What salt benchmark helps limit the risk of hypertension?

The WHO recommends that adults limit salt to less than 5 g per day, i.e. 2 g of sodium. A large part comes from processed foods such as bread, tinned foods or frozen meals. For people with hypertension, the doctor's advice takes precedence.

Are plant-sterol products recommended?

ANSES observes that they can reduce blood cholesterol, but not that this prevents cardiovascular disease. It recommends avoiding them for children and for pregnant and breastfeeding women, and offsetting the drop in beta-carotene with fruit and vegetables. This is not a product for everyone: ask a health professional for advice.

Can diet replace treatment?

No. Diet is part of prevention and of the first-line measures described by the Assurance Maladie, but it does not replace a prescribed treatment. Do not change or stop a treatment without your doctor's advice.

Cholesterol and hypertension: what to eat? Official benchmarks

Cholesterol and hypertension: what are we talking about?

Thecholesterolis a lipid present in the body: it forms part of cell structure and contributes to the making of certain hormones. The liver produces most of it, and diet provides the rest. It circulates in the blood, carried by lipoproteins. According tothe Assurance Maladie,LDL cholesterol, known as "bad cholesterol", can build up on artery walls when in excess, whereasHDL cholesterol, known as "good cholesterol", carries excess cholesterol back to the liver, where it is eliminated.

Thearterial hypertension(HTA) is, still according tothe Assurance Maladie, an abnormal increase in the pressure of the blood on artery walls. The threshold used is a systolic pressure of 140 mmHg or more, or a diastolic pressure of 90 mmHg or more, measured over several consultations. In most cases, no specific cause is identified.

In both cases, these arecardiovascular risk factors: they are measured through tests (blood test, blood pressure monitor) and discussed with a doctor. Diet is only one lever among others, alongside physical activity, stopping smoking and, if needed, treatments.

What diet contributes to prevention

Official sources converge on a few simple messages, with no miracle food:

Less salt.The Assurance Maladie indicates that a diet too rich in salt promotes hypertension and that limiting salt is one of the first-line measures.
Less saturated and trans fats.The French Federation of Cardiology (FFC) stresses that saturated and trans fats raise LDL cholesterol.
More plants and fibre.The FFC recommends at least five portions of fruit and vegetables per day and stresses that fibre, found mainly in pulses and cereals, helps lower cholesterol.
Alcohol and weight.Heavy alcohol consumption, overweight and obesity are among the factors that favour hypertension, according to the Assurance Maladie.

These messages apply to the general population. They do not say what suits a given individual.

Salt: the official benchmark

The WHO recommends that adults limit salt intake toless than 5 g per day(2 g of sodium), noting that high sodium consumption is associated with higher blood pressure. Most salt does not come from the salt cellar but from processed products, such as bread, tinned foods or frozen meals. We detail where it hides inHidden sugar and salt: where do they hide?.

Saturated fats

The WHO recommends that saturated fats do not exceed10% of total energy intake, and trans fats no more than 1%. In practice, saturated fats are found in butter, cream, cheeses, fatty meats and many industrial products. Our articleSaturated fats: where do they hide and how to limit them?lists them.

Two dietary models studied: DASH and Mediterranean

TheDASH(Dietary Approaches to Stop Hypertension) emphasises vegetables, fruit, wholegrain cereals, low-fat dairy products, fish, poultry, pulses, nuts and vegetable oils. It limits foods rich in saturated fats, sugary drinks and sweets, according to theNHLBI, the American heart research institute. In the trial published in 1997 in the New England Journal of Medicine, 459 adults followed a control diet, a diet rich in fruit and vegetables, or a "combined" diet (fruit, vegetables, low-fat dairy products and less fat) for eight weeks. The authors concluded that the combined diet could significantly lower blood pressure, in a setting where sodium and weight were kept constant. This is a short-term trial, conducted under controlled conditions.

TheMediterranean diet(vegetables, fruit, pulses, cereals, fish, olive oil, nuts) was evaluated in the Spanish PREDIMED trial, published in 2018 in the New England Journal of Medicine (revised version, after the withdrawal of the 2013 publication over randomisation irregularities) under the title "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts". We refer you to the publication for its results: it mainly shows that these diets work across the whole plate, not food by food.

Foods to limit

Butter, cream, full-fat cheeses, cured meats and fried foods, rich in saturated fats (the WHO recommends staying below 10% of energy). See alsoNitrites in cured meats, with the benchmark of 150 g per week.
Highly salted industrial dishes: bread, cured meats, ready meals, tinned foods.
Sugary drinks and sweets, limited in the DASH model.
Alcohol: the Assurance Maladie lists heavy consumption among the factors that favour hypertension.

Relatively favourable foods

No single food controls cholesterol or blood pressure on its own. Sources generally cite foods that fit well into a protective diet:

Pulses (lentils, chickpeas) and wholegrain cereals, rich in fibre.
Fruit and vegetables, at least five portions a day according to the FFC; the WHO indicates at least 400 g per day.
Vegetable oils: the FFC favours rapeseed, walnut and olive oils for seasoning (leaflet "Balanced diet", July 2019).
Fish, including oily fish, a source of omega-3 according to the FFC.
Nuts and oilseeds, featured in the DASH and Mediterranean models, to be eaten in reasonable quantities as they are calorie-dense.

Plant sterols and enriched products

Some margarines, drinks or dairy products are enriched with phytosterols. ANSES examined the question. According to its opinion, these products can reduce blood cholesterol, with an average LDL reduction of around 10%, but the effect varies widely from person to person. No study has measured their direct effect on cardiovascular events: the agency therefore does not consider them an appropriate means of prevention at population level.

ANSES also notes a drop in blood beta-carotene, to be offset by reaching at least the PNNS fruit and vegetable benchmarks, and recommends that peopleavoid these products among children, pregnant women and breastfeeding women. For people concerned about their cholesterol, it refers them to personalised medical follow-up. These are therefore not products for everyone, and the question should be raised with a health professional.

Dietary supplements: no advice here

We give no advice on dietary supplements for cholesterol or blood pressure. If you are considering them, or already take a treatment, talk to your doctor or pharmacist: some products can interact with medicines.

Reading the label

Salt: look for the "salt" line in the nutrition table. If only sodium is given, salt equals about 2.5 times the sodium. Compare two products per 100 g.
Saturated fats: they are shown under the "fat" line. Compare them from one product to another.
Ingredients list: be wary of ready meals, cured meats and bakery products, which are often salty.

In Yumiq, the product page shows the number of additives detected (harmless, to monitor, at risk); the Yumiq-Score penalises controversial additives assessed by EFSA and ANSES, and the Yumiq star requires the absence of at-risk additives.

Key takeaways

Cholesterol and hypertension are cardiovascular risk factors that are measured and monitored medically.
The official messages are simple: less salt and saturated fat, more plants, fibre and fish.
No food is a miracle, and diet does not replace a prescribed treatment.
This article is informative: for your own situation, ask your doctor for advice.