Eating a low-salt diet for Ménière's disease

The vertigo (spinning sensation) experienced in Ménière's disease can be severe and debilitating. There is little you can do to change the intensity of an episode, but eating a low-sodium (salt) diet may help reduce the frequency of your episodes.

The U.S. daily value for sodium is less than 2,300 mg a day, while the typical U.S. diet includes about 4,000 mg of salt a day. Evidence exists that restricting salt to 1,000 mg a day may help those with Ménière's disease.

Eating less salt does not have to be difficult. Following are five keys to decreasing salt in your diet:

• Read labels, especially on processed foods, to see how much sodium (salt) foods contain.
• Ask for low-salt meals at restaurants.
• If you use canned vegetables, rinse them thoroughly.
• Call your local water company to find out the salt content of your water supply. If you drink bottled water, read the label and choose a salt-free brand.
• Don't add salt to your food.

 What is the benefit of eating a low-salt diet?
 Why should you follow a low-salt diet?
 How do you limit the salt in your diet?
 Where to get more information

More information about vertigo can be found in the following topics:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Ménière's Disease
• Dizziness: Lightheadedness and Vertigo
• Labyrinthitis
• Vestibular Neuronitis

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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. Thus, eating less salt may result in less buildup of fluid in the ear and fewer episodes of vertigo. However, eating less salt does not reduce the intensity or severity of vertigo during episodes.

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Many of us like to use table salt—it adds flavor to the foods we eat. Salt is also found in many prepared foods, both for flavor and for preservation. However, salt contains a great deal of sodium—1 teaspoon contains 2 g (2,000 mg). This amount alone nearly meets the recommendation of the U.S. daily value for salt, 2,300 mg. The typical U.S. diet includes about 4,000 mg of salt a day. Evidence exists for restricting salt 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 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.

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Limiting the salt in your diet may seem difficult; after all, the typical U.S. diet includes about 4,000 mg of salt a day. However, if you are aware of the salt content in foods and avoid high-salt foods, you will be able to reach a salt intake of 1,000 mg a day.

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

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

Evaluate your diet

• Talk with a health professional about how much salt 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 salt intake. Have questions prepared to ask him or her.
• Track your salt intake for a few days by counting the milligrams of salt 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 health professional. 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. Don't use soy sauce, steak sauce, onion salt, garlic salt, mustard, or ketchup on your food, since 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 salt a food contains in each serving.
• Read ingredient lists and be aware of other forms of salt. These include 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 while 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.

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Before you start reducing the salt in your diet, talk to your health professional. 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 salt in food, see the U.S. Department of Agriculture nutrition Web site: http://www.nutrition.gov/.

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