Reducing dietary sodium difficult but not impossible


My husband was recently hospitalized and diagnosed with congestive heart failure. He was instructed to follow a 2,000 mg sodium diet. He tries, but it’s hard. I’m afraid he’ll get frustrated and give up. Words of wisdom?


Dear unsigned,

For readers unfamiliar with congestive heart failure, it is a chronic condition in which fluid builds up around the heart, causing it to pump inefficiently. Salt attracts water; therefore, a low sodium diet is prescribed to help manage the condition. A salty diet low in sodium (2000 mg) is not easy to follow. To put that into perspective, most Americans consume 3,400 mg of salt per day.

The good news is that a low-salt diet can still be delicious.

Behavior change is a process that takes time; it is not an event. Here are the stages of change.

1. Precontemplation – The person has no intention of changing in the near future. They believe that the advantages of using salt outweigh the disadvantages.

2. Contemplation – A person at this stage may consider reducing salt intake, but is reluctant to take the first step.

3. Readiness – The person sees the harms of continuing the behavior outweigh the benefits and is more willing to take the first step.

4. Action — The person has changed their behavior and is considering moving forward. There is always ambivalence about change, and relapse is possible.

5. Maintenance — The person can avoid temptations to start using salt again. They may have slips but don’t see it as a failure.

There are several things you can do to support your husband in his lifestyle change. Most hospitals offer cardiac rehabilitation classes in which diet and exercise are taught. You may have already taken these courses with your husband.

Although patients are educated about their diet in the hospital, there is a lot to take in. I highly recommend an outpatient appointment with a registered dietitian nutritionist. The outpatient setting is much more relaxed. The patient usually feels better at this time, so it is easier to learn. Most insurance will cover the costs. Also, ask the dietitian by phone to see if this is right for you before making an appointment. Any dietitian will have the information to teach you, but styles and attitudes vary widely.

If you’re the cook, prepare appetizing meals that use herbs as seasonings instead of salt. There are many recipes on the Internet.

Finally, compliance is a choice that the patient must make. Nobody else can do it for them. Don’t expect to see significant changes for at least six weeks, so try to be patient.

Until next time, be healthy!

Dear Dietitian

Leanne McCrate, RDN, LD, aka Dear Dietitian, is based in Missouri. Its mission is to educate the public about healthy, evidence-based nutrition. Do you have a nutritional question? Email him at [email protected] Dear Dietitian does not endorse any product, health program or meal plan.

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