Synopsis
Putting down the saltshaker is just the first step....
Experts agree that a low-sodium diet can decrease the risk of heart disease, migraines, diabetes, and osteoporosis.
But to significantly reduce the salt in your diet, you must learn how to spot the hidden sodium in frozen foods, canned goods, and popular recipes.
Fully revised and updated using the latest medical research, Cooking Without a Grain of Salt is a nutrition guide and cookbook all in one. It's filled with useful tips on how to limit sodium without sacrificing flavor--as well as savory recipes that will help you put your healthy, low-salt lifestyle into action.
From Stuffed Mushrooms and Double Corn Biscuits to Pork Medallions in Pesto, Grilled Tuna with Salsa, and Pasta Primavera, Cooking Without a Grain of Salt lets you enjoy all the dishes you love while forming healthy eating habits for years to come..
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The Role Of Sodium: Nutritional Background
Sodium is a mineral basic and necessary to animal and plant life, and salt (sodium chloride) has been used as a seasoning since ancient times. But medical consensus tells us that excess sodium can cause us all eventual harm. The kidneys are the organs that control the level of salt in our bodies. If there is too much salt, healthy kidneys excrete it into our urine. When kidneys are faulty, or if too much salt enters the system, the excess salt stays in the bloodstream, absorbing water to keep it dissolved. That excess liquid in the confined space of our circulatory system causes swelling that puts dangerous hydraulic pressure on the walls of blood vessels and leaves us at risk for strokes and heart attacks. If arteries are clogged with fat, that risk is compounded.
But we can lessen the risk of such damage by maintaining adequate potassium in our diet. A healthy body needs more potassium than sodium in order to ensure the efficient workings of its cells. These minerals work cooperatively to activate the intake of nutrients and the excretion of wastes on the cellular level in a process governed by the sodium-potassium pump, a kind of engine that drives cell activity. To maintain the essential high-potassium ratio, known as the "K factor," people must eat fresh fruits and vegetables. The National Academy of Science recommends between 1,600 and 2,000 milligrams of potassium a day. Foods particularly high in potassium include dried apricots, bananas, potatoes (especially sweet potatoes), dried beans and peas, meat, peanut butter, and orange juice.
For additional information, read The K Factor by Richard D. Moore and George D. Webb (Macmillan, 1986).
Primitive societies lived close to their plant and animal food, did not salt food as a matter of course as we do, and ate much of it uncooked. Potassium was plentiful in this natural diet. Sodium wasn't. Thus humans were genetically programmed millennia ago to excrete potassium and retain sodium. There is even a particular place at the edge of the tongue that detects saltiness in foods. As civilizations developed and some groups moved away from their food source, salt became the indispensable preserving ingredient so that food could both travel and keep. So honored was the role of salt that it entered the language both as a measure of value and an index of excellence. Hence we are paid a salary; good folk are the salt of the earth.2
It is interesting to note just how effective a preserving agent salt became in ancient Egypt. Mummification depended on salt! When the Nile receded from its yearly floods, it left behind pockets of a substance the Egyptians called natron, a sodium-based chemical essential to the technology of preserving mummies.
As people discovered that salt could preserve foods for long periods, they also discovered that they liked the taste it gave to food. As salt came into common use, the proportion of sodium to potassium in human diets reversed, with sodium gaining dominance. The effect of sodium dominance on whole societies has been dramatic and destructive. Hypertension, once unknown in cultures that traditionally followed low-sodium diets, now affects tens of millions as those societies adapt to the high-sodium diet of "commerce" or "civilization." As much as 95 percent of the sodium we eat is put in our foods by someone else, most typically in the processed foods that are, unfortunately, a staple of the American diet. It is by informing ourselves of the sodium content of the foods we buy that we most usefully exercise our salt vigilance.
Medical demographers estimate that around 15 percent of the general population is particularly sensitive to the adverse effects of salt. That works out to be roughly 40 million people. At least 50 percent of those with hypertension risk harm by maintaining a high-sodium diet. Several other conditions are also commonly treated by salt-free diets. These include congestive heart failure, diabetes, migraines, and premenstrual tension. Women after menopause are encouraged to reduce salt because studies show that sodium contributes to the loss of calcium, which is needed to prevent osteoporosis. Current research has determined that certain forms of cancer are related to high-sodium levels. Many cancer therapies, in fact, involve eliminating salt intake. Certain kinds of stress have been shown both to be sodium-caused and to increase desire for salt; lowering salt intake lowers stress levels.
Thirty years ago there was a sharp distinction between those for whom it was medically necessary to limit salt intake and those who had no need to do so. Today we know better: most of us would be healthier if we used less salt.
We conclude this nutritional note with a statement of two convictions. The first is that sodium has invaded our culture in a highly dangerous way, because it is all too often silently present and frequently unsuspected. Sometimes we can't taste it even when it is there in startlingly high concentrations--in milkshakes, for instance, which contain nearly 300 milligrams of sodium. The use of sodium in preparing fast foods, most baked goods, and most canned and frozen foods, is common and under-recognized. The current federal truth-in-packaging guidelines make it increasingly easier for consumers to learn the exact ingredients of what they buy and eat. On the other hand, as the nutritionist Dodie Anderson has said, "You won't have to bother reading labels because the foods I want you to eat don't have labels."
Our second conviction is that an addiction to salt, because it is an acquired taste or acquired craving, can be unlearned. (Babies are born with no interest in salty foods and breast milk is very low in sodium.) Because the taste for salt is a habit, developed both by cultures and by individuals, it can be changed and replaced by a taste for flavors and textures and smells much better for our health. In just a matter of weeks you'll lose the desire for salt and become newly sensitive to the array of seasonings that await you.
Work with Your Doctor
The simplest way to monitor your sodium susceptibility is to ask your doctor to test your sodium blood level. A reading of between 137 and 144 indicates you should maintain a moderate salt intake of about 2,000 milligrams a day. If your reading is over 144, it indicates an unhealthy salt retention in your tissues, and your doctor will probably urge you to identify and cut sharply the sources of salt in your diet. A sodium blood level under 137 means you may need to slightly increase your sodium intake.
Get the Salt Out by Ann Louise Gittleman, M.S., C.N.S. Crown Publishers (New York, 1996), p. 24.
In our parents' case, the doctor placed Ted on a low-sodium diet and he followed it, with Elma's help. Thirty years ago, before more sophisticated medications, doctors treated hypertension with diet. It is still the preferred method, but, probably because of the less arduous alternatives, many doctors find that it is too difficult to get people to comply. There are countless approaches to the curing of illness in the medical profession. Some doctors rely primarily on medication; others look first at dietary changes, along with weight loss and exercise. Many suggest a combination, believing that a low-sodium diet contributes to the effectiveness of medication. Make sure you and your doctor are of a mind. Because you have this book in your hands you are embracing a nutritional approach, but you also will need the advice and encouragement of your doctor as you set out.
The original recipes in Cooking Without a Grain of Salt were created so that they might be used for a sodium-restricted diet of 500 milligrams per day (in 24 hours). Most people need not follow such a limited low-sodium diet. But if you must, there is a range of recipes from which you may select your menu. To ensure well-balanced meals, careful planning will be needed for 500 milligrams. But if your sodium restriction is under 500 milligrams, very careful planning must be employed. You and your doctor should be certain you are receiving adequate nutrition, especially for the recommended amount of calcium, perhaps in the form of a supplement. (An 8-ounce cup of milk contains between 120 and 125 milligrams of sodium. One glass would then limit you to 375 milligrams of sodium for the rest of the day.)
If your diet permits more than 500 milligrams per day, the recipes in this book are adaptable. Many doctors restrict all added salt, rather than prescribing a specific milligram limit. Your doctor may allow light salting in the cooking or in the preparation of food. If the food was prepared without salt, a limited amount may be permitted at the table. But keep in mind that there are 570 milligrams of sodium in 1/4 teaspoon of salt, about 2,300 in a teaspoon. It will take discipline and ingenuity to stay safely within your limit.
If there are foods on the permitted lists or ingredients in these recipes that your doctor forbids, follow those orders and do not use those foods. On the other hand, as you gain understanding of the principles of salt-free cooking, you will take responsibility for how it applies to you and allow yourself occasional foods on the off-limits list as you learn to balance and combine ingredients during a single day.
Your doctor will explain your individual dietary needs. But the only way any doctor can truly assist and benefit your health is for you to fully participate in the process. Take to heart the instructions your doctor lays out for you. Make sure the instructions make sense. Ask questions. Read and learn on your own. Work and live within the dietary guidelines and understand that in following them with determination you are creating your own health.
Our susceptibility to sodium's harmful effects tends to increase with age. If we learn to limit our intake early in life, we reduce our risk of sodium-induced diseases later on.
Starting To Cook Without Salt
1. Go slowly.
Habits of eating are developed over many years. Change will take time. You, your body, and your mind need to become accustomed to a new way of eating. Concentrate on one area at a time--main courses or lunches--and then move on to another area--salads or vegetables.
2. Treat food shopping as a vital, active exploration.
Seek freshness and variety. Buy at least one new item every week. So often we tend to fill our shopping basket with the same ingredients, following a fixed, safe path through the supermarket. Something different can make us nervous, but active exploration is one of the joys of cooking. Foods from around the globe are now in our supermarkets. Take one home. Remember to concentrate on the outside aisles, where most of the unprocessed food is stocked.
3. Appeal to the senses.
A grain of salt is nearly invisible, has no smell, and very little texture. Think of putting ingredients on an imaginary palette, then draw on their variety to involve every sense. Think about aroma, color, texture, crunch, and taste.
4. Put food into a wider context.
Candlelight, flowers, music, fine linens, firelight, and conversation enhance the eating experience.
5. Keep your ingredients tidy.
Napoleon said, "Order is progress." If you always know what you have on hand, you can be much more daring and versatile. Organization gives you security.
6. Experiment and play with food.
Teachers who use hands-on materials to teach their students generally give them the opportunity to explore first, free of instruction. The same applies to cooking. What if you've never used chili peppers? Buy one. Put on some rubber gloves or put your hands inside a plastic bag (hot peppers can sting your hands and eyes), slice it in half, take out the seeds, cut it up. Maybe cook it. Use it in a recipe another day.
7. Cook with a friend.
Find someone whose healthful cooking you admire. Arrange to cook together. You will be amazed at how much you learn just by watching someone else use ingredients that are unfamiliar to you.
8. Decorate with food.
Capture the eye with a garnish. If food looks pretty, you've attracted your eater. Think not only of what to use but how to present it. Here are some ideas:
grate apples, lemons, oranges, limes, carrots, and zucchini
cut citrus triangles or half circles, sprinkle with mint or parsley
snip 5-inch lengths of herbs, such as thyme, rosemary, chives, oregano, cilantro, tarragon, lavender, dill, and fennel--wrap in bundles
use leaves either under or over a dish, such as edibles: mint, basil, arugula, spinach, celery, and kale; or inedibles: maple, gingko, raspberry, blueberry, oak
grind nuts
arrange flowers, with or without stem, such as buttercup, nasturtium, marigold, violet, or bachelor's button on the tablecloth or around the food
slice disks of radish, cucumber, kiwi, bananas, or grapes
make patterns of combinations
use whole raspberries, blueberries, cherry tomatoes, strawberries, sunflower seeds, corn kernels in groups of three
9. Experiment and fail--then keep learning.
Failure generally teaches us to be good at something.
Poultry and Game
Chicken really benefits from flavors imparted before the cooking process begins--so many of the recipes that follow feature marinades. Experiment with herbs and spices you add to the liquid. We suggest a few combinations: crumbled rosemary, marjoram, and sage; cumin, ginger, and turmeric; tarragon, dill, and thyme; oregano, basil, and cayenne pepper. The Condiments and Sauces section offers additional marinade recipes, basting sauces, and herb butters.
Try rubbing combinations of dried herbs and spices directly into the meat several hours before cooking--these "rubs" infuse the dish with a rich, but subtle taste. Add a squeeze of lemon juice and an extra sprinkle of fresh herbs right before serving to keep the flavors at their fullest.
Please note that all nutritional information refers to 1 serving size.
Roast Chicken
1 4-lb. roasting chicken
3 tablespoons unsalted butter
1 teaspoon dried tarragon
1 tablespoon lemon juice
Piece of lemon peel
Have chicken at room temperature. Rub chicken with 2 tablespoons of the butter, tarragon, and lemon juice. Place 1 tablespoon of butter and lemon peel inside the chicken. Roast chicken uncovered in oven at 300 degrees until tender, basting often. Chicken requires 30 to 35 minutes per pound. Instead of lemon peel and butter, a piece of low-sodium bread fried in unsalted butter and rubbed with garlic may be substituted. Serves 6.
Variation: Put a green pepper or onion in the cavity of the chicken before roasting.
Calories. . . 219
Protein. . . 25 g.
Fat. . . 12 g.
Carbohydrate. . . tr
Saturated Fat. . . 5 g.
Sodium. . . 61 mg.
Cholesterol. . . 88 mg.
Potassium. . . 213 mg.
Broiled Chicken
1 2-lb. broiler, quartered
1 clove garlic
Pepper to taste
1/2 teaspoon tarragon, thyme, or rosemary
1 cup hot water
2 tablespoons unsalted butter
Rub chicken with garlic. Brown quickly on both sides under hot broiler. Place chicken in baking dish and season with pepper and tarragon. Bake in 350-degree oven and baste with hot water and butter until tender. Serves 4.
Calories. . . 220
Protein. . . 26 g.
Fat. . . 12 g.
Carbohydrate. . . 1 g.
Saturated Fat. . . 5 g.
Sodium. . . 63 mg.
Cholesterol. . . 88 mg.
Potassium. . . 220 mg.
Chicken with Almond Rice
2 whole chicken breasts
6 tablespoons olive oil
2 tablespoons minced onion
8 mushrooms, sliced
1 tablespoon lemon juice
11/2 cups low-sodium chicken-flavored broth
Pepper to taste
3/4 cup uncooked rice
1/3 cup slivered blanched unsalted almonds
Preheat the oven to 300 degrees. Brown chicken breasts in oil. Remove and drain on paper towels. Sauté onion in oil remaining in pan. Add mushrooms and lemon juice and sauté 3 minutes longer. Add chicken-bouillon mixture, pepper, and rice. Bring to a boil and simmer 3 minutes more. Stir in almonds. Place rice mixture in oiled casserole. Top with chicken. Cover and bake 45 minutes. Serves 4.
Calories. . . 545
Protein. . . 31 g.
Fat. . . 32 g.
Carbohydrate. . . 33 g.
Saturated Fat. . . 5 g.
Sodium. . . 66 mg.
Cholesterol. . . 74 mg.
Potassium. . . 640 mg.
Herb Chicken
1 chicken, 3 to 3 1/2 lbs., cut in pieces
1 teaspoon marjoram
1 teaspoon thyme
1 tablespoon chopped parsley
Freshly ground black pepper
4 tablespoons unsalted butter
Wash and dry chicken. Place in greased low baking dish, and sprinkle with marjoram and thyme. Let stand 1 hour. Sprinkle with parsley and pepper. Dot with butter. Bake in 400-degree oven for 35 to 45 minutes or until tender. Breast meat has less sodium. For company, heat pineapple chunks and place under chicken. Serves 4.
Herb chicken/breast:
Calories. . . 271
Protein. . . 26 g.
Fat. . . 18 g.
Carbohydrate. . . 1 g.
Saturated Fat. . . 9 g.
Sodium. . . 62 mg.
Cholesterol. . . 103 mg.
Potassium. . . 222 mg.
Herb chicken/leg:
Calories. . . 301
Protein. . . 22 g.
Fat. . . 23 g.
Carbohydrate. . . 1 g.
Saturated Fat. . . 10 g.
Sodium. . . 76 mg.
Cholesterol. . . 110 mg.
Potassium. . . 205 mg.
Chicken Cacciatore
3 whole chicken breasts, split
1/4 cup olive oil
1 onion, chopped fine
2 tablespoons chopped green pepper
1/2 cup dry white wine
1 bay leaf
1/4 teaspoon rosemary
1/4 teaspoon basil
4 fresh tomatoes cut in small pieces or 2 cups canned low-sodium tomatoes
1 clove garlic, minced
Pepper to taste
Sauté chicken in olive oil for about 20 minutes or until brown. Remove to platter. Cook onion and green pepper until transparent. Stir in wine, add remaining ingredients, and cook for about 15 minutes or until tender. Serves 6.
Calories. . . 286
Protein. . . 26 g.
Fat. . . 16 g.
Carbohydrate. . . 6 g.
Saturated Fat. . . 3 g.
Sodium. . . 72 mg.
Cholesterol. . . 72 mg.
Potassium. . . 441 mg.
Chicken Marengo
Marengo is the name of a village in Italy where Napoleon defeated the Austrians on June 14, 1800. Maybe this recipe explains why Napoleon said, "An army marches on its stomach."
1 4-lb. frying chicken cut up in serving pieces
4 tablespoons olive oil or vegetable oil
2 tablespoons flour
1/2 cup water
1/2 cup dry white wine
1 garlic clove, minced
Small bay leaf
1/4 teaspoon thyme
2 tablespoons chopped parsley
1 tablespoon canned low-sodium tomato paste (or fresh tomatoes may be used)
8 large mushrooms
Pepper to taste
Sauté chicken in oil in deep pan. Turn frequently so it is golden brown and crisp. Remove chicken. Stir flour in drippings. Add water and wine, and blend well. Add garlic, herbs, tomato paste, and mushrooms. Season with pepper. Replace chicken in sauce, cover pan, and simmer 1 hour.
In place of wine, water, and tomato paste, 2 cups of canned low-sodium tomatoes may be used. Serves 6.
Calories. . . 280
Protein. . . 26 g.
Fat. . . 16 g.
Carbohydrate. . . 4 g.
Saturated Fat. . . 3 g.
Sodium. . . 65 mg.
Cholesterol. . . 72 mg.
Potassium. . . 351 mg.
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