Sodium, Caffeine, and Alcohol

Dr. Neal Pinckney

High levels of sodium, including table salt, are a common ingredient in processed foods and many restaurant dishes. The typical American eats three times more sodium than the 2,400 mg. maximum recommended daily intake. This can lead to kidney failure and to heart attacks and stroke, even for those who are not sodium sensitive. While only about 15% (1 in 7) people with high blood pressure are salt sensitive, for optimum health everyone else should limit sodium intake to between 1000 mg and 2000 mg a day.

Many foods that don't taste salty may be high in sodium, and it is wise to know which these are. Most canned foods, fast food sandwiches and packaged soups and mixes contain as much as 1,000 to 2,000 mg of sodium per serving. A single slice of one well-advertised brand of pizza has over 3,500 mg. A tablespoon of soy sauce has up to 1,300 mg. Many cheeses have between 200 and 300 mg. per ounce. Commercially packaged bread can have 100 to 300 mg per slice.   Most fresh and frozen vegetables, fruits and whole grains are very low in sodium.If a recipe calls for salt, see if you can leave it out until the food is on the table and then lightly sprinkle the surface with a small amount of salt. You'll find you can use much less salt than the recipe calls for and get a saltier taste. Salt added in cooking often makes foods tougher and the taste is mostly lost. Salt substitutes, including "lite salt" which is half potassium chloride, can reduce your sodium intake. Citrus acid is often called "sour salt". When added in very small amounts is can impart a salty flavor - but in larger amounts is can be very sour. Most health food stores carry Bragg's Liquid Aminos, a product made entirely from soy beans. It has a very salty soy sauce flavor, but has about the same amount of sodium as salt-reduced soy sauce, shoyu or tamari.

Caffeine is one of the world's most popular drugs. Some research has shown it to be harmful to those who already have heart disease and many other health problems, but a large scale study published in 2001 indicated that moderate intake of caffeine, up to 2 cups of ordinary coffee per day, does not increase risk factors for heart disease. Persons who have had recent heart surgery or have irregular heartbeat should definitely avoid caffeine.

Caffeine can shorten reaction time, keep one awake temporarily and give the feeling of increased energy. As with many drugs, the body can begin to build a tolerance to caffeine. This means that a person may need increasing amounts to get the same effects. As the dosage increases, trembling, muscle tension, irritability, nervousness, depression, disorientation, lethargy and throbbing headaches can result. For those with little or no tolerance, a single cup of coffee may produce some of these symptoms. Others, whose body has become used to the drug, may be able to drink more than three or four cups of coffee without experiencing any outward signs. Inwardly, blood pressure, cholesterol, heart and metabolic rates, respiration and blood glucose concentration are all affected by caffeine. While some studies claim to have linked caffeine to cancer, benign breast fibrocystic disease and other illnesses, the evidence is not sufficient to link any of these with certainty. There is stronger evidence that caffeine takes calcium out of the body, a risk for teens when bones are growing rapidly and for post-menopausal women who are at greater risk for osteoporosis.

Serving Size
Caffeine mg.
Coffee 12 ounce 375
No-Doz Extra Strength, Vivarin 1 tablet 200
7-11 BigGulp cola 64 ounce 190
Excedrin 2 tablets 130
Brewed Coffee 5 ounce 60-150
Aquaban, Dexatrim, Nodoze 1 tablet 100
Strong Tea (5 min.) 5 ounce 40-100
Cafe latte, cappuccino 16 ounce 70
Expresso 2 ounce 70
Anacin, Empirin, Midol 2 tablets 65
Weak Tea (3 min.) 5 ounce 20-50
Milk Chocolate 2 ounces 2-30
Cocoa 5 ounce 2-10
Decaffeinated Coffee 5 ounce 2-18

Caffeine is a powerful drug and it may be difficult to give up at first. Some people suffer headaches and other discomfort when suddenly discontinuing caffeine. It is usually easier to gradually reduce caffeine than to stop all at once. If coffee is your primary source of caffeine, after your first cup in the morning, mix regular coffee with decaffeinated coffee, starting with about three-fourths regular coffee and reducing the amount after a few days until you are drinking 100% decaffeinated coffee. Then gradually do the same for your first cup of the day.

Ruth Heidrich's Race for Life Cookbook recommends "Morning Toffee" as a breakfast drink: one teaspoon of black-strap molasses in a cup of hot water. Brimming with vitamins and minerals, it is only 15 calories. I drink it most mornings and find it delicious.


Alcohol is another drug whose effect on heart disease and health has been debated, but the exact degree of cause and effect is not clearly established. Excess alcohol is definitely known to be linked to increased risks of cancers of the mouth, larynx, esophagus and pharynx. A relationship between alcohol consumption and cancers of the pancreas, rectum and breast has also been shown. Liver disease is a common result of long term alcohol use. Some studies have shown a link between small amounts of alcohol and a rise in one kind of HDL good cholesterol, but that may not actually reduce total cholesterol.

For many, keeping the amount of alcohol to the low levels may prove beneficial is difficult or impossible. Consumption of alcohol in larger amounts can lower HDL, raise blood pressure, damage the heart and also lead to loss of bone mass, which can increase the risk of osteoporosis. It is recommended that persons with increased risk of heart disease avoid excess alcohol. If you choose to drink, men should have no more than two drinks a day, women one drink per day, preferably with meals. A drink is either a standard cocktail, a 12 ounce serving of beer or a 4 ounce glass of wine. Some studies suggest that the skins of red grapes have a blood thinning effect that is beneficial in preventing heart attacks. A glass of red wine with dinner might help, but grape juice may have the same benefit.

Charcoal-broiled foods have been linked to cancer, but it is primarily the fats that drop onto the coals when meats are cooked that is thought to make the smoke dangerous. Burnt meat and some other foods may also be carcinogenic (can lead to cancer). Barbecuing vegetables does not carry the same risk as with meats if the charcoal has not been used to cook meat.