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Feature Article Salt Vs. Sugar – Which is Worse for Your Heart?

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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.

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.”

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.

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.

If you consume more than the recommended limit, a study published in JAMA Internal Medicine found that those who got more than 17 percent of their daily calories from added sugar had a significantly higher risk of dying from cardiovascular disease.

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.”

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.

While sodium may not be as big of a problem in the American diet as sugar these days, keeping your intake within the recommended range is still important and will help maintain a healthy blood pressure. Often, the foods that are high in sodium are highly processed and have other unhealthy factors, although even healthy pantry staples like canned beans, soup, broth or vegetables can have excess sodium.

  • 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.