How do I manage the relationship between sodium and sugar intake?

Managing the Relationship Between Sodium and Sugar Intake

Key Recommendations

People should limit sodium consumption to <2,300 mg/day while simultaneously replacing sugar-sweetened beverages with water and minimizing foods with added sugar to improve overall health outcomes. 1

Understanding the Sodium-Sugar Relationship

Recent research has identified an important relationship between sodium and sugar intake:

• Lower sodium intake is often associated with higher sugar consumption 2
• People reporting low sodium intake on dietary recalls tend to have higher sugar consumption, which may partially explain cardiovascular health impacts 2
• Processed and ultra-processed foods are major contributors to both excessive sodium and sugar intake 1, 3

Sodium Intake Guidelines

General Population

• Limit sodium to <2,300 mg/day 1
• This recommendation applies to people with diabetes and prediabetes 1

Higher-Risk Populations

• For those with hypertension and diabetes, further sodium restriction may be considered, but should not go below 1,500 mg/day due to potential adverse effects 1, 3
• The American Heart Association recommends 1,500 mg/day for higher-risk populations including:
  • People with hypertension
  • African Americans
  • Adults over 51 years
  • People with diabetes
  • People with chronic kidney disease 3

Sugar Intake Guidelines

• Replace sugar-sweetened beverages (including fruit juices) with water 1
• Minimize consumption of foods with added sugar 1
• For people with diabetes, sugar-sweetened beverages should be avoided to:
  • Control weight
  • Reduce risk of cardiovascular disease
  • Reduce risk of fatty liver disease 1
• The American Heart Association recommends children under 2 years should avoid added sugars completely 4

Practical Implementation Strategies

Reducing Sodium

1. Read food labels (foods with <140 mg or 5% Daily Value are considered low in sodium) 3
2. Replace processed foods with fresh alternatives 3
3. Reduce salt added during cooking and at the table 3
4. Use herbs and spices as flavor alternatives 3
5. Be aware of hidden sodium in medications 3

Reducing Sugar

1. Replace sugar-sweetened beverages with water 1
2. Choose whole foods over highly processed foods 1
3. Emphasize non-starchy vegetables in your diet 1
4. Consider using non-nutritive sweeteners as a short-term replacement strategy for sugar-sweetened beverages 1

Important Considerations and Pitfalls

Sodium Intake Pitfalls

• Very low sodium intake (<1,500 mg/day) may be associated with adverse health outcomes in some studies 1, 5
• Some research suggests moderate sodium intake (3-5 g/day) may be associated with lowest cardiovascular risk 5
• Sodium recommendations should consider palatability, availability, affordability, and nutritional adequacy 1

Sugar Intake Pitfalls

• Non-nutritive sweeteners should be used in moderation 1
• While non-nutritive sweeteners may help reduce calorie and carbohydrate intake, they should be viewed as a short-term replacement strategy 1
• Focus on decreasing both sweetened and non-nutritive-sweetened beverages over time, emphasizing water intake 1

Food Sources to Monitor

• 75-80% of sodium consumption comes from processed and restaurant foods 3
• Top sodium contributors: bread, cold cuts, pizza, poultry, soups, sandwiches, cheese, pasta dishes 3
• Major sugar sources: sweetened beverages, desserts, snacks, and breakfast pastries 4, 6

By implementing these evidence-based strategies to manage both sodium and sugar intake, you can significantly improve your health outcomes related to blood pressure, weight management, and cardiovascular risk.