This purpose of this site is neither to advocate such diets nor promote the health benefits of such diets as I have no professional qualifications in this area. Rather this site is intended to serve as a resource for those, like me, who have been advised by medical personnel to switch to such a diet. Unfortunately, the people who do have the right qualifications usually don't know how to give practical advice and often treat low salt and low fat as independent issues.
Indeed, you probably should seek medical advice before unilaterally making such a dramatic diet change. But in general, most Americans eat far too much salt and fat in their daily diet. (See Dietary Guidelines for Americans, 2005.)
The webmaster of this site lives on the East Coast of the US so product information focuses on national and regional products he is familiar with. Information on products sold only in other regions is welcome as well as information on products in other countries.
Note: Fats and oils are needed for normal child development. Women who might be pregnant, pregnant women, nursing mothers, and children should not start low fat diets without consulting medical personnel about appropriate dietary goals.
In a low fat diet, one basically has to reduce significantly the amount of red meat in the normal American diet. This is basically done by replacing red meat with poultry, sea food, or vegetarian dishes (while paying attention to salt content). FDA and EPA have warned that women who might be pregnant, pregnant women, nursing mothers, and children should pay attention to the mercury levels in some seafoods. So if you or others in your family sharing your meals are in these categories, discuss with your medical team what seafoods are appropriate and in what quantity before making a major increase in seafood consumption..
While other sites deal with either low salt diets or low fat/low cholesterol diets, none seem to deal with the issue of simultaneously reducing both salt and fat intake. This lack of information seems odd to me since it is estimated that 30 million American suffer from both high blood pressure and high cholesterol. Since 47 million are estimated to high blood pressure alone, this means that 64% of Americans with high blood pressure have a cholesterol problem also. Indeed, the simple fact that Caduet, a combination medicine that treats both high blood pressure and high cholesterol, is advertised on prime time TV is an indication that the need for LS/LF diets is not a small market niche. LS/LF diets might also be indicated for a number of other conditions including Meniere's disease, congestive heart failure and certain digestive conditions. Thus the number of Americans with a possible need for such a diet exceeds the 30 million with both high blood pressure and high cholesterol.
Unlike other sites on similar topics I will not burden you with my medical situation or medications, although I assure you that in my case by far the biggest impact on my daily life is the diet challenge.
The LS/LF Challenge
So you think you can lower your salt intake by just throwing away the salt shaker and avoiding foods with obvious external salt such as pretzels and potato chips? Maybe you could if you lived in a country with less processed food and fewer chain restaurants. But in typical US diets most salt comes from "invisible salt" in the food that you eat that does not obviously taste like salt. The salt shaker and junk foods are just the tip of the iceberg!
Sticking to a LS/LF diet is complicated by several factors:
• The human body often craves salts and fats even though Americans generally get too much of both. This may well be a primeval survival mechanism. The addiction-like response to the high salt and fat levels of normal American diets makes starting a LS/LF diet particularly challenging. (Giving up Big Macs and fries?)
• Food producers often use high fat and salt levels to make their products more attractive to consumers. A message to me from Betty Crocker/General Mills states "Our soups containing higher sodium levels have been developed in response to consumer preferences." (Dear General Mills, Perhaps adding opium to soups would also result in positive consumer preferences! After all, Coca-Cola contained cocaine until 1914 and 7-Up contained lithium until 1950.)
• Most of the sodium in the typical American diet is not from obvious sources like your salt shaker or the visible salt on pretzels, french fries and potato chips. The salt in bread and other baked products may not be immediately noticeable, but it is quite real and adds up quickly along with the salt in most mainstream processed foods. Indeed, throwing away the salt shaker and avoiding foods with visible external salt is only a small first step and doesn't have much impact by itself.
"In the US diet, 77% of sodium comes from processed and restaurant foods, 12% occurs naturally in foods, 6% is added at the table, and 5% is added during cooking." -- S. Havas, B. Dickinson, M. Wilson, "The Urgent Need to Reduce Sodium Consumption", JAMA, 9/26/07, p. 1439-1441
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"The salt that you put into your own cooking or add at the table is obvious, but only about a quarter or less of the salt we eat comes from salt that we have control over. The rest comes from processed food. Salt is hidden in processed foods and most people are unaware of how much salt is added to these types of food. You can either cut down or cut out processed foods. Read the label on these foods, and only eat those that do not contain large amounts of added salt.
Your taste buds get used to the large amount of salt in processed foods. When you stop, food with less salt will taste bland. However, your taste buds adapt very quickly so that after about three weeks you will find that food with added salt tastes very unpleasant and may mask the real flavour of the food." - UK Blood Pressure Association *
Many people fear that food without salt has no flavor. The UK's Food Standards Agency says,
"If you're used to foods that are high in salt, or adding lots of salt to your food, you could miss it when you first cut down. This is because our taste buds get used to high levels of salt.
But our taste buds can get used to eating less salt in a few weeks and then you're more likely to enjoy food with less salt, or without any salt at all. If a food contains lots of salt this can hide more subtle flavours, so you might prefer some foods with less salt when your taste buds have had time to adjust."
• Even the makers of many low fat products seek to maintain their palatability by increasing their salt content! So products that claim to "heart healthy" may have higher salt content than normal products! Even the American Heart Association seems to be condoning part of this practice through their "heart check" labeling program that focuses on saturated fats and cholesteroland ignoressalt content.
* A 1/2-cup serving of a low-fat cottage cheese had twice as much sodium (360 milligrams) as a 1-ounce serving of regular potato chips (180 milligrams).
* A Premium Caesar Salad with grilled chicken from McDonald's had more than twice the salt (890 milligrams) as a large order of McDonald's fries (350 milligrams). And that's without the dressing.
* A half-cup serving of Prego's Heart Smart Traditional Italian Sauce had 430 milligrams of sodium, slightly less than what the USDA allows per serving in foods labeled "healthy."
* Breakfast foods were an unexpected source of hidden salt. A popular whole-grain bagel had 440 milligrams of sodium, a best-selling pancake mix had 200 milligrams per pancake, and raisin-bran cereals had between 230 milligrams and 350 milligrams per cup serving. A maple and brown sugar-flavored instant oatmeal had more than three times as much sodium as its original flavored version.
For example, the makers of Egg Beaters, "taste the healthy side of eggs", may not want you to know that their product has added salt and actually has 115 mg of sodium per serving (in this case 1/4 cup or the the equivalent of 1 egg) while a real egg has about 70 mg of sodium but a lot more cholesterol (212 mg). Their "nutritional facts poster" compares the product to real eggs - leaving out all the inconvenient sodium information. Now 115 mg is not a lot of sodium and Egg Beaters could be legally called a "low sodium" product. But if you are also trying to get sodium down in your diet, which I assume many purchasers of this product are, who needs added salt? (This discussion refers to Original Egg Beaters, the newer flavors have more sodium.)
The sodium content of egg substitute brands varies, check labels when you buy!
Cheerios makes a big deal about its impact on cholesterol levels. They are not so open about the fact that the traditional Cheerios (yellow box as shown here) has the following top 5 ingredients: "Whole Grain Oats, Modified Corn Starch, Sugar, Oat Bran, Salt," and has 190 mg of sodium/serving.
Hot oatmeal has no sodium and the same fiber. Many Cheerios clones, such as Kashi's Heart to Heart, have lower sodium. (Note that Kashi's Heart to Heart waffles, on the other hand, are high in sodium.)
So you want to eat healthy for the holidays by having Tofurky rather than meat? The Tofurky folks even have a neat comparison to show you that a serving only has 0 cholesterol and 190 calories vs. 86 mg of cholesterol and 240 calories for "roasted turkey meat and skin". Sounds good, doesn't it? Oddly, they forgot to tell you that Tofurky also has 396 mg of sodium/serving.
The chart at right compares Tofurky with turkey with skin and without skin.
Turkey meat is actually pretty healthy if the processing adds no salt and you avoid the skin and fat. But some turkeys in mainstream stores have added salt, some have added salt and added fat (e.g. Butterball brand), and packaged sliced turkey meat often has added salt.
This tradeoff between sodium level and cholesterol appears to be quite common in products from the US food industry.
• Often producers try to make low fat or low salt products more palatable by increasing sugar levels, hence calories. The problem here is that many conditions leading to a LS/LF diet also result in a need for weight loss. Thus the real need for you could be maintain a low salt, low fat and low calorie diet. You will quickly find out that many of the low calorie products sold are high in salt!
• Maintaining a LS/LF diet is complicated by the lack of immediate body feedback (in many people) associated with other special diets. People with lactose intolerance, celiac disease, and diabetics often get near term feedback from their bodies if they drift from their dietary goals. People with weight loss diet can get feedback from their scales every day. But for those with high blood pressure and high cholesterol there likely is no immediate physical feedback as the damage is long term in nature. (Blood pressure monitoring can give some feedback, but it is not immediate and requires a conscious step.) People with other conditions may get noticeable feedback if they drift off course. Thus, in reality, high motivation is needed by many people for LS/LF diet compliance.
• Trans Fats - These are fats that are even worse for heart disease than saturated fats! FDA now requires labeling of trans fat products on packaged foods and as a result they are rapidly disappearing from you supermarket shelf due to marketplace forces at work. However, they may well be in your plate at restaurants where no labeling is required. Montgomery County, Maryland was the first jurisdiction to ban trans fats from restaurants in 2007. Since then Brookline, MA, King County (Seattle), WA, and Louisville, KY have followed. New York City is phasing in a total ban effective 7/1/08. A New York Timesarticle points out that it is possible to eliminate this product from restaurant recipes but often outside help is needed to adapt recipes for healthier contents. You may wish to ask restaurants about the recipe ingredients they use if you area does not have a trans fat ban. Such asking is a form of market place pressure!
• Water Softeners - If you live in an area with hard water, consider the possible adverse impact of a home or office water softener on your sodium consumption. Most water softeners function by replacing the calcium in drinking water with sodium or potassium. (Note that for some medical conditions, potassium is not a desirable alternative for sodium.) The amount of sodium added by the water softener is directly proportional to the hardness of the water. Reverse osmosis water softeners do not add either sodium or potassium but are generally more expensive. Bottled water is another alternative. Suggested readings with quantative information on resulting sodium levels:
• The Heart Failure Society of America has a useful free brochure, How to Follow a Low-Sodium Diet, available on their website dealing practical issues for low salt diets.
• There seems to be a bad case of market failure in the marketing of products and services for those needing LS/LF diets in that specialized products and appropriate restaurant menu items are hard to find. By contrast, consider the case of celiac disease (wheat/gluten intolerance) which 1-3 million people in the US are afflicted with, although the number who have been formally diagnosed is only about 100,000. This is less than 10% of the number with both high blood pressure and high cholesterol, not to mention other less frequent conditions needing a LS/LF diet. Yet gluten-free breads and other products are generally available in mainstream stores and many restaurants offer some gluten-free dishes. Clearly the celiac community should be commended for its success in making food processors aware of their needs. Of course, the lack of timely body feedback on your eating, mentioned above, is also a factor here. Many with celiac disease feel sick if they deviate from the proper diet. Many people needing LS/LF diets feel OK if they deviate, they just die sooner!
An illustration of market failure: Safeway.com sells gluten free bread but does not have either low salt or no salt bread, even though the potential number of buyers greatly exceeds the number with celiac disease.
It never ceases to amaze me that with the graying of the baby boomers the food manufacturing and retail communities have paid so little attention to the niche market of LS/LF foods. While I will not advocate reducing the salt and fat content of main stream products (although it probably should be done for public health reasons) I will advocate that manufacturer and retailers should make it easier for consumers to find the products that are on the market. I will also highlight both national brand products and regional products with mail order distribution that are particularly useful for people with LS/LF diets.
Practical information to make the LS/LF diet less burdensome will make compliance easier and improve your long term health. That's why we're here!
Look around this site for practical information on finding realistic options for a LS/LF diet.
Where other web sites have useful information related to this topic, I will not hesitate to give such links and ask that they consider reciprocity. I have no financial interest at all in any of the links on this websites except for the Amazon links that are clearly identified as belonging to Amazon.
Feel free to contact me with comments and suggestions:
* Note that UK sites have interesting information on diet issues and that their government has a more proactive policy on salt and fat in the diet than the US Government. While both the US and UK use metric units for discussing nutrition, UK web sites normally quantify salt in grams of salt while in the US milligrams of sodium is the usual unit.
1 gram of salt = 500 mg of sodium
Disclaimer
The author of this web site has absolutely no formal education, training, or certification related to its subject matter. This is only an attempt to share information he has gathered. Every attempt has been made to reference statements to their original source so you can review them.
Do not make decisions concerning your medical situation based on information herein.
Always consult your medical provider on health-related matters including diet.
