Why low salt diet
Salt is an indispensable seasoning in daily life and a major source of sodium and chloride ions, which play an important role in maintaining the life activities of the human body. Modern medical research shows that excessive salt intake. It can enhance amylase activity, thus promoting starch digestion and absorption of free glucose in the small intestine, which can cause an increase in blood glucose concentration and lead to the aggravation of diabetes. Hypertension as a risk factor for coronary heart disease, most diabetic patients with hypertension and obesity, more salt will make the blood pressure rise, is not conducive to the prevention and treatment of hypertension, so salt must be limited.
The effect of limiting sodium intake is to reduce systemic hypertension and improve the local hemodynamic effects of the kidneys as well as improve the effect of antihypertensive drugs.
The average person’s daily salt intake without special restrictions is about 12 grams or more. And according to the results of the study, treating hypertensive patients with a low-salt diet for 1 month, compared with a control group that consumed only 12 grams of salt per day, if only 6 grams of edible salt were consumed per day, blood pressure could be reduced by 8/5 mm Hg; if the daily salt intake was reduced to 3 grams, blood pressure could be reduced by 16/9 mm Hg, which is quite effective. Glomerular damage is caused by glomerular hyperperfusion and high flow rate in hypertension. hypertension due to increased extracellular fluid is common in CRF, so patients should be instructed to limit sodium intake before rational application of antihypertensive drugs.
The effect of salt intake on hemodynamics has been reported in several studies that sodium intake can cause glomerular hyperfiltration and increase intracapsular pressure. This is presumably related to the constriction of the small glomerular arteries, resulting in hyperrenin-angiotensin system, sympathetic excitation, or lack of vasodilators such as dopamine, kininogen, and nitric oxide. Studies have also reported that high salt can cause proteinuria.
More importantly, the effect of ACEI in reducing urinary protein depends on the restriction of sodium intake; its effect almost disappears in high salt diet and is restored with the addition of thiazide diuretics. Some animal studies have also demonstrated that a high-sodium diet can lead to renal fibrosis.
The following are some of the conditions that should be noted.
High salt plus diuretics One by one, high salt intake in the diet plus taking diuretics will lead to hypokalemia, which can cause general weakness, severe arrhythmias, and even sudden death, which are the main side effects of diuretics. If you can change to a low salt diet, you can at least reduce the loss of potassium ions by more than half, significantly reducing the side effects of low potassium caused by diuretics.
Salt and heart failure: The heart’s function is not sufficient to cope with the body’s needs caused by a series of changes, mainly in two aspects: first, water and salt retention; second, neurohormonal changes, such as sympathetic hyperexcitation, and renin? ～The second is neurohormonal changes, such as sympathetic hyperexcitability and activation of the renin-adrenocorticotropin system. Limiting sodium intake can improve the symptoms of pulmonary edema, pleural effusion, fluid retention in the lower extremities and abdominal distension caused by excess water and salt, and can prevent hypokalemia caused by diuretics and adrenocorticotropic hormones.
Salt and kidney failure – When the kidneys lose their ability to regulate salt properly, salt intake will only cause thirst, excessive water and weight gain, and even worsen hypertension.
Salt and cirrhosis – Due to the increase of adrenocorticosterone, there will be ascites and low blood potassium, salt restriction can improve these discomforts.
Salt and toxemia of pregnancy – also associated with edema and hypertension, salt restriction is as important as medication for patients with toxemia of pregnancy.
Requirements for a low-salt diet
We recommend that healthy people should not eat more than 6 grams of salt per day in total, and that diabetic non-hypertensive patients should consume less than 5 grams of salt per day, and that hypertensive patients and patients with diabetic nephropathy should consume no more than 3 grams of salt per day, with stricter restrictions if the condition worsens, and should not consume more than 1 gram of salt per day. The average daily salt intake per person in our population (including all the sodium contained in food converted into salt) is 7-20 grams, which is significantly higher than the World Health Organization’s recommended amount (less than 6 grams of salt per person per day).
Sodium-restricted diets are generally divided into three types.
1, low-salt diet: the whole day supply of sodium 2000mg. in addition to the sodium contained in the food itself, it is allowed to add 2-3g of salt or 10-15ml of soy sauce when cooking or eating. avoid all high-sodium or salty foods in the diet, such as salted vegetables, sweet noodle sauce, rotten roux, salted eggs, sausages, salami, hanging noodles, etc.
2, no salt diet: the whole day supply of sodium 1000mg, the above high sodium or salty food is contraindicated, while cooking without adding soy sauce and salt.
3, low-sodium diet: the whole day supply of sodium is controlled within 500mg, in addition to the requirements of the salt-free diet, but also to limit some foods containing high sodium, such as matsutake eggs, kelp, sea jelly, food made of alkali or baking soda, and vegetables containing a lot of sodium, such as root daikon, artemisia stems, fennel, celery, etc.
To ensure a low-salt diet should eat more natural foods and less or no processed foods. Natural foods are low in sodium and high in potassium, and most processed foods have sodium added and potassium removed. Do not add salt when cooking, but in order to maintain the taste. You can add a little salt at mealtime. Do not eat overnight meals. Do not eat or eat less fast food, most of which are high in sodium.
The four elements of a low-salt diet are: eat less pickled foods, stay away from processed foods, limit the use of condiments, and eat salt with low sodium salt.
Eat less pickled food: usually we will use some pickled food to accompany the meal, especially at breakfast, its salt content are very high. Such as squash, kimchi, pickles, salted meat, salted eggs, etc. 100 grams of squash contains 11 grams of salt.
Eat less processed food: food in the processing process are often added to the salt, some salt content is also very high, such as instant noodles, ham sausage, etc.. Not only does it contain salt, and the amount of salt contained in processed foods should not be controlled and calculated. So do it yourself and add how much salt you know in your heart.
Limit the use of condiments: limit the use of condiments, put less soy sauce and add less MSG. Soy sauce, vinegar, MSG and other condiments contain salt.
Low sodium salt: If you feel the dish is tasteless, you can use low sodium salt, which contains less sodium but does not taste bland and has added potassium, which is suitable for patients with low potassium. However, it is not suitable for patients with high potassium. Do not use low sodium salt in general.
For those who have a heavy taste． Should gradually reduce salt intake． Do not pursue a step change.
In daily life, it is of particular importance to estimate the correct amount of salt. A flat spoon of salt from a porcelain spoon is about 18 grams, a flat spoon of soy sauce from a porcelain spoon is equivalent to 3 grams of salt, a flat spoon of salt from a coffee spoon is about 3 grams, and a small pinch (with three finger tips) of salt is about 2 to 3 grams, which can be chosen according to needs and possibilities.
Cooking for a low-salt diet
For people with diabetes, it is understandable to restrict sugar intake, but they may have difficulty accepting restricted salt intake. Most people find low-salt diets to be very unappetizing and to affect their appetite. Here are some ways to prepare a low-salt diet.
Make use of the flavor of vegetables as much as possible. The flavor of the vegetables themselves can stimulate the taste buds and increase appetite, such as fried eggs with tomatoes, tomatoes and cauliflower, shredded pork fried persimmons and peppers, steamed eggplant.
2.Concentrate on the salt. Sprinkle the minced salt directly on the dish, the taste buds are strongly stimulated, can promote appetite.
3, when the dish is hot, the salt taste can be covered by the stimulation of heat, so the salt unknowingly ingested more, so the dishes should be cooled to a certain extent before eating.
4, available vinegar, sesame sauce, tomato sauce and other seasonings to increase appetite, such as vinegar mixed with cold vegetables or sesame sauce mixed with eggplant, tomato meat slices.
5, eat more fresh mushrooms. Mushrooms, fungus, seaweed as the main ingredient of the soup dishes, fresh taste and color, and has a tonic function, can add a little salt or not. Mushrooms also have the effect of softening blood vessels.
6, polyuria, you can use special salt that does not contain sodium and potassium; but little urine is contraindicated.
Low-salt diet is easy to lose appetite, thus causing nutritional deficiencies, so the following principles should be given due attention in the intake of nutrition.
1, appropriate to eat more iodine-containing foods such as kelp sea jelly, etc., not only can puff full of nutrition, but also to prevent the occurrence and development of atherosclerosis.
2, full intake of vitamin-rich fruits and vegetables. Vitamin C, P (lutin), IF (niacin), B, etc. have the effect of lowering blood cholesterol and reducing atherosclerosis, which has a rehabilitative effect on patients with hypertension.
3, fish, meat, eggs, milk animal protein, containing sulfur amino acids (such as taurine, methionine, etc.) and other antihypertensive ingredients. Adequate intake is not only beneficial to improve the function of the body, but also to prevent and treat hypertension. The incidence of the latest blood pressure is significantly higher than the scientific diet with meat and vegetables.
4, soy is rich in plant protein. Eat more of this type of food can make the blood vessels strengthen. Inhibit the rise of cholesterol to prevent strokes caused by high blood pressure.
5, potatoes because of the high potassium content, diuretic effect, can promote the body’s sodium discharge, can eat more. In addition, can also be clever use of acidity, so that the flavor of the dish increased, appetite, and at the same time there is a hypotensive effect. However, it is not suitable for patients with high potassium.
What kind of kidney disease should be low salt diet.
It is common knowledge that kidney disease should have a low salt diet, but it is not always the case, and some kidney diseases do not need to be concerned about salt. In glomerular lesions and chronic renal insufficiency, the glomerular filtration of water and sodium is reduced. The body water and sodium accumulation, resulting in urine, edema, hypertension, etc., when low sodium or even salt, but children, renal tubular lesions, pyelonephritis and interstitial nephritis, renal tubular reabsorption is impaired and the retention of water and sodium, etc., the body to increase the elimination of water and sodium, resulting in polyuria, water loss, low sodium, hypotension, etc., when not only do not need to avoid salt, but also to increase the intake of water and sodium, in order to replace the loss of water and sodium from the urine In this case, it is not only necessary to avoid salt, but also to increase the intake of water and sodium in order to replace the water and sodium lost in urine and thus maintain the balance of water and sodium in the body.
Whether or not to limit sodium intake in patients with kidney disease depends on their condition, and in cases of combined edema, hypertension and heart failure, sodium intake should be limited. The purpose of sodium restriction is to prevent water retention due to excessive sodium in the body, which can lead to increased edema, increased blood volume, increased cardiac load and uncontrollable hypertension.
Sodium restriction in acute glomerulonephritis.
For oliguric edema and hypertension is not obvious, there is no need to strictly limit salt, generally can supply 4 grams of salt per day, but if there is severe edema and hypertension, the intake of salt should be strictly limited, otherwise it will cause heart failure and hypertensive encephalopathy. In general, the intake of sodium in this case is controlled at 250-500mg per day, and if the condition is in between, the intake of sodium can be controlled at 1000-2000mg per day, and a low salt diet of 1-3g per day should be adopted during the recovery period of acute glomerular examination, which is conducive to the recovery of the disease.
Sodium restriction in nephrotic syndrome.
Nephrotic syndrome mostly has swelling. The general daily sodium intake is controlled at about 2000mg. If there is a high degree of edema, combined with plasma cavity effusion can be given a salt-free or low-sodium diet. However, it is difficult to deal with in clinical practice because the starting cause of edema in nephrotic syndrome is hypoproteinemia, and sufficient protein and energy should be given in the diet, and the restricted diet will cause many patients to lose appetite due to tasteless diet, which affects the intake of protein and calories, and some patients with nephrotic syndrome have difficulty in eliminating edema, and long-term sodium is not easy to accept. Therefore, it is better for patients with nephrotic syndrome to tolerate sodium restriction without affecting their appetite, and after the swelling subsides, the condition is stable and plasma protein is normal, they can be given a general diet.
Sodium restriction in chronic glomerulonephritis.
If edema is obvious, blood pressure is high or even combined with heart failure, then salt should be strictly limited and can be given a salt-free or low-sodium diet.
Sodium restriction in acute renal failure: The intake of water and sodium should be strictly controlled during the oliguric phase of acute renal failure. Body fluid should be “measured out for in”.
Sodium intake should not exceed the amount lost. If it is found that the blood sodium is reduced, the first thing to consider is whether it is due to excessive fluid intake resulting in dilution of blood, if so, water should be strictly limited, if it is not effective, dehydration can be done through dialysis instead of blindly replenishing sodium, if it is indeed sodium deficiency hyponatremia, sodium chloride should be appropriately replenished according to the blood sodium level, and sodium bicarbonate can be replenished if there is metabolic acidosis.
Specific implementation of low-salt diet for hypertensive patients
It is very important to educate patients about low-salt diet, and when talking to patients about low-salt diet for prevention and treatment of hypertension, it is important to explain to them
It is important to explain that a low-salt diet means that the total amount of salt consumed in a day is lower than the amount previously consumed by the patient, and that it does not depend on the saltiness of the meal.
It is necessary to explain to the patient that the total volume of the meal is lighter, but the total volume of the meal is increased, and that the salt intake does not necessarily decrease or even increase, so that the patient really understands, so that the patient’s hypertension can be easily controlled.
When treating patients with hypertension, we should explain clearly to patients that they should not increase their salt intake because they want to eat tasty food in order to increase their appetite, but explain to them that it is worthwhile to reduce the taste of food due to a low-salt diet in order to cure the disease, improve their quality of life, and live and work in good health, and that this little difficulty is easy to overcome. The patient’s hypertension is then easily controlled. For the low salt diet for patients with hypertension, it is easier said than done. In order to better control hypertension, the control of the low salt diet for patients with hypertension should be increased.
The low-salt diet for patients with hypertension can also be adjusted appropriately according to specific circumstances:.
1, a day of hypertension patients low salt diet control rule should be: daytime diet without any salt, while the evening diet can add a salt, but should be appropriate to add as little as possible, so that the patient’s hypertension is easy to control.
2, labor and rest or vacation hypertension patients low salt diet control rules are: in labor hypertension patients should eat without salt or further in the original low salt diet on the basis of less low salt diet, in rest or vacation, hypertension patients should continue to do low salt diet, but may not do serious low salt diet control, appropriate adjustments to the diet, so that it has a good taste, increase the pleasure of life.
3.The rule of low salt diet control for hypertensive patients in winter and summer is: in summer, the low salt diet control for hypertensive patients still continues, but the addition or reduction of salt in the low salt diet should be adjusted according to the amount of sodium loss and changes in blood pressure of the patient, and in winter, the low salt diet control for hypertensive patients should be further strengthened, even without adding salt.
4, emotional changes in hypertension patients with low salt diet control rule is: hypertension patients in a comfortable mood, low salt diet control can not stop; and hypertension patients with anger, can be carried out without salt diet, so that hypertension patients with anger, hypertension is easy to control.
5, if the patient drinks alcohol, it is likely that the blood pressure will rise: at this time, should strengthen the control of low-salt diet for patients with hypertension, so that the patient’s blood pressure will not fluctuate too much; patients in high animal fat diet, at this time, should be appropriate to do low-salt diet control, can not be carried out without salt diet, if salt-free diet, the patient’s blood viscosity will increase.