SALT AND SUGAR; SUGAR MORE HURTING THAN SALT?

Sugar vs salt: which is worse for your heart health?

They are also very different chemically. Salt is made up of sodium and chloride and is ionically bonded. Sugar, on the other hand, is composed of carbon, oxygen, and hydrogen and has covalent bonds. A salt molecule is made up of one sodium atom and one chlorine atom.

For example, sugar is much more soluble in water than is salt. But even sugar has an upper limit on how much can dissolve. In a half liter of 20 °C water, the maximum amount is 1000 grams

Sodium & Blood Pressure

Sodium is a necessary nutrient for the body and can be found naturally in foods like celery and beets. Table salt is made up of sodium chloride and provides most of the nutrient sodium in people’s diets, nearly 90 percent according to the Centers for Disease Control and Prevention (CDC). The CDC also reports that the majority of salt in the American diet, more than 70 percent, is from processed or restaurant foods.

“The recommended amount of sodium is 2,300 mg a day, which is about a teaspoon,” said Christopher Dubuque, DO, Samaritan Internal Medicine - Corvallis. “But 90 percent of people eat too much. Many studies have shown that cultures with low sodium diets also have low blood pressure, and reducing excess sodium intake is tied to lower blood pressure within a few weeks

When considering heart health, blood pressure is one of the most significant risk factors. And if you have high blood pressure, chances are you might be thinking about lowering your salt intake. But new research is pointing a finger at sugar as the culprit for causing a number of health conditions including high blood pressure, and increasing the risk for cardiovascular disease.

Despite the link between sodium and blood pressure, the journal Open Heart published a review that proposes added sugar may be more strongly and directly associated with high blood pressure and overall cardiovascular risk.

We’ve always been told that too much salt and sugar in our diets is not good for our heart health, so what are we to make of research that claims excess sugar is by far the worse of the two?

• Why sugar and salt are bad for heart health
• How to cut your salt intake
• How to reduce sugar consumption

Along with suggesting that people need to focus more on cutting sugar consumption levels than their salt intake, the researchers claim that reducing salt levels could, in certain circumstances, actually do more harm than good.

The Rise of Sugar

According to the Department of Health and Human Services (HHS), sugar is the most popular ingredient added to foods in the U.S. To be considered an added sugar, these sweeteners are incorporated during processing or at the table and not naturally part of the food you are eating.

Fruit, vegetables, dairy and many grains have natural sugars. Added sugars include white and brown sugar, corn syrup, honey, glucose, fructose, dextrose, lactose, malt syrup, maltose, brown rice syrup and molasses, among others. These added sweeteners are not limited to desserts and soda. Sugar is also found in processed savory foods like condiments, bread, soup, peanut butter, spaghetti sauce, crackers and more.

The HHS reports that Americans consume about three pounds of added sugar a week — that’s 41 teaspoons a day of processed sugars, far above the American Heart Association’s recommended limits of six teaspoons a day for women and nine teaspoons for men. Following the recommended limits for added sugar equals 100 to 150 calories, or about one 12-ounce can of regular soda.

The American Heart Association’s journal Circulation notes that added sugars have a negative effect on cholesterol, may be linked to inflammation and oxidative stress markers, and may increase the risk for being overweight or obese. All of these conditions decrease heart health and increase the risk for cardiovascular disease.

Why sugar and salt are bad for heart health

There are a number of studies that show excess sugar consumption could increase your risk of dying from heart disease (even if you’re not overweight) such as this report published in JAMA Internal Medicine.2 Here, the excess sugar caused inflammation of the arterial walls. It’s this consistent chronic inflammation of the blood vessels that can lead to heart disease and strokes.

Weighing the Results

So which is worse? Americans consume about 1 ½ times the amount of sodium they need and seven times the limit of added sugar. So sugar may be the biggest concern because it’s the biggest problem. Sugar is also linked to a host of other health concerns beyond high blood pressure and the heart.

“Historically, doctors have focused on limiting sodium to control blood pressure but more recently we’re seeing emerging research that shows added sugars can raise blood pressure and overall are dangerous to heart health in other ways,” said Dr. Dubuque. “Average sodium intake has remained somewhat stable over the years even as cardiovascular disease has grown, but people are getting an unprecedented amount of sugar in their diet. There’s a lot of room for improvement.”

Meanwhile, salt is essential for keeping your body fluids balanced at the right concentration but too much could send your volume of body fluids soaring. This in turn raises your blood pressure, which can cause even more serious heart health problems such as stroke or heart disease.

How to cut your salt intake

NHS guidelines suggest that you shouldn’t consume more than 6g (one teaspoon) of salt per day.3 Here are a few quick and easy ways to start reducing your salt intake today:

• Instead of adding extra salt to your homemade dishes, add some flavour by making the most of heart-healthy herbs and spices as ingredients.
• Opt for buying fresh meat as opposed to more processed versions which tend to have a much higher salt content.
• Did you know that dissolvable (effervescent) tablets such as painkillers and vitamin supplements can contain as much as 1g of salt per tablet? Where possible, choose capsule alternatives instead.

How to reduce sugar consumption

Current guidelines suggest that no more than 50g of sugar for women and 70g for men should be consumed per day.4

• A typical 250ml glass of fruit juice can contain up to seven teaspoons of sugar. Switch to water or lycopene-packed tomato juice instead.
• Ditch the extra teaspoons of sugar in your cup of tea/coffee. If you can’t forgo them completely, opt for a low calorie sweetener.
• Craving a sugary treat? Chow down on a piece of fruit instead of reaching for your usual chocolate fix. Although fruits do contain some sugar, they’re also packed full of vitamins, minerals and fibre. They’ll also help you to reach your 5 a day.

Rethink Your Diet

Sugar-sweetened drinks like soda make up 47 percent of the added sugars in the diet, according to the HHS. Snacks and sweets make up another 31 percent.

• To reduce your intake of sugar, replace regular soda with carbonated or tap water and flavor it with fresh fruit or herbs.
• Replace processed snacks with whole foods like nuts and fruit.
• Limit dessert to one meal a day. If you drink a sweetened beverage like soda, consider that your dessert for the day.
• Read labels and compare ingredients on the packaged foods you buy like bread or spaghetti sauce to make sure there aren’t added sugars.
• Added sugars should make up no more than 10 percent of your daily calories. Look at the nutrition label. Total sugars for the day should add up to no more than 25 to 38 grams.
• When you can, buy “unsalted” or “low sodium” versions of pantry staples and add salt while cooking if needed.
• Reduce or eliminate boxed foods like seasoned rice and frozen meals like pizza or ready-dinners.
• Limit the amount you eat out at restaurants.
• If the sodium content in the right column of the nutrition label is more than 20% DV, the food is considered high in sodium. Low sodium is 5% DV or less. Total daily sodium should add up to no more than 2,300 mg.

“The bottom line is to know what you are consuming,” said Dr. Dubuque. “Sugar and salt are everywhere and just taking notice of food labels when you go shopping and being conscious of reducing your salt and sugar intake can make a big difference to your health.”

If you have high blood pressure or feel you are consuming too much salt and sugar, consult your primary care provider. Learn more about heart health, and understand your risks for heart disease by taking a heart risk assessment from our health library

Summary

Whether or not sugar is indeed worse for heart health than salt, the fact of the matter remains that too much of either can be damaging to our hearts. We can all take steps to reduce our consumption and protect ourselves from these adverse effects.

References

1. DiNicolantonio JJ, Lucan SC. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 2014;1:e000167. doi: 10.1136/openhrt-2014-000167

2. Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Intern Med. 2014;174(4):516–524. doi:10.1001/jamainternmed.2013.13563

3. NHS, Salt: the facts, Live well eat well

4. NHS, How much sugar is good for me?, food and diet common health questions

https://futureyouhealth.com/

1Gill Shaffer

https://www.samhealth.org/