My New Sodium Restricted Life - Part 1

My doctor gave me medication, told me not to exercise, other than walking, and that I needed to be off from work at least until my next echo.  At that point, his recommendations may change based on my ejection fraction.  However, he did not give me any advice regarding vitamins, supplements, sodium intake or liquid restrictions.

I've read various articles and there is plenty of conflicting information.  I've also read some stories from women who share what worked for their recovery.  I want to start with the American Heart Association recommendations and discuss how I've approached my recovery and why.  Also, I should mention that there are studies that did not find it beneficial for heart patients to restrict their sodium intake.  These studies found that limiting sodium did not result in better results and in some cases, resulted in higher readmission to the hospital.  The readmitted patients had low sodium levels and high creatinine levels.  It also seems like those patients were prescribed high-dose diuretic therapy and that the high-dose diuretic in combination with a low sodium diet may have been too aggressive.

The American Heart Association recommends that people with mild heart failure limit their sodium intake to 1500mg and people with severe heart failure should consult their physician.  The daily recommended maximum for people without heart conditions is 2300mg.  It's estimated that on average Americans consume 3300mg - 5000mg per day.  So even if you don't have health problems, it may be a good idea to track your sodium for a few days to determine if you are over or under the recommended daily maximum.

Through a little research and by asking women who started their PPCM journey before me, I found that they believe limiting sodium to 1500mg and water to 50 ounces is best.  See, when your heart isn't pumping efficiently, fluid accumulated in your lungs and you can experience swelling.  Your brain and your heart gets priority and receive oxygen rich blood and organs like your kidneys are not getting what they need.  When the kidneys, which help your body get rid of excess water, are no longer functioning properly.

I decided to try the liquid limit that other PPCM women recommended and the sodium limit of 1500mg that is also recommended by the American Heart Association.  I have not been prescribed a high-dose diuretic and my sodium and creatinine levels are normal so I believe limiting my sodium will be beneficial.  Through a lot of hard work, I have been able to stay under 1500mg most days.  Some days I go up to 2000mg but not often and I've had 1 cheat day since December 15th.  In a later post, I will discuss some of the food that I've found works for me and share links to recipes that I've actually tried.

I don't know how many people reading this track their sodium and stick to a low sodium diet but it is almost impossible without completely changing the foods you consume.  I think most of us at one point count calories or carbs but rarely pay attention to sodium content. 

A teaspoon of salt has 2300mg and most recipes add salt to your dish unless you specifically look for low sodium recipes.  You would think that lowering your sodium intake means not adding salt to recipes and definitely avoiding the salt shaker at the dinner table but it’s not that easy. Let me tell you why you must change everything about the way you eat (unless you are already a healthy foodie). 

Any processed foods, including frozen foods are extremely high in sodium.  Most sauces, cheeses, cereals, and breads are high in sodium.  Here is a list of the sodium content in common foods.

• slice of pizza - 400mg to 800mg
• hotdog - 820mg
• dinner roll - 200mg to 300mg
• 1/4 cup of ketchup - 550mg
• cereal - 100mg to 250mg
• milk - 100mg
• taco - 300mg

Restaurant meals are also very high in sodium and I've found that most meals alone are over the 2300mg daily limit. However, there are a few meals that fall under 1000mg (I would like to eat more than one meal a day) by looking for the nutrition facts for almost every restaurant that I could think of. Unfortunately, there are still plenty of restaurants that do not post their nutrition facts and that will usually keep me from trying to eat there.  I will try to summarize the restaurants that I've visited and even those that I decided against in my next post.  

** Update ** At my last doctor's appointment, I asked if there were any food/liquid restrictions that I should follow.  He said that I should avoid alcohol and restrict my sodium by cooking at home, not adding salt and by switching to a salt substitute.**