Salt vs. Sugar: The Real Culprit in the Heart Disease Epidemic

For decades, we've been told that salt is the primary cause of high blood pressure and heart disease. Doctors, health officials, and food labels have drilled it into us: “Cut back on sodium to protect your heart.”

But what if salt has been wrongfully accused?

What if the real culprit — the true driver of heart disease and hypertension — has been quietly hiding in plain sight this whole time?

The truth is, while salt was taking the blame, sugar was silently fueling metabolic dysfunction, hypertension, and cardiovascular disease.

In this post, we'll unpack how:

• Salt became the scapegoat for what sugar was really doing.
• The sugar industry’s cover-up misled public health policies.
• Insulin resistance, triggered by sugar, plays a much bigger role in high blood pressure than sodium ever did.
• History shows us that traditional diets — often higher in salt than today’s recommendations — didn’t lead to the metabolic dysfunction we see now.

If you’ve been struggling with high blood pressure despite cutting salt, this post will help you understand why.

How Salt Became the Scapegoat for Heart Disease

The fear of salt largely began in the 1970s, when a scientist named Dr. Lewis Dahl conducted studies that linked sodium intake to high blood pressure. But here’s what they don’t often tell you:

In his experiments, Dr. Dahl fed rats the human equivalent of 500 grams of sodium per day — roughly 50 times what the average person actually consumes.

Of course, those extreme sodium doses drove up blood pressure — but those conditions didn’t reflect how real people eat. Still, the results were alarming enough to make headlines, and the idea that “salt causes hypertension” became mainstream.

Shortly after, the DASH Diet (Dietary Approaches to Stop Hypertension) was introduced, heavily emphasizing sodium reduction. While the DASH Diet did show some success in lowering blood pressure, the truth is that its biggest strength wasn’t sodium reduction — it was the diet’s emphasis on potassium-rich whole foods like fruits, vegetables, and nuts.

Potassium is nature’s blood pressure regulator. It helps your body balance sodium levels, making potassium far more powerful than simply cutting salt.

But while the public was busy cutting salt, another ingredient was quietly infiltrating nearly every processed food on the market — sugar.

The Sugar Cover-Up: How the Food Industry Misled Us

In 2016, documents were uncovered revealing that the Sugar Research Foundation — now known as the Sugar Association — paid Harvard scientists in the 1960s to shift the blame for heart disease away from sugar and onto fat and salt instead.

Instead of warning the public about sugar’s damaging effects, they vilified salt and fat.

This cover-up had devastating consequences.

By the 1970s and 1980s, low-fat and low-sodium products flooded the market. But to replace the flavor lost when fat was removed, food manufacturers packed those products with sugar.

Everything from yogurt to salad dressings, sauces, and snacks was loaded with hidden sugars — and people unknowingly consumed more sugar than ever before.

While doctors kept telling people to cut salt, sugar consumption skyrocketed.

In the early 1800s, the average person consumed about 2-4 pounds of sugar per year, mostly from natural sources like honey or seasonal fruit.
By the year 2000, the average American was consuming 150-170 pounds of sugar per year — nearly 20 times what our ancestors ate.

And what happened during that same period? Rates of obesity, type 2 diabetes, and heart disease exploded.

Why Sugar — Not Salt — Is the Real Driver of Hypertension

So how exactly does sugar impact blood pressure? The key lies in insulin resistance.

Here’s how it works:

1️⃣ When you eat sugar or refined carbs, your blood sugar spikes.
2️⃣ Your body releases insulin to shuttle that sugar into your cells.
3️⃣ Over time, if you’re constantly spiking blood sugar with processed foods, your insulin levels remain elevated.
4️⃣ Insulin tells your kidneys to retain sodium. This sodium retention leads to fluid buildup, which increases blood pressure.

In other words, the real issue isn’t just sodium — it’s chronically elevated insulin caused by excess sugar.

This is why many people who reduce sugar — even without cutting salt — often see their blood pressure improve dramatically.

The real issue isn’t the pinch of salt on your steak — it’s the constant influx of sugar-laden processed foods that drives metabolic dysfunction.

What History Can Teach Us About Salt and Heart Disease

For most of human history, populations consumed far more salt than current dietary guidelines recommend — yet hypertension and heart disease were rare.

Ancient cultures often consumed 20-30 grams of salt per day, especially in communities that relied on cured meats, preserved fish, or fermented foods.

So why didn’t those populations experience the same heart disease epidemic we see today?

Because they:
✅ Ate whole foods naturally rich in potassium.
✅ Lived active lifestyles, which improved insulin sensitivity.
✅ Avoided processed foods loaded with refined sugars and industrial oils.

The takeaway? Salt wasn’t the problem — the modern processed food diet is the true culprit.

What You Can Do to Improve Heart Health

If you're concerned about high blood pressure or metabolic health, the solution isn’t just about cutting salt — it’s about focusing on the right things.

Here’s what I recommend:

✅ Cut processed foods — they combine sodium with sugar and unhealthy fats, which fuel inflammation and insulin resistance.

✅ Prioritize whole foods — fresh vegetables, quality protein, and healthy fats naturally balance your sodium and potassium levels.

✅ Increase potassium-rich foods — avocados, leafy greens, sweet potatoes, and wild-caught salmon are excellent choices.

✅ Improve insulin sensitivity — strategies like fasting, reducing refined carbs, and prioritizing protein at meals can help regulate your body’s sodium balance.

✅ Embrace salt in moderation — if you’re eating whole, unprocessed foods, you can safely season your meals with salt without fear.

The Bottom Line

For years, we’ve been told that salt is the enemy — but the truth is far more complex.

Salt isn’t the root cause of heart disease — sugar and insulin resistance are. If you’ve been cutting salt without seeing improvements in your health, it’s time to shift your focus.

By reducing processed foods, improving insulin sensitivity, and embracing whole foods rich in potassium, you can improve your heart health far more effectively than by simply cutting salt.

If you’d like to hear more on this topic, be sure to check out my latest podcast episode where I dive even deeper into the science behind salt, sugar, and metabolic health.

👉 Listen to the full episode here on SPOTIFY and APPLE PODCAST

Your health is in your hands — and understanding the real causes behind heart disease is a powerful step in the right direction.

Disclaimer:
The information provided in this blog is for educational and informational purposes only and is not intended as medical advice. While I am a certified coach with expertise in nutrition and metabolic health, I am not a medical professional. Always consult with your healthcare provider before making changes to your diet, exercise routine, or lifestyle, especially if you have any existing health conditions or concerns. The content shared here reflects my personal experience and research and should be used as a guide, not a prescription.