Ménière's disease: Eating a low-salt diet

The cause of Ménière's disease is unknown, but it may be related to a fluid imbalance in the inner ear. When the fluid builds up, it causes excess pressure. This pressure affects the sensory systems in the inner ear used to maintain balance, which leads to episodes of vertigo.

Salt "attracts" fluids-it makes your body retain excess fluid. So eating less salt may result in less buildup of fluid in the ear and fewer episodes of vertigo. But eating less salt does not reduce the intensity or severity of vertigo during episodes.

Test Your Knowledge

1. Vertigo in Ménière's disease may be caused by pressure in the ear due to fluid buildup.

   1. True

      This answer is correct.

      Vertigo in Ménière's disease may be caused by pressure in the ear due to the buildup of fluid.

   2. False

      This answer is incorrect.

      Vertigo in Ménière's disease may be caused by pressure in the ear due to the buildup of fluid.

2. Eating less salt may result in less severe episodes of vertigo.

   1. True

      This answer is incorrect.

      Eating less salt may result in fewer episodes of vertigo, not in less severe episodes.

   2. False

      This answer is correct.

      Eating less salt may result in fewer episodes of vertigo, not in less severe episodes.

3. Salt causes the body to retain fluid.

   1. True

      This answer is correct.

      Salt does cause the body to retain fluid.

   2. False

      This answer is incorrect.

      Salt does cause the body to retain fluid.

Many of us like to use table salt because it adds flavor to the foods we eat. But salt contains a lot of sodium: 1 teaspoon of salt contains 2 g (2,000 mg) of sodium. This amount almost meets the recommended U.S. daily value for sodium, which is 2,300 mg. Sodium is also found in many prepared foods, both for flavor and for preservation. Evidence exists for restricting sodium intake to 1,000 mg a day for Ménière's disease.

It is well worth the effort for those with Ménière's disease to know how much salt food contains and to limit its intake.

• Episodes of vertigo can be severe, and eating less salt may reduce their frequency.
• Because you may experience fewer episodes of vertigo, you may reduce your risk for falls and injuries.
• Fewer episodes of vertigo may also reduce problems with balance. This is because the more vertigo episodes you have, the weaker your inner ear becomes. A weak inner ear contributes to poor balance.
• Fewer episodes of vertigo means a better quality of life due to less risk of falling.

Test Your Knowledge

1. Those with Ménière's disease should limit sodium intake to:

   1. 2,300 mg.

      This answer is incorrect.

      Evidence exists that those with Ménière's disease should limit their sodium intake to 1,000 mg a day. The correct answer is b.

   2. 1,000 mg.

      This answer is correct.

      Evidence exists that those with Ménière's disease should limit their sodium intake to 1,000 mg a day.

   3. 4,000 mg.

      This answer is incorrect.

      Evidence exists that those with Ménière's disease should limit their sodium intake to 1,000 mg a day. The correct answer is b.

2. Fewer episodes of vertigo means:

   1. Less risk of falling.

      This answer is correct.

      Fewer episodes of vertigo means less risk of falling and less risk of poor balance. Both answers are correct.

   2. Less risk of poor balance.

      This answer is correct.

      Fewer episodes of vertigo means less risk of falling and less risk of poor balance. Both answers are correct.

Limiting the salt in your diet may seem difficult. But if you are aware of the sodium content in foods and avoid high-sodium foods, you will be able to reach a sodium intake of 1,000 mg a day.

Perhaps the major misconception people have when limiting sodium is that the biggest source of sodium in the diet is salt added at the table. This is not true. In general, the biggest source of sodium is processed foods and foods from restaurants. About two-thirds of the sodium in our diet comes from these sources, while salt added at the table accounts for only about 15% of our sodium intake.

Following are some suggestions to help you limit your sodium intake.

Evaluate your diet

• Talk with a doctor about how much sodium you need and how to evaluate your current diet. He or she will probably ask you what types of foods you are eating and get a rough estimate of your current sodium intake. Have questions prepared to ask him or her.
• Track your sodium intake for a few days by counting the milligrams of sodium in the foods you eat. You will have to know how to read food labels . Record your intake in the salt record (What is a PDF document?) .
• Review your record with your doctor. He or she will be able to help you target which foods to avoid and provide other dietary advice.

Cook with less salt

When you cook your food, you can cut down on salt by:

• Using fresh or frozen foods.
• Rinsing canned vegetables.
• Flavoring your food with spices, not salt. But don't use soy sauce, steak sauce, onion salt, garlic salt, mustard, or ketchup on your food because these contain a lot of salt.
• Avoiding processed foods.

Limit salt in your foods

Look for salt in the foods you prepare and try to avoid high-salt foods.

• Read food labels . They tell you how much sodium a food contains in each serving.
• Read ingredient lists and be aware of the many forms of salt. These include sodium chloride, monosodium glutamate (MSG, common in Chinese food), sodium citrate, sodium alginate, sodium hydroxide, and sodium phosphate.
• Substitute low-salt foods for high-salt foods. Use a general list of foods allowed and foods to avoid. For instance, milk and vegetables are low-salt foods but frozen prepared meals and crackers are high in salt. Foods allowed have low salt content. Foods to avoid have high salt content.
• Avoid fast food and processed foods.
• Ask for low-salt foods when you eat out.
• Drink low-salt bottled water.
• Don't add table salt to your food.
• Don't drink water that has been softened.

If you do not cook for yourself, let those who help you know that you need a low-salt diet:

• If family members or friends help you, or if you hire someone, print this section and have them read it. This will help them provide you with the right food choices.
• If you have meals delivered to you, attend a senior center for meals, or have another source of meals, ask the administrator of the program about low-salt meals. You may have to ask for special meals.
• If you feel you need help, ask the provider of a nutrition program (often a health department or hospital in your area) to find out where meals are served in your area. Be sure they know that you have to limit the amount of salt in your diet.

Test Your Knowledge

1. In general, the biggest source of sodium in our diets is:

   1. Salt added at the table.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not salt added at the table. Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About two-thirds of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

   2. Processed foods and foods from restaurants.

      This answer is correct.

      In general, the biggest source of sodium in our diets is processed foods and foods from restaurants. About two-thirds of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake.

   3. Salt added in cooking.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not salt added in cooking. Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About two-thirds of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

   4. Milk.

      This answer is incorrect.

      In general, the biggest source of sodium in our diets is not milk. Processed foods and foods from restaurants are the biggest contributors of sodium in our diets. About two-thirds of the sodium in our diets comes from these sources. Salt added at the table is only about 15% of our sodium intake. The correct answer is b.

2. Choose the food lowest in salt (you may need to review the general list of foods allowed and foods to avoid):

   1. Fresh green beans

      This answer is correct.

      Fresh green beans have the least salt. All the other foods have salt added to them.

   2. Canned green beans

      This answer is incorrect.

      Canned green beans contain more salt. Fresh green beans have the least salt. The correct answer is a.

   3. Green bean casserole

      This answer is incorrect.

      Green bean casserole contains more salt. Fresh green beans have the least salt. The correct answer is a.

   4. Green beans served at a restaurant

      This answer is incorrect.

      Green beans served at a restaurant usually contain more salt. Fresh green beans have the least salt. The correct answer is a.

Before you start reducing the salt in your diet, talk to your doctor. He or she will want to know about any changes you are making to your diet and may be able to help you.

For more information on salt and the amount of sodium in food, see the U.S. Department of Agriculture nutrition Web site: www.nutrition.gov.