Jessica Goldman Foung almost died during her junior year at Stanford. The petite, cheerful dancer had spent fall quarter abroad in Italy, having fun yet never really feeling well. In the land of pasta and pizza, she conscientiously avoided gluten, having been told that celiac disease was making her tired and achy. On the plane back home to California, she found a lump in her neck. "I thought I had cancer," she recalls.
Doctors made a new diagnosis: lymphoma. Determined to remain upbeat, she started winter quarter and thought about the head-shaving party she would throw herself. A few days later her body stiffened and her head pounded with the worst headache of her life. Her mother brought her home and within half an hour found her on the bathroom floor in the midst of a seizure.
Foung, '05, had neither lymphoma nor celiac disease. She was suffering from lupus, an autoimmune disorder that is notoriously difficult to diagnose—in part because it expresses itself differently in every patient. Foung's lupus attacked her brain and her kidneys. She spent the next three months in Stanford Hospital, interspersed with brief periods at her parents' nearby home. She underwent chemotherapy—and had that head-shaving party after all. She had thrice-weekly dialysis. When her embattled kidneys failed, she prepared for a transplant.
Foung took her medicine and embraced the strict low-sodium diet that her doctors ordered. As anyone who has ever stepped onto the bathroom scale after a night of overindulgence in nachos and margaritas knows, salt causes the body to retain water. Healthy kidneys eliminate excess fluid and sodium as needed. Sick kidneys can't keep up, and as sodium and fluid accumulate, blood pressure can rise dangerously. Swelling, difficulty breathing and heart failure can follow.
Somehow—even her doctors can't fully explain why—Foung recovered, and her kidneys partially regenerated.
But she quickly tired of the bland meals her diet required, so she taught herself to cook and turned her attention to a new goal: Put bright flavors and fun back on her plate without the sodium that her kidneys couldn't handle. Little did she know that simple desire would lead to a new career as a food writer and educator.
Today, at 30, Foung is known as "Sodium Girl." Her first cookbook, Sodium Girl's Limitless Low-Sodium Cookbook (Wiley), was published in February with book parties on both coasts and a healthy lineup of media interviews. Fans of Foung's lively SodiumGirl.com blog will find more of the modern, creative recipes for which she has become known, along with her trademark breezy tone and beautiful photographs. She uses herbs, spices, vinegar and other ingredients to pump up flavors in everything from Bloody Mary mix to buffalo wings while keeping sodium low.
Foung writes regularly for national publications, speaks about lupus before audiences of physicians and medical students, and recently taught a course on Writing Through Illness via Stanford's Continuing Studies program. She lives in San Francisco with her husband, Alejandro Foung, '04, and their baby daughter, Nomi.
This January marks 10 years since Foung's diagnosis. Dialysis and the transplant list are behind her. Though she jokes that her doctors call her "one of the healthiest unhealthy people they know," she lives with joint pain, chronic fatigue and a weak immune system and must weigh every activity and invitation against its cost to her energy reserves. "I try to balance the ambition and stubbornness. I think that's why I survived in the first place."
The average American consumes about 3,400 milligrams of sodium daily, far in excess of the 200 milligrams per day that our bodies need. Foung aims to consume just 500 to 1,000 milligrams per day. It's tough to stay in that range even though she eliminates salt from cooking because sodium occurs naturally in many foods. (An egg, for example, contains 70 milligrams.) Three quarters of the salt we consume comes from prepared and processed foods such as bread, lunchmeat and canned soups.
The USDA recommends an upper limit of 2,300 milligrams of sodium per day—the equivalent of
one teaspoon of salt, with a lower limit of 1,500
milligrams for those over age 50, African-Americans or those who suffer from hypertension, kidney
disease or diabetes.
Foung offers these tips to limit sodium:
• Read labels. Sodium quantities can differ dramatically from brand to brand of a single product.
• Some foods such as beets, celery and beef are naturally high in sodium. Use these to bring a slightly salty flavor to a dish without adding salt.
• A sprinkle of nutritional yeast can stand in for salty cheeses like Parmesan, and low-sodium ricotta can replace goat cheese.
• Communication is key when dining out. Call ahead or do as Foung does and bring a card listing your dietary needs and emphasizing what you can eat.
• When cooking at home, "remember that you can't just remove the salt, you have to replace it," Foung advises. Explore spices and ingredients you have never tried before. "When you surprise your palate, you don't miss the salt."
Julie Kaufmann, '83, is a freelance writer and cookbook author in Palo Alto.
