control the level of salt in our bodies. If there is too much salt, healthy kidneys excrete it into our urine. When kidneys are faulty, or if too much salt enters the system, the excess salt stays in the bloodstream, absorbing water to keep it dissolved. That excess liquid in the confined space of our circulatory system causes swelling that puts dangerous hydraulic pressure on the walls of blood vessels and leaves us at risk for strokes and heart attacks. If arteries are clogged with fat, that risk is compounded.
But we can lessen the risk of such damage by maintaining adequate potassium in our diet. A healthy body needs more potassium than sodium in order to ensure the efficient workings of its cells. These minerals work cooperatively to activate the intake of nutrients and the excretion of wastes on the cellular level in a process governed by the sodium-potassium pump, a kind of engine that drives cell activity. To maintain the essential high-potassium ratio, known as the "K factor," people must eat fresh fruits and vegetables. The National Academy of Science recommends between 1,600 and 2,000 milligrams of potassium a day. Foods particularly high in potassium include dried apricots, bananas, potatoes (especially sweet potatoes), dried beans and peas, meat, peanut butter, and orange juice.
For additional information, read The K Factor
by Richard D. Moore and George D. Webb (Macmillan, 1986).
Primitive societies lived close to their plant and animal food, did not salt food as a matter of course as we do, and ate much of it uncooked. Potassium was plentiful in this natural diet. Sodium wasn't. Thus humans were genetically programmed millennia ago to excrete potassium and retain sodium. There is even a particular place at the edge of the tongue that detects saltiness in foods. As civilizations developed and some groups moved away from their food source, salt became the indispensable preserving ingredient so that food could both travel and keep. So honored was the role of salt that it entered the language both as a measure of value and an index of excellence. Hence we are paid a sal
ary; good folk are the salt of the earth.2
It is interesting to note just how effective a preserving agent salt became in ancient Egypt. Mummification depended on salt! When the Nile receded from its yearly floods, it left behind pockets of a substance the Egyptians called natron,
a sodium-based chemical essential to the technology of preserving mummies.
As people discovered that salt could preserve foods for long periods, they also discovered that they liked the taste it gave to food. As salt came into common use, the proportion of sodium to potassium in human diets reversed, with sodium gaining dominance. The effect of sodium dominance on whole societies has been dramatic and destructive. Hypertension, once unknown in cultures that traditionally followed low-sodium diets, now affects tens of millions as those societies adapt to the high-sodium diet of "commerce" or "civilization." As much as 95 percent of the sodium we eat is put in our foods by someone else, most typically in the processed foods that are, unfortunately, a staple of the American diet. It is by informing ourselves of the sodium content of the foods we buy that we most usefully exercise our salt vigilance.
Medical demographers estimate that around 15 percent of the general population is particularly sensitive to the adverse effects of salt. That works out to be roughly 40 million people. At least 50 percent of those with hypertension risk harm by maintaining a high-sodium diet. Several other conditions are also commonly treated by salt-free diets. These include congestive heart failure, diabetes, migraines, and premenstrual tension. Women after menopause are encouraged to reduce salt because studies show that sodium contributes to the loss of calcium, which is needed to prevent osteoporosis. Current research has determined that certain forms of cancer are related to high-sodium levels. Many cancer therapies, in fact, involve eliminating salt intake. Certain kinds of stress have been shown both to be sodium-caused and to increase desire for salt; lowering salt intake lowers stress levels.
Thirty years ago there was a sharp distinction between those for whom it was medically necessary to limit salt intake and those who had no need to do so. Today we know better: most of us would be healthier if we used less salt.
We conclude this nutritional note with a statement of two convictions. The first is that sodium has invaded our culture in a highly dangerous way, because it is all too often silently present and frequently unsuspected. Sometimes we can't taste it even when it is there in startlingly high concentrations--in milkshakes, for instance, which contain nearly 300 milligrams of sodium. The use of sodium in preparing fast foods, most baked goods, and most canned and frozen foods, is common and under-recognized. The current federal truth-in-packaging guidelines make it increasingly easier for consumers to learn the exact ingredients of what they buy and eat. On the other hand, as the nutritionist Dodie Anderson has said, "You won't have to bother reading labels because the foods I want you to eat don't have labels."
Our second conviction is that an addiction to salt, because it is an acquired taste or acquired craving, can be unlearned. (Babies are born with no interest in salty foods and breast milk is very low in sodium.) Because the taste for salt is a habit, developed both by cultures and by individuals, it can be changed and replaced by a taste for flavors and textures and smells much better for our health. In just a matter of weeks you'll lose the desire for salt and become newly sensitive to the array of seasonings that await you.Work with Your Doctor
The simplest way to monitor your sodium susceptibility is to ask your doctor to test your sodium blood level. A reading of between 137 and 144 indicates you should maintain a moderate salt intake of about 2,000 milligrams a day. If your reading is over 144, it indicates an unhealthy salt retention in your tissues, and your doctor will probably urge you to identify and cut sharply the sources of salt in your diet. A sodium blood level under 137 means you may need to slightly increase your sodium intake.Get the Salt Out
by Ann Louise Gittleman, M.S., C.N.S. Crown Publishers (New York, 1996), p. 24.
In our parents' case, the doctor placed Ted on a low-sodium diet and he followed it, with Elma's help. Thirty years ago, before more sophisticated medications, doctors treated hypertension with diet. It is still the preferred method, but, probably because of the less arduous alternatives, many doctors find that it is too difficult to get people to comply. There are countless approaches to the curing of illness in the medical profession. Some doctors rely primarily on medication; others look first at dietary changes, along with weight loss and exercise. Many suggest a combination, believing that a low-sodium diet contributes to the effectiveness of medication. Make sure you and your doctor are of a mind. Because you have this book in your hands you are embracing a nutritional approach, but you also will need the advice and encouragement of your doctor as you set out.
The original recipes in Cooking Without a Grain of Salt
were created so that they might be used for a sodium-restricted diet of 500 milligrams per day (in 24 hours). Most people need not follow such a limited low-sodium diet. But if you must, there is a range of recipes from which you may select your menu. To ensure well-balanced meals, careful planning will be needed for 500 milligrams. But if your sodium restriction is under 500 milligrams, very careful planning must be employed. You and your doctor should be certain you are receiving adequate nutrition, especially for the recommended amount of calcium, perhaps in the form of a supplement. (An 8-ounce cup of milk contains between 120 and 125 milligrams of sodium. One glass would then limit you to 375 milligrams of sodium for the rest of the day.)
If your diet permits more than 500 milligrams per day, the recipes in this book are adaptable. Many doctors restrict all added salt, rather than prescribing a specific milligram limit. Your doctor may allow light salting in the cooking or in the preparation of food. If the food was prepared without salt, a limited amount may be permitted at the table. But keep in mind that there are 570 milligrams of sodium in 1/4 teaspoon of salt, about 2,300 in a teaspoon. It will take discipline and ingenuity to stay safely within your limit.
If there are foods on the permitted lists or ingredients in these recipes that your doctor forbids, follow those orders and do not use those foods. On the other hand, as you gain understanding of the principles of salt-free cooking, you will take responsibility for how it applies to you and allow yourself occasional foods on the off-limits list as you learn to balance and combine ingredients during a single day.