Posts Tagged ‘Hypertension’

Eating out is generally considered a pleasurable experience, not least because of its convenience. Busy lifestyles as well as lack of cooking skills and amenities make it an easy choice for many working-age adults to let others take care of their nutritional needs. Unfortunately, not being in charge of your own food preparation can prove hazardous for your health in the long run.

For example, a new study from Duke-NUS Graduate Medical School in Singapore showed for the first time a direct link between eating meals away from home and hypertension, a.k.a. high blood pressure.

Hypertension is considered a risk factor for heart disease, heart attack and stroke, all of which are among today’s leading causes of death.

Even young adults were found to suffer from pre-hypertension or full-fledged hypertension if they ate out on several days a week. In fact, just one weekly restaurant visit was associated with a six percent increase in risk of pre-hypertension. The researchers involved in the study advised especially younger males to have their blood pressure checked regularly and, if necessary, modify their eating behavior.

Although this particular study focused mainly on young Asian adults, the warnings should be heeded worldwide. It is estimated that hypertension affects about one in three Americans to various degrees, based on statistics of the Centers for Disease Control and Prevention (CDC). Only half of all patients diagnosed with the disease have their condition under control through medication as well as diet and lifestyle changes, the agency says.

Almost 30 percent of what causes hypertension is attributed to excessive dietary sodium (salt). Processed foods, which are widely used in restaurants like fast food places and other low-cost eateries, are notorious for high sodium contents.

Although consumers have shown greater interest in reducing their salt intake in recent years, and some restaurant chains have pledged to cut back on salt use, there is still not enough progress to make a noticeable difference. According to the Center for Science in the Public Interest (CSPI), a consumer advocacy group, too many food outlets are making it hard for their patrons to identify how much sodium they are getting with their meals. Items that don’t even taste salty can nevertheless have sodium levels that exceed recommended limits.

Eating out on a regular basis makes it difficult for people to control their salt intake because they don’t know how the food was prepared. And many fast food and fast-casual restaurants don’t monitor the quality of their ingredients, since they often only assemble their meals instead of making them from scratch. So it’s hard to make special requests for less salt use in these places, explains Sarah Krieger, a registered dietitian, professional chef, and media spokesperson for the Academy of Nutrition and Dietetics (AND).

Still, patrons should be able to ask questions and navigate around the worst pitfalls, she says.

Preferably patronize locally owned eateries where the food is mostly cooked to order. Avoid dressings, toppings, and sauces as much as possible, and stick to whole food items like fresh vegetable dishes and fruits, and go easy on cheese platters and desserts, she advises.

Of course, none of this will give you the kind of control you have in your own kitchen, but a little bit of awareness and caution when eating out can be a good first step.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Trying to Cut Back on Salt Is Hard to Do

February 4th, 2015 at 6:17 pm by timigustafson

The warnings have been loud and clear for a long time: High levels of sodium (salt) intake are hazardous to our health. Especially the so-called “Western diet,” which is dominated by processed foods, is notorious for its sodium content that is often obscured in hard to decipher nutrition facts labels and ingredient lists. That makes it difficult even for health-conscious consumers to keep their daily sodium doses down.

The Institute of Medicine (IOM) recommends 1,500 mg of daily sodium intake for people age 51 and older, those who suffer from hypertension, diabetes, or chronic kidney disease, and African Americans in general; for everyone else, 2,300 mg is considered the tolerable upper limit. The average daily intake for most Northern Americans is about 3,400 mg – way above what is believed to be safe.

The potential consequences are multiple. While a small amount of sodium – approximately 180 mg to 500 mg per day – is necessary for the body to function properly, excessively high amounts can cause a wide range of health problems, including heart disease, kidney disease, and certain forms of cancer. At an advanced age, it can also contribute to osteoporosis. And, as a recent study found, even the brain can get affected by an elevated sodium presence, leading to adverse biochemical changes in its neurons.

Still, experts remain divided over the actual effects of dietary sodium on overall mortality. A study just published in the Journal of the American Medical Association (JAMA) concluded that higher sodium intake was not correlated with greater mortality risk from all causes, at least not in healthy older adults, regardless of gender or race.

As it is too often the case, contradictory findings of various studies such as these leave consumers ever more confused. Of course, only by continuously questioning and testing its work science can progress, but first ringing the alarm bells and then backtracking on issues of public interest is not always the most helpful approach. There should be a minimum of what we can agree upon before releasing guidelines and recommendations that are meant to influence people’s behavior.

This, it seems to me, is one these occasions. None of the studies I’m aware of calls for more consumption of salt in any form. None advise against keeping levels low. There is only disagreement over its impact on people’s health and well-being. For this, empirical evidence is hard to come by because it requires large-scale, long-term investigations, which are laborious and expensive. But that doesn’t mean we are completely in the dark without them.

One of the main reasons why people consume so much salt is that they are unaware of its many sources. It’s not the saltshaker that puts us at risk but sodium used by food manufacturers in countless food items, many of which don’t taste salty at all. High amounts can be found in most canned and packaged foods, including breads, breakfast cereals, soups, lunch meats, pasta sauces, pancake mixes, cheese, condiments, salad dressings, pizza, frozen dinners, even medications and nutritional supplements. In other words, sodium is nearly omnipresent in much of our commercial food supply, which makes it next to impossible to avoid.

So, if you are absolutely determined to escape the sodium trap, the best you can do is to stick with whole fruits and vegetables, lean, unprocessed meats, fresh seafood, beans and legumes, and unrefined whole grains.

On a personal note, I decided a long time ago not to even own a can opener. I like my meals made from scratch with minimally invasive cooking techniques like steaming and sautéing. To me, this is preferable to anything that can be purchased in ready-to-eat form. Soups, salads, or pasta sauces of almost endless varieties can easily be created on a whim without using any ingredients other than what Mother Nature provides. Yes, that sometimes comes with a little more work and a little less convenience, but to me, that’s part of my investment in my health and certainly worth the effort.

If you liked this article, you may also enjoy reading “Too Much Salt and Too Little Potassium Makes for a Deadly Combo” and “Reducing Salt Intake by Small Amounts Could Save Thousands of Lives Every Year.”

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Lifestyle-Related Ills Tend to Multiply with Age, Study Finds

April 24th, 2013 at 7:13 am by timigustafson

Seniors who suffer from chronic health conditions like high blood pressure or heart disease often develop a host of other, seemingly unrelated health problems, including cognitive impairment like memory loss and dementia, according to a new study based on data collected by the National Center for Health Statistics.

For the study, the researchers analyzed the medical records of hundreds of thousands of seniors residing in assisted-living facilities and found that most had at least one chronic health condition. What was more alarming, however, was that many had overlapping ailments. While high blood pressure and heart disease were most common, nearly half of the assisted-living residents showed signs of dementia.

“These findings suggest a vulnerable population with a high burden of functional and cognitive impairment,” the authors of the study report wrote.

Many studies have suggested a link between vascular disease and dementia, particularly Alzheimer’s, said Dr. P. Murali Doraiswamy, a professor for psychiatry and behavioral sciences at Duke University’s Institute for Brain Sciences (DIBS). Therefore it may not be possible to treat dementia without treating vascular problems, he added.

But that may be easier said than done. “We don’t universally do a great job of how we treat conditions that overlap, for example Alzheimer’s and high blood pressure,” said Dr. Cythia M. Boyd, an associate professor of geriatric medicine at the John Hopkins University Center on Aging and Health, to the New York Times. “Much of the way we practice medicine is looking at disease by disease. We aren’t doing enough thinking about how to add them together and really integrate care.”

What makes things more complicated is that most doctors are not sufficiently trained in preventing or reducing lifestyle-related illnesses – not in the general public and certainly not in older patients – other than through medicating. For instance, the importance of nutrition as a part of preventive care is rarely ever mentioned in medical schools. The approximate time devoted to nutrition science over the first two years of medical education is six hours, which is clearly inadequate, according to the National Academy of Sciences. The same goes for other health-promoting measures such as exercise, especially for the aging population.

Yet many studies have provided compelling evidence that diet and exercise play a significant role for physical and mental health at any time in life but increasingly so as we age.

For example, a more recent study from Britain concluded that the so-called “Western diet,” which typically includes fried, sweet and processed foods, red meat, refined grains and high-fat dairy products, increases the risk of chronic diseases, which in turn can adversely affect both physical and mental health in later years. Eating a Western diet makes it less likely to have an ideal aging process, says Dr. Tasnime Akbaraly, a researcher at the University College of London and lead author of the study report. Conversely, making dietary improvements can yield multiple benefits in this regard.

There is also further evidence that exercise can give a boost to the aging brain. Scientists at the University of British Columbia found that older women who suffered from mild cognitive impairment could improve their memory through weight training and brisk walking.

The connections between physical and mental decline may not yet be completely understood, but it seems clear that chronic diseases play a major role in the process. While these are widespread, the encouraging news is that many, if not all, are preventable by healthier lifestyle choices.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

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Less salt in our food supply could save at least half a million Americans from dying prematurely over the next ten years, according to separate studies conducted at three universities, two American and one Canadian. If the average daily salt intake were to drop to 1,500 milligrams, as recommended by the Dietary Guidelines for Americans, the number of lives saved could more than double. All study results were published in the medical journal Hypertension, a publication of the American Heart Association (AHA).

Americans currently consume on average 3,600 milligrams of salt daily, mostly in form of sodium, widely used as an ingredient in processed foods. Sodium is considered a significant contributor to high blood pressure, which can lead to heart disease, heart attack and stroke, all leading causes of death in the U.S. today.

About a third of American adults, or 68 million, suffer from high blood pressure, a.k.a. hypertension, according to the Centers for Disease Control and Prevention (CDC). The condition was identified as a primary or contributing cause of nearly 350,000 deaths in the U.S. in 2008, the last time the CDC has updated its research on the subject.

Despite of these alarming statistics, there are currently no signs of improvement. Even better treatment has only shown mixed results. Less than half (46 percent) of high blood pressure patients have their condition under control, according to the CDC.

Because the salt content in processed food is already added before it reaches the consumer, there is little opportunity to make changes on an individual basis other than limiting one’s choices to fresh items like produce. This would also exclude many options in restaurants.

“Individuals can’t make this choice easily,” said Dr. Kirstin Bibbins-Domingo, professor of medicine and epidemiology at the University of California, San Francisco (UCSF), to ABC News. “So maybe we should find ways to work with the food industry,” she suggested.

The National Salt Reduction Initiative, a partnership started by the New York City Health Department that has expanded to nearly 100 city and state health organizations across the country, has been trying to get food manufacturers and restaurant operators to cut salt by 25 percent or more since 2008, the year of the organization’s inception. The current goal is to achieve a reduction of 20 percent by 2014.

Critics say that such measures are impractical and would make little difference. Public health advocates have been focusing on hypertension as if no other health threats existed, said Morton Satin, Vice President of science and research at the Salt Institute, a trade association for the salt industry, in response to the recent studies to ABC News. The association warns that low salt intake could produce its own set of health problems, especially for the elderly.

While most experts would agree that multiple factors can be responsible for the development of high blood pressure, including genetic predisposition, gender, age and other non-modifiable components, poor diet and lifestyle choices, which are modifiable and therefore preventable risk factors, usually play a much greater role. In a milestone conference on the connections between sodium intake and blood pressure, sponsored by the National Heart, Lung and Blood Institute (NHLBI), the participating scientists concluded that “an abundance of scientific evidence indicates that higher sodium consumption is associated with higher levels of blood pressure, [as demonstrated in] animal studies, observational epidemiologic studies, and clinical studies and trials.” They were also hopeful that more effective strategies could be developed to improve diet and lifestyles patterns that benefit the larger population.

If you liked this article, you may also enjoy reading: “Too Much Salt in Our Food Creates Serious Health Hazards.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

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Even Slightly Elevated Blood Pressure Poses Health Risks

November 16th, 2011 at 10:39 am by timigustafson

If you think your blood pressure is normal, you may want to double-check with your doctor. According to new guidelines, blood pressure of 120/80 mmHg, which was until recently seen as within a healthy range, is now classified as elevated.

Scientists at the University of California, San Diego (UCSD) found that people under the age of 65 who were diagnosed with a condition called “prehypertension” had a 68 percent increased risk of suffering a stroke compared to those with normal readings.

Prehypertension is defined by the National Institutes of Health (NIH) as a systolic pressure (upper number) of 120 to 139 mmHg and a diastolic pressure (lower number) of 80 to 89. Higher readings than 140/90 are considered to be hypertension. Ideally, the normal range should be well below the prehypertension threshold.

When blood pressure rises, the heart has to work harder. If blood pressure remains chronically elevated, the risk of cardiovascular disease increases, which can eventually lead to heart attack, stroke or heart failure.

A primary risk factor is obesity. The greater the body mass, the more blood is needed to transport oxygen and nutrients. The higher volume of blood circulating through the blood vessels puts ever more force on the artery walls.

There are other causes as well. Atherosclerosis, the buildup of fatty deposits in the arteries, is quite common. Other contributing conditions are sleep apnea, kidney disease, thyroid disease and adrenal disease.

Poor diet- and lifestyle choices are most often (at least in part) responsible for high blood pressure to occur. But even some medications, including birth control pills, cold remedies, painkillers and other prescription drugs can play a role. So can recreational drugs like cocaine and amphetamines.

There is no cure for high blood pressure, only treatment through medication and lifestyle measures like diet and exercise.

Prehypertension should be seen as a warning sign, according to Dr. Bruce Ovbiagele, a professor at UCSD and lead author of the study that lead to the revised guidelines. “This doesn’t mean that people with prehypertension should start taking anti-hypertensive drugs. Instead, they should modify their lifestyle, maintain an ideal weight and lower their sodium intake.”

The worst you can do is to ignore the numbers, said Dr. Ovbiagele. “You shouldn’t be deceived because nothing seems to be going on.” Because there are no specific symptoms for prehypertension or hypertension, people tend to think they can live with the condition.

Nothing could be further from the truth. If you are overweight, even moderately, shed the extra pounds as soon as possible. Exercise regularly. Nothing is better for your blood pressure and your heart than a rigorous workout several times a week (consult with your doctor if you already have elevated blood pressure and don’t currently exercise). Eat plenty of fruits, vegetables, whole grains, fish and low-fat dairy products. Avoid foods that are high in sodium like processed and packaged food items. Eat foods that are low-fat, low-cholesterol and free of trans fats and other unhealthy ingredients. Cut back on meat, especially red meat. Drink alcohol in only moderation, preferably red wine. Last but not least, manage your stress and get enough sleep.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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