Lowering Blood Pressure By Reducing Sodium

Supermarkets have some low-sodium foods available, and more are appearing all the time. You can help increase these foods by voting with money every time you purchase them because money counts to the manufacturer and the supermarket owner.

Low-sodium salad dressings are an outstanding example of food technology capabilities. For example, most brands of Russian or Thousand Island salad dressings provide about 125 to 130 milligrams of sodium per tablespoon (and who only uses a tablespoon?) and very little potassium, so their K-factor is nil.

In contrast, low-sodium (and usually low-calorie) salad dressings contain only 2 milligrams sodium and 32 of potassium, giving them a K-factor of 16. Salads are already naturally high in potassium and low in sodium.

By using one of these salad dressings, you make the salad still better and improve the flavor. Other low-sodium foods, especially prepared foods like soup, seem bland because we are accustomed to more salt, but they can be spiced up.

For example, a single drop of Tabasco adds only 2.5 milligrams of salt (an insignificant amount), and six drops can make a low-sodium soup taste much better, at a cost of only 15 milligrams of sodium.

Or try adding a tablespoon or less of horseradish. Horseradish adds 17 milligrams of sodium and 52 milligrams of potassium, improves the K-factor, and adds a modest amount of texture.

Salt Substitutes

In general, the best salt substitutes are not made from potassium chloride. Remember, sodium retention is really salt retention. If you get sodium from one source and chloride from another, the nephrons in your kidneys can’t distinguish them; they sense only sodium chloride, or salt.

Therefore, you must read the label carefully and select products made from other potassium salts. Potassium gluconate and potassium bitartrate are the most common. Salt substitutes can improve a meal with their potassium content.

There are times when they serve as more than a flavor enhancer in cooking and are necessary to the recipe, such as in low-sodium bread. In addition, other people eating with you will appreciate the flavor they add to the food.

Salt substitutes are excellent for those occasions but should be used only when necessary. Salt substitutes are good for cooking but not essential, and they can lead to over-consumption of potassium.

While 5,000 to 10,000 milligrams (5 to 10 grams) of potassium should be fine, it is possible through excessive use of salt substitutes to exceed that level. More than 10 grams of potassium is excessive, so use salt substitutes cautiously and emphasize spices and herbs instead.

The best salt substitutes are not substitutes at all; they are seasonings made from herbs and spices. Two excellent ones can be found on your supermarket’s condiment shelf: Vegit All Purpose Seasoning and Mrs. Dash All Natural Seasoning.

Sauces and Graves

Most commercial sauces and gravies are not acceptable on this dietary plan. They are prepared with far too much salt, and there is no room for compromise. There are some available that provide taste without salt, but you must search them out.

Nature can solve your taste problem with garlic, onions, shallots, spices, and other herbs. For example, a little garlic sautéed in olive oil on a barbecued or broiled steak, hamburgers, fish, or poultry is an excellent seasoning.

Try grated ginger over fish, poultry, and salads or sautéed with other foods to accomplish the same objective—good taste and good health.

Food: Do's and Don'ts

Serving size is usually expressed as 3.5 ounces (100 grams) or as a single piece of fruit or other convenient serving.

Cooked Cereals

  • Do’s - Cooked cereals are excellent if no salt is added in their preparation. Instant cooked cereals (add hot water) are often unacceptable because salt is used in the processing.

Milk is not included in these servings; it is tabulated separately. Each cup of milk or soy beverage adds 120 milligrams sodium and 375 milligrams potassium.

  • Don’ts - Following the recipe on the box and adding salt destroys cooked cereal for this plan. These cereals taste excellent without added salt. If your taste buds crave salt, add six drops of Tabasco per serving.

I know it sounds strange in cereal, but the taste is fine, and six drops adds only 15 milligrams. As another alternative, don’t use milk; try your cereal with canned apricot nectar. It tastes great, reduces sodium, and elevates potassium even more.

Ready-to-Eat Cereals

  • Do’s - Milk is not included in these servings; it is tabulated separately. A cup of milk usually adds 120 milligrams sodium and 375 milligrams potassium to each serving. See milk tabulation where low sodium is expressed, however.
  • Occasionally - These cereals are borderline because, though they are moderate in sodium, they are not high in potassium. Consequently, they have a poor K-factor.

The addition of milk elevates the sodium content very close to the 200-milligram cutoff even though the K-factor is acceptable. Therefore, use them only occasionally and remember to eat other low-sodium, high-potassium foods in compensation.

  • Don’ts - Most ready-to-eat cereals cannot be used on this plan. I have identified those that can be served. Those that have sodium on the nutritional label should be avoided.

Milk for Cereals and Beverages

  • Do’s - All milk, whether canned, dry, condensed, or whole, are do’s for beverages or for cereals. The sodium in milk is not in the form of sodium chloride (salt), and although it is higher than desirable, it is acceptable. Low-sodium milk is available. I strongly recommend avoiding high-fat milk and using the low-fat varieties.

Beverage Mixes for Milk

Milk mixes are fine, but be sure to add the sodium and potassium from the milk to the total figures. Chocolate powder, a common mix for milk, contains, on average, 54 milligrams sodium and 168 milligrams potassium for a K-factor of 3.


  • Do’s - In general, eggs are acceptable because the sodium is not in the form of sodium chloride and their protein quality is excellent.
  • Don’ts - Though eggs are acceptable on this eating plan, the method of preparation can cause trouble. If you fry, don’t add salt to the oil. Omelets should be made with a few drops of Tabasco or horseradish in place of salt. They should always be vegetarian, with ingredients such as onions, mushrooms, and tomatoes.


  • Do’s - Oroweat bread is the most readily available low-sodium bread. Two slices of this bread contain only 10 milligrams of sodium. Available in the frozen section, it thaws quickly and can be used for toast or for sandwiches. Its sodium content is insignificant.
  • Don’ts - Breads and baked goods account for much of the hidden 5 to 10 grams of salt that Americans consume daily. If you like sandwiches and want to beat high blood pressure, you must learn to like Oroweat or other low-sodium bread. Not all grocers carry Oroweat bread, but other brands are available; usually in the frozen section. Be sure to ask.


  • Do’s - Fruit toppings for cereals and fruit as an accompaniment to any meal, especially breakfast, is excellent. Fruit is not only acceptable, it is highly recommended.

You can’t eat too much fruit, nor can you eat too many varieties. Note that in the table I have tabulated the average value; please be aware that sizes vary, as well as varieties of fruit.

Fruit Juices

  • Do’s - Fruit juices, like fruit, are generally low in sodium and rich in potassium. They can be used to offset a meal component that is not rich in potassium but is low in sodium.

For example, a poached egg on Oroweat toast and a glass of apple juice are balanced in sodium and potassium, even though the egg itself is not. Except where noted, serving size is 8 ounces.

  • Don’ts - Any fresh fruit and fresh fruit juice is excellent on this plan. Therefore, the only don’ts are sugary processed juice drinks that contain only a small amount of real juice. Fruit is not canned or frozen with salt, so it is usually fine; similarly for fruit juice. You can’t use too much of either category.


Most non-organ meats are fine. Chapter 8 will help you reduce the fat content and consequently your caloric intake. I have included the percentage of calories from fat for beef, pork, and white meat and broken it into low-, medium-, and high-fat selections, listing the high-fat meat for occasional consumption.

Low-fat meat, in general, is excellent on this diet. It is low in sodium, rich in potassium, and if lean cuts are selected with excess fat trimmed, its caloric content is fine. How meat is prepared, including poultry, is important.

In general, poultry is excellent for any dietary program. If it is roasted, broiled, or barbecued without skin, or the skin is removed after cooking, it is low in fat and excellent in sodium and potassium.

But even poultry can be high in fat if not selected correctly. Meat should always be broiled or barbecued without sauces or salt. Condiments, such as garlic, onions, shallots, ginger, and other herbs and spices, add flavor and zest to meat without increasing either its fat or sodium content.

In the meat section of the table, serving size is the standard 3.5 ounces.

  • Do’s - In general, low-fat cuts of meat provide less than 25 percent of their calories as fat. Medium-fat cuts provide 26 to 40 percent of their calories as fat. Both low- and medium-fat cuts are acceptable on a weight-controlled diet.
  • Occasionally - These cuts of meat are fine for control of high blood pressure, but because of their high fat content, they are recommended only occasionally and never on a weight-loss diet. Over 40 percent of their calories are derived from fat.

Organ meats, listed on page 54, are usually excessive in fat, but I have selected a few that are moderate in fat. Some organ meats are so high in sodium that, even though it is not always sodium chloride, it is often excessive for our purposes.

  • Don’ts - Virtually no processed meats can be eaten by people following this plan to control high blood pressure. Processed meat, whether beef, veal, lamb, or chicken and turkey ersatz meats, such as turkey pastrami, bologna, and franks, is simply unacceptable. Since these foods are unacceptable, I have not included sodium, potassium, or the K-factor ratio.

Beef to Avoid

  • Beef burgundy
  • Breakfast strips
  • Corned beef
  • Frozen meatloaf
  • Frozen or canned chipped beef (several brands)
  • Frozen or canned salisbury steak
  • Frozen or canned sliced beef

Pork to Avoid

  • Bacon bits
  • Canadian bacon
  • Cured bacon
  • Cured ham
  • Ham loaf
  • Ham steaks
  • Sausages (including bockwurst, blood, bratwurst, Polish luncheon, smoked, and turkey)
  • Sweet and sour pork

Veal to Avoid

  • Frozen veal parmigiana

Luncheon Meats, Franks, and Spreads to Avoid

  • Barbecue loaf
  • Bologna of all types
  • Corned beef loaf
  • Frankfurter
  • Loaves (olive, mother’s, pepper, pickle, picnic)
  • Mortadella
  • Salami of all types
  • Sandwich spreads
  • Turkey ham, turkey loaf, pastrami
  • Vienna sausage
  • Seafood


  • Do’s - In general, fish contain fat that is polyunsaturated, and many fish are low in fat. There is a sodium concern, however, because many fish contain over 75 milligrams in a normal serving.

Although this is a caution, it is minor, since the sodium is usually not in the form of sodium chloride (salt). Therefore, select fish at least two or three times weekly, and use shellfish in moderation. Fish is best when baked, broiled, or poached.

If you fry it, do so without added salt and in olive oil. For zest and flavor, use ground ginger, bay seasoning, and other spices and onions, garlic, and shallots. A few drops of Tabasco are excellent.

  • Occasionally - Shellfish must be eaten with caution in this dietary program. Although low in fat, it is often high in sodium. Exceptions are soft clams and oysters.

One serving of shellfish can use up 25 percent of the daily allowance of 800 milligrams of sodium; therefore, menu planning is absolutely critical when these fish are used.

  • Don’ts - Don’t use processed, breaded, or batter-dipped fish, especially fish fillets. This list does not include sodium and potassium content because these foods are too high in sodium to be acceptable under any circumstances.

Low-sodium processed fish is available, however, which is acceptable on this dietary plan.

  • Crab cakes, deviled crab, or crab imperial
  • Crab, canned
  • Fillet almondine
  • Fish fillets or other pieces, breaded and seasoned
  • Fish, canned or packed in brine, unless specified as low sodium
  • Fish sticks, breaded and frozen
  • Lobster Newburg
  • Lobster paste
  • Oysters, clams, or mussels, canned or frozen
  • Sardines in any sauce
  • Shrimp, breaded, french fried, or as a paste

Vegetables and Legumes

  • Do’s - Fresh and frozen vegetables are excellent for this dietary plan. They are naturally high in potassium and low in sodium. Do not use frozen mixed vegetables, however, unless they are on the do list of prepared mixed frozen vegetables.

And, never, under any circumstances, use canned vegetables. Likewise, avoid canned beans and use dried. Soaking and cooking beans from scratch is time consuming but enables you to eliminate salt in their preparation.

Vegetables can be prepared in a variety of ways, ranging from boiling to frying in a wok with small amounts of oil. None of these methods will change their sodium-potassium content. However, when cooking vegetables or starches such as potatoes, rice, low sodium pasta, and so on, never add salt.


  • Do’s - The word snack is often synonymous with highly salted or sugary foods eaten between meals, such as chips, fries, and doughnuts. But snacks can be apples and vegetables, such as carrot sticks.

These foods, with their excellent potassium content, actually have a beneficial effect on high blood pressure. The table lists acceptable snacks if no salt is added.

  • Don’ts - All other processed snacks are unacceptable unless you can purchase snacks that have no sodium added or provide less than 25 milligrams sodium in a normal serving.


  • Do’s - An average adult (150 pounds) requires 64 ounces of water daily. Most is obtained from a variety of beverages ranging from coffee to beer.

However, people with high blood pressure should strive to drink six 8-ounce glasses of water daily. Make sure the water is low in sodium. Charged seltzer water into which gas is injected is fine. However, bottled soda water usually contains sodium.

  • Occasionally - Many carbonated beverages contain more than 75 milligrams of sodium, with insufficient potassium to redeem them. Therefore, they do not appear in the table. In contrast, some beverages do appear because their sodium content is low enough that their overall contribution is insignificant if used in moderation and if the diet is correct.


  • Do’s - Desserts are often an important part of the meal, and dairy products provide an excellent opportunity for eating pleasure without penalty.

Whenever possible, whether you’re eating ice cream or sherbet, top it with any fresh fruit. The fruit not only provides variety and eating pleasure but also contributes potassium without a sodium penalty.

Some puddings and gelatin desserts are borderline, but if served with fruit, or whipped topping, the sodium-potassium K-factor ratio is acceptable. Some, like gelatin desserts, are fine, especially when fruit is added to the mix or served as a topping.

Your store may carry another brand. If so, it probably has a composition similar to the ones shown here. A variety of dessert toppings are acceptable. For some people cream is essential in coffee, on fruit, or as a whipped cream topping on desserts.

The products listed in the table can effectively convert fruit from a low-sodium snack to a great dessert. You gain the low sodium and high potassium of fruit with the taste and texture of whipped cream.

  • Occasionally - I do not advocate the use of candy; it is something we can do with- out. However, it sometimes seems unavoidable. Remember our discussions about excessive insulin!

Salad Dressings and Condiments

  • Do’s - Low-sodium products are excellent for this plan. Other condiments such as Tabasco sauce can also be used to make plain, low-sodium food taste much better.
  • Don’ts - Mustard and Ketchup; Neither of these condiments is acceptable on this program. Learn to use other flavorings.


  • Do’s - Low-sodium soups generally taste bland and seem watery, but they can be made much better with the addition of four to six drops of Tabasco or a tablespoon of horseradish. Low-sodium onion soup, tomato, or cream of mushroom are all excellent if made more tasty as suggested.
  • Don’ts - Canned soups are unacceptable. Dry soups are even worse. For example, a serving of many of these soups provides over one gram of sodium, all in the form of sodium chloride.

I have not listed these products because they are simply too high in sodium and their potassium content is even worse. Do not be coerced by the statements “no salt added” or “homemade”; the sodium content is still excessive.

Spices, Herbs, and Flavorings

  • Do’s - For thousands of years, spices and herbs have been used to enhance the flavor of foods. Spices were also used to protect food from spoiling and to hide the taste of bad food. We are no longer faced with problems of contaminated or spoiled food.

We now use herbs, spices, and condiments strictly for pleasure. In this way they help us to eat foods without salt and rich in potassium. All amounts are one teaspoon.

In the amount of one teaspoon, the sodium content in most herbs and spices is trace or equivalent only to 1 milligram. Potassium is 20 to 30 milligrams, making the K-factor 20 to 30.

  • Don’ts - You cannot use flavored salts. These are mostly salt, flavored with other ingredients.


  • Do’s - Cooking Oils; Polyunsaturated fatty acids, such as sunflower and safflower oils, should not be used for frying or sautéing because heating these oils to high temperatures can often change the natural structure from one that is safe and healthful to one that several studies have implicated in cancer.

With both that and the need to prevent heart disease in mind, I have listed oils that I recommend in descending order of quality.

  • Olive oil
  • Peanut oil
  • Sesame oil
  • Shortening
  • Soft margarine
  • Butter

Oils for Dressing

For salad dressings or wherever oil is required in non-frying cooking, I recommend light oils, high in polyunsaturated fatty acid (PUFA). The following list presents preferred oils, in descending order of quality.

  • Safflower oil
  • Sunflower oil
  • Canola oil
  • Corn oil
  • Soybean oil
  • Olive oil
  • Peanut oil

Exotic Oils

Some gourmet stores provide oils from nuts that are especially rich in the omega-3 fatty acids that, in your body, produce eicosapen-taenoic acid (EPA), such as walnut oil and almond oil.

There are many low-sodium cookbooks and other books and resources available that provide food compositions listing sodium and potassium. In general, natural foods are fine so long as you don’t add salt during their preparation. Frozen foods with no salt in the ingredients list are also fine.