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Why Low-Sodium Diets Could Lead to Injury

Many elders are on low-salt diets. Why? Salt (sodium) has many harmful effects on health. Salt is associated with high blood pressure and cardiac disease (including strokes, heart attacks and heart failure). Other conditions associated with high salt intake include:

Mental decline. Individuals with high salt intake experience more problems with mental performance over time than those individuals with moderate salt intake.

Osteoporosis, which causes bones to more easily break.  Eating a lot of salt can cause calcium losses through the urine which can lead to weakening of bone.

Fluid retention (edema). This can be caused by eating a high-salt diet, and is more likely to occur when one gets older. Cutting down salt intake (and the likelihood of edema) in particular helps individuals with heart and kidney diseases.

While eating too much salt can be dangerous, too little salt can be problematic as well. Several recent medical reports suggest that elders with low blood sodium or salt (hyponatremia) have a greater likelihood experiencing unsteadiness, falls and bone fractures. In assisted living facilities and nursing homes, places where almost all elders are on low salt diets, hyponatremia (low salt in the blood) is common cause of falling.

Elders on low salt diets often experience a lack of thirst which can lead to dehydration. Not having adequate water in the body can result in a host of bad health problems (such as a drop in blood pressure and a loss of mental focus or attention) that result in falling and injury.

What causes low blood sodium?

Aside from being on a low salt diet, low levels of sodium (hyponatremia) in the blood can result from:
  • Too much water (or fluid) in the body, which dilutes the normal amount of sodium so that the concentration appears low.
  • Consuming excess water, for example during strenuous exercise, without adequate replacement of salt (sometimes this is referred to as ‘water intoxication’).
  • A loss of sodium (and fluid) from the body, for example, during long periods of sweating and severe vomiting or diarrhea.
  • Medical conditions that are associated with low sodium, such as having too little thyroid hormone (hypothyroidism) and chronic kidney or heart disease.
  • Medications that can lower blood sodium levels. Examples include diuretics (water pills), pain killers, and antidepressants.

Symptoms of low sodium (hyponatremia) that may result in falls and injury include:
  • Altered mental status; confusion
  • Headache; loss of concentration
  • Nausea and dizziness
  • Tiredness and weakness
  • Restlessness
  • Muscle spasms or cramps
  • Difficulty walking in a safe manner

Once identified, most people with low sodium can usually be treated with a change in diet or medication. Some individuals with sudden or severe hyponatremia, may require intravenous fluids and electrolytes.

To Salt or Not To Salt

No mineral is more essential to human survival than salt, which.
  • Allows for the normal function of the nervous system.
  • Helps muscles to stay strong
  • Keeps the brain healthy and functioning.
  • Maintains fluid balance in the body and regulation of blood pressure.

However, salt (sodium chloride) is a nutrient that the body cannot produce, and, therefore, it must be eaten. But here’s the problem: eating too much salt increases the risk of health problems and not eating enough salt can be equally harmful. Yikes, what’s a person to do?

Managing Salt

The CDC (Centers for Disease Control and Prevention) and the American Heart Association recommends that elders consume no more than 1,500 milligrams of sodium per day. This comes to about 2/3 teaspoon per day (1 teaspoon of salt contains almost 2,300 milligrams of sodium).

However, a recent study (from Emory University in Atlanta), suggests that elders can live relatively healthy lives even if they consume up to 2,300mg (about one teaspoon) of salt each day. This is still far less than the 3,400mg the average American consumes. As well, 1 teaspoon of daily salt also helps to avoid any problems with low sodium (hyponatremia).

But this doesn’t mean that elders should eat salt freely, as going over 1 teaspoon brings on the risk of heart-related health problems. To avoid the perils of high and, especially low salt, elders need to pay attention to their dietary intake of salt. It’s important to talk to the family doctor about how much or how little salt to eat based on their health status.

For elders with chronic health problems (especially heart disease or high blood pressure), managing dietary salt should always be done under the supervision of the family doctor. Since the causes of hyponatremia are varied, often blood and urine tests are needed to measure and monitor the levels of sodium in the body and determine the exact cause (and treatment) of hyponatremia.

This blog was originally posted on Dr. Rein's blog on eCareDiary.com, Click Here to read this and other blogs from Dr. Rein.

Rein Tideiksaar, PhD, PA-C, or Dr. Rein as he is commonly referred to, is the president of Fall Prevent, LLC, Blackwood, New Jersey, a consulting company that provides educational, legal, and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist, which is a health care professional who specializes in working with elderly patients, and a geriatric physician's assistant. He has been active in the area of fall prevention for over thirty years. He has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care, and nursing facility settings. He has as authored several books devoted to the topic of fall prevention.

Pedagogy Education offers several online continuing education courses for nurses, nurse aides, home care aides and assistants, and caregivers authored by Dr. Rein:
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Click on the course title to learn more and get started on your fall prevention education. If you would like to offer your entire team online continuing education on fall prevention, send us an email at sales@pedagogy-inc.com to receive our best pricing available.
Posted: 9/15/2016 4:04:30 PM
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