While sugar and salt can both have a place in a healthy diet—in moderation—excess added sugar and salt (sodium) can court health problems. One of the best ways to start reducing added sugar—not the natural sugar found in some foods—and salt is to prepare more of your meals at home, using whole or minimally processed ingredients. Over time, you’ll find that your sweet tooth—or salt tooth—starts to fade.
Sugars
You probably know that consuming too much sugar isn’t good for health, but you may be surprised to learn what counts as “sugar.” When you hear advice to limit sugar, that doesn’t mean the sugars that are naturally present in fruit, vegetables, and milk because these sugars are not a health concern.
For example, when you eat a piece of whole fruit, your body receives vitamins, minerals, phytochemicals, and fiber along with the sugars. Plus, the amount of sugars you can consume from foods like fruits and vegetables is typically limited, because it would be challenging to eat enough of these foods to get an excessive dose of sugar. Not only does the fiber and other components of whole plant foods fill you up, they may also slow the release of sugars into the bloodstream.
What is concerning is our intake of added sugars, because the foods that contain them typically provide a large dose of sugar and calories without providing much in the way of fiber or nutrients. A 2018 study found that consuming more than 36 grams (9 teaspoons) of added sugar per day was associated with frailty in older adults, when compared with participants consuming less than 15 grams (about 4 teaspoons) per day. One reason may be that foods high in added sugar may displace more nutritious foods.
Defining “Added” Sugar
Humans long ago figured out how to extract the sugars naturally found in plants (like sugar cane, sugar beets, and corn) and add them to a wide variety of foods. The USDA estimates that, on average, Americans now consume more than 22 teaspoons of these added sugars every day. That’s approximately 18 percent of the recommended calories for someone consuming 2,000 calories a day—nearly double the recommendation of the 2015–2020 Dietary Guidelines for Americans, which advise limiting added sugars to less than 10 percent of our daily calories.
The American Heart Association goes even further, recommending that women and children consume no more than 6 teaspoons (100 calories) of added sugars a day and men no more than 9 teaspoons (150 calories).
As we know, sugar beverages are a major dietary source of added sugar, and a recent prospective study published in Circulation this year confirmed for us that sugary drinks are bad! One prospective study of 11,733 U.S. adults found a significant relationship between added sugar consumption and increased risk of death from CVD over 18 years.
Reducing added sugars not only is good for your heart health, but research also suggests it could help reduce the risk of tooth decay, obesity, type 2 diabetes, and some types of cancer in adults. There are ways excess sugar in our diets may lead to an increase in disease risk—increasing blood sugar and cholesterol levels, increasing body fat around our organs, and contributing to inflammation. Research on the mechanism whereby added sugars lead to poor health and a recent explanation that emerged was linked to AGEs, or Advanced 
Glycation End products (which were discussed in the previous chapter).
Sugar’s Various Guises
Most forms of sugars are chemically similar, so switching from one kind of sugar to another won’t make a huge difference in terms of your health. The key is to cut back on sweet treats in general. If you see a sweetener listed as one of the first three ingredients in a packaged food, it likely contains a significant amount of added sugar.
Nearly half of the added sugars that people consume are in the form of sugar-sweetened beverages, especially soft drinks, but also fruit drinks, coffee, tea, and sports and energy drinks. People also consume a significant amount of added sugars from more surprising sources, such as pasta sauces, salad dressings, ketchup, barbecue sauces, breakfast cereals, breads, baked beans, and many other packaged foods.
Curb Your Sweet Tooth
Since added sugars are seemingly everywhere, reducing your dietary intake can be difficult. The most important thing to 
remember is that naturally sweet foods are typically healthier than processed sweet foods. Getting more of your sweet fix from fruits can help you cut back on added sugars: frozen banana slices puree into an ice cream-like treat that can be flavored however you like (think berries, chocolate, mint, or coffee). Grilled pineapple or peaches, fresh strawberries drizzled with balsamic vinegar, and cored, baked apples make simple, delectable desserts. A sweet, juicy orange or fresh cherries makes a satisfying (and nutritious) snack when that urge for something sweet hits.
Checking Sodium
On average, American adults consume approximately 3,500 mg of sodium per day, as opposed to the recommended 2,300 milligrams (mg) of sodium, or about 1 teaspoon of salt. Typically, as sodium in the diet increases, so does blood pressure. Excess sodium in your bloodstream causes water to be pulled into your blood vessels, increasing blood volume. More blood flowing through your blood vessels increases the pressure on the walls of the vessels and your blood pressure.
Over time, the added pressure can tire out the heart by making it work harder to pump blood through the body. It can also damage blood vessel walls by overstretching them. Somewhat like a scab that covers a wound, plaque forms to seal damage in your blood vessels. This plaque can block blood flow, potentially leading to a heart attack or stroke.
That’s why sodium also is associated with increased risk of stroke, cardiovascular disease, congestive heart failure, and kidney disease. If you’re age 51 or older, you are more likely to be affected by the blood-pressure-raising effects of sodium than you were when you
were younger.
If you already have high blood pressure (hypertension) or prehypertension, the Dietary Guidelines recommend reducing your sodium intake to 1,500 mg per day. It can be challenging to reduce sodium to recommended limits, but every step you take toward decreasing sodium intake can help in lowering blood pressure.
To trim sodium from your diet, you will need to do more than hide the salt shaker. Surprisingly, only about 11 percent of our sodium intake comes from salt added during cooking or at
the table.
Packaged foods and restaurant foods account for the bulk (almost 80 percent) of the sodium in our diets. Reading Nutrition Facts labels can help you scale back on sodium in packaged foods—this is important because these foods often don’t taste salty.
Restaurant meals are often high in sodium, and it is difficult to determine the amount of sodium in meals when eating out. However, chain restaurants with more than 20 locations now are required to post nutrition information, including sodium content, online, in the restaurant, or both, so be sure to check this information.
Some ways to cut back on sodium include:
- Prepare more foods at home and from scratch. Eating out less often can help reduce sodium intake. If you cook whole, unprocessed foods from scratch (as opposed to using pre-packaged foods like flavored rice dishes and canned soups), you’ll automatically slash your sodium intake even further.
- Shop for packaged foods that are lower in sodium. Foods that have lower sodium content often advertise this on the front of the package. Look for foods marked “low sodium,” “no salt added,” or “reduced sodium.” If you don’t like the lower-sodium version, try combining it with the regular version of the food. For example, add some regular canned soup to the low-sodium version and cut back over time as your taste buds adjust.
- Choose condiments carefully. Foods like bottled salad dressings, ketchup, mustard, soy sauce, jarred salsa, pickles, and olives are often very high in sodium. Choose lower-sodium versions. “Low-sodium” products contain 140 mg sodium or less per serving. “Reduced sodium” or “less sodium” on a label means the product contains at least 25 percent less sodium than the standard version. Be aware that reduced sodium products may still contain plenty of sodium.
- Choose poultry that hasn’t been injected with sodium solution. Skip items with terms such as “broth,” “saline,” or “sodium solution” on the package to avoid unnecessary hidden sodium.
- Use other seasonings. Flavoring foods with herbs, spices, garlic, onions, citrus juices, and vinegars can add flavor without salt. When purchasing spice blends, read the label to be certain that salt is not one of the ingredients.
It can take several weeks to get used to a lower sodium intake, but don’t give up. Your taste buds will adapt.
Increasing dietary magnesium, calcium, and potassium also are important when it comes to controlling blood pressure. Increasing potassium intake may be as important as reducing sodium intake.
The kidneys are responsible for keeping levels of sodium and potassium balanced in the body, so when potassium levels are high, the kidneys excrete more sodium, along with more water. Eating more plant foods is an easy way to increase potassium intake. Beans, sweet potatoes, greens, tomatoes, yogurt, oranges, and bananas are some of the many good sources of
this mineral.
Many of these potassium-rich foods are part of the DASH dietary pattern, which has been shown to be very effective for lowering blood pressure.
Alternatives
Seasonings generally cost only pennies per serving, and many have potential health benefits. Herbs and spices contain nutrients and phytochemicals that may help lessen inflammation, improve digestion, protect against harmful bacteria, support healthy blood sugar levels, and defend against cancer. Collectively, herbs and spices contain more than 2,000 phytochemicals, many of which act as antioxidants. One study that evaluated the 50 foods highest in antioxidants revealed that the top five were spices (ground cloves, dried oregano, ground ginger, ground cinnamon, and
turmeric powder).
Examples of common herbs and spices containing anti-inflammatory compounds include chili peppers, black pepper, bay leaves, ginger, marjoram, oregano, rosemary, sage, and thyme. If you tend to shy away from “spicy” foods, keep in mind that only chili pepper is spicy hot. Since you don’t typically consume a lot of these seasonings at one time, the impact they have on your health may not be large, but these tasty plant foods are certainly a simple, healthful way to punch up the flavor of your food without picking up the salt shaker.
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