Did you ever notice that people think about salt, sugar, and other demonized foods in all or nothing terms? They’re either good or bad, in or out. So one of the most common questions I get when speaking about blood pressure is, “How can I make food taste good, now that I can’t use salt?”
The good, albeit slightly more complicated news is that the impact of foods on health depends on the amount. A sprinkle of salt on a homemade meal is fine. Make a habit of ordering takeout and you’re more likely to develop high blood pressure.
If used strategically, alongside other flavourful ingredients, a little salt can go a long way. Same for other sodium-rich ingredients typically found on “do not use” lists. Let’s see if we can move away from this all or nothing paradigm, shall we?
So what counts as “low-sodium”?
If you read my “Summer Salt Swaps” post, you might recall that sodium recommendations range from 1500mg to 2300mg per day. Hypertension Canada suggests aiming for 2000mg or less, for both prevention and management of high blood pressure, so I usually go with that.
I like use 500mg per meal as a rule of thumb, assuming you eat three times a day, which leaves room for snacks. If one meal is higher, say if you eat out, then you can aim lower for the rest of the day.
500mg per meal is in line with Canada’s food labeling regulations. Pre-packaged meals can boast of being “low-sodium” if they have less than 140 mg sodium for every 100g of food. A decent-sized frozen meal is about 350g. Do the math, and you’ll find that as long as it’s lower than 490mg of sodium, it can say “low-sodium” on the package. Of course most frozen meals are higher than that, but in our kitchens… we can do this.
No-sodium flavour boosters
Start with your favourite of these no- or very-low-sodium options. If you’re not an improviser, look for them in recipes.
- Cooked onion, garlic, or ginger
- Cooked wine
- Vinegar, lemon, or lime juice
- Lemon or lime zest for more intense flavour
- Hot peppers, dried or fresh, or hot sauce
- Herbs and spices, dried or fresh
- Good quality olive oil, infused with herbs if you like
- Roasted vegetables
- Low- or no-sodium spice mixtures such as those from Mrs. Dash or Epicure.
If that doesn’t quite give you enough flavour, try pulling one of these tricks out of your hat.
More sodium, but still fine in small amounts with minimally-processed food
Quick disclaimer before we get to this list. These will only give you a low-sodium meal if the rest of the food isn’t hiding any sodium.
Fresh/frozen salmon, broccoli, and pasta yes. Sausage on a bun with ketchup, not so much.
That sausage meal would be around 1000mg of sodium. No salt needed. But the fish? About 50-100mg. (Most food naturally contains small amounts.) So think about adding no more than ~400mg.
So before you do this with abandon, check your other ingredients: Spaghetti sauce, bread, store-bought salad dressing… read the label!
And you might want to pull out the measuring spoons to be sure. Here goes…
- Salt! Salt? I can hear it now. Are you serious, cardiac dietitian? Hear me out. Do you have a 1/8 teaspoon measuring spoon? If so, measure out 1/8 of a teaspoon of salt.
See how much that is? It’s about 300mg of sodium. Add it to roasted chicken, carrots, and potatoes for two, you’re only adding about 150mg per person. Still absolutely a low-sodium meal, even though you pulled out the dreaded salt shaker. Combine that with some of the seasoning ideas above – say a sprinkle of balsamic vinegar before you roast the carrots, and you’ll have great taste.
- Soy sauce. Another very-high sodium food, right? But it doesn’t have to be. Read the label. Soy sauce products vary from about 600mg to 1200mg per tablespoon. If you can find a 600mg product you like and again, measure it, you can use a little to get a lot of flavour.
520mg sodium per tablespoon. They’re out there.
Put a tablespoon in the frying pan with stir-fried veggies for two, and you’re only adding 300mg of sodium each. Just measure it if you want to reassure yourself. And add some cooked ginger, onion, or garlic and you’ll have a fantastic dish. I find it a very handy way to whip up a stir-fry.
- Olives. Another little sodium bomb! But used sparingly… so good! Two tablespoons of chopped olives, just 124mg sodium. Are you starting to get the idea?
- Cheese. Again, can this be a big source of sodium in the diet? Absolutely. But pick a good, strong cheese and use sparingly to dial up the flavour. Feta, for example, known for being high in salt, adds just 180mg of sodium if you crumble up just two tablespoons, say on top of your salad. Or two tablespoons of Parmesan (the good stuff, the kind you have to grate yourself) adds just 172mg.
- Reduced-sodium bouillon/stock. Yes, you can make your own, and if you do, can you please bring me some? Because it’s not happening in this house. Of the storebought lower-sodium products, I’ve found some are flavourful, some not so much. I haven’t had much luck with the salt-free stuff. But check the label, because “reduced-sodium” or “lower in sodium” means it’s just 25% less than the standard product, which is still pretty high.
One in the middle I like is the “Better Than Bouillon” (sold at Costco, and also, not sponsored, just a tip.) 
I made chicken noodle soup last night with a tablespoon of it, which adds about 1050mg of sodium. Sounds high, but it made at least 10 cups of soup, so ~100mg sodium each. Canned chicken noodle soup, on the other hand, can be in the neighbourhood of 850mg per cup. And my soup also got flavour from cooked onion, celery, carrots, mushrooms, dry thyme, and white wine. But the chicken stock put it over the top. 
The point is that these sodium-containing flavourful ingredients are fine, even if your blood pressure is a concern, when used in measured amounts on homemade, minimally processed food. The trick is not to go overboard, but you’re much more likely to do that by adding a couple of buns vs. getting too heavy-handed with the salt shaker.
Conventional cardiac nutrition advice usually just says to stay away from them. But we want people to cook more! And that’s not going to happen if the food tastes like cardboard. So if you need a little extra zip, you don’t have to be a sodium saint. No points for the lowest sodium intake. Just keep it reasonable.
cc: Earls Restaurants, purveyors of several 3000-4000mg sodium dishes. You can do this.
Did you find this helpful? I hope so! If so, send it to a friend or family member who is struggling with high blood pressure. Let’s spare them bland low-sodium food too, shall we?
Note – All nutrient amounts are from Canadian Nutrient File unless otherwise noted.