Greeley cardiac rehabilitation expert: A heart failure diagnosis doesn’t mean never dining out again
When dining out and managing a diagnosis of heart failure, if possible, have food cooked to order and request no added salt. Above, Carne Asada is cooked to order by Cazadores Mexican Grill & Cantina, 2140 35th Ave. The meal was seasoned with paprika, cumin, black pepper and other spices but no salt. Ask your server what foods on their menu contain a lot of salt and have those served on the side. Photo by Emily Kemme.
By Emily Kemme
A diagnosis of heart failure often comes with nutritional recommendations to reduce saturated fat and salt intake. Restaurant meals are conspicuously high in salt, but that doesn’t mean you have to take them off the table.
According to the American Heart Association, the term “heart failure” means that the heart isn’t pumping as well as it should to circulate oxygen to your body’s cells. People with the diagnosis may experience tiredness, shortness of breath and coughing.
The Centers for Disease Control and Prevention state that nearly 6.2 million adults in the United States have heart failure.
Living to the fullest with this chronic condition requires making physical lifestyle changes, including creating new healthy eating habits. Tracking salt intake is one part of these lifestyle changes.
Budgeting sodium for heart health
Susan Bush is a cardiac rehabilitation nurse with UCHealth. She works primarily with heart failure outpatients in northern Colorado to educate and counsel them on how to achieve a healthier, more sustainable lifestyle after diagnosis. She often recommends sodium restrictions — but to make it palatable, she calls it budgeting.
The question of how much salt — or sodium chloride — is recommended in your daily diet depends on the state of the disease, Bush said. For heart disease (and renal failure, which she also addresses), that range is from 1500-2300 milligrams daily.
One teaspoon of salt equals 2,360 mg of sodium — if you’re counting, that’s around 40,000 grains of Morton table salt.
Some sodium isn’t bad, and in fact, our bodies require this mineral to regulate nerve impulses, coordinate muscle function, and maintain a balance of water and minerals, according to the Harvard School of Public Health.
Sodium exists naturally in most foods, including fresh fruits, dairy products and meats.
Where it becomes problematic is when sodium is added to food.
“Sodium acts like a sponge and hangs on to extra fluid in the body which causes shortness of breath because the excess fluid backs up in the lungs,” Bush said. “Fluid gets into the blood and expands blood volume and the body can’t excrete it.”
The result is swelling in legs, feet, ankles, abdomen, hands and face. Other symptoms include fatigue, weakness, the inability to lie flat in bed and breathe and weight gain.
She recommends learning about food sodium content by researching amounts online; you can track nutritional breakdowns with apps like MyFitnessPal or Sodium Tracker.
Restaurant foods and knowing what’s on your plate
With few exceptions, restaurant food has a much higher sodium content than foods prepared at home.
“It’s hard to single out a certain type of food, but if you look at sodium content in restaurant foods, it’s astounding,” Bush said.
Bush teaches strategies to make eating out work. Budgeting sodium intake is realistic — most people go out for a meal occasionally. The idea that individuals control the choices helps them feel less restricted, she said.
One proviso: if you go out regularly for meals, she recommends cutting back.
To start, if you’re going to eat out, budget that day for a restaurant meal and eat much less sodium the rest of the day.
Before you go, research the restaurant’s menu to determine how much sodium a dish contains so you can weed it out of your choices. Chain restaurants often post nutritional information on the internet; otherwise, Google it or check an app to research ahead of time.
If possible, have food cooked to order and request no added salt.
Ask for sauces, gravies and dressings to be served on the side. Use them sparingly by dipping your fork in a sauce and spearing the food. You’ll get much less sauce with sodium that way. Bush said this includes pasta sauces.
Avoid condiments, including barbecue sauce.
Since restaurant servings are large, ask for a take out box and immediately put half in the box for another meal.
Order fruits and vegetables instead of chips or french fries.
Don’t salt your food at the table (or when cooking, for that matter).
Bush finds restaurants sometimes list nutritional information on the menu. You might find it printed next to a heart icon, but the meaning can be different in individual establishments.
Because eating a heart healthy diet also includes monitoring saturated fat and increasing fiber, there may not be a sodium content provided, she said.
Looking at nutrition fact labels on food can help you become more informed because of details pairing serving size and the amount of sodium in milligrams.
But be aware of marketing. “Labels on foods that say, ‘heart healthy’ or ‘lower sodium,’ in all honesty I don’t know what that means other than there’s less sodium in this product than another one,” Bush said.
Making food taste delicious without salt
Bush recommends adding herbs and spices, including black pepper, to counterbalance the impression that food without salt is tasteless. Educate yourself on differences: garlic powder has no salt but garlic salt does.
There are many products on the market that add herbal, salt-free flavor to meals. Mrs. Dash, Penzeys Spices Mural of Flavor, and Savory Spice’s No Salt For You! spice set — there’s mustard-based Bohemian Forest for chicken, Park Hill Maple & Spice for veggies — to name a few, are all tasty options.
“Patients tell me, ‘I cannot eat x without a little bit of salt,’ so I tell them: calculate how much you need and then budget it out. I’m here to help them and be a resource,” Bush said.