When you were diagnosed with diabetes, one of your first concerns was probably how you were going to monitor your carbohydrate intake. So you thought about potatoes, bread, pasta, and even fruit. But there’s actually another nutrient that everyone with type 2 diabetes should have on their radar: sodium.

It’s true that the human body needs sodium, as it’s a necessary electrolyte, according to the MedlinePlus, a mineral that regulates your body’s fluid balance and helps ensure proper muscle and nerve function. Problem is, 89 percent of adults get too much, according to an article published in July 2020 in the American Journal of Hypertension. When sodium excretion levels rise, the risk for high blood pressure increases, and so do your chances of developing heart disease, notes the Centers for Disease Control and Prevention (CDC).

Diabetes and Heart Disease: What to Know About Your Risk

The statistics linking diabetes and heart disease are enough to get anyone to rethink their soy sauce usage. According to the American Heart Association (AHA), adults with diabetes are up to two times more likely to die from heart disease compared with those who don't have diabetes. That could be because people with type 2 diabetes may have certain risk factors that make them more prone to cardiovascular disease, like having high blood pressure, having high LDL (“bad”) cholesterol, carrying excess weight, and living a more sedentary lifestyle.

Research backs this up. Adults with type 2 diabetes who consumed the highest intake of sodium increased risk of cardiovascular disease by more than 200 percent compared with those who ate the lowest amount, according to previous research. The authors concluded that restricting salt can go a long way in helping preventing complications of diabetes.

How Much Salt Is Safe to Eat When You Have Type 2 Diabetes?

Salt and sodium may seem like the same thing, but they’re not. Sodium refers to the natural element, which is a mineral. Salt, on the other hand, contains 40 percent sodium by weight, according to the AHA. Still, you can think about lowering your salt or sodium; both will do your heart good.

Reducing how much sodium you consume may be a big player in lowering your risk of high blood pressure and thus heart disease, notes the AHA.

Research has also found that restricting sodium significantly lowers systolic blood pressure (the first number) by about 5.5 points and diastolic blood pressure (the bottom number) by 1.6 points, according to a meta-analysis of randomized controlled trials in Nutrition, Metabolism and Cardiovascular Diseases in June 2021. The American Diabetes Association recommends people with diabetes limit their sodium intake to 2,300 milligrams (mg), which is 1 teaspoon (tsp) of table salt per day, though just 7 percent of people with diabetes met these guidelines, according to a study in Nutrition & Diabetes in June 2020.

That said, some experts recommend lowering it even further. “People with diabetes should strive to consume only 1,500 mg of sodium daily,” or ¼ tsp of salt, says Lori Zanini, RD, CDCES, author of Eat What You Love Diabetic Cookbook in Dana Point, California. Because recommendations vary per person, consult your doctor to find out which limit is best for you.

It may seem difficult to think about sodium when you’re already so focused on making sure you’re getting an okay amount of carbs at each meal or snack. With more to keep track of, it can throw you for a loop, but it’s completely doable, and most important, it's worth it. “The encouragement I provide to my clients is that all individuals can benefit from eating this way, whether or not you have diabetes. This is simply a healthy eating plan,” says Zanini. While there’s some controversy around whether healthy adults should monitor their sodium intake, this is crucial for people with diabetes.

The No. 1 source of salt isn’t from your salt shaker: It’s eating out at restaurants and the like. In fact, 70 percent of sodium intake was found in restaurant and processed foods, according to a study published in May 2017 in the journal Circulation. “The best advice is to eat more at home. Preparing meals at home and limiting the amount of times you dine out every week will drastically cut back on your sodium intake,” Zanini says. “I like to say, ‘If it comes in a bag, box, or through a window, there’s a good chance there’s going to be a significant amount of salt added to that food,’” she adds.

6 Sneaky Sodium Sources

If you’re not already a sodium sleuth, shopping for low-salt fare can be tough at first, but after the first couple of visits spent comparing labels, it’ll be a breeze. Still, sodium can hide in some surprising places, like these:

1. Marinara Sauce

A serving can contain more than 500 mg of sodium, per the U.S. Department of Agriculture (USDA) , and you may pour on far more than that. Zanini recommends making your own at home by cooking fresh tomatoes into a sauce; you can even eliminate the salt or use less than the recipe suggests.

2. Packaged Oatmeal

Flavored packets of oatmeal are a shocking source, packing in around 200 mg of sodium, according to the USDA. Instead of buying these packets, make your own oatmeal at home, flavoring with fruit or nuts on your own.

3. Certain Condiments

While they add a punch of flavor to cookout favorites, mustard and ketchup may actually be salt bombs. You don’t necessarily need to go to the trouble of making these at home, but Zanini suggests comparing the nutrition labels of brands to find one that contains less than 100 mg of sodium per 1 tsp serving. “Anything more than this can add up quickly,” she says.

4. Bread

Sorry, sandwich. This is one of the top sources of sodium in our diet, per the CDC. It’s another place where it’s so important to compare labels, as brands can differ so much. Also consider eating open-faced sammies to eliminate a slice or replacing the bread altogether with something like lettuce wraps or even sweet potato toasts. When shopping for bread, opt for loaves that contain less than 200 mg of sodium per slice, advises Zanini.

5. Chicken

Another potential shocker, but poultry is also a top source of sodium. It may be enhanced with a mix of water and salt to plump it up. In data from the USDA, 3.5 ounces (oz) of enhanced dark meat chicken contains significantly more sodium compared with a non-enhanced bird. Here’s another case where you want to read the label. If the ingredient lists something like “chicken broth and sea salt,” that’s a red flag the bird was enhanced.

6. Cheese

A 1 oz slice of cheddar cheese may offer more than 150 mg of sodium, notes the USDA. The happy news: The type of cheese can make a big difference. Past research concluded that processed cheeses, like American cheese and string cheese, were the saltiest. Swiss is one of the big winners when it comes to being low salt, containing just 53 mg per 1 oz slice, according to the USDA. Mozzarella was also found to be lower on the salt scale, according to another previous study. The gist: Go for fresh!

Diabetes and Salt: How Much Is Safe and How to Limit It in Your Diet