Two years ago, after surviving breast cancer, chemotherapy and a bilateral mastectomy, I ended up in the hospital with congestive heart failure because I ate too much salt at dinner the night before.
When the cardiologist gave me this news, I laughed. "Too much salt? Are you kidding me?" I honestly thought he was making a joke, but he said this was no laughing matter. If I didn't seriously make an effort to reduce and monitor my salt intake, my next dinner could be my last one.
In the midst of my astonishment, all I could think of was that after all I had been through and survived, this doctor was telling me that my life depended on some seemingly harmless little white grains. At the time, I felt he was being overly dramatic, but I agreed to see a nutritionist to address my salt consumption. Besides, how hard could it be?
To be fair, salt had been on the table before this. I had been born with a hole in my heart and the chemotherapy had taken its toll on my already challenged 53-year-old ticker. My family doctor, usually during my annual physical, regularly inquired about how much salt I ate. My stock response, delivered in a very self-satisfied way, was, "I don't use salt." I rarely added salt to my food, either while cooking or afterwards. And if I did, I usually used sea salt as a healthier alternative to table salt.
I was shocked when the nutritionist I met with started to talk numbers with me. The real problem with salt, the nutritionist explained, is that too much of it can cause the body to retain excessive water, and to pump that added fluid, even a healthy human heart has to work harder. Eventually, this strain can weaken the heart and ultimately bring about a complete shutdown. The cardiologist had told me I could safely ingest 750 milligrams of sodium a day and not more than 250 mg in one meal (1 teaspoon of salt = 2,400 mg of sodium). If you are a healthy adult, Health Canada recommends between 1,200 and 1,500 mg of sodium per day, although it is not uncommon for many Canadians to consume as much as 4,000 to 5,000 mg.
When I mentioned to the nutritionist how, like many busy professionals, I often popped a frozen entree (usually labelled as a "healthy choice") into the microwave at the end of the day, I was informed that even the new "sodium-conscious" line of frozen entrees contained enough sodium (an average of 550 mg) to give me heart failure.
As I was coming to terms with the radical overhaul of my diet, salt was suddenly becoming a national concern. Just last fall, 17 of Canada's leading health groups declared a "war on salt," joining forces to demand that the government take action to reduce sodium levels in food. In response, federal Health Minister Tony Clement formed an expert Sodium Working Group. Recent research studies have linked excessive sodium in our food to various ailments, including obesity, osteoporosis, weight gain, premenstrual syndrome and asthma. The pressure from fluid retention, the result of excess sodium, is also linked to carpal tunnel syndrome.
Then I left the hospital, now appropriately frightened, I embarked on a journey to rid my diet of excessive sodium, feeling an affinity with those who face possible fatality due to ingesting even trace amounts of peanuts. First on the agenda was removing from my kitchen what I assumed were high-sodium items, based on what the nutritionist had told me. Afterwards, I gazed with despair at my now almost-empty cupboards and fridge. Gone were most of my gourmet mustards and sauces, my favourite Gardennay Butternut Squash soup, wraps and, most heart-wrenching of all, my beloved cheeses. Still, I was not to be daunted. Surely there were foods I would like that contained no, or at least a minimum of, sodium. Buoyed by the challenge, I headed off to the grocery store, but not without making a quick detour en route to my local bookstore to buy a calorie counter that indicated sodium levels.
As I stood in the supermarket, I sent up a prayer of thanks for the mandatory nutrition labels that had come into effect in Canada in December 2007. That was before I attempted to read and understand the packaging and labels. At one point, I became dizzy trying to understand the difference between salt free, sodium free and no salt added, not to mention labels that read very low, low, light, less or reduced sodium. Perhaps I was just getting hungry.
I cut short my shopping trip and grabbed what I thought would be a safe dinner: chicken (boneless and skinless), ingredients for a salad and a multi-grain baguette. After dinner, I looked up the sodium content in my calorie counter: chicken (three ounces = 80 mg), salad (1/2 cup = 65 mg) and a slice of baguette (230 mg) for a total of 375 mg of sodium. If I were a healthy adult, I would still have 25 mg of sodium to spare. For me, however, I was 125 mg over my single-meal target of 250 mg.
Making matters worse, upon closer inspection, I probably ate closer to six ounces of chicken (who but a child eats only three ounces of chicken?). I'd also forgotten to account for a teeny bit of barbeque sauce (1 tsp = 180 mg), a small dollop of salad dressing (1 tsp = 130 mg) and two slices of bread (460 mg) with unsalted butter (0 mg), for a grand total of 995 mg of sodium. Wasn't this supposed to be a low-sodium, heart-healthy meal? I didn't die that night, thankfully, but I did learn a lot about serving sizes and the startling amounts of sodium contained in sauces, dressings and bread. Just for fun, I looked up some fast-food items and found that a single hamburger or submarine sandwich could have in excess of 2,000 mg of sodium more than the daily amount for a healthy adult. On the other hand, I was surprised to discover that pasta, grains, oils and vinegars, as well as most fruits and vegetables, have only trace amounts of sodium. Basically, all food has sodium, either natural or added, and you have to decide how you want to spend your daily allotment. For me, I would rather not spend 60 mg on a carrot (one of the more sodium-filled veggies), no matter how healthy it is otherwise.
Throughout this entire experience, I've begun to enjoy cooking more than ever and am told I am becoming quite the gourmet cook. I experiment with different oils and herbs, and make my own soups and sauces. An unintended bonus is that I lost a lot of those extra pounds I was carrying. But it wasn't all love and light. There were further bumps in the road when I ventured from the safety of my own kitchen.
The first assurance I received from just about every friend and family member who tried to cook for me is "I don't use salt" precisely what I thought at the beginning of this journey. I didn't have much more luck eating out at restaurants. Asking a chef to leave out the salt is akin to asking them to cook a medium-well chateaubriand. I have had at least one chef replace salt with MSG, almost landing me in the hospital. And after going into heart failure on a trip to Cuba, I was told by a local cardiologist that there was no food in the entire country that did not contain salt.
These days, I travel with my salt-free butter and a selection of dressings and sauces. Along with my weight loss, I am told I have never looked healthier. Living with less sodium is difficult and a challenge, but as those behind the war on salt warn us, our lives may depend on it.
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