Study Suggests Sugar Is Worse Than
Salt for Blood Pressure
February 25, 2015
Story at-a-glance
Added sugars, particularly fructose, in the US diet
may be more strongly related to high blood pressure
than salt
Cutting processed foods from your diet may benefit
high blood pressure not only because it reduces
salt, but more likely because it reduces sugar
Excess sugar in your diet increases blood pressure
and heart rate and contributes to inflammation,
insulin resistance and metabolic dysfunction
By Dr. Mercola
One out of every three US adults has high blood pressure
(hypertension).1
If you're among them, one of the first recommendations your
physician probably gave you was to cut back on salt.
Yet, there's far more to maintaining a healthy blood pressure
than eating a low-salt diet – a strategy that works for some people
and fails for others.
In fact, fewer than half of Americans with high blood pressure
have their condition under control,2
and perhaps this is because conventional physicians have been
focused on the "wrong white crystals," namely salt instead
of sugar.
One of the primary underlying causes of high blood pressure is
related to your body producing too much insulin and leptin in
response to a high-carbohydrate (i.e. high sugar) and
processed food diet.
New Study: Sugar May be Worse for Your Blood Pressure Than Salt
You've probably heard of the
DASH diet, which is claimed to be among the most effective for
controlling hypertension. It consists largely of fresh vegetables,
fruits, lean protein, whole grains, low-fat dairy, and very low
sodium content.
But it's ALSO low in
sugar/fructose. So, while people on DASH diets do tend to
show reduced hypertension, the reason for this may not be solely the
reduction in salt, but the reduction in sugar.
The same holds true for reducing your intake of processed foods,
which are top sources of both heavily processed salt and
sugar/fructose. In a new review in the journal Open Heart,
the authors also argue that the high consumption of added sugars in
the US diet may be more strongly and directly associated with high
blood pressure than the consumption of sodium.
"Evidence from epidemiological studies and experimental
trials in animals and humans suggests that added sugars,
particularly fructose, may increase blood pressure and blood
pressure variability, increase heart rate and myocardial oxygen
demand, and contribute to inflammation, insulin resistance and
broader metabolic dysfunction.
Thus, while there is no argument that recommendations to
reduce consumption of processed foods are highly appropriate and
advisable, the arguments in this review are that the benefits of
such recommendations might have less to do with sodium—minimally
related to blood pressure and perhaps even inversely related to
cardiovascular risk—and more to do with highly-refined
carbohydrates."
Take, for instance, one 2010 study that showed consuming a
high-fructose diet lead to an increase in blood pressure of about
7mmHg/5mmHg, which is greater than what is typically seen with
sodium (4mmHg/2mmHg).4
Research also shows that drinking a single 24-ounce
fructose-sweetened beverage leads to greater increases in blood
pressure over 24 hours than drinking a sucrose-sweetened beverage,5
which again points to the detrimental effects of fructose on your
health. The Open Heart study authors concluded:
"It is time for guideline committees to shift focus away
from salt and focus greater attention to the likely
more-consequential food additive: sugar.
A reduction in the intake of added sugars, particularly
fructose, and specifically in the quantities and context of
industrially-manufactured consumables, would help not only curb
hypertension rates, but might also help address broader problems
related to cardiometabolic disease."
How Excess Sugar Causes High Blood Pressure
In order to effectively treat and recover from high blood
pressure, it's important to understand its underlying cause, which
is often related to your body producing too much insulin and leptin
in response to a high-carbohydrate and processed food diet. As your
insulin and leptin levels rise, it causes your blood pressure to
increase. Eventually, you may become insulin and/or
leptin resistant.
As explained by Dr. Rosedale,
insulin stores magnesium, but if your insulin receptors are
blunted and your cells grow resistant to insulin, you can't store
magnesium so it passes out of your body through urination. Magnesium
stored in your cells relaxes muscles.
If your magnesium level is too low, your blood vessels will be
unable to fully relax, and this constriction raises your blood
pressure. Fructose also elevates
uric acid, which drives up your blood pressure by inhibiting the
nitric oxide in your blood vessels. (Uric acid is a byproduct of
fructose metabolism. In fact, fructose typically generates uric
acid within minutes of ingestion.)
Nitric oxide helps your vessels maintain their elasticity, so
nitric oxide suppression leads to increases in blood pressure. So
any program adapted to address high blood pressure needs to help
normalize both your insulin/leptin sensitivity and uric acid level.
As it turns out, by eliminating excess sugar/fructose from your
diet, you can address all three issues (insulin, leptin, and uric
acid) in one fell swoop. As a standard recommendation, I recommend
keeping your total fructose consumption below 25 grams per day.
If you're insulin resistant (the majority of Americans are), have
high blood pressure, diabetes, heart disease, or other chronic
disease, you'd be wise to limit your fructose to 15 grams or less
per day, until your condition has normalized.
In his book The Sugar Fix, Dr. Richard Johnson includes
detailed tables showing the content of fructose in different foods,
but you can view a sampling of the fructose content of several
common fruits below.
Keep in mind that for most Americans, in order to lower your
fructose/sugar consumption you'll also need to eliminate
sugar-sweetened beverages and processed foods.
New Website Shows How Too Much Sugar Can Make You Sick
SugarScience.org is a new website that uses graphics, videos and
science to show you the many links between excess sugar and chronic
disease. It's a product of
Dr. Robert Lustig and colleagues, who have reviewed more than
8,000 independent studies on sugar and its role in heart disease,
type 2 diabetes, liver disease and more.6
The site notes:7
"Over time, consuming large quantities of added sugar can
stress and damage critical organs, including the pancreas and
liver. When the pancreas, which produces insulin to process
sugars, becomes overworked, it can fail to regulate blood sugar
properly. Large doses of the sugar fructose also can overwhelm
the liver, which metabolizes fructose. In the process, the liver
will convert excess fructose to fat, which is stored in the
liver and also released into the bloodstream. This process
contributes to key elements of MetS [metabolic syndrome],
including high blood fats or triglycerides, high cholesterol,
high blood pressure and extra body fat in the form of a sugar
belly."
The site points out that added sugar can be found in 74 percent
of packaged foods, using at least 61 different names on food labels.
If you see sucrose, sugar or high-fructose corn syrup, you'll
probably recognize that the food contains added sugars, but barley
malt, dextrose, maltose and rice syrup (among many others) also
signal added sugar. The World Health Organization (WHO) recommends
that no more than 10 percent of your daily calories (and ideally
less than 5 percent) come from added sugar or natural sugar. At 5
percent, if you eat a 2,000-calorie daily diet, this amounts to 25
grams of sugar a day. For comparison, the average American eats
closer to 82 grams of sugar daily.8
Even in the US, acknowledgement of sugar's health dangers
continues to grow. The 2015 Dietary Guidelines Advisory Committee
also recommended Americans limit their added sugars to 10 percent of
their total daily calories, while the American Heart Association
recommends no more than 150 calories a day for men and 100 for
women. The Dietary Guidelines Advisory Committee's working group on
added sugar pointed out "strong scientific evidence" and "moderate
evidence" that added sugars play a role in:9
Excess weight and obesity
Type 2 diabetes
High blood pressure
Heart disease
Stroke
Tooth decay
Does Salt Play a Role in Hypertension?
While the role of sugar in high blood pressure is becoming
clearer, what does this mean for advice to
cut salt from your diet to boost heart health? Overindulgence in
the typically used commercially processed table salt can lead to
fluid retention, high blood pressure, swelling of your limbs, and
shortness of breath. In the long term, it is thought to contribute
to high blood pressure, kidney and heart disease, heart attacks, and
heart failure. However, compelling evidence suggests that while
processed salt can indeed cause fluid retention and related health
problems, numerous studies have, overall, refuted the
salt-heart disease connection.
For example, a 2011 meta-analysis of seven studies involving more
than 6,000 people found NO strong evidence that cutting salt intake
reduces the risk for heart attacks, strokes or death. In fact, salt
restriction actually increased the risk of death in those
with heart failure.10
Some studies have shown a modest benefit to salt restriction among
some people with high blood pressure, but the evidence does
not extend to the rest of the population. So what's really going on?
For starters, there's a huge difference between natural salt and the
processed salt added to processed foods and salt shakers in most
homes and restaurants. The former is essential for good health,
whereas the latter is best avoided altogether.
Another factor that can have a significant impact on whether salt
will harm or help your health is the ratio between the salt and
potassium in your diet. Among other things, your body needs
potassium to maintain proper pH levels in your body fluids, and it
also plays an integral role in regulating your blood pressure. It's
possible that potassium deficiency may be more responsible for
hypertension than excess sodium. Imbalance in your sodium-potassium
ratio can lead to hypertension, and the easiest way to achieve this
imbalance is by consuming a diet of processed foods, which are
notoriously low in potassium while high in sodium. Remember,
processed foods are also loaded with fructose, which is clearly
associated with increased hypertension risk, as well as virtually
all chronic diseases.
This may also explain why high-sodium diets appear to affect some
people but not others. According to a 2011 federal study into sodium
and potassium intake, those at greatest risk of cardiovascular
disease were those who got a combination of too much sodium
along with too little potassium.11
According to Dr. Elena Kuklina, one of the lead authors of the
study, potassium may neutralize the heart-damaging effects of salt.
Tellingly, those who ate a lot of salt and very little potassium
were more than twice as likely to die from a heart attack as those
who ate about equal amounts of both nutrients.
My Top-Recommended Strategies to Prevent Hypertension
If you are diagnosed with high blood pressure,
dietary
strategies will be crucial to controlling your levels. Avoiding
processed foods (due to their being high in
sugar/fructose,
grains,
trans fat and other damaged fats and processed salt) is my
number one recommendation if you have high blood pressure. Instead,
make whole, ideally organic, foods the focus of your diet. As you
reduce processed foods, and other sources of non-vegetable carbs,
from your diet, you'll want to replace them with healthy fat.
Sources of healthy fats to add to your diet include:
Coconuts and coconut oil (coconut
oil actually shows promise as an effective Alzheimer's
treatment in and of itself)
Unheated organic nut oils
Raw nuts, such as pecans and macadamia, which are low in
protein and high in healthy fats
Grass-fed meats or pasture raised poultry
It's not only your diet that matters for healthy blood
pressure … a comprehensive fitness program is another strategy that
can improve your blood pressure and heart health on multiple levels
(such as improving your insulin sensitivity). To reap the greatest
rewards, I strongly suggest including
high-intensity interval exercises in your routine. You'll also
want to include weight training. When you work individual muscle
groups you increase blood flow to those muscles, and good blood flow
will increase your insulin sensitivity. If you want to kill several
birds with one stone, exercise barefoot outdoors on sunny days.
Not only will you get much-needed sunshine to promote production
of heart-healthy vitamin D, but bright daylight sun exposure will
also help maintain a healthy
circadian clock, which will help you sleep better.
Poor sleep is yet another oft-ignored factor that can cause
resistant hypertension. Going barefoot, meanwhile, will help you
ground to the earth. Experiments show that walking barefoot
outside—also referred to as
Earthing or grounding—improves blood viscosity and blood flow,
which help regulate blood pressure. Keep in mind that, in most
cases, high blood pressure is a condition that can be managed and
oftentimes reversed with natural lifestyle changes.
Skip breakfast: Research shows that
intermittent fasting helps fight obesity and type 2
diabetes, both of which are risk factors for high blood
pressure. Your body is most sensitive to insulin and leptin
after a period of fasting. While there are many types of fasting
regimens, one of the easiest to comply with is an
eating schedule where you limit your eating to a specific,
narrow window of time each day. I typically recommend starting
out by skipping breakfast, and making lunch your first meal of
the day until you resolve insulin resistance, then you can eat
breakfast if your fasting insulin levels remain normal.
Optimize your vitamin D
levels: Arterial stiffness (atherosclerosis)
is a driving factor for high blood pressure. As your blood
travels from your heart, cells in the wall of your aorta, called
baroreceptors, sense the pressure load, and signal your nervous
system to either raise or lower the pressure. However, the
stiffer your arteries are, the more insensitive your
baroreceptors become, and the less efficient they become at
sending the appropriate signals. Vitamin D deficiency is, in
turn, linked to stiff arteries, which is why
optimizing your levels is so important.
Address your stress: The link between
stress and hypertension is well documented. Suppressed negative
emotions such as fear, anger, and sadness can severely limit
your ability to cope with the unavoidable every day stresses of
life. It's not the stressful events themselves that are harmful,
but your lack of ability to cope. I recommend
Emotional Freedom Technique
(EFT) to transform your suppressed, negative emotions and
relieve stress.
Normalize your omega 6:3 ratio: Most
Americans get too much omega-6 in their diet and far too little
omega-3. Consuming omega-3 fats will help re-sensitize your
insulin receptors if you suffer from insulin resistance. Omega-6
fats are found in corn, soy, canola, safflower, and sunflower
oil. If you're consuming a lot of these oils, you'll want to
avoid or limit them. For omega-3s, your best bet is to find a
safe source of fish, or if this proves too difficult or
expensive, supplement with a high-quality krill oil, which has
been found to be 48 times more potent than fish oil.
Optimize your gut flora: Compared to a
placebo, people with high blood pressure who consumed probiotics
lowered systolic blood pressure (the top number) by 3.56 mm Hg
and diastolic blood pressure (the bottom number) by 2.38 mm Hg.12
The best way to
optimize your gut flora is by avoiding sugar and processed
foods and including naturally fermented foods in your diet,
which may contain about 100 times the amount of bacteria in a
bottle of high-potency probiotics. Using fermented foods with a
starter culture like Kinetic culture will also add therapeutic
levels of important nutrients like
vitamin K2.
Maintain an optimal sodium-potassium ratio:
As mentioned, an imbalanced ratio may lead to hypertension. To
ensure yours is optimal, ditch all processed foods, which are
very high in processed salt and low in potassium and other
essential nutrients. Instead, eat a diet of whole, unprocessed
foods, ideally organically and locally-grown to ensure optimal
nutrient content. This type of diet will naturally provide much
larger amounts of potassium in relation to sodium.
Eliminate caffeine: The connection between
coffee consumption and high blood pressure is not well
understood, but there is ample evidence to indicate that if you
have hypertension, coffee and other caffeinated drinks and foods
can exacerbate your condition.
Vitamins C and E: Studies indicate that
vitamins C and E may be helpful in lowering blood pressure.
If you're eating a whole food diet, you should be getting
sufficient amounts of these nutrients through your diet alone.
If you decide you need a supplement, make sure to take a natural
(not synthetic) form of vitamin E. You can tell what you're
buying by carefully reading the label. Natural vitamin E is
always listed as the "d-" form (d-alpha-tocopherol,
d-beta-tocopherol, etc.) Synthetic vitamin E is listed as "dl-"
forms.
Olive leaf extract: In one 2008 study,
supplementing with 1,000 mg of
olive leaf extract daily over eight weeks caused a
significant dip in both blood pressure and LDL ("bad")
cholesterol in people with borderline hypertension. If you want
to incorporate olive leaves as a natural adjunct to a
nutritionally sound diet, look for fresh leaf liquid extracts
for maximum synergistic potency. You can also prepare your own
olive leaf tea by placing a large teaspoon of dried olive leaves
in a tea ball or herb sack. Place it in about two quarts of
boiling water and let it steep for three to 10 minutes. The tea
should be a medium amber color when done.
Quick tricks: Increasing nitric oxide in
your blood can open constricted blood vessels and lower your
blood pressure. Methods for increasing the compound include
taking a warm bath, breathing in and out through one nostril
(close off the other nostril and your mouth), and eating bitter
melon, rich in amino acids and vitamin C.
Copyright 1997- 2015 Dr. Joseph Mercola. All Rights Reserved.