Love salty food, can't stop, and wake up with a puffy face?

If you love salty food and cannot seem to stop, cut back step by step rather than all at once: the level of salt you find tasty follows how much you usually eat, and it shifts as you eat less. The US FDA notes that as you reduce sodium, your taste for it gradually decreases. If you wake up with a puffy face after a salty dinner, salt may be one of several reasons: the UK's NHS lists eating too much salty food among the usual causes of swelling from fluid build-up in the ankles, feet and legs. Thai adults take in about 3,636 mg of sodium a day on average, against a Thai Reference Daily Intake (Thai RDI) of 2,000 mg. If your face stays puffy all day or for several days, or comes with swollen legs or other symptoms, see a doctor.

This article is about the "can't stop" feeling and puffiness. For a full guide to the sodium in fish sauce, soy sauce and other seasonings, and to eating out, see Love salty food and can't cut back? What can you do?

Why is it so hard to stop eating salty food?

Your sense of "tasty" follows your habits

In a US study published in 1982, young adults lowered their sodium intake for 5 months. The saltiness they found most pleasant in soup and crackers fell, while it did not change in a comparison group who ate as usual. The researchers concluded that the preferred level of salt depends on how much salt people eat, and that it can be lowered. So food that tastes bland at first is part of the process, not a sign that cutting back cannot work.

A Ramathibodi Hospital doctor, Asst. Prof. Surasak Kantachuvessiri, makes the same point for Thai cooking: the tongue adapts, and cutting saltiness by about 10% at a time is hard to notice, so reduce it little by little. Cutting a lot at once makes food taste unappetising, and people tend to give up.

A lot of salt does not taste salty

The FDA points out that some foods are high in sodium without tasting salty, so taste alone is not a good guide. In Thai food, sauces, pastes and seasoning powders go in during cooking, so you can take in a lot without ever picking up the salt shaker.

How much salt do Thai people actually eat?

The national average

A nationwide survey led by Chailimpamontree measured sodium in 24-hour urine from 1,599 Thai adults in the North, South, Northeast, Central region and Bangkok. The average intake was 3,636 mg a day, which the researchers describe as nearly twice the recommended level. It was highest in the South, at 4,108 mg, and lowest in the Northeast, at 3,316 mg. Younger adults were more likely to take in 2,000 mg or more a day than older adults. The figures are averages from one survey, and only about two-thirds of the 2,388 adults selected completed the urine collection.

What the Thai RDI says

The Thai RDI for sodium is 2,000 mg a day. That covers everything you eat and drink in the day, including the salt already in sauces, noodles, snacks and processed foods.

Where the salt comes from

A study by Thailand's Department of Health (Chotivichien and colleagues, 2021) used national food consumption surveys and product analyses to estimate where Thai people's salt comes from. It estimated that adults take in about 11.5 g of salt a day from household salt and from salt in processed foods and condiments.

Condiments are very salty but eaten in small amounts. Meatballs, sausages and instant noodles are less salty by weight, but people eat more of them, so they add up.

Dr Surasak's column for Ramathibodi Hospital gives the average sodium in some everyday Thai foods:

Instant noodles and broth

A survey of instant noodle and rice soup products in shops in Bangkok and nearby provinces, 788 products in total across 2018, 2019 and 2021, found a median of 1,750 mg of sodium per 100 g in 2021, down 11.6% from 2018. Products with soup contained about 1,913 mg per 100 g, against about 1,077 mg for those without soup. Among 57 products sold in both years, 47.4% did not change, 33.3% went down and 19.3% went up. The researchers note that most products are still above World Health Organization benchmarks.

Why does my face look puffy after salty food?

Salty meals and swelling

The NHS lists eating too much salty food among the usual causes of swelling from a build-up of fluid, on a page about the ankles, feet and legs. Some people also feel their face or eyes look puffy the morning after a salty dinner, a late night or drinking alcohol. Puffiness has several possible causes, so a salty day is only one of them.

Other everyday reasons

• Short sleep. In a study by Sundelin and colleagues in Sweden, 10 people were photographed after normal sleep and again after a night without sleep. Forty observers rated the sleep-deprived faces as having more swollen eyes, darker circles and more hanging eyelids.
• Sitting or standing still. The NHS lists standing or sitting in the same position for too long as another usual cause of fluid build-up.
• Medicines. The NHS notes that some medicines can cause swelling. Do not stop a medicine on your own; ask your doctor or pharmacist.

How can I cut back on salt without giving up the food I love?

Small steps you can keep

• Taste first. Season after tasting, not out of habit.
• Check instant products with soup. In the Thai survey above, products with soup had about 1,913 mg of sodium per 100 g, against about 1,077 mg for those without soup. For more on noodles, broth and eating out, see our guide to salty food.
• Use part of the seasoning sachet in instant noodles, and add egg, vegetables or herbs for flavour.
• Keep dipping sauces on the side and dip rather than pour.
• Watch the processed extras. Meatballs, sausages and fish balls are eaten in larger amounts than sauces, so smaller portions lower the total for the day.
• Flavour with herbs and spices. The FDA suggests herbs and spices in place of salt; lime, chilli, garlic, lemongrass and basil already play that role in Thai cooking.
• Try lower-salt versions. The NHS suggests low or reduced-salt versions of sauces and stock cubes, and not using too many salty sauces.

Give your taste time

The 1982 study followed people for 5 months, and the US FDA notes that your taste for sodium decreases gradually as you cut back. Following the Ramathibodi doctor's tip, lower the salt by about a tenth, wait until that tastes normal, then lower it again. Start by not adding extra seasoning at the table.

On a salty day

If you have had a salty dinner, keep the next meals lighter on sauces and broth, and get to bed on time.

What can I do on a puffy morning?

For swelling of the ankles, feet or legs, the NHS suggests:

• raising your legs on a chair or pillows when you can
• gentle exercise, such as walking
• not standing or sitting still for long periods
• not wearing clothes, socks or shoes that are too tight

A puffy face is not covered by this NHS advice; if it does not go down during the day, see the next section. If you want to use any medicine for swelling, ask a doctor or pharmacist first. If you are pregnant or breastfeeding, or take regular medicines, ask a doctor or pharmacist before making big changes to what you eat or drink.

When should I see a doctor about puffiness?

See a doctor if

• your face stays puffy all day, or is puffy for several days in a row
• swelling in both ankles, feet or legs has not improved after a few days of looking after it at home
• the swelling is getting worse

Get urgent help if

• only one ankle, foot or leg is swollen and you do not know why
• the swelling is severe, painful or starts very suddenly
• your ankles, feet or legs are swollen and you also have swelling in your face or tummy
• the swollen area is red or feels hot
• you have a very high temperature, or feel hot, cold or shivery

Call 1669 straight away if

• you feel short of breath or are struggling to breathe
• your chest feels tight, heavy or painful
• you are coughing up blood
• your heartbeat is more noticeable, or you feel lightheaded, faint, confused or clammy