The U.S. News & World Report recently evaluated and ranked 20 different diets based on the ease of the regimen, level of nutrition, safety, and their effectiveness for combating obesity, diabetes, and heart disease. Topping their list is the Dietary Approaches to Stop Hypertension (DASH), followed by the Mediterranean diet.
What Makes the DASH Diet Successful?
The DASH diet, in many ways is similar to the Mediterranean diet, and has been found to be quite successful at both reducing hypertension and promoting weight loss at the same time. DASH promotes the consumption of vegetables, fruits, lean protein, whole grains, and low-fat dairy, and recommends avoiding sugars, red meat, and salt.
Many believe that the low sodium is responsible for its success. However, salt probably doesn’t have that much to do with it. I believe the primary reason why it works so well is because it restricts your intake of fructose—as does the Mediterranean diet. The idea that salt promotes high blood pressure is actually, at least in part, a myth.
In order to make heads or tails out of it, you must first understand that not all edible salts are created equal. One is health damaging, and the other is healing.
Salt—Essential or Harmful?
Ordinary table salt undergoes a great deal of processing. It is approximately 97.5 percent sodium chloride and 2.5 percent chemicals, such as iodine and moisture absorbents, dried at over 1,200 degrees Fahrenheit. This high heat alters the natural chemical structure of the salt. By contrast, unrefined natural salt, such as Himalayan salt, is 84 percent sodium chloride and 16 percent other naturally occurring minerals, including many trace minerals like silicon, phosphorous and vanadium.
Ordinary table salt has absolutely nothing in common with unrefined natural salt. The latter is essential for proper biological function, while too much of the former can indeed create health problems.
Unrefined natural salt is important to many biological processes, including:
- Being a major component of your blood plasma, lymphatic fluid, extracellular fluid, and even amniotic fluid
- Carrying nutrients into and out of your cells
- Helping the lining of your blood vessels to regulate blood pressure
- Helping you regulate propagation of nerve impulses
- Helping your brain send communication signals to your muscles, so that you can move on demand (sodium-potassium ion exchange)
However, for every gram of excess sodium chloride that your body has to neutralize, it uses up 23 grams of cellular water. Hence, eating too much common processed salt will cause fluid to accumulate in your tissues, which may contribute to:
- Unsightly cellulite
- Rheumatism, arthritis and gout
- Kidney and gall bladder stones
- Hypertension (high blood pressure)
Fructose and High Blood Pressure
That said, hypertension is actually promoted more by excess fructose than excess salt. So while I certainly agree you should not consume large quantities of refined processed salt, just switching to low-sodium processed foods is not going to do much to improve your health.
The connecting link between fructose consumption and hypertension lies in the uric acid produced. Uric acid is a byproduct of fructose metabolism, and increased uric acid levels drive up your blood pressure.
The amounts of salt Americans consume pales in comparison to the amount of fructose eaten on a daily basis, and I’m convinced that it’s the sugar/fructose consumption that is the major driving force behind our skyrocketing hypertension rates, not excess salt. For more information about this, see investigative journalist Gary Taubes’ article, The (Political) Science of Salt.
In it he writes:
“While the government has been denouncing salt as a health hazard for decades, no amount of scientific effort has been able to dispense with the suspicions that it is not. Indeed, the controversy over the benefits, if any, of salt reduction now constitutes one of the longest running, most vitriolic, and surreal disputes in all of medicine….
[T]he data supporting universal salt reduction have never been compelling, nor has it ever been demonstrated that such a program would not have unforeseen negative side effects. This was the verdict, for instance, of a review published in the Journal of the American Medical Association (JAMA).
University of Copenhagen researchers analyzed 114 randomized trials of sodium reduction, concluding that… a “measurable” benefit in individuals with normal blood pressure (normotensives) of even a single millimeter of mercury could only be achieved with an “extreme” reduction in salt intake. “You can say without any shadow of a doubt,” says Drummond Rennie, a JAMA editor and a physiologist at the University of California (UC), San Francisco, “that the [NHLBI] has made a commitment to salt education that goes way beyond the scientific facts.”
After decades of intensive research, the apparent benefits of avoiding salt have only diminished. This suggests either that the true benefit has now been revealed and is indeed small, or that it is nonexistent, and researchers believing they have detected such benefits have been deluded by the confounding influences of other variables…”
Fructose and Weight Gain
Taubes has also delved deep into the science of fructose, and his new book, Why We Get Fat: and What to Do About It, explains why a low-carb diet is the path to optimal health. His excellent New York Times article, “Is Sugar Toxic?” shed much needed light on this issue. At the heart of the low-carb theory is this: You don’t get fat simply because you overeat—you overeat because your fat tissue is accumulating excess fat.
But why would your fat tissue continuously accumulate fat if you’re not simply “eating too much and exercising too little”? Because:
1. Dietary carbohydrates, especially fructose, are the primary source of a substance called glycerol-3-phosphate (g-3-p), which causes fat to become fixed in fat tissue, and
2. At the same time, high carb intake raises your insulin levels, which prevents fat from being released
The resulting equation is simple: fructose and dietary carbohydrates (grains, which break down into sugar) lead to obesity and related health issues.
It’s Not About the Amount of Calories, But the Type of Calories
Conventional wisdom tells you that if you consume more calories than your burn, you will gain weight. But as you can see, the issue is more complex than that. It’s really important to understand that the type of calories you consume is far more important than the number of calories.
If you eat a lot of fructose (and there’s a good chance you are, considering it’s the number one source of calories in the United States), it could be “programming” your body to become fat.
Dr. Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, has been a pioneer in decoding sugar metabolism. Here are a few important facts about fructose:
- After eating fructose, 100 percent of the metabolic burden rests on your liver. With glucose, your liver has to break down only 20 percent. The fatty acids created during fructose metabolism accumulate as fat droplets in your liver and skeletal muscle tissues, causing insulin resistance and non-alcoholic fatty liver disease (NAFLD). Insulin resistance progresses to metabolic syndrome and type 2 diabetes.
- Fructose converts to activated glycerol (g-3-p), which is directly used to turn free fatty acids (FFAs) into triglycerides that get stored as fat. The more g-3-p you have, the more fat you store. Glucose does not do this. When you eat 120 calories of glucose, less than one calorie is stored as fat. 120 calories of fructose, however, results in 40 calories being stored as fat. Consuming fructose is essentially consuming fat!
- The metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which drives up blood pressure and causes gout.
- Glucose suppresses the hunger hormone ghrelin and stimulates leptin, which suppresses your appetite. Fructose has no effect on ghrelin and interferes with your brain’s communication with leptin, resulting in overeating. For further confirmation on this, check out this 2008 study published in the Journal of Nutrition. The researchers concluded that fructose turned into body fat much quicker than glucose, and that having fructose for breakfast changed how the body handled fats at lunch.
Ironically, the food products that most people rely on to lose weight—low-fat diet foods—often contain the most fructose! So beware, and always read the content labels.
Quality is More Important than Quantity
Another recent study illustrating the connection between your weight and the type or quality of the calories you consume (as opposed to just counting calories) was published recently, in the New England Journal of Medicine (NEJM).
As reported in Time Magazine:
“It matters, of course, how many total calories you take in each day, but the authors say the age-old advice simply to ‘eat less and exercise more’ may be naïve. To control weight over the long term… the study suggests that people benefit more by focusing on eating right, rather than less.” [Emphasis mine]
In this comprehensive study, the researchers determined how much weight gain is associated with the consumption of certain foods:
- Potato chips led the pack, causing more weight gain per serving than any other food; followed by potatoes, and sugar-sweetened beverages.
- Weight gain was inversely associated with: yogurt, nuts, fruits, whole grains, and vegetables.
However, I would caution you to not fall into the whole grain trap. Whole grains will increase your insulin levels just like any other grain. Additionally, whole wheat contains very high amounts of Wheat Germ Agglutinin (WGA), which even in small quantities can have profoundly adverse health effects.