Mineral / electrolyte diet - sodium - 50mmol
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To limit total sodium intake to 50mmol (1150mg) per day, to promote loss of excess fluid in oedema or ascites.
Characteristics
Strictly limits foods high in sodium.
Indications
- congestive heart failure
A very low sodium diet has not been shown to be beneficial in managing ascites and / or oedema in advanced liver disease.
Nutritional adequacy
Nutritionally adequate.
Precautions
No salt sachets are provided on meal trays.
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Suggested meal structure
- Breakfast: <15mmol (345mg)
- Morning tea: <3mmol (69mg)
- Lunch: <15mmol (345mg)
- Afternoon tea: <3mmol (69mg)
- Dinner: <15mmol (345mg)
- Supper: <3mmol (69mg)
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | <10mmol (230mg) sodium per serve Plain roasted and grilled meat, fish and poultry Some egg dishes | ≥10mmol (230mg) sodium per serve (e.g bacon, sausages, pies, smoked fish, silverside, some mornays, lasagne, quiche, cheese-based dishes) |
| Sauces, gravies | Salt-free gravies and sauces Apple and mint sauces | Commercial sauces such as tomato sauce, soy sauce |
| Starchy vegetables / pasta / rice | <2mmol (46mg) sodium per serve Plain steamed, roasted or mashed potato without added salt Plain rice, pasta and unsalted noodles | Any rice, pasta, noodles or potato dishes with added salt or ingredients containing sodium e.g. potato wedges, scalloped potato Fried rice |
| Vegetables | <2mmol (46mg) sodium per serve All others, cooked without salt | Any vegetables served with cheese sauce |
| Soups | <3mmol (69mg) sodium per serve | All other soups, e.g tomato |
| Sandwiches | <12mmol (276mg) sodium per serve Sandwiches made with low-salt bread and salt-free margarine | ≥12mmol (276mg) sodium per serve (e.g ham, silverside, cheese sandwiches) Chutney and pickles |
| Salads, dressings | <12mmol (276mg) sodium for full salad, including salad dressing | ≥12mmol (276mg) sodium per serve (e.g ham, silverside, cheese salads) Canned vegetables |
| Breads, cereals | Low-salt breads and crackers (<120mg sodium per 100g) Breakfast cereals ≤120mg sodium per 100g (e.g rolled oats, natural muesli, Just Right®, puffed wheat) | Bread and crackers with >120mg sodium per 100g Breakfast cereals >120mg sodium per 100g (e.g Corn Flakes®, Rice Bubbles®) |
| Spreads | Salt-free butter and margarine Jam, honey, marmalade | Regular butter and margarine Vegemite™, Marmite™, peanut butter |
| Hot breakfast choices | Plain boiled, poached or scrambled eggs and omelettes, prepared with no added salt | Bacon, sausages, canned spaghetti Egg dishes prepared with salt Canned baked beans |
| Fruit | All fruit | - |
| Yoghurt | All Yoghurt | - |
| Desserts | <6mmol (138mg) sodium per serve Milk-based desserts, ice-cream, jelly | ≥6mmol (138mg) sodium per serve (e.g many commercial desserts and pastries) |
| Milk and cheese | All milk Ricotta and cottage cheese | Semi-hard and hard cheeses Swiss cheese |
| Beverages | Tea, coffee, cordial, soft drinks Fruit juices Milo® powder, drinking chocolate. Unsalted tomato or vegetable juice | Salted tomato and vegetable juice |
| Biscuits | Low-salt biscuits <2mmol (46mg) sodium per serve | Regular commercial biscuits |
| Miscellaneous | Herbs, spices, vinegar, lemon wedges, pepper Unsalted nuts Sugar, sweetener, cream | Salted nuts Olives Potato crisps and salted popcorn Monosodium glutamate (MSG), salt sachets |
References
- Food Standards Australia New Zealand. NUTTAB Online searchable database: foods that contain sodium. [accessed 13 Aug 2015].
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 17 March 2010].
- National Heart Foundation of Australia. Position statement: the relationships between dietary electrolytes and cardiovascular disease. 2006.
- Queensland Health. Low salt diet. 2015. [accessed 13 Aug 2015].
- European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. Journal of Hepatology 2010 vol. 53: 397–417