The twin white herrings: Salt and sugar

Abstract

India has the dubious distinction of being a hotspot for both diabetes and hypertension. Increased salt and sugar consumption is believed to fuel these two epidemics. This review is an in-depth analysis of current medical literature on salt and sugar being the two white troublemakers of modern society. The PubMed, Medline, and Embase search for articles published in January 2018, using the terms “salt” [MeSH Terms] OR “sodium chloride” [All Fields] OR “sugar” [All Fields]. India is world's highest consumer of sugar with one of the highest salt consumption per day. Increased salt intake is associated with increased risk of hypertension, left ventricular hypertrophy and fibrosis, cardiovascular events, renal stones, proteinuria, and renal failure. Increased sugar intake is directly linked to increased risk of obesity, fatty liver disease, and metabolic syndrome. Also, increased sugar intake may be indirectly related to the increased risk of type 2 diabetes. Both salt and sugar intake is directly linked to increased systemic and hypothalamic inflammation, endothelial dysfunction, microangiopathy, cardiovascular remodelling, cancers, and death. High fructose corn is especially damaging. There is no safe limit of sugar consumption, as the human body can produce its own glucose. Being nature's gift to mankind, there is no harm in moderate consumption of salt and sugar, however, modest reduction in the consumption of both can substantially reduce the burden of non-communicable diseases. Public health interventions to facilitate this behavioural change must be instituted and encouraged.

The Association between Nutrition, Physical Activity, and Cardiometabolic Health at 6 Months following a Hypertensive Pregnancy: A BP2 Sub-Study

“…As expected, increased rates of suboptimal diet behaviours were all found to have significant associations with increased BMI and waist circumference, consistent with findings in the general population that foods high in salt and sugar are associated with raised BMI, hypertension, and overall worsened cardiometabolic outcomes [53][54][55]. The correlation between increased salty snack serves and raised systolic and diastolic BP was also expected, as sodium intake has been shown to have a significant association with increased BP [4,53,55]. In women following a pregnancy affected by HDP, who are already at an increased risk of worsened cardiometabolic risk profiles, controlling dietary sodium and processed sugar intake via education or intervention could significantly improve their cardiometabolic health, and potentially reduce long-term CVD risk [53][54][55].…”

“…Future interventions which target fruit and vegetable intake post-HDP have the potential to optimise cardiometabolic health and mitigate increased CVD risk in this population [16,33]. As expected, increased rates of suboptimal diet behaviours were all found to have significant associations with increased BMI and waist circumference, consistent with findings in the general population that foods high in salt and sugar are associated with raised BMI, hypertension, and overall worsened cardiometabolic outcomes [53][54][55]. The correlation between increased salty snack serves and raised systolic and diastolic BP was also expected, as sodium intake has been shown to have a significant association with increased BP [4,53,55].…”

“…The correlation between increased salty snack serves and raised systolic and diastolic BP was also expected, as sodium intake has been shown to have a significant association with increased BP [4,53,55]. In women following a pregnancy affected by HDP, who are already at an increased risk of worsened cardiometabolic risk profiles, controlling dietary sodium and processed sugar intake via education or intervention could significantly improve their cardiometabolic health, and potentially reduce long-term CVD risk [53][54][55].…”

Functional Food Consumption and Its Associated Factors among University Students in Malaysia during COVID-19 Pandemic

“…A past study by Mullie et al ( 45 ) concluded that functional food consumption was associated with healthy dietary pattern, which is characterised as high consumption of tomatoes, fruits, low-fat dairy products, whole grains, vegetables, cold breakfast cereals, fruit juice, fish, tea and nuts. However, this relation could not be confirmed in the present study as both salty snacks and soft drinks/SSB consumption were also found to be associated with the use of functional foods; and these foods are high in sugar and sodium, which are widely proven for their negative effects on human health, particularly increased risk of non-communicable diseases ( 46 ).…”