Too Much vs Not Enough: Is Stealth Sodium Throwing Off My Count?

According to most sources, >1500-2000mg of sodium is too much and <1200mg is not enough. Recent experience has me questioning these numbers - specifically the 1200mg one.

My Meniere's symptoms had all but disappeared during the summer when I was making a concentrated effort to keep my sodium intake as low as possible. It was probably not even consuming 800mg a lot of days (if my calculations were correct). No dizziness or vertigo, no sense of aural fullness, and most days I did not have any noticeable tinnitus. Went to my first recheck with my doctor and mentioned all this. He warned me not to go too low on sodium, so I started to relax a bit to bring up my daily consumption to around 1200mg. About a month later I was having tinnitus nearly every day and then had a string of horrible vertigo episodes.

After the really bad week of nausea and vertigo, I cut way back on the sodium again. Now that a week has passed with no dizziness, I have had two straight days of quiet. No tinnitus! When my ear doesn't ring, I know I won't have any problems with vertigo. It is a nice feeling.

There are only two conclusions I can draw from this experience. Not sure which one (if either) is correct. Either my daily sodium consumption to prevent Meniere's attacks is much lower than the recommended 1500mg, or I am consuming more sodium than I think I am. The second option seems more plausible. Fresh foods that do not come with a nutritional label may be the problem - especially meats. It is much easier to figure out my sodium intake when the info is there on a nutritional label. I am going to have to compile a list of sodium content for fruits, meats and vegetables so I can make sure I am including it in my sodium counts. Will also have to be more vigilant about buying organic meat that hasn't been injected with salt or MSG.

My other thought is why are the sodium recommendations the same for everyone? Shouldn't it matter what a person weighs? Active vs sedentary? How much water they drink? How much they sweat? For now, I am taking the 1200mg floor with a grain of salt (pun intended). If I am feeling good with 800mg a day and don't have any symptoms of sodium deficiency then that is how I will be eating from now on. But just in case, next time I see my doctor I will request that they order a lab test to make sure my body's level of sodium is within the normal range.

Pizza 2.0 - grinding it out

We made another Italian sausage pizza tonight and managed to cut roughly half the sodium from our previous attempt. The main two changes: no salt used in the dough for the crust (I used the herbed pizza dough recipe from Dick Logue's 500 Low Sodium Recipes book), and we made the sausage from scratch using 1/3 the recommended amount of salt. PDM consulted our low sodium cookbooks and his "normal" cookbooks and kind of split the difference in the recipes for the sausage. He made three pounds and froze most of it in 12 ounce portions for future use. It was some of the best Italian sausage I've tasted and the missing salt didn't cause any loss of flavor. If I didn't know it was "lower sodium" I would not have guessed it.


The pizza made six servings. I ate two and PDM ate four. My share of sodium was about 500-600mg. We still have about 6 ounces of sausage and about half the sauce left to use for supper tomorrow night. I am thinking of picking up some fresh tortellinis on my way home and another can of no-salt-added canned tomatoes and we are back in business! Got plenty of fresh basil growing in the garden, and we'll make some homemade garlic bread to go with.

Vacation Report

Pretty sure I didn't blow my sodium budget, although I probably came close a few days. The sodium restriction did make things much more difficult. It was much harder to find a place to eat that had something which could work for me. We had much less spontaneity than we are used to. My breakfasts were a bit monotonous - had fresh fruit and granola with yogurt every day. We always eat bananas and trail mix for lunch, which was not a problem since we chose the trail mix carefully (thank you Trader Joe's). But dinners were sometimes a challenge, especially in remote places (and also on the airplane). If all else fails, portion control is a viable option.

Other than the food restriction, we had a great vacation (if a bit overscheduled). Once we got to Seattle, we drove more than 1300 miles and hiked over 36 miles of trail. Not a lot of downtime. Very pretty scenery though, and we have this weekend at home to recover.

First Vacation with the Sodium Restriction

Not sure how well it will go, but if we can't find healthy restaurant food in the Pacific Northwest, we might as well give up all hope now. Normally on vacation, we eat fruit and trail mix for breakfast and lunch (not a sodium problem), hike all day, then go out and have a great dinner. I'll let you know how it works out in practice.

Recipe - Bay Scallops in Creamy Wine Butter Sauce Over Rice

A couple of minor modifications reduced the sodium content of this recipe by about 40%. In our version, the main source of sodium is the scallops themselves. This dish has a wonderful flavor and texture, and while not a quick cooking meal the prep work isn't that laborious. And trust me, it is worth taking the time. Even PDM, who is not crazy about zucchini or cream sauces, liked it. A lot.

Ingredients:

For the main course:
8 oz bay scallops (we used frozen ones, thawed just before cooking)
8 oz zucchini (1 large or 2 small), cut into thin half rounds
1/2 vidalia onion, chopped
1 cup white wine (you'll have enough left in the bottle to drink with dinner, so get something good)
1/2 cup low sodium chicken broth
2 T unsalted butter
1/4 cup heavy cream
freshly ground black pepper to taste (we like to use a lot)

For two servings of rice:
1/2 cup jasmine rice
1/4 cup low sodium chicken broth
1/2 cup water mixed with 1/2 t Wyler's no salt instant chicken bouillon
1 T butter

Method:

1. For the rice, bring the liquid ingredients and butter to a boil in a small saucepan, add the rice, stir and cover. Simmer over medium low heat about about 15 minutes or until liquid is absorbed. Keep covered and set aside off the heat until ready to serve.

2. Bring the wine and broth to a boil in a medium pan. Add scallops, return to boil, then lower heat and simmer, covered, for about 3-4 minutes or until the scallops are done. Transfer the scallops to a bowl, cover and set aside.

3. Return the cooking liquid to higher heat and simmer uncovered until it has reduced down to about 1/3 the original volume. This may take up to 20 minutes depending on your heat setting. Stir occasionally.

4. Melt the butter in a medium skillet. Add the onion and zucchini and cook until the vegetables are crisp-tender.

5. Add the scallops to the skillet along with the reduced wine sauce. Add freshly ground pepper and the cream, and cook for about another minute, stirring often, until the cream is heated through and the sauce begins to thicken.

6. Serve immediately over the rice and enjoy! I added a bit of Mrs. Dash lemon pepper seasoning to mine and didn't miss the salt.

Serves two. (We thought the servings were rather large and that we'd never finish all of it, but it was so delicious we ate every morsel and didn't feel overstuffed.)

365 mg sodium per serving, including the rice

Snacking 101

Getting hungry between meals is common, at least in my experience on the low sodium diet. The problem is that a lot of snacks are too salty for me to eat now. I really miss the days of eating pretzels and popcorn. I am still learning the ropes (and over relying on nuts to tide me over), but as I find good quick snack ideas I will post them here. Aside from the obvious things - fruits, raw veggies and unsalted nuts, I am finding a few other things that fit the bill.

Low sodium snack idea #1 - no sugar added applesauce with powdered cinnamon mixed in. Sodium count = 0mg and it tastes great. Takes no time to prepare. Easy!

Low sodium snack idea #2 (and this also makes a great breakfast) - yogurt with granola and your favorite fruit. Sodium count approximately 130 mg (mostly from the yogurt), assuming 1 cup of yogurt and 1/2 cup granola. Read your labels and choose wisely.

Low sodium snack #3 - Terra sweet potato chips. 10 mg sodium per ounce of chips (about 17). Add some Mrs Dash to taste and they really hit the spot. You could eat the whole bag and not blow your sodium budget.

Low sodium snack #4 - Trader Joe's trail mixes. TJs has a very large variety of trail mixes, and many of them are suitable for low sodium eating. I was pleasantly surprised to find that most of my favorites are still OK for me to consume, within reasonable limits. Even the spicy ones!

Low sodium snack #5 - dark chocolate (70% cocoa or greater) is generally sodium free, or so low as to be negligible. And one of my favorite things ever. :-)

Happy snacking!

Accentuating the Positive

Happy to report no further major vertigo attacks since Tuesday - back to my daily pattern of very minor dizziness that doesn't disrupt my life and isn't obvious to anyone other than me. And after about six weeks of the low sodium diet another couple of positive side effects have become fairly obvious. Generally, I feel better. I am sure it is because it is nearly impossible to eat junky bad foods (at least, not in any sort of quantity that could harm you) and I am losing weight without any change in physical activity. I don't have a scale at home, but my clothes definitely fit more loosely and I can just tell by looking in the mirror. (Not that it would kill me to add some muscle tone by working out. Baby steps... Can't change too much at one time. Too hard to adjust!)