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January 2008
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Shaking salt and sugar from your diet
The white stuff lurks in the strangest places.

It's no accident that salt and sugar permeate the nation's food supply. Both are inexpensive palate-pleasers, and food manufacturers use them liberally to satisfy our penchant for things salty and sweet. Today the average American consumes nearly twice the recommended maximum of sodium and nearly 460 nutritionally empty calories of added sugar every day.

Overindulging those particular taste buds can have serious health consequences. A high-sodium diet not only increases the risk of high blood pressure--and subsequent heart attack, kidney disease, and stroke--but possibly also osteoporosis and kidney stones (by increasing the excretion of calcium into the urine), stomach cancer (by damaging the protective mucus membrane), and asthma (by making lungs more susceptible to irritants). And all those sugar calories probably contribute to our expanding waistlines.

Unfortunately, consuming less salt and sugar isn't easy. Three-quarters of the sodium in our diet comes from processed, packaged, and prepared foods; even products that don't taste salty, such as breads and other baked goods, often contain large amounts. And many apparently nutritious foods pack far more of the sweet stuff than you'd expect.

Still, cutting back on both is possible.


SALT: HOW LOW CAN YOU GO?

The National Academies' Institute of Medicine recommends that most adults get no more than 2,300 milligrams of sodium a day--the amount, roughly, in one teaspoon of table salt. People with a systolic blood pressure over 120 millimeters of mercury (mm/Hg) or a diastolic pressure over 80 mm/Hg should aim for 1,500 mg. So should individuals who have an increased risk of developing high blood pressure or face particular risks from high levels, including anyone over age 60, black people, and those who have diabetes or chronic kidney disease.

Reaching those targets, especially the lower one, can be hard. But since some people don't respond to a low-sodium diet, you may not need to maintain the extra effort if you don't see a blood pressure reduction after several months. Conversely, since some people react dramatically to a sodium restriction, you don't necessarily have to reach 1,500 mg to see a meaningful decline in blood pressure, though the lower your sodium intake, the lower your blood-pressure level tends to go.


LEAVING SALT BEHIND

The Food and Drug Administration is now considering whether it should regulate the amount of sodium in processed foods. But for now you still have to be in charge of limiting your sodium intake. Here's how:

Retrain your taste buds. Scale back the amount of salt used at the table and in cooking to reduce your exposure to its taste. After three months, most people no longer miss salt, research shows.

Check nutrient claims. Products labeled "sodium free" contain 5 mg of sodium or less per serving. A "very low sodium" product has 35 mg or less, and a "low sodium" item contains 140 mg or less. But be careful: Products labeled "reduced sodium" or "less sodium" need only have 25 percent less sodium than a standard version of the food. So a cup of reduced-sodium chicken-noodle soup may still serve up a hefty 660 mg, about 28 percent of your daily allotment.

Read nutrition information. Look for foods that provide 5 percent or less of the "daily value," or the government recommended maximum. Then check the serving size to tally your actual intake.

Compare brands. A serving of Newman's Own Lighten Up Balsamic Vinaigrette Dressing, for example, has 470 mg of sodium, compared with just 75 mg in Annie's Naturals Organic Balsamic Vinaigrette. And a serving of Celeste Pizza For One packs 1,080 mg of sodium, twice as much as a comparable serving of Mystic Cheese frozen pizza.

Sidestep sodium heavyweights. Avoid cured meats, such as bacon, ham, and hot dogs; sardines and smoked salmon; and brined foods, like pickles, sauerkraut, and olives. Go easy on ketchup, salt-based seasonings, and barbecue and steak sauces. And use even the reduced-sodium versions of soy and teriyaki sauce sparingly, if at all.

Rinse your food. Running water over canned tuna and salmon, canned vegetables, feta cheese, and capers can reduce the sodium load by up to 30 percent.

Swap salt for spices. Cook with fresh or dried herbs, salt-free seasoning blends, and acidic flavorings like lemon juice, citrus zest, and flavored vinegars to bring out a food's natural taste. Explore the seasonings used in ethnic recipes, such as cumin and chili powder in Mexican food, and coriander and turmeric in Indian.

Be choosy at restaurants. It's easy to consume a day's worth of sodium in a single restaurant dish. Some chains post nutrition information for each menu item, so check sodium content before ordering. At other restaurants, ask for low-salt dishes, and for sauce or dressing on the side. If you plan to eat out, reduce sodium intake at other meals.


SUGAR BLUES?

Some of the supposed dietary dangers of sugar have been overblown. Many studies have debunked the idea that it causes hyperactivity, for example. And indulging your sweet tooth won't lead to diabetes; indeed, even people with diabetes can safely eat a sugary snack if it's factored into their meal plan.

Sugar is guilty as charged, however, for nourishing the bacteria that cause dental cavities. And while there's nothing inherently fattening about sugar, it's probably not coincidental that the nation's ongoing obesity epidemic has progressed in step with our increased sugar consumption. Americans today consume 15 percent more added sugars than they did 25 or so years ago. Over that same time, the percentage of overweight or obese adults has grown from 47 to 66 percent.

Foods that contain natural sugars, such as fresh fruit and milk, also provide essential nutrients. But many foods and beverages with high levels of added sugars have little or no nutritional value--and diets high in added sugars tend to be low in important vitamins and minerals.


SUBTRACTING ADDED SUGARS

Food labels list the amount of total sugars, but they don't distinguish between added and naturally occurring sugars. So check the ingredients list for added sugars--such as brown sugar, corn sweetener, dextrose, fruit juice concentrates, glucose, high-fructose corn syrup, honey, malt syrup, maltose, molasses, and sucrose--which are listed by order of weight.

You can wean yourself from your sugar fix by gradually reducing the amount of sugar you add to coffee, tea, cereal, and other foods. Here are some other ways to cut back:

Choose sweets that contain some needed nutrients. When you crave something sweet, opt for fruit, low-fat chocolate milk, lightly sweetened whole-grain cereal, or plain yogurt flavored with fresh fruit. Watch out for some fruit-filled yogurts, however; Breyers Smart! Low Fat Yogurt, for example, packs 28 grams of sugar, most of it added.

Swap candy for healthy snacks. Opt for dry-roasted nuts, air-popped popcorn, or baked tortilla chips.

Watch what you drink. While soft drinks account for almost half of the added sugars in the American diet, many ready-to-drink teas and juice drinks are also loaded with sugar. For healthier versions, spike water with a few ounces of strongly flavored tea, a generous squeeze of lemon, or ice cubes made of fruit juice. Or blend your own smoothies from fresh or frozen fruit, nonfat yogurt, and ice.

Cook creatively. Experiment with cardamom, cinnamon, coriander, ginger, mace, and nutmeg, which add sweetness and flavor. Muffins and quick breads can be made with 25 percent less sugar, and the sugar in applesauce and pie fillings can be cut in half. Finally, try substituting 100 percent fruit juice for honey or other liquid sweeteners.

This article first appeared in the January 2008 issue of Consumer Reports on Health.
 
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