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Salt: How much, how often, and why? . Julie Matel, MS, RD, CDE CF Center Dietitian. Salt. Salt = NaCl Sodium + Chloride Essential minerals Must be supplied in the diet. Why is salt important for people who have CF?. Na CL lost in the sweat (2-5 x normal amounts) Skin tastes salty

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salt how much how often and why

Salt:How much, how often, and why?

Julie Matel, MS, RD, CDE

CF Center Dietitian

slide2
Salt

Salt = NaCl

Sodium + Chloride

  • Essential minerals
  • Must be supplied in the diet
why is salt important for people who have cf
Why is salt important for people who have CF?
  • Na CL lost in the sweat

(2-5 x normal amounts)

  • Skin tastes salty
  • Sweat chloride test used to diagnose CF
    • Normal = less than 40 mmol/L NaCl
    • CF = at least 60 mmol/L and usually more than 100 mmol/L NaCl
functions of salt in the body
Functions of Salt in the Body

Salt helps to…

  • maintain the body’s fluid balance
  • maintain muscle contractions
  • Salt is a vital component of blood, plasma, and digestive secretions
consequences of increased salt loss in cf
Consequences of Increased Salt Loss in CF
  • More rapid onset of heat prostration

(heat stroke)

  • Reduced appetite
  • Abdominal pain
  • Weakness
  • Nausea
  • Headache
  • Poor growth
who is at risk for having low sodium levels
Who is at risk for having low sodium levels?
  • Breast fed infants with CF
  • Anyone with CF experiencing vomiting and diarrhea
  • Anyone with CF living in a hot environment or exercising vigorously
acid base and electrolyte disturbances in infants with cf
Acid Base and Electrolyte Disturbances in Infants with CF
  • 103 infants diagnosed with CF prior to 1 year (1990-2000)
  • Evaluated for acid base and electrolyte disturbances

Fustik et al. Ped Inter (2002) 44, 289-292.

results
Results
  • 16% of the infant CF population had electrolyte and acid base disturbances
  • Age 2 to 6 months
  • No seasonal occurrence was found
  • All infants breast fed
  • Most not previously diagnosed with CF
  • All infants had history of some loose stools and failure to thrive prior to admission
  • 94% of infants presented with vomiting
  • All infants were pancreatic insufficient
  • Only 60% showed mild to moderate signs of dehydration

Fustik et al. Ped Inter (2002) 44, 289-292.

the bottom line
The Bottom Line….
  • Early infant age
  • Breast-feeding
  • Delayed diagnosis
  • Heat exhaustion
  • The presence of CFTR mutations associated with severe disease…

are predisposed factors for development of electrolyte and acid base abnormalities in CF patients

exercise study
Exercise Study

Objective:

To determine how much salt is

required to increase voluntary fluid

intake

exercise study13
Exercise study
  • 11 subjects with CF

(6 girls, 5 boys)

  • Ages 11-20 years
  • Attended 3 sessions of intermittent moderate exercise

(4, 20 min bouts of cycling)

  • 95 degrees F

(50% humidity)

exercise study14
Exercise Study

One of the following beverages was

assigned in each session…

  • Water
  • Flavored water
  • Flavored water with 690 mg/L of Na and 6% carbohydrate
  • Additional session in 6 subjects with flavored drink with 1150 mg/L of Na and 6% carbohydrate

Gatorade = 452 mg/L of Na

bottom line
Bottom Line…
  • Children and adolescents with CF underestimated their fluid intake and became dehydrated when exercising in the heat
  • When given a higher sodium beverage (1150 mg/L), fluid intake increased sufficiently to prevent dehydration
  • Add 1/8 tsp to every 12 oz of Gatorade
how much salt do i need
How much salt do I need?

No one is sure!

For people without CF…

  • 120 mg for infants less than 6months
  • 1500 mg for adults

People with CF need more

sodium recommendations for cf
Sodium Recommendations for CF
  • Eat salty foods
  • Use salt shaker freely at meals and snacks
  • Add 1/8 tsp of salt to 1 ½ cups

(12 oz) of sports drink during outdoor exercise (especially on hot days)

  • Add 1/8 tsp daily to breast milk or formula for infants
what are the best sources of salt
What are the best sources of salt?
  • Table salt
  • Salted nuts
  • Bacon
  • Pickles
  • Canned soup
  • Salted crackers/chips
  • Canned vegetables
  • Frozen dinners
food labels
Food Labels

Food Sodium (mg)

Ramen, Noodles 1430

Salt ¼ tsp 580

Dill Pickle 570

Canned Soup (1 cup) 480

Hard pretzels (1 oz) 385

Pedialyte (1 cup) 245

Cheerios (1 cup) 204

Bacon 1 slice 185

Gatorade 1 cup 200

can i get too much salt
Can I get too much salt?
  • Very unusual for someone with CF to get too much
  • At risk for too little!