Caregiver to Caregiver

Before we begin the second session of this topic, I thought I should clarify the difference between “salt” and “sodium.” Although these words are often used interchangeably, there is a difference. About 40 percent of table salt is the mineral sodium; the remaining 60 percent is the mineral chloride. Sodium is an essential nutrient, that while necessary for good health, can be detrimental when too much is consumed. 

Table salt (the kind that comes in round boxes) is a common staple in most, if not all, kitchens in America. It is extracted from underground mines and is processed to a great extent to remove impurities. It is finely ground (to fit through the tiny holes in saltshakers). Beginning in 1924, iodine was added to salt to prevent goiter (a visible swelling of the thyroid) and hypothyroidism, both conditions that can result from an iodine deficiency. Serious birth defects can also result when there is a lack of iodine in the diet. Iodine deficiency is the most common preventable cause of mental retardation. Because iodized salt is the best (and sometimes the only) dietary source of iodine, it is important to consume salt but only in moderation. Other sources of iodine include cod, tuna, seaweed, seafood, milk, yogurt and cheese. 

Kosher salt is coarsely grained and so named because it is used in the preparation of traditional Kosher food. Although iodine is usually not added, it may contain an anti-caking ingredient.

Sea salt is harvested from the evaporation of ocean or sea water. Mostly sodium chloride, because of less processing it may contain other trace minerals such as potassium, iron and zinc. It appears coarser and darker than fine-grained table salt which may indicate impurities found in the ocean such as lead. The main differences between the two are texture, taste and amount of processing. While some people believe it is much healthier for the body, the most benefits may be in putting it in your bath water.

The trendy salt of the moment appears to be Himalayan pink salt which comes from mines in Pakistan. Small amounts of iron oxide provide the pink hue. It is similar to sea salt, both in the size of the crystals and the inclusion of small amounts of minerals.

Whichever type of salt you prefer, it is important to keep your intake at a healthy level. Current guidelines recommend no more than 2,300 mg per day which is equal to about 1 teaspoon of salt. It is estimated that on average, Americans eat about 3,400 mg of sodium every day. Some health professionals suggest no more than 1500 mg per day, especially if there are already health problems such as chronic kidney disease.

It is a good idea to check out labels at the grocery store and choose those which claim low or reduced sodium or no added salt. I have noticed that when there is a choice – say with V-8 juice which is a staple in my pantry – the shelves are usually fully stocked with red-capped bottles (full salt) and I have to dig at the back to find reduced sodium (green-capped). I hope this is because people are making the better choice; I often wonder why manufacturers just don’t do the right thing and make all their products reduced sodium. It is not like you cannot add your own salt if you so choose.

Always check the sodium content on the nutrition label; I often return an item to the shelf after being shocked at the enormous amount of salt listed for one serving of some foods.

There are some symptoms you or your loved one may be experiencing if you are consuming too much salt. One is continual bloating and/or constipation. Eating too much salt causes the water in our intestines and stool to attempt to achieve fluid balance by moving to other parts of the body.

Constant thirst can be another sign of excessive sodium intake. Just think about those times you’ve eaten very salty foods and were unable to quench your thirst. Do not let this become a habit.

Consuming too much salt can make your fluid balance out of whack, leading to dehydration and headaches. You may be drinking the recommended daily eight glasses of water, but if this is accompanied by lots of salty food, it may not be enough. Keep drinking the water; reduce the salt.

We associate excessive salt intake with high blood pressure, and that is certainly a common result; one in three Americans are diagnosed with high blood pressure. Over time, this can damage blood vessel linings and increase the risk for blood clots, stroke or heart attacks. Other conditions related to high sodium levels include heart failure, osteoporosis, stomach cancer and kidney disease.

Caregivers should be aware of age-related anosmia – the loss of the sense of smell. The sensory neurons that effect our sense of smell lose their ability to be replaced as we age. Since the ability to smell our food is related to appetite and the enjoyment of food, as this sense declines with age, many older people lose their interest in eating because the food just doesn’t taste good to them anymore. Often, the solution is to add salt. Unfortunately, this can lead to other health problems. If your loved one complains of bland food, be creative and add herbs and spices that will improve flavor without increasing sodium levels.

I have heard many people comment that the flavor enhancement salt provides is more important to them than preventing health problems. That’s too bad. I believe it is possible to learn to enjoy healthy food without overdoing the salt.

We may have to change our eating habits in more ways than putting the saltshaker at the back of the pantry. According to the Centers for Disease Control and Prevention, here are the ten top sources of sodium in the American diet: breads/rolls; sandwiches; cold cuts/cured meats; soups, burritos/tacos; savory snacks (chips, popcorn, pretzels, crackers; chicken; cheese; eggs (omelets).

Bringing home processed foods from the grocery and eating out at fat-food restaurants (no, that’s not a typo) are a sure way to increase our salt intake. Eating more fresh fruits and vegetables is a good start. Using healthy flavor enhancers (fresh-ground black pepper, garlic, onions, rosemary, thyme, parsley etc.) is a habit worth developing. 

We cannot control every aspect of our health, but we can make dietary changes to improve our overall physical condition and prevent serious illness. A good place to start is with a little less salt in our diets.