What do your patients typically say when you tell them they need to reduce their dietary sodium? I hear, “What is sodium anyways?” Guess what? - Its salt! And in my clinic, most patients have never heard this before. As a heart failure nurse, teaching about sodium is something I practice daily. I’ve put together 5 ways to help teach your patients how to reduce their sodium intake.
Put away the salt shaker
I know – it seems obvious right? But in fact, it isn’t. Most patients have not been educated on nutrition and have never been on any dietary restrictions before. Teaching them that sodium = salt should be your first step. Did you know that a single teaspoon of salt contains approximately 2,300mg of sodium? Chances are, neither does your patient. Putting down the salt shaker could mean the difference in thousands of milligrams of sodium taken in per day. Another important consideration is to teach your patient that salt = salt. Don’t get confused by other types of salt such as Pink Himalayan or Sea Salt. These still contain sodium and count toward the total daily limit.
Read the nutrition labels
Would you be surprised if I told you that most patients don’t know how to read a nutrition facts label? This is an essential step in making sure your patient knows how to reduce their daily sodium intake. Start with the basics. What is a serving size? How many servings are in this container? Then move on to the good stuff – milligrams of sodium. A lot of my patients gravitate toward the daily percent – but what we really want is the milligrams (mg) per serving. The Heart Failure Society of America recommends that a heart failure patient should limit their sodium to between 2,000 – 3,000mg sodium per day. If your patient doesn’t understand how to read a food label, this recommendation becomes difficult to visualize. Ensure you know what their restrictions are, and help them understand how to stay within that range.
Prepare your food at home
One of my favorite memories as a new nurse in CHF was an elderly patient telling me, “Honey, I’m not going to learn how to cook now!” Cooking at home is a struggle for many patients as they belong to all backgrounds and all walks of life, but it is essential for being successful with a low sodium diet. Teaching patients that they can still have proteins that they season and prepare along with fresh fruits and vegetables is a good place to start. I always say- the fresher the better! Providing patients with a visual of options to choose and options to avoid has been really helpful in my practice because patients usually start out by saying “what can I eat?” I also like to add that seasonings are NOT off limits, they just need to be sure the seasonings they buy don’t contain sodium. Choosing seasonings like black pepper, garlic powder, onion powder, cumin or chili powder are all perfectly good alternatives to pre-made seasonings.
Limit intake of processed foods
As you can probably tell, I’ve created my own personal script after teaching low sodium for 5 years. My favorite line is, “if it comes in a box, a bag or a jar, you probably shouldn’t eat it!” Explain to your patient that processed foods (food that is not fresh and comes in packaging) generally contain much more sodium than foods that are fresh. Educate them that nutrition labels live on these food items and that it’s important to read them before purchasing. Also, inform your patient that labels are often tricky and can say things like “reduced sodium.” In reality, this could mean the difference of only a few milligrams versus several hundred.
Check restaurant menus before you go
Thankfully, most restaurants these days are sympathetic to the nutritional needs of their customers. It’s now relatively easy for a patient to Google the nutritional facts for their favorite restaurants before they leave the house. This way, they can have a plan before they go, and are aware of what foods with easily work within their sodium restrictions. Often times in the clinic I will ask my patient, where do you go out to eat? If they give me an answer, I will look it up right there and show them the sodium amounts for that particular item. It can be quite shocking to discover the chicken nuggets from your favorite place are suddenly off-limits, but this is a really great way to help your patient visualize actual amounts of sodium in processed or prepared foods.
Every opportunity we have to teach a patient can help them to be more successful.
What techniques have you developed in your practice to teach patients about sodium restriction?
HFSA Module 2: How to Follow a Low Sodium Diet