Hypertension – It’s Not Just About the Salt

Hypertension is one of the most prevalent medical conditions in the nation, affecting nearly half of all adults in the US. However, many people are unaware of the risks and complications associated with high blood pressure. Before delving into the lifestyle modifications that can reduce the risk of and manage the diagnosis of high blood pressure, let’s start off with the basic tenets of Hypertension Comprehension:

1. Hypertension is characterized by a blood pressure of over 130 systolic and over 80 diastolic. (If you’re unaware of your blood pressure and fear you may be at risk of hypertension, see a doctor to obtain an accurate reading).
2. High blood pressure puts you at an increased risk of heart disease and stroke, two of the leading causes of death in the US.
3. African-Americans and males are at a higher risk of developing hypertension.
4. High blood pressure does not come with any warning signs or symptoms, causing most unaffected individuals to be unaware of their condition.

It is generally well known that excess salt consumption can play a factor in elevating blood pressure levels. However, recent research has shown increased intake of sugars and carbs to play an equal, if not more significant, role in developing hypertension. A 2018 study published by the Journal of American Medical Association found an increased prevalence of hypertension in participants with a diet high in processed, fried, and sweetened foods. The REGARDS (Reasons for Geographical and Racial Differences in Stroke) study indicated an association between this finding and the high disparity of hypertension prevalence in African-Americans.

The hidden risks of processed foods

Processed foods, as defined by the USDA, are foods that have undergone a procedure, whether that be canning, freezing, or pasteurizing, that alters the whole food. Most processed foods are chocked full of additives, including preservatives, sugars, and salts, which frequently destroy the natural nutrients produced by the food. These time-saving meals are part of the diet for many households but their effects can be detrimental to our health. How does this happen?

• Processed foods contain an unnatural ratio of salts, sugars, and carbs to healthy nutrients. The excess amount of sugar, salt, and carbs cannot be digested properly, causing many of the nutritious vitamins and minerals to dissipate and leaving only the influx of salt, sugar, and carbs to enter your blood stream.
• Your body craves balance, a concept known as homeostasis, and the excess amounts of processed foods in your diet hinder this equilibrium and cause your body to over-compensate for the imbalance.
• In response to the carbohydrates, your body will over-produce insulin, which in turn causes your kidneys to decrease sodium and water excretion, constrict your blood vessels, and increase your blood pressure.
• An influx of sugar in your diet inhibits your body’s ability to produce a molecule called Nitric Oxide, which serves to dilate your blood vessels. Lack of nitric oxide leads to constriction of your blood vessels, directly increasing your blood pressure.

Processed foods contain very high amounts of sugars, carbs, and salts, all of which significantly increase your risk of hypertension.

• The American Heart Association recommends a daily limit of 24 grams (~100 calories) of sugar. For reference, a can of Coca-Cola contains 39g of sugar.
• The Food and Drug Administration recommends ~300g of carbs each day. A soft pretzel contains 65g of carbs, which is over 20% of your daily intake.

So, what can you do about it?

Despite the detrimental health qualities of sugar, few people will disagree with its taste. If you’re still feeling a sweet-tooth, try swapping for an alternative. Stevia, monk fruit, Allulose and honey are all great replacements.

• Stevia is an element of the sunflower leaf containing stevioside, a compound that is 200 times as sweet as sugar. It contains no carbohydrates or calories and has been shown to lower blood glucose levels.
• Monk fruit contains compounds 300-400 times as sweet as sugar. Again, with no carbohydrates, sodium, or fat, and no effect on blood glucose levels.
• Allulose is another great alternative, offering limited carbohydrates and no effect on blood glucose levels, due to ability to be absorbed quickly by the digestive tract.
• Honey is great in moderation, as it is packed full of nutrients, vitamins, and minerals for your body. However, it can still influence blood glucose levels.

Similarly, alternate seasonings can be used while cooking to reduce salt consumption, while still offering a flavorful meal. Garlic, lemon juice/zest, dried/powdered onion, pepper, paprika, dill, rosemary, red pepper flakes, and ginger are wonderful additions to any culinary dish. These seasonings will enhance the natural flavors of the food you’re cooking, which frequently contain enough sodium on their own. When you do want to use salt, keep in mind that different types of salt are not necessarily healthier. An AHA survey indicated that 61% of Americans believe sea salt to contain less sodium than table salt. In reality, these salts all contain the same chemical composition and the same amount of sodium by weight. The type of salt you choose – whether it be Himalayan, Celtic, or Kosher – is purely a matter of taste and preference. The healthiest choice in this regard is simply to limit your intake, regardless of your penchant for a certain type of salt.

For more information on what constitutes a processed food, see this article: https://www.hsph.harvard.edu/nutritionsource/processed-foods/