Sodium is one of the main elements in table salt (NaCl or sodium chloride). It is added to many foods to enhance the flavor. Too much sodium is linked to high blood pressure.

Eating a low-salt diet is an important way to take care of your heart. Most people eat about 3,400 mg of sodium a day. This is about twice as much as the American Heart Association recommends. Most healthy people should have no more than 2,300 mg of sodium a day. People over 50 years old, and those who have high blood pressure, may need to limit sodium to 1,500 mg a day or less.

To get down to a healthy level, learn how to trim the excess salt from your diet.

DASH diet; High blood pressure - DASH; Hypertension - DASH; Low-salt diet - DASH

Ready-to-eat foods make dinner preparation easy, but they account for 75% of the sodium in the American diet. They include:

• Prepared mixes
• Packaged rice dishes
• Soups
• Canned foods
• Frozen meals
• Packaged baked goods
• Fast food

A healthy level of sodium is 140 mg or less per serving. If you use prepared foods, limit sodium by:

• Looking closely at the nutrition facts label for the milligrams (mg) of sodium per serving. Be sure to note how many servings are in the package.
• Using products labeled "low-sodium," or "no salt added."
• Checking the nutrition labels of cereals, bread, and prepared mixes.
• Rinsing canned beans and vegetables to wash off some of the sodium.
• Using frozen or fresh vegetables in place of canned vegetables.
• Avoiding cured meats like ham and bacon, pickles, olives, and other foods prepared in salt.
• Choosing unsalted brands of nuts and trail mix.

Also, use small amounts of condiments like ketchup, mustard, and soy sauce. Even the low-salt versions are often high in sodium.

Fruits and vegetables are a great source of flavor and nutrition.

• Plant-based foods -- carrots, spinach, apples, and peaches -- are naturally low in sodium.
• Sun-dried tomatoes, dried mushrooms, cranberries, cherries, and other dried fruits are bursting with flavor. Use them in salads and other dishes to add zest.

Explore other flavors when you are cooking.

• Add a splash of lemon and other citrus fruits, or wine, to soups and other dishes. Use them as a marinade for chicken and other meats.
• Avoid onion or garlic salt. Instead, use fresh garlic and onion, or onion and garlic powder.
• Try different types of pepper, including black, white, green, and red.
• Experiment with vinegars (white and red wine, rice wine, balsamic, and others). For the most flavor, add it at the end of cooking time.
• Toasted sesame oil adds a savory flavor without added salt.

Read the labels on spice mixes. Some have added salt.

To add a little heat and spice, try:

• Dry mustard
• Fresh chopped hot peppers
• A sprinkle of paprika, cayenne pepper, or dried hot red pepper

Herbs and spices provide a mix of flavors. If you are not sure what spices to use, do a taste test. Mix a small pinch of a spice or spice mix into a lump of low-fat cream cheese. Let it sit for an hour or more, then try it and see if you like it.

Try these flavors to liven up your meals without salt.

Herbs and spices on vegetables:

• Carrots -- Cinnamon, cloves, dill, ginger, marjoram, nutmeg, rosemary, sage
• Corn -- Cumin, curry powder, paprika, parsley
• Green beans -- Dill, lemon juice, marjoram, oregano, tarragon, thyme
• Tomatoes -- Basil, bay leaf, dill, marjoram, onion, oregano, parsley, pepper

Herbs and spices on meat:

• Fish -- Curry powder, dill, dry mustard, lemon juice, paprika, pepper
• Chicken -- Poultry seasoning, rosemary, sage, tarragon, thyme
• Pork -- Garlic, onion, sage, pepper, oregano
• Beef -- Marjoram, nutmeg, sage, thyme

Source: Flavor That Food, National Heart, Lung, and Blood Institute

You will notice a difference when you first start cooking without salt. Fortunately, your sense of taste will change. After a period of adjustment, most people stop missing salt and start enjoying the other flavors of food.

There are many great tasting low sodium recipes. Here's one you can try.

Chicken and Spanish Rice

• One cup (240 mL) onions, chopped
• Three fourth cup (180 mL) green peppers
• Two teaspoons (tsp) (10 mL) vegetable oil
• One 8-oz (240 g) can tomato sauce*
• One tsp (5 mL) parsley, chopped
• One half tsp (2.5 mL) black pepper
• One and a quarter tsp (6 mL) garlic, minced
• Five cups (1.2 L) cooked brown rice (cooked in unsalted water)
• Three and a half cups (840 mL) chicken breasts, cooked, skin and bone removed, and diced

1. In a large skillet, sauté onions and green peppers in oil for 5 minutes on medium heat.
2. Add tomato sauce and spices. Heat through.
3. Add cooked rice and chicken. Heat through.

*To further reduce sodium, use one 4-oz (120 g) can of low-sodium tomato sauce and one 4-oz (120 g) can of regular tomato sauce.

Source: Your Guide to Lowering Your Blood Pressure with DASH, U.S. Health and Human Services.

Appel LJ. Diet and blood pressure. In: Bakris GL, Sorrentino MJ, eds. Hypertension: A Companion to Braunwald's Heart Disease. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 21.

Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 pubmed.ncbi.nlm.nih.gov/24239922/.

Mozaffarian D. Nutrition and cardiovascular and metabolic diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 29.

US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th ed. www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf. Updated December 2020. Accessed June 18, 2022.

US Department of Health and Human Services website. Your guide to lowering your blood pressure with DASH. www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf. Accessed June 18, 2022.