The modern diet often contains excessive amounts of sodium and insufficient fiber, contributing to a range of health problems. Adopting a high-fiber, low-salt diet can offer significant benefits, from managing blood pressure and cholesterol to improving digestive health and reducing the risk of chronic diseases. This article explores the advantages of such a diet, provides practical tips for implementation, and addresses common concerns.
Understanding Sodium and Its Impact
Sodium, primarily consumed as salt (sodium chloride), is an essential mineral that plays a crucial role in various bodily functions, including nerve impulse transmission, muscle contraction and relaxation, and maintaining fluid balance. The human body requires a small amount of sodium, estimated to be around 500 mg daily, to perform these vital functions. However, the typical American diet far exceeds this requirement, with most adults consuming roughly 3,500 mg of sodium per day.
Excessive sodium intake can have detrimental effects on health. Too much sodium is bad for your health, and can increase your blood pressure and make your kidneys work harder. It can also increase the risk for a heart attack or stroke. In most people, the kidneys have trouble keeping up with excess sodium in the blood. As sodium accumulates, the body holds onto water to dilute the sodium. This increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. Increased blood volume means more work for the heart and more pressure on blood vessels. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, and stroke. It can also lead to heart failure. There is some evidence that too much salt can damage the heart, aorta, and kidneys without increasing blood pressure, and that it may be bad for bones, too.
Current dietary guidelines recommend that adults in general should consume no more than 2,300 mg of sodium per day. However, experts say that if you are in the following population groups, you should consume no more than 1,500 mg per day:
- You are 40 years of age or older.
- You are African American.
- You have high blood pressure.
A new Centers for Disease Control (CDC) report shows that two out of three (69%) adults in the United States fall into one or more of these three groups. They are at especially high risk for health problems from too much sodium. Eating less sodium can help prevent, lower, or even control blood pressure.
Read also: High-Fiber Diet for Better Health
The Benefits of a Low-Sodium Diet
A low-sodium diet, typically defined as consuming less than 2,300 mg of sodium per day (and sometimes as low as 1,500 mg), offers numerous health benefits:
Lower Blood Pressure: Research has consistently shown that reducing salt intake may help decrease high blood pressure in people with elevated levels. A review even found that following the DASH diet can significantly reduce blood pressure in people of all ages, even in people who don’t have high blood pressure.
Reduced Risk of Cardiovascular Disease: High blood pressure is a major risk factor for heart disease and stroke. By lowering blood pressure, a low-sodium diet can reduce the risk of these conditions. Lower sodium intake is also associated with a reduced risk of stroke and fatal coronary heart disease in adults.
Improved Kidney Function: When your kidneys are compromised, they’re unable to effectively remove excess sodium or fluid from your body. If sodium and fluid levels become too high, pressure builds in your blood, which can cause further damage to already compromised kidneys. A 2023 systematic review concluded that reduced sodium intake of less than 2 g a day decreased blood pressure and protein in the urine.
Reduced Fluid Retention: Sodium causes your blood to retain more water, placing more pressure on your blood vessels. A low-sodium diet can reduce fluid retention, which is particularly beneficial for individuals with congestive heart failure or liver disease.
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Potential Cancer Risk Reduction: High-salt diets have been linked to certain types of cancers, including of the stomach. Research has shown that high-salt diets can damage the mucosal lining of your stomach and increase inflammation and the growth of H. Pylori bacteria - all of which may raise gastric cancer risk.
Understanding Fiber and Its Importance
Dietary fiber is a nutrient known as a carbohydrate. Fiber includes the parts of plant foods that the body can't digest or absorb. This makes it different from nutrients such as fats, proteins, and other carbohydrates including starches and sugars. The body breaks down these nutrients and absorbs them. Fiber is found mainly in plant foods such as fruits, vegetables, whole grains and members of the bean family called legumes. Fiber may be best known for its ability to prevent or relieve constipation. But foods with fiber can have other good effects as well. Choosing tasty foods that provide fiber isn't hard.
There are two main types of fiber:
Soluble Fiber: This type of fiber dissolves in water. It forms a gel-like material in the stomach that slows down digestion. It can help lower cholesterol and blood sugar. Soluble fiber found in beans, oats, flaxseed and oat bran may keep the body from absorbing some of the cholesterol in other foods. As a result, that may lower low-density lipoprotein, also called "bad," cholesterol levels in the blood. In people with diabetes, fiber may slow the absorption of sugar and help improve blood sugar levels. That's especially true of soluble fiber.
Insoluble Fiber: This type of fiber doesn't dissolve in water. It supports the movement of material through the digestive system and adds bulk to stool. So it can be helpful for people who have constipation or don't regularly pass stool. Dietary fiber increases the weight and size of stool and softens it. In general, bulky stool is easier to pass, and this lowers the chance of constipation. If you have loose, watery stools, fiber may help make them solid.
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Most high-fiber plant foods contain both soluble and insoluble fiber. The amount of each type of fiber varies with the type of plant, such as whether it's a fruit, vegetable or whole grain. But you can get both types of fiber by eating a variety of fiber-rich foods.
The Benefits of a High-Fiber Diet
A high-fiber diet offers a multitude of health advantages:
Improved Bowel Health: Dietary fiber increases the weight and size of stool and softens it. In general, bulky stool is easier to pass, and this lowers the chance of constipation. If you have loose, watery stools, fiber may help make them solid. A high-fiber diet may lower the risk of swollen veins in the anus and lower rectum called hemorrhoids. Eating plenty of fiber also may help lower the risk of a condition called diverticulitis that involves small, inflamed pouches in the colon wall.
Cholesterol Reduction: Soluble fiber found in beans, oats, flaxseed and oat bran may keep the body from absorbing some of the cholesterol in other foods. As a result, that may lower low-density lipoprotein, also called "bad," cholesterol levels in the blood.
Blood Sugar Control: In people with diabetes, fiber may slow the absorption of sugar and help improve blood sugar levels. That's especially true of soluble fiber.
Weight Management: High-fiber foods tend to be more filling than low-fiber foods. So you're likely to eat less and stay satisfied longer. High-fiber foods also tend to take longer to eat and to be less energy dense than low-fiber foods.
Reduced Risk of Colorectal Cancer: A high-fiber diet is linked with a lower risk of colorectal cancer as well.
Gut Health: Some fiber also serves as food for "good" bacteria in the gut. It's known as fermented fiber.
Implementing a High-Fiber, Low-Salt Diet
Adopting a high-fiber, low-salt diet requires a conscious effort to make informed food choices and adjust cooking habits. Here are some practical tips to get started:
Read Nutrition Labels: Carefully examine the nutrition labels of all packaged foods to check the sodium content. Aim for foods with less than 5% of the Daily Value (DV) for sodium per serving. Also, look for foods that are high in fiber, aiming for at least 3-5 grams of fiber per serving.
Choose Fresh, Whole Foods: Opt for fresh fruits, vegetables, and whole grains whenever possible. These foods are naturally low in sodium and high in fiber.
Limit Processed and Packaged Foods: Sodium is most familiar as salt in salt shakers. However, most of the sodium we eat comes from packaged, processed, store-bought and restaurant foods. Only about 5% comes from salt added during cooking and about 6% comes from being added at the table. The best way to avoid high sodium foods is to restrict salty snack foods, fast food, and packaged meals.
Cook at Home More Often: One of the best ways to reduce the amount of sodium in your diet is to control what goes into your food by cooking at home. Eating more meals at home will not only reduce your sodium intake but can also help you lose weight. According to research, foods eaten outside the home are the leading contributor to sodium intake.
Season with Herbs and Spices: Giving up salt and sodium does not mean giving up flavor. Learn to season your food with herbs and spices. Be creative and experiment for a new and exciting flavor. Don't think of a low-sodium diet as without flavor. Try the following spices with the foods listed.
- Allspice - Use with beef, fish, beets, cabbage, carrots, peas, fruit.
- Basil - Use with beef, pork, most vegetables.
- Bay Leaf - Use with beef, pork, most vegetables.
- Caraway - Use with beef, pork, green beans, cauliflower, cabbage, beets, asparagus, and in dips and marinades.
- Cardamom - Use with fruit and in baked goods.
- Curry - Use with beef, chicken, pork, fish, green beans, carrots and in marinades.
- Dill - Use with beef, chicken, green beans, cabbage, carrots, peas and in dips.
- Ginger - Use with beef, chicken, pork, green beans, cauliflower and eggplant.
- Marjoram - Use with beef, chicken, pork, green beans, cauliflower and eggplant.
- Rosemary - Use with chicken, pork, cauliflower, peas and in marinades.
- Thyme - Use with beef, chicken, pork, fish, green beans, beets and carrots.
- Sage - Use with chicken, pork, eggplant and in dressing.
- Tarragon - Use with fish, asparagus, beets, cabbage, cauliflower and in marinades.
Here are tips for cooking with herbs and spices: Purchase spices and herbs in small amounts.
Increase Fiber Intake Gradually: High-fiber foods are good for your health. But adding too much fiber too quickly can lead to gas, bloating and cramping. Add fiber to your diet slowly over a few weeks. Also, drink plenty of water. Fiber works best when it absorbs water.
Be Mindful of Restaurant Meals: Eat fewer restaurant and fast food meals. Ask for foods with no or low salt at restaurants. Restaurant foods typically have high amounts of sodium. When in doubt, go with broiled or grilled entrees and steamed vegetables, Balog says. Since these items are typically made to order, it’s possible to order them with no salt added. Other items - like braised meats, sauces, salad dressings, and roasted vegetables - are typically cooked or partially cooked ahead of time, so the salt has already been added and can’t be taken out, Balog explains.
Foods to Include and Limit
Foods to Include:
- Fresh and frozen vegetables (without sauces): Greens, broccoli, cauliflower, peppers, etc.
- Fresh, frozen, or dried fruits: Berries, apples, bananas, pears, etc.
- Grains and beans: Dried beans, brown rice, farro, quinoa, and whole wheat pasta.
- Starchy vegetables: Potatoes, sweet potatoes, butternut squash, and parsnips.
- Fresh or frozen meat and poultry: Chicken, turkey, beef, or pork.
- Fresh or frozen fish: Cod, sea bass, tuna, etc.
- Eggs: Whole eggs and egg whites.
- Healthy fats: Olive oil, avocado, and avocado oil.
- Low sodium soups: Low-sodium canned or homemade soups.
- Dairy products: Milk, yogurt, unsalted butter, and low sodium cheeses.
- Bread and baked goods: Whole-wheat bread, low sodium tortillas, and unsalted crackers.
- Unsalted nuts and seeds: Pumpkin seeds, almonds, peanuts, etc.
- Low sodium snack foods: Unsalted pretzels, unsalted popcorn, and unsalted tortilla chips.
- Low sodium condiments: Vinegar, mayonnaise, low sodium salad dressing, and low sodium sauces.
- Low sodium beverages: Tea, coffee, low sodium vegetable juice, and water.
- Low sodium seasonings: Garlic powder, no-salt blends, herbs, and spices.
Foods to Limit or Avoid:
- Fast food: Burgers, fries, chicken fingers, pizza, etc.
- Salty snack foods: Salted pretzels, chips, salted nuts, salted crackers, etc.
- Frozen dinners: Frozen meat dishes, frozen pizza, etc.
- Processed meats: Bacon, sausage, lunch meats, and hot dogs.
- Salted, canned products: Vegetables, pastas, meats, fish, etc.
- Salty soups: Canned soups and packaged soups.
- Cheese and dairy: Cheese, cheese spreads, cottage cheese, buttermilk, salted butter, and cheese sauce.
- High sodium baked goods: Salted rolls, salted bagels, croutons, and crackers.
- Baking mixes: High-sodium waffle, pancake, or cake mixes.
- Boxed meals: Macaroni and cheese, pasta meals, rice meals, etc.
- High sodium side dishes: Stuffing, boxed au gratin potatoes, hash browns, and rice pilaf.
- Sauces and condiments: Gravy, soy sauce, commercial tomato sauce, and salad dressing.
- Pickled vegetables: Pickles, olives and sauerkraut.
- Certain drinks: Regular vegetable juice, juice blends, and salty alcoholic beverages.
- Seasonings: Salt and salt blends.
Sample Meal Plan
Here’s a sample menu from Teresa Balog, RD, a food service dietitian in Austin, Texas:
- Day 1:
- Breakfast: Whole-grain oatmeal with frozen peaches and low-fat milk
- Snack: Handful of nuts and a banana
- Lunch: Mixed-lettuce salad with walnuts, apple, grilled chicken, and homemade red wine vinaigrette dressing with a slice of bread
- Dinner: Grilled cod with green beans, brown rice, and a side of fruit
- Day 2:
- Breakfast: Whole-grain toast with no-salt-added peanut butter, an apple, and a cup of fat-free milk
- Lunch: Mixed-lettuce salad with walnuts, apple, grilled chicken, and homemade red wine vinaigrette dressing with a slice of bread
- Dinner: Baked turkey breast with broccoli and almond-quinoa pilaf
- Day 3:
- Breakfast: Low-fat yogurt with sliced peaches, walnuts, and a drizzle of honey
- Lunch: Sandwich with avocado, grilled chicken, and veggies
- Dinner: Homemade lentil soup with low-sodium crackers and a small cucumber salad
- Day 4:
- Breakfast: Whole-grain oatmeal with a sliced apple, cinnamon, no-salt-added peanut butter, and low-fat milk
- Snack: Steamed edamame with olive oil
- Lunch: Chickpea salad with spinach, bell peppers, chicken, and homemade herb vinaigrette
- Dinner: Chili-rubbed baked tilapia with roasted potatoes and broccoli
- Day 5:
- Breakfast: Low-fat yogurt with mixed berries and low-sodium granola
- Snack: Banana with no-salt-added peanut butter
- Lunch: Whole-grain pasta salad with tomatoes, bell peppers, herbs, and tuna
- Dinner: Pan-seared chicken breast with brown rice pilaf and stewed tomatoes
- Day 6:
- Breakfast: Whole-wheat toast with scrambled eggs and avocado
- Snack: Carrot sticks and homemade hummus (no salt added)
- Lunch: Kale salad with walnuts, chicken breast, pumpkin seeds, and homemade vinaigrette
- Dinner: Grilled cod with lemon, green beans in olive oil, and brown rice
- Day 7:
- Breakfast: Whole-grain oatmeal with sliced banana, low-fat milk, and walnuts
- Lunch: Spinach and quinoa salad with sliced apple, grilled chicken, and homemade vinaigrette
- Dinner: Baked turkey breast with roasted potatoes, green beans, and slivered almonds
Potential Downsides and Considerations
While a high-fiber, low-salt diet is generally safe and beneficial, there are a few potential downsides to consider:
Taste Adjustment: Foods low in sodium will seem less flavorful at first. However, your taste buds adjust to lower sodium foods over time.
Risk of Hyponatremia: Avitia notes that people who sweat a lot - like athletes and people in hot climates with labor-intensive jobs - need more sodium in their diet to make up for what’s lost in sweat. Having too little sodium in your blood (a condition called hyponatremia), can lead to nausea, vomiting, headaches, confusion, drowsiness, fatigue, irritability, and muscle weakness or cramps. In severe cases, it can lead to seizures, coma, or death. However, these more serious symptoms are typically due to an underlying medical condition, not a low-sodium diet.
Gastrointestinal Discomfort: On the DASH diet eating plan you will likely be eating a lot more of fruits, vegetables, and whole grains. These foods are high in fiber and increasing your intake of fiber too quickly may cause GI discomfort. Slowly increase how much fiber you eat each day and be sure to drink plenty of fluids.