Okay, so I’ve defined what a low sodium diet is, and I’ve told you how to prepare your kitchen for the changes to come. What I have avoided, however, is how a low sodium diet works. This is the hard part — and I have to admit, it was difficult for me when I started. But if it’s the choice between surviving and needing a series of complicated and dangerous surgeries to stay alive, then it’s a choice I’m willing to make. Just remember, LVAD’s require a line in your torso that comes out of a permanent wound. This wound must be meticulously cared for to avoid infection, and you can never shower or live too far away from an electrical outlet to power the device and charge the incredible amount of batteries you must carry with you at all times. A heart transplant is procedure where your heart is removed and replaced with another person’s heart — in order to keep you alive, you must take some pretty powerful drugs with a host of side effects to ensure that your immune system does not reject your new heart. Both procedures will keep you alive, but neither is preferable to keeping your own heart.

A low sodium diet will allow you to keep your own heart — it won’t eventually remove the need for an LVAD or a heart transplant, but it will forestall that inevitability. So think about that before you decide that you really can’t do it.

The approach I take is based on the Weight Watchers diet. Every day, I give myself a certain allotment of sodium — in the beginning, it was 2,000 milligrams a day, but now it’s about 1,500 milligrams a day. Every meal I eat, I determine the amount of sodium in it and subtract it from my total. Once I get down to zero, I don’t permit myself to eat any more sodium.

It took me a very long time to get the formula just right. It requires reading the nutritional label on everything you buy, and making sure that whenever you eat something, you stick to the serving size as a measure of sodium.

For example, a jar of Green Mountain Gringo Salsa is 90 mg of sodium per two tablespoons. That means that if I want a modest helping, I can eat four tablespoons for 180 mg of sodium. It doesn’t sound like a great amount — and it isn’t — but before I mastered cooking my own sodium-free salsa, it was the way I had to go.

Following the serving size is the key — even though I don’t believe for a moment that it’s an accurate representation of how much sodium is in a given portion of food, it is the best measure we have.

Now, there’s plenty of food that contains only trace amounts of sodium — fresh fruit, vegetables and fresh meats. I don’t bother to count them, although some stricter adherents to the low sodium diet do. This is your choice to make — for me, I worry about prepared foods and sauces, but if you want a perfect count of sodium, you should look up the sodium values in fruits, vegetables and meats and add them into your total.  It’s up to you.

To give you a general idea of what my typical day looks like, here’s what I eat, with the understanding that I don’t go over 1,500 milligrams (mg) of sodium:

  • For breakfast, I have two granola bars and a piece of fruit. The granola bars are at 50 mg each, totaling 100mg of sodium. The fruit I count as 0, so I am left with 1400 mg of sodium for the rest of the day.
  • For lunch, on work days, I have a frozen Healthy Choice meal. It’s not a lot of food, but the sodium levels are pretty low, and I’ve come to really like them. I prefer the “Cafe Steamers” line of meals, especially the Cajun-style Chicken and Shrimp bowl, which costs 570 mg of a sodium. This leaves me with  830 mg of sodium for the rest of the day.
  • Now, I prepare most of my dinners from scratch, but it didn’t used to always be that way. Before I cooked everything from scratch, I used off-the-shelf products. For a spaghetti dinner, I would fry up some ground pork or hamburger and add it to some Classico sauce. The spaghetti itself, cooked without salt, is 0 mg of sodium. Classico Tomato and Basil sauce is 310 mg of sodium for a half cup, so one cup comes out to 620 mg of sodium. That leaves me with 210 mg of sodium for the rest of the day. Recall that I don’t count the meat, which has only trace amounts of sodium.
  • Later that evening, I’ll have some chips and salsa as a snack. The no salt added restaurant-style tortilla chips from Whole Foods have 0 mg of sodium per serving, so I can eat as much as I want. The salsa, as previously reported, is 180 mg of sodium for 4 tablespoons, so that leaves me with 30 mg of sodium, just under my maximum for the day. And I’m finished.
  • Remember, you should always supplement your meals with fresh fruits and vegetables.

That’s only an example of what I consider to be an “easy” day of low sodium living. You can eat a lot more if you make your foods from scratch with fresh ingredients. In future installments in this series, I’ll go through a week of how I eat now, including recipes, and show you just how livable a low sodium diet really is.

And one final note, after a year of living on this diet, I’ve lost over 45 lbs! I went from size 36 pants, to size 32 pants, and the 32′s are kind of baggy. So if watching your weight is an issue, this is a great way to lose weight and stay off the transplant list. A win-win, in my book.

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