A controversy developed last year about the proper amount of sodium for adults to consume daily. For years the American Heart Association along with most doctors encouraged us to consume substantially less salt for good cardiovascular health. But what about those who suffer from GERD? Is a low sodium diet something to manage as part of your overall GERD diet? RefluxMD is preparing to launch a new GERD friendly diet shortly, and this question is one that we found most interesting as we developed our approach to meal planning. We hope this will assist you to determine your optimal sodium levels as part of your path to relief and good health.
Sodium and general health
The American Heart Association recommends managing sodium consumption to 1,500 mg per day for everyone, especially for those at risk for hypertension. Since the average American adult consumes 3,400 mg daily, reducing salt consumption by over 50% represents a significant challenge, commitment and perhaps, super-human will power. However, the Institute of Medicine raised a question last year when it issued a report, “Sodium Intake in Populations” that stated the following: “Emerging evidence suggests sodium intakes below 2,300 milligrams (mg) per day may increase risk of adverse health outcomes, at least in some population subgroups.” The report identified anyone with moderate to severe congestive heart failure to be at risk of lower sodium intake, and it went on to say that there was “no evidence for benefit and some evidence suggesting risk of adverse health condition…for those with diabetes, kidney disease, and cardiovascular disease.” This begs the question: Who is right, and what does this mean for those suffering from GERD? And, what is the value of a low sodium diet?
Learn more: Why diet matters for ALL people with GERD
Everyone, including the AHA and the Institute of Health, agree on several facts. First, excessive sodium consumption will drive up blood pressure. Second, elevated blood pressure over time (hypertension) puts individuals at risk for several cardiovascular complications such as heart attacks and stroke. However, sodium is essential to the body and abnormally low sodium levels in the blood, called hyponatremia, can be extremely dangerous. One of our medical advisors experienced this last year when he became dehydrated and consumed excessive amounts of water; only to find out he had diluted the sodium levels in his body. He became nauseous and confused with muscle spasms and cramps. If left untreated, hypomatremia can lead to seizures, coma, and possibly death. For most of us, however, we consume far too much sodium in our diet and should move more toward a low sodium diet. If we are the “average adult” consuming 3,400 mg of sodium daily, then lowering our salt intake will result in a lowering our blood pressure and reducing our risk of a stroke and/or a heart attack.
What about the link between sodium and GERD?
One of the recognized contributing factors driving GERD is obesity. It is well recognized that excessive salt consumption can lead to fluid retention, resulting in weight gain. One of RefluxMD’s first recommendations for anyone suffering GERD symptoms is to achieve a targeted BMI of 25 or less. A good way to loss weight is to drop excessive water by reducing salt intake. Although salt has not been identified as a “trigger” food, a study published in the GUT Journal in 2004 found a link to sodium and the development of GERD. This Swedish study found those adding extra salt directly to their meal were 70% more likely to develop GERD. They also found a 50% increase in GERD from eating salted fish or salted meat more than twice a month.
Learn more: GERD Disease 101
You might be getting too much salt even if you don’t pick up a saltshaker
A saltshaker will certainly add sodium to your diet. According the National Institute of Health (NIH) a level teaspoon of salt is about 2,400 mg of sodium, which is also a target encouraged for some by the NIH. The NIH also studied the sources of sodium in our daily diets and the list might surprise you. “Mixed dishes, which consist of foods such as sandwiches, casseroles, pasta entrées, and pizza, contribute nearly half (44%) of the total sodium from foods. Other major food categories include meat and meat alternates, including cheese and eggs (16%), grains (11%), and vegetables (9%). All other food categories each contribute 5 percent or less of total sodium intake from foods we consume daily.” Before you buy food at the grocery store, we highly suggest that you look at the label and find the sodium content before you make your selection.
Where does this all leave us concerning a low sodium diet?
First to summarize what we know: 1) there seems to be some links between the development of GERD and sodium; 2) excessive consumption of sodium can lead to weight gain, a driver of GERD symptoms, and; 3) a low sodium diet should result in lower blood pressure with fewer risks of cardiac events. Based upon these facts, RefluxMD believes that anyone with acid reflux disease can benefit by reducing their daily sodium intake well below the average of 3,400 mg per day. The NIH recommends 2,300 mg of sodium daily (or 6 grams) for most adults and this is consistent with the Institute of Medicine findings, as well. The NIH further recommends that anyone with high blood pressure or someone who is part of an “at risk group” such as diabetics, those with chronic kidney disease, African Americans, and those over 51-years-old should reduce sodium consumption even further to 1,500 mg per day. If you are in one of those “at risk groups”, you should discuss a low sodium diet with your physician and together determine the appropriate amount of sodium to consume daily.
RefluxMD is here to help
Developing a diet that not only avoids GERD trigger foods and reduced sodium consumption is a challenge. The only reason we can say that with confidence is because we did exactly that — RefluxMD has developed a GERD friendly daily diet plan that offers sodium levels of 2,300 mg and 1,500 mg, based upon your needs and your physician’s recommendations. The basis for this diet was the National Institute of Health DASH diet that effectively lowers blood pressure, often within two weeks, and is excellent for weight loss or weight management. In fact, US News and World Report analyzed and ranked the 32 most popular diet programs and rated the DASH diet at #1.
RefluxMD started with the DASH diet and modified it for those suffering from GERD. This modified diet is low in saturated fat, cholesterol, and total fat, and it emphasizes fruits, vegetables, and low fat dairy foods. It also includes grain products, fish, poultry and nuts. The RefluxMD diet eliminates all GERD trigger foods, limits red meats and sweets, and it is rich in magnesium, potassium, and calcium, as well as protein and fiber. We created RefluxMD’s Recipe for Relief because we understood how difficult it is to develop a meal or diet plan that is not only GERD-freindly, but also offers two low sodium diet options. This is a safe and healthy approach to eating right and achieving a healthy BMI. This program includes a discussion of all aspects of acid reflux disease, the four key components to natural treatment, a step-by-step approach to managing both diet and weight, 21 daily meal plans, and 90 GERD-friendly recipes. We hope you will consider this program as you build your plan to relief and good health.