Healthier Salt Substitutes

As I discuss in my video Shaking the Salt Habit, the two most prominent dietary risks for death and disability in the world are not eating enough fruit and eating too much salt. Eating too little fruit kills nearly five million people every year, and eating too much salt kills four million.

There are three things we can do to lower our salt intake. First, don’t add salt at the table. One third of us add salt to our food before even tasting it! Second, stop adding salt while you’re cooking. At first, the food may taste bland, but within two to four weeks, “as the sensitivity of the salt taste receptors in the mouth become more sensitive to the taste of salt in the usual concentrations”—believe it or not—you may actually prefer the taste of food with less salt. Some of the flavorings you can use in the meanwhile instead of salt include “pepper, onion, garlic, tomato, sweet pepper, basil, parsley, thyme, celery, lime, chilli, nettle, rosemary, smoke flavoring, curry, coriander and lemon.” Even if you did add salt while cooking, though, it’s probably better than eating out, where even at non-fast food restaurants, they tend to pile it on. And, finally, avoid processed foods that have salt added.

In most countries, only about half of sodium intake comes from processed foods, so there’s more personal responsibility. In the United States, however, even if we completely stopped adding salt in the kitchen and dining room, it would only bring down salt intake a small fraction. This has led public health commentators to note how challenging it is for everyone to reduce their salt intake, since so much of our sodium intake is out of our control. But is it? We don’t have to buy all those processed foods. We can choose not to turn over our family’s health to food corporations that may not have our best interests at heart.

If we do buy processed foods, there are two tricks we can use. First, try to only buy foods with fewer milligrams of sodium listed on the label than there are grams in the serving size. So, if it’s a 100-gram serving size, it should have less than 100 mg of sodium. Or, second, shoot for fewer milligrams of sodium than there are calories. For example, if the sodium is listed as 720 and calories are 260, since 720 is greater than 260, the product has too much sodium.

That’s a trick I learned from Jeff Novick, one of my favorite dieticians of all time. The reason it works is that most people get about 2,200 calories a day. So, if everything you ate had more calories than sodium, you’d at least get under 2,300 milligrams of sodium, which is the upper limit for healthy people under age 50. Of course, the healthiest foods have no labels at all. We should try to buy as much fresh food as possible because it is almost impossible to come up with a diet consisting of unprocessed natural foodstuffs that exceeds the strict American Heart Association guidelines for sodium reduction.


Not eating enough fruit as a leading killer? For more, see my video Inhibiting Platelet Aggregation with Berries.

In my latest sodium series, I lay out the evidence and dive into the manufactured controversy to expose salt industry shenanigans. See:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

We Have Specific Fruit and Vegetable Receptors

According to a recent survey, the number of Americans adults who say they are eating ‘pretty much whatever they want’ is at an all-time high,” which unfortunately includes “too few fruits and vegetables,” as well as “too little variety.” Half of all fruit servings are taken up by just six foods: orange juice, bananas, apple juice, apples, grapes, and watermelons. Only five foods—iceberg lettuce, frozen potatoes, fresh potatoes, potato chips, and canned tomatoes—make up half of all vegetable servings. We’re not only eating too few fruits and veggies. We’re also missing out on the healthiest fruits, which are berries, and the healthiest vegetables, which are dark green leafies. The fruit and vegetable palette for our palate is sadly lacking.

Why does dietary diversity matter? As I discuss in my video Specific Receptors for Specific Fruits and Vegetables, different foods may affect different problems. Cabbage, cauliflower, broccoli, and Brussels sprouts are associated with lower risk of colon cancer in the middle and right side of our body, whereas risk of colon cancer further down on the left side of our body appears to be better lowered by carrots, pumpkins, and apples. So, “different F/V [fruits and vegetables] may confer different risks for cancer” of different parts of even the same organ.

Variety is the spice of life—and may prolong it. “Independent from quantity of consumption, variety in fruit and vegetable consumption may decrease lung cancer risk,” meaning if two people eat the same number of fruits and vegetables, the one eating a greater variety may be at lower risk.

It’s not just cancer risk. In a study of thousands of men and women, a greater quantity of vegetables and a greater variety may independently be beneficial for reducing the risk of type 2 diabetes. Even after removing the effects of quantity, “each different additional two item per week increase in variety of F&V [fruit and vegetable] intake was associated with an 8% reduction in the incidence of T2D [type 2 diabetes].” Why? Well, it “may be attributable to individual or combined effects of the many different bioactive phytochemicals contained in F&V. Thus, consumption of a wide variety of F&V will increase the likelihood of consuming” more of them.

“All the vegetables may offer protection…against chronic diseases,” but “[e]ach vegetable group contains a unique combination and amount of these [phytonutrients], which distinguishes them from other groups and vegetables within their own group.” Indeed, because “each vegetable contains a unique combination of phytonutriceuticals (vitamins, minerals, dietary fiber and phytochemicals), a great diversity of vegetables should be eaten…to get all the health benefits.”

Does it matter, though, if we get alpha-carotene or beta-carotene? Isn’t an antioxidant an antioxidant? No. “It has been shown that phytochemicals bind to specific receptors and proteins” in our bodies. For example, our body appears to have a green tea receptor—that is, a receptor for EGCG, which is a key component of green tea. There are binding proteins for the phytonutrients in grapes, onions, and capers. In my video The Broccoli Receptor: Our First Line of Defense, I talk about the broccoli receptor, for instance. Recently, a cell surface receptor was identified for a nutrient concentrated in apple peels. Importantly, these target proteins are considered indispensable for these plants foods to do what they do, but they can only do it if we actually eat them.

Just like it’s better to eat a whole orange than simply take a vitamin C pill, because, otherwise, we’d miss out on all the other wonderful things in oranges that aren’t in the pill, by just eating an apple, we’re also missing out on all the wonderful things in oranges. When it comes to the unique phytonutrient profile of each fruit and vegetable, it truly is like comparing apples to oranges.


This is one of the reasons I developed my Daily Dozen checklist of foods to incorporate into one’s routine. Download the free iPhone and Android apps, and be sure to watch my video Dr. Greger’s Daily Dozen Checklist.

I discuss how produce variety—not just quality and quantity—may be important in Apples and Oranges: Dietary Diversity and Garden Variety Anti-Inflammation, so I hope you’ll check them out. You can also learn more about why combining certain foods together may be more beneficial than eating them separately in Food Synergy.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Raw vs. Cooked Garlic and Onions for Blood Thinning

As we age, our arteries stiffen. In my video Inhibiting Platelet Activation with Garlic and Onions, you can see charts showing measurements of the stiffness of our aorta, the main artery coming off the heart, as we get older and older. “As the aorta stiffens it leads to a range of linked pathphysiological changes,” such as exposing our brain and kidneys to greater pressure fluctuations, which may increase the risk of stroke and impairment of kidney function.

However, those who consume garlic—less than a quarter teaspoon of garlic powder a day—appear to have less stiffness in their aortas. We think this is because garlic seems to improve the function of the inner lining of our arteries, which helps our arteries relax. But the protective mechanisms of garlic against cardiovascular diseases are multiple, and include a combination of anti-clotting, clot-busting, antioxidant, and blood pressure- and cholesterol-lowering effects. The latest review suggests that long-term garlic intake may drop bad cholesterol levels about 10 percent, and the blood-thinning effects are such that the American Society of Anesthesiology recommends garlic intake be stopped a week before elective surgery.

Or, presumably, you could just cook it to death. Unlike the anticlotting components concentrated in the yellow fluid around tomato seeds, which are heat stable, the antiplatelet activity in garlic and onions is lost with cooking. When comparing  platelet inhibition, garlic appears about 13 times more potent than onion, and eating garlic raw appears to be better than cooked. This suggests that “garlic and onion could be more potent inhibitors of blood [clotting] if consumed in raw than in cooked or boiled form.” So, it might be good to cook garlic right before surgery, but what about the rest of the time when we’re trying to suppress platelet over-activity to decrease the risk of heart attacks and stroke? “As garlic and onion are normally consumed in cooked food, their efficacy as preventive herbs in cardiovascular disease may be doubtful.” But, we can put some raw onion on salads and raw garlic in salsa, dressings, dips, or pesto, right?

Or, we can crush or chop it, wait ten minutes, and then cook it. Researchers demonstrated the platelet-inhibiting power of raw garlic. If you cook it for just a few minutes, it does fine; but after cooking for about five minutes, the benefit is abolished. If, however, you pre-crush the garlic and wait, some of the antiplatelet activity is retained a bit longer. That’s because the enzyme that makes the antiplatelet compounds is activated by crushing but destroyed by heat faster than it creates the compounds. So, by crushing first and letting the enzyme work its magic before cooking, one can delay the loss of function.

Even better, though, is that, (as I discussed in my video Second Strategy to Cooking Broccoli with mustard powder), the addition of a little raw garlic juice to cooked garlic can restore the “full complement of antiplatelet activity that was completely lost without the [raw] garlic addition.”

When onions are cooked, the antiplatelet activity is similarly abolished within ten minutes, but then something strange happens. After 20 or 30 minutes of cooking, the effect on platelets is reversed and appears to make matters worse. Significant pro-platelet activation effects are seen, “suggesting that extensively cooked onions may stimulate rather than inhibit” platelets. That was in a test tube, though. Thankfully, when tested in people, even when onions are dropped in boiling water, fried for 10 minutes, and then left to simmer for 30 minutes, platelet activation drops within one to three hours after eating onion soup.


For background on what platelets are, what they do, and why we should care, see Inhibiting Platelet Aggregation with Berries and Inhibiting Platelet Activation with Tomato Seeds.

What else can garlic do? Check out:

What was that about mustard powder boosting the benefits of broccoli? See my Second Strategy to Cooking Broccoli video. Broccoli is also a potent activator of our liver’s detoxifying enzymes. Learn more in my Best Food to Counter the Effects of Air Pollution video.

Wondering whether it’s better to cook vegetables or eat them raw? See Best Cooking Method and for a surprise update, The Best Way to Cook Sweet Potatoes.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: