Sodium: What gives Caregivers and Cardiac Rehab Staff Nightmares

Working cardiac rehabilitation, one wants to take time off around Saint Patrick’s day and Easter. Often patients come in with weight up 10 lbs in one to three days, short of breath, swollen, and having elevated blood pressure. When asked, they report celebrating Saint Patrick’s day with sauerkraut and sausage, corned beef and cabbage, with lots of bread on the side, then celebrated Easter early with a ham dinner with gravy.

Caregivers take note, well-intentioned friends and family may have prepared meal or stocked freezers full of sodium laden foods thinking they are helping out during a  medical crisis. Be alert to sodium and it’s effect on heart health.  Programs such as  Meals on wheels also has a tendency to have very salty meals. 

If you find weight up, swollen feet/ankles/belly/face, shortness of breath and elevated blood pressure consider the  dietary sources of sodium. 

Sodium causes fluid retention, weight goes up,  and is often treated with increased diuretics (Lasix, Aldactone, Demedex, Bumex, Zaroxolyn etc.). The body can become resistant to diuretics however, so adding more and more diuretics can be dangerous. These throw off the electrolytes and disrupt the sodium potassium balance of the body, which can set in motion additional heart problems including arrhythmia’s - irregular heart beats that could be deadly. Other side effects of diuretics include:

  • increased blood glucose levels
  • increased calcium
  • increased cholesterol
  • potassium loss
  • increased uric acid, which might trigger a gout attack in certain people

Bought raw or in a can, corned beef brisket is very salty. One 3 ounce serving of cured corned beef has 964 mg of sodium, 40 percent of your daily value of sodium. In addition to sodium, corned beef is generally made from the fattier brisket areas, so the fat and cholesterol levels tend to be on the high side when compared to some of the more commonly available beef cuts. 1 cup of Cooked Sauerkraut has about 900 mg of sodium. Ham isn’t better - 4 oz. of ham can have between 1000 and 3000 milligrams of sodium. 

Sodium, Salt, Na, MSG, natural flavors, natural spices, Sodium Nitrate,

  • Monosodium glutamite,
  • Sea salt,
  • Disodium phosphate,
  • Baking soda,
  • Sodium citrate, sodium bicarbonate, sodium algonate, are all names of sodium.

 If your diet is going be high in sodium, eat more potassium-rich foods. Potassium helps to lessen the dangerous effects of sodium. Foods high in potassium include bananas, potatoes, squash, spinach, raisins, cantaloupe, beans and lentils.

Rinsing foods such as sauerkraut, or canned beans or veggies in a colander can remove up to 40%. Read labels and aim for foods with 300 milligrams or less of sodium per serving.

 To learn more about salt and heart health click here

To learn more about how to lower sodium in diet click here.

To learn more about sodium and it’s effects on the body

Nutrition recommendation for heart patients

Load up on nutritionally dense low caloric foods. Don’t let the day go by without eating vegetables. Challenge yourself with legumes and  beans which provides essential fiber in the diet. Drink water regularly. Avoid fast food and eating out as much as possible. Use fresh herbs and spices, yet avoid salt.

Mediterranean Diet PyramidHow Fiber Works Infographic

Sodium intake affects on heart vessels

Learn your sodium intake,read food labels. Do the math. How much are you getting on a daily basis?

medwireNews: Restricting salt intake reverses vascular endothelial dysfunction in people with moderately increased blood pressure (BP), shows a randomized study published in the Journal of the American College of Cardiology. To read more on this go to link at the bottom of this page.

How Sodium Causes Fluid Retention

The job of the kidneys is to filter the excess sodium into the urine so that the body can get rid of it. Many with heart disease and diabetes kidneys cannot handle all the extra work. The kidneys become less efficient at filtering the blood stream. This causes excess sodium to enter the bloodstream. Sodium attracts water to it and effect known as being osmotic. Water follows the sodium  and is drawn into the bloodstream. Excessive salt keeps the circulatory volume higher than it should be, creating and increased pressure in the blood stream and pressing on the blood vessel walls. The stress of the pressure on the walls creates thickening and narrowing of the vessel, leaving less space for the fluid in the blood vessels and raising resistance.  The body then requires higher pressure to move blood to the organs. The heart has to pump against this high pressure system.

I equate it to trying to blow up one of those kids balloons that is turned into animal shapes. They are really tough to blow air into, your cheeks get really sore – this is the resistance of air, similar to the resistance pressure of blood in the arteries. If you stretch the balloon (relax the arteries) then there is less resistance in blowing up the balloon (filling the artery with blood). Twenty percent  of the blood pumped from the heart goes  first to the kidneys.  High blood pressure within the kidneys cause  damage to the heart and to the vascular system in the kidneys. Salt makes you thirsty so limit salty foods, especially if on a fluid restriction.

I once had a patient who lost 45 lbs simply from adhering to low sodium diet. He had a very weak heart with only 10% ejection fraction meaning very limited pumping ability. So a weak heart and sodium in the diet made him retain fluid more than most. He began to measure and count sodium with every meal for a few months and was shocked by how much sodium he consumed even though he thought he ate pretty healthy. By reading labels, doing the math every day and making changes such as eating out less, ordering special, reviewing his medication he lost the fluid and added years to his life, not to mention the improved quality of life with less shortness of breath and fatigue by easing the workload of the heart.

                                  

According to the American Heart Association, eating more than the recommended 1500 milligrams a day puts you at direct risk of high blood pressure. Yet in America we consume an average of 3400 milligrams a day; more than twice what we should. While people with hypertension, heart and kidney disease are always advised by doctors to eat less salt, the AHA wants all of us to do this, whether or not our blood pressure is currently in the normal range.

http://newsroom.heart.org/news/change-your-salty-ways-in-only-241917

http://www.medwirenews.com/463/103163/Dietetics/Multiple_vascular_benefits_in_salt_restriction.html

Carbohydrates and Heart Disease

Info graph about the benefits of low carbohydrate foods explaining the difference between "good" carbs and "bad" carbs. Learn why you gain weight when

The following link is a research study looking at how sucrose (a form of sugar) affects the heart.  Regularly consuming sucrose — the type of sugar found in many sweetened beverages — increases a person’s risk of heart disease, new research suggests. Scientists used fruit flies, a well-established model for human health and disease, to determine exactly how sucrose affects heart function. In addition, the researchers discovered that blocking this cellular mechanism prevents sucrose-related heart problems.http://tinyurl.com/bey4lox