Low-sodium diet: how to cut salt without misery

By the DieticiansWorldwide.com editorial team · 17 October 2026 · Clinical nutrition

Why sodium, and why most of it is hidden

Sodium is an essential mineral. You need a little of it to keep fluids balanced and nerves and muscles working. The American Heart Association says the body needs less than 500 mg a day to function, "the amount in less than 1/4 teaspoon", and that healthy kidneys are good at holding on to what you need (American Heart Association).

The problem is the excess. The World Health Organization estimates the global mean adult intake was 4,278 mg of sodium a day in 2021, more than double its recommendation of less than 2,000 mg, and links too much sodium to an estimated 1.7 million deaths in 2023 (WHO, sodium reduction). The main harm is raised blood pressure, which increases the risk of stroke, heart attack and kidney disease.

What makes salt hard to cut is that you rarely see it. The US Food and Drug Administration says more than 70% of dietary sodium comes from packaged and prepared foods, not from salt added at the table or in cooking (FDA, sodium in your diet). In the UK, the NHS puts it at around three quarters, from foods such as bread, breakfast cereals, meat products and ready meals (NHS, salt in your diet). So a low-sodium diet is mostly a shopping and eating-out strategy, and only partly a cooking one.

If your goal is blood pressure, a low-sodium diet works best as part of an overall eating pattern. Our guide to the DASH diet covers the food-group plan and the trial evidence; this article focuses on the practical work of cutting salt and keeping it down.

How much sodium a day? The main guidelines

Different bodies set slightly different targets. Some use sodium, some use salt, and labels in different countries use one or the other, which is a common source of confusion.

The conversion is simple: WHO gives 1 g of salt as equal to 400 mg of sodium. To turn sodium into salt, multiply by 2.5. To turn salt into sodium, multiply by 0.4.

The American Heart Association guidance answers one of the most searched questions. It recommends no more than 2,300 mg a day and an optimal goal of no more than 1,500 mg for most adults, and says that for most people "cutting back by 1,000 mg a day can improve blood pressure". It also notes that Americans eat on average over 3,100 mg a day. The FDA gives a figure of about 3,400 mg; the two use different data sources, but both are well above any guideline.

Children need less. The NHS sets maximums of 2 g of salt a day for ages 1 to 3, 3 g for 4 to 6, and 5 g for 7 to 10, and says babies under one should have less than 1 g.

How strict does a low-sodium diet need to be?

This is the question most people actually want answered, and the evidence gives a reasonably clear picture.

For blood pressure, every reduction counts

A Cochrane-based meta-analysis of 34 trials with 3,230 participants looked at modest salt reduction lasting at least four weeks (He and colleagues, BMJ 2013). An average cut of about 4.4 g of salt a day (roughly 1,750 mg of sodium) lowered systolic blood pressure by 4.18 mm Hg and diastolic by 2.06 mm Hg. In people with high blood pressure, the fall was larger: 5.39 mm Hg systolic. The relationship was dose-dependent, so larger reductions gave larger falls.

The practical message is that you do not need to hit a perfect number on day one. Moving from a typical intake to the 2,300 mg limit helps, and moving further helps more.

Lower is not always better in every condition

Heart failure is the main exception to "the lower the better". In the SODIUM-HF trial, 806 people with chronic heart failure were randomised to a diet below 1,500 mg of sodium a day or usual care (Ezekowitz and colleagues, Lancet 2022). The low-sodium group cut its median intake from 2,286 mg to 1,658 mg, but after 12 months there was no reduction in hospital admissions, emergency visits or deaths. That does not mean salt is irrelevant in heart failure, but it does mean very strict targets should be set by your cardiology team rather than copied from a diet sheet. Our guide to the heart failure diet covers fluids and salt in that setting.

The American Heart Association also notes that its 1,500 mg goal may not apply to people who lose large amounts of sodium in sweat, such as competitive athletes and people working in heat, or to anyone whose healthcare team has advised otherwise.

Generic diet sheet or an individual plan?

Many people search for a printed "2 gram sodium" handout or PDF. A handout is a reasonable start, but they cannot account for your medicines, your other conditions, your culture or what you actually eat. A sheet that bans soy sauce is little use to someone whose family cooking depends on it; a plan that finds a lower-sodium version, reduces the quantity and builds flavour elsewhere is far more likely to last. A registered dietitian can turn a target into meals you will keep eating, and in the UK the title "dietitian" is legally protected, as our United Kingdom country guide explains; our explainer on the difference between a dietitian and a nutritionist shows what to check elsewhere.

Reading labels: sodium, salt and the claims on the front

Label reading is the single most useful skill on a low-sodium diet. Two systems matter, depending on where you shop.

US-style labels and "salt-free" claims

The FDA advises using the % Daily Value on the Nutrition Facts label: 5% DV or less of sodium per serving is low, and 20% DV or more is high. Always check the serving size, because eating two servings doubles the sodium.

Front-of-pack claims have legal meanings, and they are not all what they sound like:

Source: FDA definitions, repeated by the American Heart Association.

So does "salt-free" mean sodium-free? Under the FDA definition, "salt-free" and "sodium-free" both mean less than 5 mg per serving, which is close enough to zero for practical purposes. "No salt added" and "unsalted" are different: they mean no salt was added during processing, but the food can still contain sodium naturally or from other ingredients. "Reduced sodium" is the claim to watch most closely, because 25% less than a very salty product can still be a lot.

UK-style labels and traffic lights

UK packs list salt rather than sodium, per 100 g. The NHS defines high salt as more than 1.5 g per 100 g (0.6 g sodium) and low as 0.3 g or less per 100 g (0.1 g sodium) (NHS, food labels). The front-of-pack colours follow these thresholds, so choosing green and amber over red for salt is a quick shortcut in the supermarket.

Hidden sources of sodium

Some foods taste salty and are obviously high in sodium. The harder ones are foods that do not taste salty at all.

• Bread and baked goods. The FDA notes that foods eaten several times a day, such as bread, add up across the day even when a single serving is not high.
• Breakfast cereals and pastries. These contain sodium but rarely taste salty, which is why the FDA warns that taste is not a reliable guide.
• Sodium-containing additives. Monosodium glutamate (MSG), sodium bicarbonate (baking soda), sodium nitrite and sodium benzoate all count towards the total on the label.
• Mixed dishes and convenience foods. According to CDC data cited by the FDA, about 40% of the sodium Americans eat comes from a short list of foods: deli meat sandwiches, pizza, burritos and tacos, soups, savoury snacks, poultry, pasta mixed dishes, burgers, and egg dishes and omelettes.
• Fresh meat and poultry with added solution. The FDA advises checking packs of fresh meat and poultry for added salt water or saline.
• Medicines. The NHS warns that some dissolvable tablets, including some painkillers, vitamins and prescription medicines, can be high in salt. Do not change prescribed medicines yourself; ask your GP or pharmacist whether a non-effervescent version would suit you.
• Condiments and sauces. Soy sauce, gravy granules, ketchup, mustard, mayonnaise and brown sauce are all on the NHS list of sauces to use sparingly.

A 2,000 mg sodium day in practice

A useful way to think about a 2 g sodium diet is as a daily budget. The numbers below are planning amounts, not measurements of particular foods: they show how 2,000 mg might be spread so that no single meal uses it all up.

Keeping a tally for a week, using the labels on what you buy, shows where your sodium actually comes from. Look for the few foods that contribute the most, and start your changes there. Our free healthy eating check gives you a quick picture of your overall pattern alongside the sodium work.

Eating out without blowing the budget

Restaurant and takeaway meals are a major source of sodium: the American Heart Association groups them with packaged and prepared foods as the source of more than 70% of the sodium Americans eat. You cannot control the kitchen, but you can control some of the choices. The FDA's suggestions are practical:

• Ask for your meal to be prepared without added salt.
• Ask for sauces and dressings on the side, then use less of them.
• Ask whether nutrition information is available and use it to compare dishes.
• Choose a smaller size, share a main course, or take half home.

Two further habits help. Treat dishes built on salty sauces, such as soy, teriyaki or barbecue, and on cured meats and fish as occasional choices, and choose plainer grilled, roasted or steamed options more often. If you know a meal out is coming, keep the rest of that day lighter on salt, so the day still fits your budget.

Potassium salt substitutes: useful, but not for everyone

Lower-sodium salt substitutes replace part of the sodium chloride with potassium chloride. They are one of the most important developments in this area, and one of the most important places to be careful.

The evidence for substitutes

The Salt Substitute and Stroke Study (SSaSS) enrolled 20,995 people in 600 villages in rural China who had a history of stroke, or were aged 60 or over with high blood pressure (Neal and colleagues, NEJM 2021). Villages were assigned to a substitute of 75% sodium chloride and 25% potassium chloride, or to regular salt. Over an average of 4.74 years, the substitute group had lower rates of stroke (rate ratio 0.86), major cardiovascular events (0.87) and death (0.88), and serious adverse events attributed to high potassium were not increased.

In January 2025, WHO issued a guideline suggesting that people who use table salt replace it with lower-sodium substitutes that contain potassium (WHO guideline on lower-sodium salt substitutes). It is a conditional recommendation, and the scope matters as much as the advice.

Who should not use them without advice

WHO's recommendation is for adults in the general population. It does not apply to pregnant women or children, and it excludes people with kidney impairment or other conditions that might compromise potassium excretion. The 26 trials behind the guideline all excluded people in whom extra potassium could cause harm, such as people with kidney disease or those taking potassium-sparing medicines, so there is no evidence of safety in those groups.

The US National Kidney Foundation is direct about it: if you need to limit potassium, avoid salt substitutes such as potassium chloride, and specialty low-sodium foods made with them, because they are high in potassium (National Kidney Foundation). Our guide to the renal diet explains how sodium, potassium and phosphorus fit together in kidney disease.

So check with your doctor, pharmacist or dietitian before using a potassium-based substitute if you have kidney disease, diabetes, heart failure, are older, or take blood pressure medicines or diuretics. For everyone else, a substitute used in place of salt, not in addition to it, is a reasonable step.

Flavour without salt: recipes and tricks that work

Salt is a flavour, but it is not the only one. Most "no-salt" cooking works by turning up the others.

• Acid. Lemon or lime juice, zest and vinegars brighten food in the way salt does. Add them at the end of cooking.
• Aromatics. Garlic, onion, ginger, chilli, spring onion and fresh herbs give depth. Use garlic and onion powder, not garlic salt or onion salt.
• Spice blends. Make your own from black pepper, paprika, cumin, coriander, dried herbs and chilli. Many shop-bought blends are mostly salt; check the label.
• Roasting and browning. Roasting vegetables and searing meat develops flavour that boiled food lacks.
• Rinse and swap. The FDA notes that rinsing canned beans, tuna and vegetables removes some of the sodium; buying no-salt-added cans or vegetables in water rather than brine is better still.
• Taste before you salt. The NHS suggests tasting food before adding any extra, and taking the salt shaker off the table.

Some simple meals that need no added salt: porridge with cinnamon and fruit; an omelette with spinach, tomato, herbs and black pepper; chicken roasted with lemon, garlic and rosemary; baked fish with a ginger, lime and chilli dressing; lentil soup made with no-added-salt stock and finished with lemon and cumin.

If you also follow a low FODMAP diet for IBS, note that garlic and onion are high-FODMAP, so lean on garlic-infused oil, chives, the green parts of spring onions, herbs and spices instead.

Your taste will adjust

Food can taste flat at first, but that phase passes. In a study of young adults who kept to a low-sodium diet for five months, the level of salt they found most pleasant in soup and crackers fell, while it did not change in a control group (Bertino and colleagues, 1982). The FDA makes the same point: as you cut back, your taste for sodium gradually decreases. Cutting down in steps, rather than all at once, makes the transition easier.

Combining low sodium with other goals

A low-sodium diet often sits alongside other aims: lowering blood pressure, losing weight or managing diabetes. The approaches usually help each other, because cutting processed and takeaway food reduces sodium, calories and added sugar together. If weight is part of your plan, our guide to working with a dietitian for weight loss explains what an individual programme involves.

Be cautious about stacking restrictions, though. A diet that is low in salt, low in fat, low in sugar and low in carbohydrate all at once is hard to sustain and can make it difficult to eat enough, which matters most for people with small appetites. If you are on several therapeutic diets at once, that is a strong reason to see a professional. To get a plan built around your medicines and your meals, book a session with a registered dietitian.

Book a session with a dietitian