Eating Low Salt - Tips for reducing sodium for people with liver disease.

Eating Low Salt TIPS FOR REDUCING SODIUM FOR PEOPLE WITH LIVER DISEASE

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CONTENTS 4

An Introduction To Low Salt Eating

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The ‘No Added Salt’ Diet

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Tracking Your Daily Sodium Intake

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Recipes

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Tips For Eating Low Salt When You Don’t Cook

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Resources

Ph 1800 437 222 or (08) 8362 8443 Fax (08) 8362 8559 3 Hackney Rd Hackney SA 5069 PO Box 782 Kent Town SA 5071 www.hepsa.asn.au SA Health has contributed funds towards this Program.

Last update: August 2019

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INTRODUCTION This booklet has been adapted from a series of blogs posts that were written to assist people living with liver disease to reduce the amount of salt that they eat.

Reducing salt is one of the main ways ƪ Ǧ ȋascites) that is a common complication of advanced liver disease.

While it may seem straight forward to eat less salt, we heard from many people that they were struggling to do so. For some it was a lack of experience working out the salt content of foods, while for others it was a reluctance to give up all of the familiar foods that they liked. Some ǯ ƥ Ƥ Ǥ

We hope that this resource helps you and we welcome any feedback or suggestions you might have—you can contact us by ͚͛͠͞ ͜͠​͛͜ ȋ͙͘͠​͘ ͛͜͟ ͚​͚​͚ regional callers) or by email at admin@ hepsa.asn.au.

ACKNOWLEDGEMENTS We would like to thank all of the people who have provided us with feedback about this resource including Rachel Wundke CPC Chronic Liver Disease at Flinders Medical Centre, and Viral Hepatitis Nurses Margery ǡ ơ Ǥ

This booklet gives some suggestions and resources to help you:

We would especially like to thank Kirsty McDowall, Senior Dietitian at Flinders Medical Centre for her valuable advice and contribution to this resource.

Ȉ Ƥ ǡ Ȉ adjust your diet where you need to, Ȉ and Ȉ Ƥ ǡ ǡ salt.

It’s important to note that this resource is not medical advice and you should speak to your nurse, doctor or dietitian about what’s right for you.You may need to change your diet in other ways as well, such as eating more protein and reducing ƪ Ǥ ǡ doctor or dietitian will let you know if this is the case.

If you haven’t already done so we also highly recommend that you that you consider being referred to an accredited dietitian who can help you customise an eating plan that works for you. The cost of this may be subsidised as part of a chronic illness management plan.You can speak to your GP about whether this is available for you.

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AN INTRODUCTION TO LOW SALT EATING Many people with liver disease are advised to reduce the salt in their diet.

This is usually because reducing salt is one ƪ Ǧ ȋascites) that is a common complication of advanced liver disease.

COMMON SOURCES OF SALT IN OUR DIET Processed, packaged and canned foods and most sauces tend to be the highest Ƥ as being low salt. This includes foods such as processed meats and cheeses, canned soups, convenience and snack foods including some cakes and biscuits. Some drinks, such as sports drinks, are also high in salt.

However, changing your diet isn’t always easy and many people struggle to know where to start. This section gives you some basic information about reducing the salt in your diet.

SALT OR SODIUM, WHICH IS IT?

WHAT SHOULD I EAT? Base your diet on a good foundation of fresh fruits and vegetables, whole grains ȋ ȌǤ sources will depend on whether or not you eat animal products and include ǡ Ƥ ǡ ǡ ǡ unseasoned tofu, unsalted nuts and legumes.

Although we’re used to talking about salt when it comes to food, it’s the sodium in ȋ chloride) which is of concern to our health.

Getting used to using these sodium values is much easier than trying to work out the grams of salt. Packaged foods show the amount of sodium that they contain on their nutrition panel.

Frozen fruits and vegetables are usually low in salt and retain their nutrients well.

Canned fruits, vegetables and legumes are also highly nutritious but be sure to check that they are low or reduced salt.

HOW MUCH SODIUM SHOULD YOU EAT?

ƪ ȋ high in salt), fresh herbs, lemon or lime juice, vinegar, ginger, chilli and garlic.

Remember not to add extra salt while cooking or at the table.

The Gastroenterological Society of Australia ȋ Ȍ ͚ǡ͛͘​͘ per day for the management of liver disease.

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CHOOSING PACKAGED FOODS ॥ –ŠƒÂ? ͙͚͘ Â?‰ of sodium Í™ÍšÍ˜Č‚ÍšÍ˜Í˜Â?‰ of sodium

’‡” ͙͘͘‰�• ‘” ͙͘͘�Ž• ‘ˆ ˆ‘‘† ’‡” ͙͘͘‰�• ‘” ͙͘͘�Ž• ‘ˆ ˆ‘‘†

READING NUTRITION LABELS Becoming familiar with reading nutrition labels is very helpful in working out how much sodium you’re getting from each food.

š…‡ŽŽ‡�– Very good

You may be able to include foods with Â?‘”‡ –ŠƒÂ? ͚͘͘Â?‰ ‘ˆ •‘†‹—Â? ’‡” ͙͘͘‰Â?• ‘” ͙͘͘Â?Ž• ‘ˆ ˆ‘‘† †‡’‡Â?†‹Â?‰ ‘Â? Š‘™ ›‘— are managing your daily sodium intake, the serving size and what other foods you have eaten that day. In the following sections we go into more detail about Š‘™ ›‘— …ƒÂ? …‘Â?Ƥ†‡Â?–Ž› …Š‘‘•‡ ˆ‘‘†• and stay within your daily sodium target.

‘ ƤÂ?† ‘—– Š‘™ Â?—…Š •‘†‹—Â? ‹• ‹Â? ƒ Â•Â‡Â”Â˜Â‡ÇĄ Ƥ”•– ƤÂ?† –Š‡ •‘†‹—Â? ˜ƒŽ—‡ ”‘™ ȋŠ‹‰ŠŽ‹‰Š–‡† ‹Â? ‰”‡‡Â? ‘Â? –Š‡ …Šƒ”– ‘Â? –Š‡ next page), and then work out how much of the food you will be eating. This may or may not match the serving size given by the manufacturer. Unfortunately, one of the tricks used by manufacturers to make their foods appear healthier is to give very unrealistic serving sizes so you should work out how much you think is a serve for you.

In the example below the amount of •‘†‹—Â? ’‡” ͙͘͘‰Â?• ‹• ͘͜Â?‰ ƒÂ?† –Š‡ •—‰‰‡•–‡† •‡”˜‹Â?‰ •‹œ‡ ˆ‘” ‹• ÍšÍ?͘Â?Ž•Ǥ Š‹• means that the amount of sodium you’ll „‡ ‡ƒ–‹Â?‰ ‹• ͙͘͘Â?‰Ǥ As serving sizes vary from product to product the best way to compare products is to read the Average Quantity ’‡” ͙͘͘‰ ȋ•‡‡ …Šƒ”– ÂƒÂ„Â‘Â˜Â‡ČŒÇ¤

ˆ ›‘—ǯ”‡ Šƒ˜‹Â?‰ †‹Ƽ…—Ž–› ”‡ƒ†‹Â?‰ –Š‡ labels on food packaging or would like some idea of what to buy before heading to the shops, many food companies make the nutritional content of their food available online.

Fresh herbs, spices and aromatics such as chilli ƒÂ?† ‰ƒ”Ž‹… …ƒÂ? ƒ†† Ž‘–• ‘ˆ ĆŞÂƒÂ˜Â‘Â—Â” ™‹–Š‘—– •ƒŽ–Ǥ

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NUTRITION INFORMATION Servings per package: 4

Serving size: 250mL Average Quantity per serving

Average Quantity per 100g

Energy

600 kJ (141 Cal)

240 kJ (57 Cal)

Protein

6g

2.4 g

Fat, total

8g

3.2 g

- saturated

5g

2g

Carbohydrate

14 g

5.6 g

- sugars

14 g

5.6 g

Sodium

100 mg

40 mg

Calcium

300 mg (38% RDI)*

120 mg

*Percentage of recommended dietary intake

costly, takeaways and packaged foods can also be very expensive for small serving sizes.

There is no need to buy overpriced superfoods. The foods recommended Ǧ ǡ legumes, rice, pasta, dairy foods, eggs ǡ Ƥ ǡ and alternatives such as tofu and nuts ơ Ǥ Some tips for controlling the costs of food are to: Ȉ Plan what you are going to eat before you go to the shop, write a shopping list and stick to it. Ȉ ƪ buy foods on special. Ȉ Choose fresh foods in season when they are the cheapest. Ȉ Look for frozen or canned alternatives to fresh especially if you are using them in soups or stews where freshness is less important. Ȉ Buy meat or poultry in bulk and freeze some for another meal.

ADJUSTING YOUR PALATE The good news is that you can adjust your palate, although it can be tough when you have to change quickly. Of course, food has many meanings for us and change may be hard. If gradual change is not an option for you, try to be kind to yourself Ȃ Ǧ Ǧ Ȃ Ǥ

THE COST OF CHANGING YOUR DIET Some people are concerned that it will be more expensive to eat healthier foods.

This may or may not be the case for you depending on what you are eating now.

Although some healthy foods can be

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Ȉ Cook meals in bulk and freeze them. Ȉ Freeze your leftovers to reduce waste and get the most for your money. Ȉ Legumes are very nutritious and Ƥ ǡ them to many styles of meals. Ȉ Choose less processed foods for Ǧ Ƥ ƪ Ǥ

FOCUS ON THE BENEFITS Reducing sodium can be challenging at times and it may mean that you need to reduce or change the types of food that you eat, but the good news Ƥ the management of your liver will far outweigh this and your taste buds change to accept foods with lower sodium content.

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THE ‘NO ADDED SALT’ DIET The Gastroenterological Society of ȋ Ȍ people with liver disease limit their daily sodium intake by following a ‘No Added Salt diet’. If you plan to follow this diet we recommend that you read the ‘No Added Salt Diet’ pamphlet, available from gesa.org.au under ‘Patient Information’. Call us if you aren’t able to download it yourself.

Ǥ Ƥ dinner suggestions in the centre of this booklet.

For more suggestions, see our weekly meal plan example which has links to all Ƥ at Ǥ Ǥ Ȁ Ȁ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ǧ Ȁ

Note that the word diet is used to mean “way of eating” and not “weight loss plan”.

CHALLENGES Some challenges you may face when changing your diet may include the need to spend more time preparing food, Ƥ ǡ missing the foods you are used to eating and feeling as though you are missing out when getting together with others. Try to focus on your overall goal of having better management of your liver disease and the other positive aspects of changing your diet. These might be trying new foods, ƪ without salt, improving your cooking skills and saving money on takeaways and convenience foods.

The No Added salt diet is an uncomplicated way to reduce the sodium in your diet and can lead to better symptom control and improved health outcomes.

NO ADDED SALT DAILY MEAL PLAN EXAMPLE An example of two days of meals is included below. This is a general example of the types of meals you can eat on

Breakfast

Lunch

Poached eggs on Burgen toast.

Grilled chicken, avocado and salad Roasted chicken wrap on a and vegetables.

Freedom Foods Barley Max wrap.

Day 1

Day 2

Dinner

Low salt soup (try Porridge with the ones in the Curry and rice. sultanas, almonds fridge for lower and yoghurt salt options) and Burgen toast.

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Dessert Baked banana with honey.

Canned peaches with icecream.

TRACKING YOUR DAILY SODIUM INTAKE Ƥ Dz dz diet too much of a change from their usual way of eating and simply give up trying to reduce their sodium. If this is the case for you then tracking your daily sodium might be a good alternative as it allows you to eat a wider variety of foods and to keep some of your favourites. It can also be a good way to manage festive or social events as you can eat some of the same foods as everyone else while still managing your sodium.

daily menus as needed and only track when you are eating something out of your daily routine.

Combining tracking with the No Added Salt Diet can also make things easier.You can eat the “no added salt” way most of the time but learn how to track your sodium intake so that you can have more ƪ ǡ eating out or on holiday.

On the other hand, if you prefer to track most of the time you could, once in a while, make a daily meal plan of no added salt foods you like and forget about tracking for the day.

ơ ƪ challenges: x you need to track everything that you eat x Ƥ content of foods in advance

WAYS TO TRACK

x your overall diet may not be as healthy as the No Added Salt diet

There are a number of options for tracking your sodium intake:

x you will need to plan ahead or choose no added salt foods once you have reached your daily sodium target

Ȉ what you eat and adding it up Ȉ

x tracking may not be suitable for people who have experienced an eating disorder

Ȉ or tablet For those who would like to track on paper we have a Weekly Sodium Tracker and a Favourite Foods Sodium Values booklet that you can print out for this ȋ look for the post on TrackingYour Daily ȌǤ Ƥ are listed in the resources at the end of this booklet.

However, although it takes quite a lot of ơ ǡ Ǥ Ƥ only need to track for a short while until you become familiar with the sodium levels of the foods you eat regularly. Many of us eat the same foods frequently, and this makes tracking easier. Once you have tracked a week or a month you can repeat 9

’”‘†—…–Ǥ ‘�‡–Š‡Ž‡••ǥ –Š‡ Ƥ”•– –‹�‡ ›‘— add a food, you should still check the sodium information on the nutrition panel to make sure it matches what’s in their database. Some foods have been added by individuals and may be inaccurate.

CalorieKing doesn’t have a barcode scanning feature but it does have an extensive database of Australian ˆ‘‘†•Ǥ ˜‡Â? ‹ˆ ›‘— †‘ —•‡ › ‹–Â?॥ ƒŽǤ …‘Â?ÇĄ ƒŽ‘”‹‡ ‹Â?‰ ‹• ƒ ‰‘‘† „ƒ…Â?nj—’ ˆ‘” Ž‘‘Â?‹Â?‰ —’ ˆ‘‘†• ›‘— …ƒÂ?ǯ– ƤÂ?† ‘Â? –Š‡ MyFitnessPal.com. You don’t need to join Calorie King to look up foods in their database.

”ƒ…Â?‹Â?‰ ›‘—” •‘†‹—Â? …ƒÂ? ‰‹˜‡ ›‘— ‡š–”ƒ ƪ‡š‹„‹Ž‹–› ‹Â? ™Šƒ– ›‘— …ƒÂ? ‡ƒ–

TIP: Planning ahead can make tracking easier. Add all of the foods that you would like to eat for a day in advance so that you can spot any foods that need to be reduced or replaced.

There are many websites and apps –Šƒ– ‘ƥ‡” ˆ‘‘† –”ƒ…Â?‹Â?‰Ǥ ‡ –‡•–‡† three longstanding free services with good reputations and high popularity: CalorieKing.com.au, MyFitnessPal.com and Spark People.com. Spark People turned out to be unsuitable for sodium tracking.

DAILY FOOD EXAMPLE

Important note: Š‡•‡ •‡”˜‹…‡• ƒ”‡ †‡˜‡Ž‘’‡† ˆ‘” –”ƒ…�‹�‰ …ƒŽ‘”‹‡• ˆ‘” ™‡‹‰Š– Ž‘•• ƒ�† ƒ”‡ �‘– ‡š…Ž—•‹˜‡Ž› ˆ‘” •‘†‹—� �ƒ�ƒ‰‡�‡�–Ǥ ‡‘’Ž‡ ™‹–Š Ž‹˜‡” †‹•‡ƒ•‡ should not —•‡ –Š‡•‡ •‡”˜‹…‡• ƒ• ƒ ‰—‹†‡ –‘ Š‘™ �ƒ�› …ƒŽ‘”‹‡• –‘ …‘�•—�‡ ™‹–Š‘—– –Š‡ †‹”‡…– ƒ†˜‹…‡ ‘ˆ ƒ †‘…–‘” ‘” †‹‡–‹–‹ƒ�Ǥ Š‡ …ƒŽ‘”‹‡ •‡––‹�‰• ’”‘˜‹†‡† „› –Š‡•‡ •‡”˜‹…‡• ƒ”‡ „ƒ•‡† ‘� ˜‡”› ‰‡�‡”ƒŽ ‹�ˆ‘”�ƒ–‹‘� ƒ�† �ƒ› �‘– ƒŽŽ‘™ ˆ‘” ƒ†‡“—ƒ–‡ ‰‡�‡”ƒŽ �—–”‹–‹‘� ‘” ’”‘–‡‹� ‹�–ƒ�‡Ǥ

The MyFitnessPal app and the Calorie King website both let you enter the foods you eat into a daily food log. We have screenshots from both on our blog if you’d Ž‹Â?‡ –‘ •‡‡ ‡šƒÂ?’Ž‡• ȋ‰‘ –‘ ‘—” ‡’ blog and look for the post on Tracking Your Daily Sodium).

Information is given in calories and kilojoules. Macronutrients such as carbohydrates and protein are also included in the MyFitnessPal log. To keep things simple, just focus on tracking the sodium.

Setting up accounts on both the MyFitnessPal mobile app and CalorieKing website was easy and adding foods to the daily log was quick and simple. It was also ‡ƒ•› –‘ ƤÂ?† ˆ‘‘†• –Š”‘—‰Š „‘–Š •‡”˜‹…‡•Ǥ

Both tools provide a column for sodium with a running total. On Calorie King you Â?‡‡† –‘ ‰‘ ‹Â?–‘ ›‘—” ’‡”•‘Â?ƒŽ ’”‘ƤŽ‡ ƒÂ?† add a daily sodium amount for this to show. MyFitnessPal also shows how much allowance you have remaining.

MyFitnessPal allows you to scan food packet barcodes with a mobile device.

This ensures that you get the nutrition information for the local version of the 10

Eating Low Salt: Recipes

ROAST CHICKEN & VEGETABLES Ingredients x Í?Í˜Í˜ÇŚÍžÍ˜Í˜Â‰ …Š‹…Â?‡Â? –Š‹‰Š•ǥ …Š‘’• ‘” ’‹‡…‡• x ͙nj͙ǤÍ?Â?‰ ‘ˆ ƒÂ?› ”‘ƒ•–‹Â?‰ ˜‡‰‰‹‡• •—…Š ĥ •™‡‡– Â’Â‘Â–ÂƒÂ–Â‘ÇĄ Â’Â‘Â–ÂƒÂ–Â‘ÇĄ Â…ÂƒÂ”Â”Â‘Â–Â•ÇĄ ’ƒ”•Â?‹’•ǥ •™‡†‡Ǥ ”‘œ‡Â? ’‡ƒ• ‘” …‘”Â? ȋ‘’–‹‘Â?ÂƒÂŽČŒ x Ž‹˜‡ ‘‹Ž –‘ †”‹œœŽ‡ Č‹ÂƒÂ„Â‘Â—Â– Íš –ƒ„Ž‡•’‘‘Â?Â•ČŒ x ’‹…‡• ‘” ĆŞÂƒÂ˜Â‘Â—Â”Â‹Â?‰•Ǥ ”› –Š‡•‡ …‘Â?„‹Â?ƒ–‹‘Â?• –‘ •–ƒ”– ÇŚ ‡ Žƒ…Â? ’‡’’‡” ƒÂ?† ’ƒ’”‹Â?ƒ ÇŚ Í™Č€Íœ ‘ˆ ƒ –‡ƒ•’‘‘Â? ‘” ƒ ˆ‡™ ‰”‹Â?†• ‘ˆ „Žƒ…Â? ’‡’’‡” ƒÂ?† Í™ teaspoon of sweet, hot or smoked paprika as you prefer.

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‡ ‡Â?‘Â?ÇĄ ”‘•‡Â?ƒ”› ĆŹ Š‘Â?‡›Ǥ —‹…‡ ‘ˆ Í™ Ž‡Â?‘Â?ÇĄ Í™Č€Íœ –‡ƒ•’‘‘Â? ‘ˆ †”‹‡† ‘” Í™ •’”‹– ‘ˆ ˆ”‡•Š ”‘•‡Â?ƒ”› ƒÂ?† Í™ –ƒ„Ž‡•’‘‘Â? ‘ˆ Š‘Â?‡›Ǥ

Instructions ”‡Š‡ƒ– –Š‡ ‘˜‡Â? –‘ Í™Í Í˜ ˆ‘” ͙͘ Â?‹Â?—–‡•Ǥ ÂƒÂ•ÂŠÇĄ ’‡‡Ž ȋ‘” Ž‡ƒ˜‡ •Â?‹Â? ‘Â? ‹ˆ ›‘— Â’Â”Â‡ÂˆÂ‡Â”ČŒ ƒÂ?† …Š‘’ –Š‡ ˜‡‰‰‹‡•Ǥ Š—Â?Â?• ‘” ™‡†‰‡• around 5cm are best, although carrots can be smaller.

Arrange the chicken and vegetable onto a baking tray or dish. ‡ƒ•‘Â? ™‹–Š ›‘—” …Š‘•‡Â? ĆŞÂƒÂ˜Â‘Â—Â”Â‹Â?‰• ƒÂ?† –Š‡Â? †”‹œœŽ‡ –Š‡ ‘Ž‹˜‡ ‘‹Ž ‘˜‡” ‡˜‡”›–Š‹Â?‰Ǥ ˆ ›‘— prefer you can measure the oil into a tablespoon and drizzle it from the spoon.

Mix together so that all of the veggies & chicken are coated. Place into the middle rack in –Š‡ ‘˜‡Â? ƒÂ?† ”‘ƒ•– ˆ‘” ͘͜Â?‹Â?•Ǥ Š‡Â? †‘Â?‡ǥ –ƒÂ?‡ ‘—– ‘ˆ –Š‡ ‘˜‡Â? ƒÂ?† ”‡•– ˆ‘” ͙͘Â?‹Â?• …‘˜‡”‡† ™‹–Š ˆ‘‹Ž ‘” ƒ …Ž‡ƒÂ? –‡ƒ towel. This helps to make the chicken more tender.

While the roast is resting you can cook the peas or corn. Use the instructions on the packet to cook them on the stove or in the microwave.

For more information and support: 1800 437 222 11

Eating Low Salt: Recipes

TUNA AND PEA PASTA Ingredients x ͙nj͚ Â?‡†‹—Â? –‹Â?• ‘ˆ –—Â?ƒ ‹Â? •’”‹Â?‰™ƒ–‡” ‘” ‘Ž‹˜‡ ‘‹Ž x ͙Ȁ͚ …—’ ”‘œ‡Â? ’‡ƒ• x Jar of low salt pasta sauce x ͚͘͘‰ †”‹‡† ’ƒ•–ƒ x ”‡•Š ‘” †”‹‡† „ƒ•‹Ž ‘” ’ƒ”•Ž‡› ƒÂ?† ’‡’’‡” ȋ‘’–‹‘Â?ÂƒÂŽČŒ

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Instructions Cook the pasta on the stove or buy a microwave pasta cooker. This should come with instructions. Add the frozen peas to the pasta in the last 4 minutes of cooking or you can cook them separately according to the packet instructions. Drain the pasta in a colander.

In the same pot used for cooking the pasta heat the pasta sauce and stir the drained tuna through it until just hot. Season with dried basil and pepper if using. ƒÂ?‡ –Š‡ ’‘– ‘ƥ ‘ˆ –Š‡ •–‘˜‡ ƒÂ?† ƒ†† –Š‡ ’ƒ•–ƒ „ƒ…Â? ‹Â?–‘ –Š‡ ’‘– ™‹–Š –Š‡ •ƒ—…‡ ƒÂ?† •–‹” through.

For more information and support: 1800 437 222 12

Eating Low Salt: Recipes

STIRFRY WITH RICE Ingredients x Í?͘͘‰ …Š‹…Â?‡Â? •–”‹’• „‡‡ˆ •–”‹’• ÍšÍ?͘‰ ‘ˆ Ƥ”Â? –‘ˆ— x 2 or 3 tablespoons of olive oil x Fresh vegetable stirfry pack from the supermarket x Pouch of rice or grains

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ˆ —•‹Â?‰ –‘ˆ— ›‘— Â?‹‰Š– Ž‹Â?‡ –‘ Â?ƒ”‹Â?ƒ–‡ ‹– Ƥ”•– ‹Â? •‘Â?‡ ĆŞÂƒÂ˜Â‘Â—Â”Â‹Â?‰•ǣ –”› ƒ ‹Â?Â?‘Â?ƒÂ? Â?ƒ”‹Â?ƒ†‡ ȋ™Š‹…Š ƒ”‡ Â?—…Š Ž‘™‡” ‹Â? •ƒŽ– –ŠƒÂ? –Š‡‹” •‘› •ƒ—…‡• „—– Šƒ˜‡ ƒ •‹Â?‹Žƒ” ĆŞÂƒÂ˜Â‘Â—Â”ČŒ or some garlic or chilli infused oil, or crushed ginger and/or garlic in a jar.

Instructions ‡ƒ– ƒ ’ƒÂ? ‘Â? Š‹‰Š Š‡ƒ– ƒÂ?† Š‡ƒ– Í™ ‘” Íš –ƒ„Ž‡•’‘‘Â?• ‘ˆ –Š‡ ‘Ž‹˜‡ ‘‹ŽǤ —”Â? –Š‡ Š‡ƒ– †‘™Â? –‘ Â?‡†‹—Â? ƒÂ?† ƒ†† –Š‡ …Š‹…Â?‡Â?ÇĄ „‡‡ˆ ‘” –‘ˆ—Ǥ ‡‡’ •–‹””‹Â?‰ —Â?–‹Ž …‘‘Â?‡† Č‹ÂƒÂ”Â‘Â—Â?† Í?ÇŚÍ™Í˜ minutes). Chicken will be white all over with no transparent bits and beef will be mainly brown with only a little red.

Tofu is already cooked but should be slightly coloured from the stirfrying. Remove the chicken, beef or tofu from the pan and put onto a plate for later.

Reheat the pan with the rest of the oil and then add the vegetables. Stir to coat with oil and cook for 3 minutes. Add 3 tablespoons of water to the pan and cover—use a lid, a dinner plate or some aluminium foil. Let the veggies cook through for another 3 minutes.

Remove the lid and return the chicken, beef or tofu to the pan and stir through to mix together. Heat the rice according to the directions on the pack.

Serve the stirfry over the rice.

For more information and support: 1800 437 222 13

Eating Low Salt: Recipes

CHICKPEA AND PEA CURRY (with meat and tofu options) Ingredients x

Í™ –‹Â? ‘ˆ …Š‹…Â?’‡ƒ• Č‹Â?‘ ƒ††‡† Â•ÂƒÂŽÂ–ČŒÇĄ †”ƒ‹Â?‡† ƒÂ?† ”‹Â?•‡†

x

͙ …—’ ‘ˆ ˆ”‘œ‡� ’‡ƒ•

x

͙Ȁ͚ …—’ ˆ”‘œ‡Â? …Š‘’’‡† ‘Â?‹‘Â?•

x

Í™ –‹Â? –‘Â?ƒ–‘‡• Č‹Â?‘ ƒ††‡† Â•ÂƒÂŽÂ–ČŒ

x

Í™ –ƒ„Ž‡•’‘‘Â?• ‘ˆ …—””› ’‘™†‡” ȋ…Š‡…Â? –Šƒ– –Š‡”‡ ‹• Â?‘ ƒ††‡† Â•ÂƒÂŽÂ–ČŒ

x

͙ –ƒ„Ž‡•’‘‘� ‘Ž‹˜‡ ‘‹Ž

x

Í™ –ƒ„Ž‡•’‘‘Â? ‘ˆ ›‘‰Š—”– ’‡” ’‡”•‘Â? –‘ •‡”˜‡ ȋ‘’–‹‘Â?ÂƒÂŽČŒ

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Instructions Heat the oil in the pan and then fry the onion with the curry powder for a few minutes.

Add the tin of tomatoes in their juice to the pan. Drain the chickpeas and add them. ‹��‡” ˆ‘” ͙͘ �‹�• ƒ�† –Š‡� ƒ†† –Š‡ ’‡ƒ• ƒ�† …‘‘� ˆ‘” ƒ�‘–Š‡” ͜ �‹�—–‡•Ǥ Heat the pouch of rice or grains according to the directions on the packet. Serve the curry over the rice, topping with the yoghurt if desired.

To make into a meat curry, add beef or chicken strips at the beginning with the onion and curry powder and cook through as explained in the stirfry recipe before adding the tomatoes and chickpeas. To use tofu add chunks at the end with the peas.

For more information and support: 1800 437 222 14

CONCLUSION Tracking your sodium intake with these services or with our paper guides could provide a good alternative if you aren’t able to stick to the No Added Salt diet or if you’d like a break from time to time.

The services are straight forward and reasonably easy to set up and use. There is also plenty of freely available sodium information for those who prefer a paper system. However, it will suit some people more than others depending on whether Ƥ Ƥ Ǩ Ƥ Ƥ ǡ Ƥ greater variety of food choices. If you get

stuck setting up either of the services, send an email to rose@hepatitissa.asn. au.

If you think that the variety of foods that you can eat with this approach might suit you but don’t think that you are able to track you could ask your doctor for a referral to a dietitian who can help you make a personalised meal plan that incorporates some of your favourite foods. This may be available as part of a Medicare subsidised care plan for people with chronic illnesses.

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TIPS FOR EATING LOW SALT WHEN YOU DON’T COOK Managing your sodium when you rely on packaged or takeaway foods is certainly more challenging than when you prepare your own food. If you don’t prepare your own meals but want to reduce your •‘†‹—Â? ›‘— ™‹ŽŽ Â?‡‡† –‘ „‡ ƒ„Ž‡ –‘ Č‚

EAT FRESHER, LESS PROCESSED FOODS FOR BREAKFAST AND LUNCH

x ”‡ƒ† Â?—–”‹–‹‘Â? Žƒ„‡Ž• ȋ–Š‡”‡ǯ• ƒ ‰—‹†‡ ƒ– the beginning of this resources)

ƒ–‹�‰ Ž‘™‡” •‘†‹—� ˆ‘‘†• ˆ‘” ›‘—” breakfast, lunch and snacks can give you more leeway when choosing foods for dinner.

x look up estimates of sodium …‘Â?–‡Â?– ˆ‘” ˆ‘‘†• ™‹–Š‘—– Žƒ„‡Ž• ȋ–”› CalorieKing.com) If you want to be certain that you are staying within the recommended daily limit you will also need to track the sodium you’ve consumed for the day. We have covered these topics in detail in the previous sections.

You will also probably need to change some of the foods that you eat. The examples below show how high in sodium Â?‘•– –ƒÂ?‡ƒ™ƒ› ƒÂ?† Â’Â”Â‡ÇŚÂ’Â”Â‡Â’ÂƒÂ”Â‡Â† ˆ‘‘†• ƒ”‡ ȋ”‡Â?‡Â?„‡”ǥ ™‡ ƒ”‡ ƒ‹Â?‹Â?‰ ˆ‘” ƒ Â?ƒš‹Â?—Â? ‘ˆ ÍšÇĄÍ›Í˜Í˜Â?‰ ’‡” Â†ÂƒÂ›ČŒÇŁ

Breakfast Čˆ low salt cereals Čˆ oats Čˆ banana or other fresh or canned fruits Čˆ Ž‘™‡” •ƒŽ– „”‡ƒ†• Č‹ —”‰‡Â? ‹• Ž‘™‡” sodium) with no added salt nut butters, unsalted butter, jam or honey Čˆ „ƒÂ?‡† „‡ƒÂ?• Č‹Â?‘ ƒ††‡† •ƒŽ– ‘” •ƒŽ– reduced) Čˆ ‡‰‰• ȋ›‘— …ƒÂ? ‡˜‡Â? Â?‹…”‘™ƒ˜‡ –Š‡Â? Č‚ google it for instructions)

x Big Mac: 933mg x ‘Â?‹Â?‘ǯ• ‡‰ƒ ‡ƒ– ‘˜‡”• ‹œœƒ Č‹Í› Â•ÂŽÂ‹Â…Â‡Â•ČŒÇŁ ͙͙͛͜Â?‰ x ƒÂ?‡ƒ™ƒ› Ġ ÂŠÂƒÂ‹ÇŁ ͙͚͚͛Â?‰ x —„™ƒ› –ƒŽ‹ƒÂ? ͞dzǣ ͙͙͘͘Â?‰ x ‡ƒ– ‹‡ǣ Í Í&#x;Í?Â?‰ However, small changes can make a real †‹ƥ‡”‡Â?…‡ –‘ Š‘™ Â?—…Š •‘†‹—Â? ›‘—ǯ”‡ eating over the day; the following are some strategies for you to try.

Â‘Â™ÇŚÂ•ÂƒÂŽÂ– Â…Â‡Â”Â‡ÂƒÂŽÂ•ÇĄ Â?—‡•Ž‹• ƒÂ?† ‘ƒ–• ƒ”‡ ƒ •‹Â?’Ž‡ „”‡ƒÂ?ˆƒ•– •‘Ž—–‹‘Â?

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Čˆ avocado toast Čˆ tinned mushrooms on toast Čˆ yoghurt Many of these foods are also great for Ž—Â?…Š ȋ‘” ‡˜‡Â? ƒ •‹Â?’Ž‡ †‹Â?Â?Â‡Â”ČŒ ‘” ƒ •Â?ƒ…Â?Ǥ Lunches Čˆ ™”ƒ’• ‘” •ƒÂ?†™‹…Š‡• ™‹–Š ƤŽŽ‹Â?‰• •—…Š as egg, cold left over roast meat, tinned tuna in oil or water and salad Čˆ •‘—’• Č‚ ‰‘ ˆ‘” –Š‡ ‘Â?‡• ˆ”‘Â? –Š‡ fridge rather than tinned but remember to check the label The wwwǤƤÂ?†Ž‘™•ƒŽ–ˆ‘‘†Ǥ‹Â?ˆ‘ website keeps a list of low salt foods available in Australian supermarkets.

CHOOSE HEALTHIER FROZEN OR PREPARED MEALS There are many more options for frozen ƒÂ?† Â’Â”Â‡ÇŚÂ’Â”Â‡Â’ÂƒÂ”Â‡Â† Â?‡ƒŽ• ƒ˜ƒ‹Žƒ„Ž‡ ‹Â? –Š‡ supermarket these days. However, their sodium content can vary widely so be sure to check the label even if they promote themselves as a healthy brand. The Michelle Bridges, Supernature and Aldi brands may have good frozen choices.

‘— ‘‘†œ Č‹youfoodz.com) have fresh prepared meals that you can have †‡Ž‹˜‡”‡† ‘” „—› ƒ– •‘Â?‡ •Š‘’• Č‹Â?‘•–Ž› Drakes and Foodland). Nutrition info is on their website. ‹–‡Â? ƒ•› Č‹www.liteneasy.com.au) also deliver meals. They have nutrition ‹Â?ˆ‘”Â?ƒ–‹‘Â? ˆ‘” ƒŽŽ ‘ˆ –Š‡‹” †‹Â?Â?‡”• ȋ„—– Â?‘– all of their other meals) on their website.

You may be eligible for Meals on Wheels.

Speak to them about your sodium ”‡“—‹”‡Â?‡Â?–•Ǥ ‘Â?–ƒ…– –Š‡Â? ‘Â? Í™Í Í˜Í˜ Í Í?Íœ 453.

If you’re prepared to do some cooking –Š‡Â? ‡ŽŽ‘ ”‡•Š Č‹www.hellofresh.com.au) provides ingredients and instructions for you to prepare meals at home. Nutrition information is on their website but you will need to watch out for their spice/ ĆŞÂƒÂ˜Â‘Â—Â”Â‹Â?‰ •ƒ…Š‡–• ĥ –Š‡› †‘Â?ǯ– –‡ŽŽ ›‘— what’s in them and it’s probably high in sodium.

MarleySpoon are a similar company but they don’t provide any sodium information on their meals.

Recommendations for particular brands –Šƒ– ™‡ Šƒ˜‡ ‰‹˜‡Â? ‹Â? –Š‹• •‡…–‹‘Â? Šƒ˜‡ „‡‡Â? ’”‘˜‹†‡† –‘ —• „› Â•Â–ÂƒĆĄ ƒÂ?† ˆ”‹‡Â?†• ‘ˆ ‡’ƒ–‹–‹• Ǥ Š‡”‡ ƒ”‡ Â?ƒÂ?› ‘–Š‡” „”ƒÂ?†• ƒ˜ƒ‹Žƒ„Ž‡ –Šƒ– Â?ƒ› „‡ ĥ ‰‘‘†Ǥ

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CHOOSE LOWER SODIUM TAKEAWAYS Sodium levels can really vary from product to product even within the same takeaway chain. Here are some Ǧ given above. Swap a: MacDonald’s Big Mac 933mg

for a

MacDonald’s Fillet-o-Fish 613mg

Domino’s Mega Meat Lovers Pizza (3 slices) 1413mg

for a

Domino’s Garden Vege Pizza (3 slices) 756mg

Takeaway Pad Thai 1232mg

for a

Supernature Frozen Chicken Pad Thai with Rice Noodles 990mg (may be a smaller serving)

Subway Italian BMT 6” 1010mg

for a

Subway Oven roasted chicken 6” 477mg

Meat Pie 875mg

for a

frozen Sargents Aussie Angus Beef Family Pie (1/4 of pie) 530mg (a slightly smaller serving)

ȋ Ȍ steamed rice.

Most companies make their nutrition information available online and they should also have the printouts available Ǧ ǯ menu board.

Some of the main foods which make takeaways salty are the processed meats, sauces, yellow cheese and added salt on deep fried foods. Some less salty choices are:

Ȉ Thai: salads and wok fried dishes ȋ Ȍ Ȉ Japanese: grilled meats and vegetables Ȉ Vietnamese: rice paper rolls, noodle ȋ Ȍ

Ȉ Fish & chip shop: no sauces and no Ǥ Ƥ steak sandwiches are a good option.

Again, watch the sauce and ask for no cheese. Ȉ Pizza: avoid olives, anchovies and processed meats. Mozzarella cheese has far less salt than yellow cheeses. Ȉ ǣ Ƥ ǡ Ǥ Ǧ

Ǧ

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BULK OUT YOUR MEALS WITH FILLING AND NUTRITIOUS LOW SODIUM FOODS Plain rice pouches from SunRice, Tilda and Coles brand are low in sodium. Tilda also has varieties with pulses, other grains ƪ are higher in sodium so check before buying.

No Added Salt beans are also a great option. Lentils will blend in with many foods such as pastas, curries and stews. ƪ ǡ Ƥ and protein and are very nutritious and Ƥ Ǥ Frozen veggies, especially starchy peas Ƥ adding more sodium or learn how to cook fresh veggies in the microwave. Most microwave vegetable steamers you can buy in the supermarket will come with instructions.

Try other types of vegetable such as vacuum packed cooked beetroot, bags of spinach, tinned baby potatoes and tinned buttered mushrooms.

There are also some varieties of grain and vegetable mixes in the freezer section now.

Ƥ

ǡ

LEARN TO PREPARE SOME SIMPLE MEALS Learning to cook some simple meals will give you some more low sodium options.

We have included four recipes for you to try in the centre of this booklet.

CONCLUSION We hope this resource has provided you with some ideas for managing your sodium intake no matter what your level of skill or interest in cooking is.

If you feel that you aren’t up to tackling this by yourself, get some help. As we mentioned at the beginning of this booklet a dietitian should be able to help you create a meal plan that is satisfying and enjoyable for you while meeting your sodium intake and other nutrition needs.

Remember — any eating plan is only a Ǩ your nurse or doctor about a referral and it may be subsidised as part of a care plan.

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RECIPES

RESOURCES

Here are a few sites to get you started with your search for low sodium recipes.

Not all of the recipes at these sites are Ž‘™nj•‘†‹—�ǥ •‘ „‡ •—”‡ –‘ …Š‡…�Ǥ

A list of low salt foods available in Australian supermarkets wwwǤƤÂ?†Ž‘™•ƒŽ–ˆ‘‘†Ǥ‹Â?ˆo

‹ƒ„‡–‹… ‹˜‹Â?‰ Magazine www.diabeticlivingonline.com/diabeticÇŚ ”‡…‹’‡•ȀŽ‘™nj•‘†‹—Â?

ƒ– ˆ‘” Â‡ÂƒÂŽÂ–ÂŠÇŁ Š‘Â?‡ ‘ˆ –Š‡ —•–”ƒŽ‹ƒÂ?

Dietary Guideline www.eatforhealth.gov.au Salt Matters: Australia and New Zealand.

Â?ˆ‘”Â?ƒ–‹‘Â? ‘Â? ÂŽÂ‘Â™ÇŚÂ•ÂƒÂŽÂ– ‡ƒ–‹Â?‰Ǥ www.smanz.info

—•–”ƒŽ‹ƒ ‡ƒŽ–Š› ‘‘† —‹†‡: a …‘Â?Â?‡”…‹ƒŽ Â?ƒ‰ƒœ‹Â?‡ǥ Â?‘– –Š‡ Â‘ĆĽÂ…Â‹ÂƒÂŽ government guidelines wwwǤŠ‡ƒŽ–Š›ˆ‘‘†‰—‹†‡Ǥ…‘Â?Ç¤ÂƒÂ—Č€ÂŠÂ‡ÂƒÂŽÂ–ÂŠÇŚ ‹Â?ˆ‘”Â?ƒ–‹‘Â?ȀŽ‘™nj•‘†‹—Â?

ÇŁ ‘ ƒ††‡† •ƒŽ– †‹‡–ǣ wwwÇ¤Â‰Â‡Â•ÂƒÇ¤Â‘Â”Â‰Ç¤ÂƒÂ—Č€Â”Â‡Â•Â‘Â—Â”Â…Â‡Â•Č€Â’ÂƒÂ–Â‹Â‡Â?–•ȀÂ?‘nj ÂƒÂ†Â†Â‡Â†ÇŚÂ•ÂƒÂŽtnj†‹‡–

All Recipes Website www.allrecipes.com/recipes/Í™Í&#x;Í Í Č€ ÂŠÂ‡ÂƒÂŽÂ–ÂŠÂ›ÇŚÂ”Â‡Â…Â‹Â’Â‡Â•Č€ÂŽÂ‘Â™ÇŚÂ•Â‘Â†Â‹Â—Â?Č€

No added salt weekly meal plan example Š‡’ƒ–‹–‹••ƒǤƒ•Â?Ç¤ÂƒÂ—Č€Â„ÂŽÂ‘Â‰Č€Â‡ÂƒÂ–Â‹Â?‰njŽ‘™nj •‘†‹—Â?ÇŚÂ’ÂƒÂ”tnj‘Â?‡nj–Š‡njÂ?Â‘ÇŚÂƒÂ†Â†Â‡Â†ÇŚÂ•ÂƒÂŽtnj†‹‡–

‘™nj ‘†‹—Â? ‘—”Â?‡– lowsodiumgourmet.com Mayo Clinic Low Sodium Recipes www.mayoclinic.org/healthylifestyle/ ”‡…‹’‡•ȀŽ‘™nj•‘†‹—Â?ÇŚÂ”Â‡Â…Â‹Â’Â‡Â•Č€Â”Â…Â•ÇŚÍšÍ˜Í˜Í&#x;Í&#x;͙ͥÍ&#x; Glycemic Index Recipes ™™™Ǥ‰‹•›Â?„‘ŽǤ…‘Â?Ȁ”‡…‹’‡•njÂ?Â‡ÂƒÂŽÇŚÂ’ÂŽÂƒÂ?• Nutrition Sleuth www.everydayhealth.com/columns/ Œ‘ŠƒÂ?Â?ƒŠ•ƒÂ?‹Â?Â—Â”ÂƒÇŚÂ?—–”‹–‹‘Â?ÇŚÂ•ÂŽÂ‡Â—Â–ÂŠČ€Â•ÂŽÂƒÂ•ÂŠÇŚ Â–ÂŠÂ‡ÇŚÂ•ÂƒÂŽÂ–ÇŚÂ‹Â?ÇŚ Â›Â‘Â—Â”ÂˆÂƒÂ˜Â‘Â”Â‹Â–Â‡ÇŚÂ•ÂƒÂ?†™‹…Š Taste.com.au wwwǤ–ƒ•–‡Ǥ…‘Â?Ç¤ÂƒÂ—Č€Â•Â‡ÂƒÂ”Â…ÂŠÇŚ recipes/?q=low+sodium British Heart Foundation Recipe Search www.bhfǤ‘”‰Ǥ—Â?Č€ÂŠÂ‡ÂƒÂ”Â–ÇŚÂ?ÂƒÂ–Â–Â‡Â”Â•Č€ Š‡ƒŽ–Š›‡ƒ–‹Â?‰nj–‘‘ŽÂ?‹–Ȁ”‡…‹’‡njƤÂ?†‡” Diabetic Recipes www.diabeticlivingonline.com/diabeticÇŚ recipes The No Salt Spot www.thenosaltspot.com/lowsodiumrecipes 20

TRACKING YOUR DAILY SODIUM INTAKE

LOW SALT EATING ON SPECIAL OCCASIONS

Ǥ Ǥ Ȁ Ȁ Ǧ rǦ Ǧ tǦ Ǧ Ǧ

Ȉ Weekly Sodium Tracker Ȉ Favourite Foods Sodium Values Recorder Ƥ booklets in pdf format in this blog post: Ǥ Ǥ Ȁ Ȁ Ǧ Ǧ Ǧ tǦ Ǧ Ǧ rǦ Ǧ sodium, or call us ͙͘͠​͘ ͛͜͟ ͚​͚​͚ we’ll send you printed copies.

CalorieKing.com.au

MyFitnessPal.com

Ȉ ȋ packaged foods under Australian law) Ȉ ǯ Ȉ CalorieKing.com.au has an extensive database of Australian food.You do not need an account to search the database.

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NOTES

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1800 437 222 3 Hackney Rd Hackney SA 5069 www.hepatitissa.asn.au

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