Sodium diet - low (no added salt)
This document is part of the ACI Diet Specifications for Paediatric Inpatients. It is not to be used for patient education.
Aim
To limit the sodium intake while including foods from all food groups. No specific goal for sodium.
Characteristics
No added salt during cooking and consumption of food. Limits foods high in sodium such as preserved, canned and processed meats, commercially prepared foods, sauces, high salt spreads and flavourings, salty snack foods. Specialised reduced sodium products may be used if available. Fresh foods are preferred. Nutrient-dense foods may be required to help meet energy and nutrient needs. Some high sodium foods which are also good sources of calcium and protein are allowed.
Indications
- acute or chronic renal failure
- Nephrotic syndrome
- fluid restriction
- haemodialysis/peritoneal dialysis
- Diabetes insipidus
- oedema
- hypertension.
Nutritional adequacy
Nutritionally adequate.
Precautions
No salt sachets are provided on the meal trays. Salt or sodium restriction in paediatrics should be linked to clinical indications. Sodium restriction may be recommended for a period of time in response to clinical indications and then may be lifted once clinical improvement occurs. A liberalised diet is important to help a child meet energy and nutrient needs, while maintaining fluid balance and normal biochemistry.
Diet may be used in conjunction with Fluid Restriction Paediatric diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | No added salt in cooking Use low salt stock Use tuna/salmon canned in water | Bacon, sausages, frankfurts, salami, pies, smoked fish, corned silverside, commercially prepared foods such as chicken nuggets, fish fingers, spring rolls |
| Sauces, gravies | Low salt gravy and sauces Tomato sauce as portion control, mayonnaise | Gravy/sauces made with salt/high salt stock Salad dressing Sauces made with cheese Soy sauce Seasoning mixes |
| Starchy vegetables/pasta/rice | All without added salt | Potato chips, wedges with added salt |
| Vegetables | All, no added salt in cooking | - |
| Soups | <6mmol (138mg) sodium per serve | All others |
| Sandwiches | Fillings of salad, egg, roast meats, tuna/ salmon canned in water, cheese | Fillings of processed meat such as ham, salami, corned silverside Vegemite™ |
| Salads, dressings | All, canned vegetables in spring water (<120mg sodium/serve), salmon/tuna canned in spring water Vinegar, lemon juice/wedge | All other dressings |
| Breads, cereals | All | - |
| Spreads | Jam, honey Low salt peanut butter | Vegemite™ |
| Hot breakfast choices | All others (e.g. eggs, pancakes, tomato, mushrooms, reduced salt baked beans) | Bacon, sausages, canned spaghetti, hash browns |
| Fruit | All – fresh, canned, dried | - |
| Yoghurt | All | - |
| Desserts | All | - |
| Milk and cheese | Milk Hard cheese, cottage cheese, ricotta | Processed cheese |
| Beverages | All | - |
| Biscuits | Plain crackers and sweet biscuits (<600mg sodium per 100g) | All others |
| Miscellaneous | Use herbs or lemon/vinegar for flavouring in place of salt | Salt sachet, savoury snack foods (e.g. chips, pretzels, salted nuts) |
References
- Agency for Clinical Innovation. Nutrition standards for paediatric inpatients in NSW hospitals. Sydney 2011.
- Agency for Clinical Innovation. Nutrition standards for adult inpatients in NSW hospitals. Sydney 2011.
- Dietitians Association of Australia. 2009. Nutrition Manual 8th ed. Canberra: DAA.
- American Dietetic Association. Paediatric Nutrition Care Manual. Chicago: ADA.
- Heart Foundation Healthy Eating.
- NHMRC 2003 Dietary Guidelines for Children and Adolescents in Australia.
- Caring for Australians with Renal Impairment Guidelines.
- National Kidney Foundation Kidney Disease Outcome Quality Initiative.
- Shaw V and Lawson M. 2007. Clinical Paediatric Dietetics. 3rd Edition. Blackwell Publishing.