CHOLESTEROL- & SODIUM-RESTRICTED DIET

PURPOSE

The cholesterol- and sodium-restricted diet is designed to help improve serum lipid profiles and to achieve a reduction in sodium intake necessary for the control of hypertension in salt-sensitive persons or for the treatment of other disorders such as congestive heart failure.

DESCRIPTION

This diet meets the general requirements of the National Cholesterol Education Program Therapeutic Lifestyle Changes diet (TLC) and the 3-gram Sodium Diet. African Americans, the elderly and overweight adults are more likely to be salt sensitive than other patients. The level of sodium may need to be reduced further; the National High Blood Pressure Education program recommends a moderate sodium restriction (2300 mg/day), while some patients with moderate or severe congestive heart failure may require a 1 to 2 gram sodium restriction.

Foods high in total fat, saturated fat, and cholesterol are controlled. Total cholesterol intake is restricted. Limited amounts of mono- and polyunsaturated fats are used as replacements for saturated fats. Calories are to be adjusted to achieve or maintain desired body weight.

Foods high in sodium content are omitted. Depending on the degree of sodium restriction, one-half teaspoon of salt per day is allowed in the preparation of food or for use at the table. Spices, herbs, natural flavoring agents, and low salt or salt-free seasonings may be used in place of table salt.

BASIC INFORMATION

Cholesterol is found only in animal products. Saturated fats are often solid at room temperature and are usually found in animal products such as meats, poultry, butter, cheese, and ice cream. Plant sources of saturated fats include palm oil, palm kernel oil, and coconut oil. Monounsaturated fats are found in products such as olives and olive oil, peanuts and peanut oil, avocado, and canola (rapeseed) oil. Polyunsaturated fats are usually liquid at room temperature and are found in safflower, sunflower, corn, soybean and cottonseed oils, seeds, and certain nuts.

Salt substitutes must be ordered by the health care provider or dietitian. Salt-free herbs and spices may be used freely. Carefully read labels as some salt-replacement seasonings contain sodium chloride. "Light" salts that are a mixture of potassium chloride and sodium chloride are also limited on sodium-controlled diets.

NUTRITIONAL ADEQUACY

Depending on an individual's food choices, the low-cholesterol, low-sodium diet will normally be adequate in all nutrients.

FOOD LISTS

Milk/Dairy (Limit to 2 to 3 servings a day)

• Allowed: Fat-free or 1% fat milk (liquid, powdered, evaporated), fat-free or low-fat yogurt, fat-free or low-fat cottage cheese, fat-free or low-fat cheese (limit to one ounce a day), fat-free cream cheese, fat-free sour cream.
• Avoid: Whole milk (over 3% fat) (liquid, evaporated, condensed), 2% milk, cream, half-and-half, imitation milk products, most nondairy creamers, whipped toppings, whole milk yogurt, regular cottage cheese (4% fat), natural cheeses made from whole milk (cheddar, Swiss, blue, Camembert, etc.), low-fat or regular cream cheese, low-fat or regular sour cream.

Meat/Meat Substitute

• Allowed: Dried beans, split peas, lentils, pinto beans cooked without salt, poultry without the skin, fish, tuna packed in water (limit to 1.5 oz a day), lean beef (extra-lean ground beef, eye of round, sirloin, round tip, round, top round, tenderloin, top loin), lean pork (fresh not cured, tenderloin, leg, shoulder), lamb (arm, leg, loin, rib), luncheon meats (1 gram fat or less per ounce), egg whites (2 egg whites = 1 whole egg), low-cholesterol egg substitutes.
• Avoid: Fried meats or meat substitutes; any meat, fish, or poultry that is smoked, cured, salted, or canned (such as bacon, dried beef, corned beef, cold cuts, ham, turkey ham, hot dogs, sausages, sardines, anchovies, pickled herring); fatty cuts of beef, pork, lamb, goose, duck; liver, kidney, brains, or other organ meats; sausage, bacon; regular luncheon meats; egg yolks in excess of allotments.

Breads and Grains (6 to 11 servings a day)

• Allowed: Whole-grain breads (oatmeal, whole wheat, rye, bran, multigrain, etc.); English muffins, bagels, pita bread, corn and flour tortillas; rice; pasta; homemade baked goods low in fat; low-fat or fat-free unsalted crackers (rice cakes, popcorn cakes, Rye Krisp, melba toast, breadsticks); hot or cold cereals (with less than 2 grams of fat/serving), baked fat-free and salt- free chips.
• Avoid: High-fat baked goods (pies, cakes, doughnuts, croissants, pastries, muffins, biscuits); high-fat crackers; egg noodles; granola type cereals; cereals with more than 2 grams of fat per serving; pasta and rice prepared with cream, butter, or cheese sauces; breads, rolls and crackers with salted tops; instant rice and pasta mixes; commercial stuffing; commercial casserole mixes; regular chips (corn, tortilla, potato), pretzels.

Vegetables (3 to 5 servings per day or more)

• Allowed: Any fresh, frozen, dried, or low-sodium canned; regular canned, drained vegetables— limit to 1 serving per day; low-salt vegetable juices.
• Avoid: Vegetables prepared in butter, cream, or other sauces; fried vegetables; sauerkraut; pickled vegetables and others prepared in brine; regular vegetable juice; potato casserole mixes.

Fruits (2 to 4 servings per day or more)

• Allowed: Any that are fresh, frozen, canned, or dried.
• Avoid: Coconuts, avocados (except as allowed under Miscellaneous).

Desserts and Sweets (Limit to control calories if needed)

• Allowed: Sugar, jelly, jam, honey, molasses; low-fat or fat-free frozen desserts (sherbet, sorbet, ices, fat-free frozen yogurt, Popsicles); angel food cake; low-fat or fat-free cakes and cookies (vanilla wafers, graham crackers, ginger snaps); baking cocoa; low-fat or fat-free candy (such as jelly beans, hard candy), low-fat or fat-free puddings; gelatin desserts.
• Avoid: Ice cream; high-fat cakes, pies, and cookies (most commercially made); puddings made from whole milk; chocolate; nut candies.

Beverages (As desired; limit high-calorie beverages if needed)

• Allowed: Juices, tea, coffee, decaffeinated coffee, carbonated drinks, sports beverages, and most alcoholic beverages.
• Avoid: Milkshakes; ice cream floats; eggnog; alcoholic beverages containing milk, cream, or coconut; commercially softened water as a beverage or in food preparation.

Miscellaneous

• Allowed: Limit fat based on total number of calories consumed (use very sparingly). Limit (1 tsp per serving): Unsaturated vegetable oils (corn, olive, canola, safflower, sesame, soybean, sunflower), margarine or shortening made from unsaturated vegetable oils, mayonnaise and salad dressings made from unsaturated oils (1 Tbsp), diet margarine (2 tsp), avocado (1/8 medium or 2 Tbsp), salt-free seeds and nuts (1 Tbsp seeds, 6 almonds, 20 small peanuts), salt-free peanut butter (1 tsp).
  No Limit: Vegetable oil sprays; fat-free salad dressings, herbs, spices, pepper, salt substitute (with medical approval), mustard, vinegar, lemon and lime juice, cream sauces made with allowed ingredients, fat-free sour cream.
  Limit added salt to 1/2 teaspoon per day; may be used in cooking or at the table.
• Avoid: Butter, coconut oil, palm oil, palm kernel oil, lard, bacon fat, salad dressings made with egg yolk, fried snack foods (potato chips, cheese curls, tortilla chips), olives, regular cream sauces, salt, garlic salt, celery salt, onion salt, seasoned salt, sea salt, kosher salt, seasonings containing monosodium glutamate (MSG, Accent), salted nuts and seeds, salted peanut butter, canned soups.

SAMPLE MENU

Nutrient Analysis

Special Notes: