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Test Your Sodium IQ

Split screen image of TV host Anne Marie Mediwake and dietitian Sue Mah

Cardiovascular disease is still the number one cause of death globally (1). Eating too much sodium is linked to high blood pressure which is a major risk factor for heart disease. Here are 5 questions to test your sodium IQ!

Watch Sue’s national TV interview on YouTube or click on the image below.

 

 

 

 

1. True or False: We need sodium to stay healthy.

True!  We do need some sodium to maintain our blood pressure and fluid levels in our body. Sodium is also needed to keep our muscles and nerves running smoothly. The problem is that most of us are getting too much sodium, which can lead to health problems such as hypertension (high blood pressure) and cardiovascular disease.

On average, we should stick to less than 2,300 mg of sodium a day, but we’re eating about 1½ times that amount (2). In fact, 3 out of 5 Canadians eat too much sodium (2). A report by Health Canada found that 72% of kids between the ages of 4 to 13 are eating too much sodium. And over 95% of males aged 19-30 are eating too much sodium (2).

Eating too much sodium today can lead to high blood pressure later in life. According to a report by the Heart and Stroke Foundation, about 20% of Canadians have high blood pressure or hypertension, and another 20% of Canadians have pre-hypertension (where their blood pressure is above normal but not quite diagnosed as high yet) (3).

2. True or False: Sodium is the same thing as salt.

False!  Salt and sodium are often used interchangeably, but they’re not exactly the same thing. Sodium is a mineral that’s found naturally in foods and / or added to foods. Salt or table salt is a combination of sodium plus chloride. Salt is the main source of sodium. Other sources of sodium include sodium bicarbonate (baking soda), sodium benzoate (a preservative) and monosodium glutamate (a seasoning).

3. True or False? Sea salt is healthier for you than table salt.

False!  The main differences between sea salt and table salt are the taste, texture and how they’re made.

Sea salt is made by evaporating sea water and can taste differently depending on where it’s from. There are some trace minerals in sea salt such as calcium and iron, but the amounts are very low. The sea salt crystals can be large.

Table salt is made from fine crystals mined from ancient dried up salt lakes, and then ground to give it a finer texture. You may find iodine in table salt – it’s a nutrient that’s added to lower the chances of developing an iodine deficiency.

Kosher salt is the same as table salt, but has larger crystals and no iodine. And Pink Himalayan salt is actually mined in Pakistan. The pink color is from the iron in the salt.

By weight, all of these types of salt have about the same amount of sodium as table salt.

By volume however, (i.e. if you’re measuring it with a teaspoon), sea salt, Kosher salt and Pink Himalayan salt will have slightly less sodium because they have larger crystals.

Whichever type of salt you prefer, use less to cut down on your overall sodium intake. Boost the flavour of food with sodium-free ingredients like herbs, spices, garlic, lemon juice or citrus zest.

4. True or False? You can tell which foods are high in sodium because they taste salty.

False!  Some foods such as bread and cereal don’t really taste salty, but they do contain sodium. Sodium can also be hidden in salad dressings, soups, pasta sauces, different condiments and baked goods like cookies and muffins. Read food labels and look for foods that generally contain less than 15% of the Daily Value (%DV) for sodium. Or look for foods that are specifically labelled “low sodium”.

The image below shows a Nutrition Facts table for crackers. You can see that 4 of these crackers contain 6% of the Daily Value (DV) for sodium. A %DV that is 5% or less is considered “a little” and a %DV that is 15% or higher is considered “a lot”.

Nutrition Facts table for crackers, showing 6% DV for sodium

Image source: Sue Mah

 

 

 

 

 

 

 

 

 

5. True or False? Most of the sodium we eat comes from the salt shaker.

False!  Only about 11% of the sodium we eat comes from the salt shaker when we add salt to our cooking or to our food at the table Almost 80% of the sodium we eat comes from packaged foods. The rest is from sodium found naturally in foods.

In fact, the top 6 sources of sodium in are diet are:

  • Bakery products (e.g. bread, muffins) – salt is added to baking, and even though the food doesn’t taste very salty, but we tend to eat a lot of these foods, so the sodium adds up
  • Appetizers and entrées (e.g. pizza, frozen meals)
  • Processed meat
  • Cheese
  • Soups
  • Sauces and condiments

Fast food / restaurant meals also tend to be higher in sodium. Sodium is added to foods to act as a preservative and also to bring out the flavour of foods. To cut back on sodium, enjoy more wholesome fruits and veggies because they’re essentially sodium-free. If you’re making a recipe, try cutting down on the ingredients which contain sodium. If you’re eating out, ask for sauces, salad dressings and gravy on the side so that you can control the amount of sodium that you eat.

 

References:

1) World Heart Foundation (no date). World Heart Day is celebrated every year on 29 September. Retrieved September 20, 2020 from https://www.world-heart-federation.org/world-heart-day/about-whd/

2) Health Canada (no date). A salty situation. Retrieved Sept 20, 2020 from https://www.canada.ca/content/dam/hc-sc/documents/services/publications/food-nutrition/infographic-salty-situation/26-18-2058-Sodium-Infographic-eng-08.pdf

3)  Heart and Stroke Foundation (2014 August). Position statement – Dietary sodium, heart disease and stroke. Retrieved September 20, 2020 from https://www.heartandstroke.ca/-/media/pdf-files/canada/2017-position-statements/dietary-sodium-ps-eng.ashx?rev=29762d89e1e3446084fa988ac9b0c3d7&hash=6523A0B22CEB23AC5B87207DB5C00E8C

 

Which New Nutrition Symbol Would YOU Like to See on Food Packages? Send Your Vote to Health Canada Now!

Couple in a supermarket shopping groceries and other stuff, they are looking for what they need

Eating too much sodium, sugars and saturated fat is linked to health problems such as obesity, high blood pressure, heart disease, stroke and type 2 diabetes. Health Canada is proposing a new nutrition symbol that would appear on the front of food packages to identify foods that are high in sodium and / or high in sugars and / or high in saturated fat. This new Front-of-Package labelling will help Canadians more quickly compare different products and make healthier choices.

Under the proposed new labelling regulations, pre-packaged foods which contain 15% DV (15% Daily Value) or more for either sodium, sugars or saturated fat will need to display a special nutrition symbol. Pre-packaged meals or dinners which contain 30% DV or more for either sodium, sugars or saturated fat will also need to display the symbol. Foods such as plain milk, most vegetable oils, and fruits and vegetables without added saturated fat will all be exempt from this new labelling rule.

In 2016, Chile implemented a similar front-of-package labelling program. Evaluation results found that almost all (92%) of Chilean consumers said that the label influenced their purchase in some way. And 18% of food products in Chile have been reformulated to contain less sodium, sugars or saturated fat. The proposed front-of-package labelling regulations may be an important catalyst for new and reformulated products here in Canada.

Health Canada has proposed the following four symbol options and now wants to hear which one would be the most useful for YOU. Have your say in shaping this important national nutrition policy. Vote now by completing this short online consumer consultation here by April 26, 2018.

Front of Pack symbol - all 4

5 Nutrition Myths – Busted!

hosts + Sue - 2

Test your nutrition IQ with this fun 5-question quiz!

Watch my interview clip on CTV Your Morning!


1) TRUE or FALSE: Brown eggs are more nutritious than white eggs.

Answer: FALSE

There really is no nutritional difference between brown eggs and white eggs. The main difference is in the hens. Generally speaking, white eggs come from hens with white feathers, and brown eggs come from hens with brown feathers!

Brown hens are slightly larger birds and need more food, so that may be a reason why brown eggs usually cost more than white eggs.


2) TRUE or FALSE: You need to drink 8 cups of water every day.

Answer: FALSE

Actually, it’s recommended that women get 9 cups of FLUID every day and men get 12 cups of FLUID every day. If you’re exercising, or if the weather is hot and humid, you may even need more fluid.

Fluid comes from the food you eat and the beverages that you drink – so milk, soup, coffee, tea, watermelon, grapes – all of that counts towards your fluid intake for the day. So the actual amount of water you need really depends on what you’re eating and drinking.

Water is always an excellent choice because it’s calorie-free and very refreshing. And here’s the best tip – take a look at your urine. If it’s light or clear, then it usually means that you’re getting enough fluids. But if it’s dark yellow, then it’s a sign of dehydration and you need more fluids.


3) TRUE or FALSE: Sea salt has the same amount of sodium as table salt.

Answer: TRUE

By weight, sea salt and table salt have the same amount of sodium. By volume though, sea salt does contain a little less sodium because sea salt crystals are larger.

The biggest differences between sea salt and table salt are: taste, texture and source.
Sea salt is made by evaporating seawater and tastes different depending on where it’s from. Sea salt does contain very small amounts of trace minerals such as calcium, magnesium and potassium.

Table salt is mined from dried-up ancient salt lakes. Some table salts include iodine, a nutrient that helps prevent thyroid disease (goiter).

4) TRUE or FALSE: Drinking lemon water first thing in the morning is a good way to detox your body.

Answer: FALSE

There is nothing magical about lemon water. Drinking lemon water in the morning actually adds extra acid into your empty stomach and this can give you a stomachache.
Another problem with lemon water is that the acid from the lemon can erode / wear down your tooth enamel. If you really love to drink lemon water, try to have a plain glass of water afterwards, and wait at least 15 minutes before brushing your teeth.

5) TRUE or FALSE: Energy drinks give you energy.

Answer: TRUE

Energy can mean calories. A bottle of energy drink can have about 100 calories, so in that sense, yes, you’re getting energy!

Energy can also mean physical energy. Energy drinks typically contain caffeine which is a stimulant. One cup of an average energy drink has almost as much caffeine as a cup of coffee. So in that sense, energy drinks will make you feel energized and alert.

The problem is that energy drinks also contain added sugar – up to 7 teaspoons in a serving- yikes! And there’s also herbal ingredients. Energy drinks are a no-no for kids, teens and pregnant/breastfeeding women.

What’s the best way to feel energized? Eat well, be active, stay hydrated and get enough sleep!

10 Things I Want for the New Canada’s Food Guide

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It’s been nine years since the release of the last Canada’s Food Guide and based on emerging research and trends, it’s sure time for an update! In fact, Health Canada is in the process of revising the Guide. Help all Canadians eat better and fill in this online questionnaire from Health Canada to help shape the new Food Guide.

Here’s my wish list of the top 10 wants for the new version.

1. Create age-specific Food Guides – how about a different one for kids, teens, adults and older adults. Each Food Guide could address the specific nutritional needs and issues for each of these age groups. For example…
• The Food Guide for young kids could include tips for feeding picky eating and food literacy/cooking skills.
• In the teens’ Food Guide, there could be messages around sodium and sugar sweetened beverages, maximizing bone density, and the benefits of cooking and eating meals with your family.
• The adult’s Food Guide could include tips for meal planning and healthy eating in the workplace.
• For older adults, the Food Guide could highlight the need for certain supplements, bone health, and the important role of protein in the prevention of age-related sarcopenia.
2. Take the emphasis off “low-fat” foods. Highlight foods that naturally contain healthy fats such as avocados, nuts, seeds and olives in addition to healthy oils.
3. Include advice about eating protein – evenly throughout the day, at every meal, and especially breakfast to help with satiety and to maintain muscle mass.
4. Include visual images of portion sizes – for example, a fist is about 1 cup (250 mL) and the size of your palm is about one serving size of meat, poultry or fish. Encourage Canadians to fill half their plate with vegetables and fruit to help keep other foods in the right proportions.
5. Add ideas for eating sustainably and locally. We are eating for the health of ourselves, our families and our planet.
6. Encourage individuals and families to connect with food. Cook meals, grow a garden and create healthy eating environments at work, home, school and play.
7. Focus not just on what to eat, but also how to eat. Sit down and eat mindfully. Enjoy meals with family and friends.
8. Consider creating a vegetarian Food Guide or include more vegetarian options in the new Guide.
9. Add a message about alcohol that echoes the national low risk alcohol drinking guidelines.
10. Include lifestyle messages about the importance of sleep and physical activity that are essential partners to a healthy, wholesome diet.

Revising the Food Guide is no easy task! It requires an extensive review of the evidence-based research as well as consultation with health professionals and consumers. Here’s hoping that some of my top 10 – and your comments too – will make it to the final round!

7 Cooking Hacks to Cut the Sodium

Lemon basil garlic

Most of us are eating too much sodium, which can lead to hypertension (high blood pressure). In fact, the average adult has a 90% chance of developing hypertension which is itself the number one risk factor for stroke and a major risk factor for heart disease. Swapping out the sodium can help.

I had a chance to chat with Shelley Martin, President and CEO of Nestlé Canada who recently announced that the company has achieved a 10% reduction in sodium across its product portfolio (by volume) such as pizzas and frozen meals. “We want to support people in the foods they love to eat by making them as great tasting and nutritious as they can be,” said Martin. For some products, the sodium content was simply reduced, while for other products, the spice mix was also tweaked.

I applaud food industry initiatives like this to help Canadians eat better. Your own habits can also make a big difference. Here’s what you can do at home, at the grocery store, and when eating out:

1. Cook from scratch. Dig out your apron and make a delicious meal from scratch using fresh, wholesome ingredients. If a recipe calls for salt, consider using less.

2. Play with herbs, spices and citrus. Basil pairs perfectly with tomatoes and pasta. Curry adds a hint of heat to meat, poultry, soups and stews. A little bit of garlic and onion goes a long way. And a splash of fresh lemon or lime juice instantly perks up any dish!

3. Rinse canned beans.
I love cooking with canned beans because they’re super convenient and easy on the budget. A quick rinse helps to wash away some of the sodium that may have been added.

4. Go easy on the bottled sauces
such as ketchup, BBQ sauce and soy sauce. I grew up on Chinese food, so soy sauce, hoisin sauce and oyster sauce were our go-to flavourings. Today, lower sodium soy sauce is our pantry staple. Sometimes, I dilute the sauces with water too.

5. Read and compare food labels.
Choose the brands that have less sodium. From canned fish to frozen entrées to pasta sauces – you may be surprised to see the range of sodium found in different foods!

6. Order smaller portions when eating out. Just think – if you split an entrée with a friend, then you’re also splitting the calories and sodium content. It’s win-win. Ask for sauces and dressings on the side too if possible.

7. Give your taste buds a chance to adjust.
We all need some sodium for good health. The idea is to gradually swap out the sodium so in time, you’ll retrain your taste buds and savour the wonderful flavours that food has to offer. Your heart will thank you!

My POV on Health Canada’s proposed new nutrition labels

On June 12th, Health Canada released a proposed new Nutrition Facts table aimed to improve nutrition information on food labels. While I agree that nutrition labels can provide useful information to help Canadians find healthier choices, I’m not 100% sold on all of the proposed changes. Even after tuning in to Health Canada’s webinar on the proposed changes last week, I still have a number of questions and a long wish list. Here are just some of my comments which I’ll be sending to Health Canada during the consultation phase.

Realistic serving sizes – LIKE – If you’re a cereal lover, you’ll know that the current serving sizes are based on a weight of 30 grams. This means that a serving of cereal could be anywhere from 1/3 cup to 1 1/2 cups, depending on the density of the cereal. On the proposed new label, the serving size of all cereals will be 1 cup. With this type of standardized serving size, it will be easier for us to compare the nutritional profile of one cereal to another.
Wish list: Let’s change the serving sizes on Canada’s Food Guide so that they’ll finally match the serving sizes seen on nutrition labels. For consistency, we should also keep the serving of bread at 1 slice (which is currently a Food Guide serving) instead of upping it to the proposed 2 slices.

%DV (Daily Value) for carbohydrates and fibre removed – DISLIKE – Oh boy, I have so many question marks about the %DV on the proposed new labels, starting with carbs and fibre! The current nutrition labels include a %DV for carbohydrates and fibre. So why will these be removed in the proposed new label? When I asked Health Canada, they replied that carbohydrate is not a nutrient that Canadians need to limit. And that the %DV would only be listed for nutrients of public health concern for which our intakes are either insufficient or excessive. I have a few issues with this argument. First of all, no where on the proposed new food label does it say that the %DV is only given for nutrients that we’re missing out on or getting too much of. So how’s a consumer supposed to know? To me, including the %DV for some but not all of the nutrients is essentially withholding important information and does not provide the full picture to consumers. Secondly, there may be some folks who need to watch their carb intake, so providing a %DV for carbs would be helpful. Thirdly, we know that Canadians are only getting about 1/2 the fibre they need in a day and we know very well about the health benefits of fibre. So doesn’t that qualify fibre as a nutrient with an insufficient intake?? Health Canada’s rationale is that the definition of fibre has broadened and that consumers can still use the “source of fibre” claims to help guide them in their decision making. Lastly, the proposed new nutrition label would only provide a %DV for one macronutrient – fat – with the rationale that we need to be limiting our fat intake. OK, so here’s the super confusing part: If Health Canada wants us to limit our overall fat intake, why did they INCREASE the daily recommended dietary allowance of fat from 65 to 75 grams (from 30% of the calories in a day to 35% of calories in day)? If the proportion of fat is going UP in the diet, then which macronutrient is going down – carbs or protein or both??
Wish list: Full disclosure. Give consumers the full picture. Add a %DV for carbohydrates and protein too, and while you’re at it, re-assess the daily recommendations for protein. OR completely remove the %DV fat.

Changes to the %DV of nutrients – LIKE BUT CONFUSING! – I applaud Health Canada for lowering the daily recommended intake for sodium from 2400 mg to 2300 mg (some health professionals might argue that the recommendation should even be as low as 1500 mg) and for increasing the daily recommended dietary allowance for vitamin D from 200 mcg to 800 mcg. But here’s the confusing part. The 800 mcg amount of vitamin D is the recommended daily amount for a 70+ year old adult. The proposed new calcium %DV of 1300 mg on the other hand is based on the needs of a growing teenager, and the proposed new iron %DV at 18 mg is based on the needs of a woman in her child-bearing years.
Wish list: How about basing the %DV for these nutrients on the needs of an average adult who’s eating 2000 calories. That’s what it is now. Why are we making it more confusing for consumers?

Sugars grouped together in the ingredients list – LIKE – I agree that all sugars should be listed together. However, I wondered why “Added sugars” was not added to the proposed new nutrition label. Health Canada tells me that not many foods would have a different value for “Total sugars” and “Added sugars”, and that the ingredients list could help consumers determine how much added sugar is in the food.
Wish list: We break down saturated and trans fat under the “Total fat” category. We should do the same for “Total sugars” and “Added sugars”.

Cholesterol on the nutrition label – DISLIKE –
We know that dietary cholesterol doesn’t have as much impact on our blood cholesterol as we once thought. Do we need to label the cholesterol content of a food anymore?
Wish list: Nix the cholesterol. Use the space on the food label to put back “Added sugars”

Vegetable and fruit health claim – LIKE – Vegetables and fruit don’t need a Nutrition Facts table and can state the claim “A healthy diet rich in a variety of vegetables and fruit may reduce the risk of heart disease.” Yes, finally!
Wish list: Tell us if/how processed vegetables and fruit can carry this health claim on their packaging.

I encourage you to send your comments too by August 26, 2015. You can email or fax your comments. For more info, see Health Canada Consultation on Proposed Food Label Changes.

Bust a Nutrition Myth

Nutrition can sure be confusing! Here’s the truth about a few common nutrition myths.

MTYH: Sea salt is healthier for you than table salt.
Sea salt, just like kosher salt and gourmet salt, actually has about the same amount of sodium as table salt. Eating too much sodium – from any type of salt – is linked to high blood pressure. The main differences between sea salt and table salt are taste, texture and how they are made. Sea salt is coarse and made by evaporating seawater, so it has a distinct taste depending on where it’s sourced. Table salt is mined from dried-up ancient salt lakes. Some table salts have added iodine, a nutrient that helps prevent thyroid disease. Whichever salt you prefer, try to use less.

MYTH: Agave syrup, honey and brown sugar are better for you than white sugar.
From a nutrition perspective, these are all sugars and provide calories with very few nutrients. Brown sugar is usually white sugar with molasses added. Agave syrup and honey and brown sugar may be considered more natural, but in fact our body handles sugars in the same way.

MYTH: Everyone should eat a gluten-free diet.
Gluten is type of protein found in grains like wheat, barley and rye. About one percent of Canadians have celiac disease. If you’re among them, then a gluten-free diet is a must. However, you may also benefit from eating a gluten-free diet if you have a gluten sensitivity. In this condition, there are similar symptoms as celiac disease. Since wheat flour is enriched with B vitamins, iron and folate, be sure to get enough of these nutrients from other foods and/or a multivitamin-mineral supplement if you are following a strict gluten-free diet. Keep in mind that everyone can enjoy gluten-free whole grains such as quinoa, corn, rice and millet as part of a healthy diet.

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