In counseling a client who is following a low-sodium diet, which statement about using soy sauce to add flavor is most accurate?

• A. Soy sauce is high in potassium and therefore lowers blood sodium levels when used freely on a low-sodium diet.
• B. Soy sauce is naturally sodium-free and is a good way to add flavor without increasing sodium intake.
• C. Soy sauce provides mostly sodium as $N_a+$, which is not absorbed in the intestine and does not affect total sodium intake.
• D. Soy sauce is typically high in sodium, so regular soy sauce is usually not appropriate unless a reduced-sodium version is used and portions are carefully limited.

Answer: (D)

Verified step by step guidance

1. Understand that soy sauce is commonly used as a flavor enhancer but is known to contain a significant amount of sodium, which is important to consider in a low-sodium diet.
2. Recognize that sodium in the diet primarily comes from sodium ions, represented chemically as \(\mathrm{Na}^+\), which are absorbed in the intestine and contribute to total sodium intake.
3. Evaluate the statements given: soy sauce is not naturally sodium-free, nor does it contain potassium in amounts that would lower blood sodium levels significantly.
4. Recall that regular soy sauce contains high sodium content, so using it freely would increase sodium intake, which is counterproductive for someone on a low-sodium diet.
5. Conclude that the most accurate advice is to use reduced-sodium soy sauce versions and to limit portion sizes carefully to manage sodium intake effectively.