Tagged with 'hypertension'

The importance of eating quercetin-containing foods.

My wonderful hubby isn’t normally the target of my blogs, but against his knowledge, he is today. He suffers from high blood pressure (aka: hypertension). He has been told it is genetic, handed down from his father, and has actually had an issue with it since college, but only got serious about taking care of it in his late 20’s. Regardless of the cause, he has been seen by the appropriate health care practitioners to rule out any other causes, he takes blood pressure medication, exercises (when he feels like it!), and has made some dietary changes to reduce his risk of adverse health outcomes. If you haven’t heard, there’s a direct and consistent relationship between blood pressure and cardiovascular disease and stroke.

Luckily for him he lives with a nutritionist, haha. I’ve been pleasantly surprised, he has only had perfect cholesterol and triglyceride blood tests since I've known him, so when tweaking his diet, we primarily focused on sodium (salt) and potassium.

Excess sodium intake is not only linked to high blood pressure, but is also linked to kidney stones, asthma, osteoporosis, and gastric cancer. A diet high in fruits and vegetables (good sources of potassium) and fat-free or low-fat dairy foods can help lower systolic blood pressure by more than 10 points in people with high blood pressure.

The American Heart Association’s Sodium Recommendations:

New studies reinforce recommendations to limit sodium intake to less than 1,500 milligrams (mg) per day. This is a big decrease from previous American Heart Association recommendations of 2300 mg a day, and quite honestly, 1,500 mg is very hard to achieve! See my recommendations and strategies for coming close to achieving it.

Why Did the American Heart Association Change its Sodium Recommendations?

One in 10 Americans will develop high blood pressure in their lifetime, and over-consumption of sodium is strongly linked to the development of high blood pressure.

Data from the U.S. Centers for Disease Control (CDC) released in 2009 showed 70% of the U.S. population is salt sensitive, which means their blood pressure is prone to rise in response to excess sodium in their diet. In addition, 97%of all children in the U.S. are eating too much salt, putting them at early risk for high blood pressure.  

Lifestyle Recommendations for People with High Blood Pressure:

• Adopt a healthy lifestyle, which includes reducing excess body weight, increasing physical activity, lowering alcohol intake, increasing dietary potassium intake (assuming normal kidney function), and reducing salt intake.

• Reduce salt intake to less than one teaspoon of salt per day (approximately 1550 mg of sodium a day).

Strategies to Reduce Sodium Intake:

• Cook your food from scratch when possible (ie: make your own salad dressing vs. purchasing it).

• Choose foods normally processed without salt and foods labeled ‘no added salt’ or ‘low salt’ (‘low salt’ means no more than 120 mg of sodium per 100 g).

• Choose ‘reduced salt’ products if these are the lowest salt options available.

• Avoid high salt processed and prepared foods.

• Avoid salty snacks. If salt is visible on the food, it’s definitely high in salt (ie: pretzels, chips, crackers, nuts). Choose unsalted version.

• Ditch the salt shaker. Avoid adding salt during cooking and at the table.

• Food in restaurants is almost always higher in sodium than what you might make at home. Foods typically high in sodium: Chinese food, Thai food, Italian food, Mexican food.

• When using spices, read the ingredients and avoid spices with salt in them. For example, if you use a poultry seasoning, find one without salt. Choose garlic powder, not garlic salt. Choose onion powder, not onion salt, etc.

• If you chose a salt substitute, potassium chloride salt substitutes should be avoided in people with renal dysfunction or in those who are taking potassium-sparing diuretics. Talk to your health care provider about salt substitutes.

What about Potassium?

Eating potassium-containing foods is important (if you have fully functioning kidneys). Please don't go to your local nutrition supplement store to buy a potassium supplement. It can be toxic. I suggest getting potassium from food. The recommendation is to eat 5-10 servings of fruits and vegetables every day. A serving is ½ cup of cooked, canned, and frozen produce and 1 cup of fresh produce. Basically, eat fruits and/or vegetables at every meal. Just to reinforce, if you eat a large serving of a fruit or vegetable, it counts as more than 1 serving. (ie: 2 cups of cooked broccoli on your plate counts as 4 servings).

High Potassium Foods:

Apples, Apricots, Artichoke, Asparagus, Bananas, Brazil Nuts, Brown Rice, Cabbage, Corn, Cantaloupe, Dates, Figs, Green Beans, Green Pepper, Honeydew, Kiwi, Iceberg Lettuce, Romaine Lettuce, Legumes, Lima beans, Nectarine, Oranges, Orange Juice, Papaya, Peaches, Peas, Potatoes, Sweet Potatoes, Prunes, Pumpkin, Raisins, Roasted Peanuts with skin, Spinach, Squash, Strawberries, Wheat Bread, Winter Squash, Tomatoes (all forms: dried, sauce, paste, etc.), Celery, Avocado, Carrots, Broccoli, Watermelon, All Beans (Kidney, Pinto, Lima), Black eyed peas, Lentils, Almonds, and Dairy Products.

Additional Information:

• If you adopt a low salt diet, follow up with your health care provider because the dosage of both antihypertensive medication and lithium carbonate may need to be reduced.

• The combination of diuretic treatment and low dietary salt intake may result in unacceptable volume depletion and hyponatremia.

• Dietary salt restriction is inappropriate in people with salt-wasting forms of renal and gastrointestinal disease.

• Women who become pregnant should continue their usual level of dietary salt intake.

Bottom Line: With some determination and experimentation, it is possible to reduce your sodium intake, and although you may not reach 1500 mg/day, any reduction is a good start. Don’t forget about boosting your fruit and veggie intake for potassium, which also helps lower blood pressure.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. Institute of Medicine. Appel LJ, Baker DH, Bar-Or O, Minaker KL, Morris RC, Resnick LM, Sawka MN, Volpe SL, Weinberger MH, Whelton PK (Panel on Dietary Reference Intakes for Electrolytes and Water). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press;2005.

2. Heart Foundation. Salt and Hypertension (Professional Paper)

Olive oil truly is liquid gold with its many health benefits. Considered the most important component of the traditional Mediterranean diet, this extraordinary fruit juice and its effects are still not fully understood. Yet some of the ways olive oil can preserve and improve human health have been firmly established.

Here are the five most scientifically supported health benefits of olive oil today.

1. It Can Help Lower Your “Bad” Cholesterol

Low Density Lipoprotein (LDL), also known as the body’s “bad cholesterol,” transports and deposits cholesterol in the tissues and arteries, which can eventually cause plaque and block the artery. Monounsaturated fats can lower LDL thus protecting against atherosclerosis (hardening of the arteries). Plus, monounsaturated fat does not negatively affect the levels of High Density Lipoproteins (HDL) known as the “good cholesterol,” which carries all cholesterol away from the arteries. High levels of HDL are associated with a decreased risk of heart disease.

Olive oil is one of the best sources of monounsaturated fats and has the advantage of being less susceptible to oxidation. In addition, oleic acid, a fatty acid abundant in olive oil, appears to also protect from oxidation of LDL.

It is important to mention, to achieve this reduction in bad cholesterol you cannot just add olive oil to a diet high in saturated and trans fats and expect a miracle. You must replace the unhealthy fats with olive oil in combination with a Mediterranean-style diet.

2. Olive Oil Can Help Lower Your Blood Pressure

Several studies for different age groups, and with a large number of participants, have found the consumption of olive oil is associated with a decrease in blood pressure.

The SUN study with over 6,000 participants found olive oil intake reduced the incidence of hypertension in men, while another Spanish study published in the American Journal of Hypertension found a diet containing polyphenol rich olive oil reduced blood pressure in young women with mild hypertension.

Results from the Greek component of the EPIC study (European Prospective Investigation into Cancer and Nutrition) which included over 28,500 volunteers concluded olive oil intake is inversely associated with both systolic and diastolic blood pressure. While it appears the polyphenols in the olive oil may be responsible for this action, researchers have demonstrated that oleic acid; a fatty acid in olive oil may also induce this lowering effect.

3. Eating Olive Oil Can Help Prevent Cancer

Olive oil consumption has been associated with a reduced risk of cancer. A review conducted last year by Greek researchers from the University of Athens looked at 19 observational studies, with over 36,000 participants, and found higher rates of olive oil consumption were associated with lower odds of having any type of cancer. Another review of 25 epidemiological studies concluded that “preferring olive oil to other added lipids, particularly those rich in saturated fats, can decrease the risk of upper digestive and respiratory tract neoplasms, breast and, possibly, colorectal and other cancer sites.”

4. It Protects from Oxidative Damage

Oxidative damage occurs when your body doesn’t have enough antioxidants to protect against the damaging free radicals. Apart from the beneficial monounsaturated fats in olive oil and specifically oleic acid, olive oil also contains polyphenols. Polyphenols are phytochemicals, components that have antioxidant activity. The specific type of polyphenols found in olive oil appear to protect the oxidation of LDL cholesterol in the body.

Researchers for the Eurolive Study Group found that consumption of olive oil at real-life doses of about 2 tablespoons per day improved the fatty acid profile in LDL, associated with a reduction of the oxidative damage to lipids. It appears that oxidized LDL is a major contributor to atherogenesis; the process of plaque buildup in the arteries that eventually can lead to atherosclerosis (hardening of the arteries).

This is an approved claim for olive oil in the European Union: “Olive oil polyphenols contribute to the protection of blood lipids from oxidative stress.”

It is important to note that only polyphenol rich extra virgin olive oils may have this effect, not refined olive oil, which does not contain these substances.

5. Olive Oil Can Help Cognitive Function

Although olive oil is better known for its protection against heart disease and cancer, there is an emerging amount of research regarding the effect of olive oil on cognitive function and, specifically, on cognitive decline associated with aging.

Generally, the type of fat consumed can affect cognitive function. A study from Brigham and Women’s Hospital, a teaching affiliate of Harvard Medical School, analyzed data from 6,000 women over the age of 65, a subset of the Women’s Health Study. They found women who consumed the highest amount of monounsaturated fats, which can be found in olive oil, had better patterns of cognitive scores over time.

But it appears olive oil specifically has a protective effect. Results from the Three City Study, an ongoing multicenter study of vascular risk factors for dementia using information from almost 7,000 participants, showed individuals who had moderate to intensive use of olive oil had lower odds of cognitive deficit for verbal fluency and visual memory compared to individuals who had never used olive oil.

How much of a good thing?

When looking at the different studies in regards to the protective effect of olive oil for various conditions the amount generally ranges between 25 and 40 grams per day, or about 2-3 tablespoons.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations http://ajcn.nutrition.org/content/70/6/1009.full

2. Effects of Monounsaturated Fatty Acids on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis http://www.karger.com/Article/FullText/334071

3. The effect of olive oil polyphenols on antibodies against oxidized LDL. A randomized clinical trial. http://www.clinicalnutritionjournal.com/article/S0261-5614(11)00029-X/fulltext

4. Elevated Circulating LDL Phenol Levels in Men Who Consumed Virgin rather Than Refined Olive Oil are Associated with Les Oxidation of Plasma LDL. http://jn.nutrition.org/content/140/3/501.long

5. Low Fat and High Monounsaturated Fat Diets Decrease Human Low Density Lipoprotein Oxidative Susceptibility In Vitro. http://jn.nutrition.org/content/131/6/1758.full

6. Olive oil consumption and reduced incidence of hypertension: The SUN study. http://link.springer.com/article/10.1007%2Fs11745-004-1352-x?LI=true

7. Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. http://ajcn.nutrition.org/content/80/4/1012.abstract

8. Olive oil consumption and reduced incidence of hypertension: The SUN (Seguimiento University of Navarra) study. http://link.springer.com/article/10.1007%2Fs11745-004-1352-x?LI=true

9. Oleic acid content is responsible for the reduction in blood pressure induced by olive oil. http://www.pnas.org/content/105/37/13811.abstract

10. Virgin olive oil reduces blood pressure in hypertensive elderly subjects http://www.clinicalnutritionjournal.com/article/PIIS026156140400024X/fulltext  

11. Olive oil intake is inversely related to cancer prevalence: a systematic review and a meta-analysis of 13,800 patients and 23,340 controls in 19 observational studies. http://www.lipidworld.com/content/10/1/127

12. Olive oil and Cancer Risk: an Update of Epidemiological Findings through 2010 http://www.benthamscience.com/cpd/contabs/contents.php?JCode=CPD&Vol=00000017&Iss=00000008#3167024

13. Olive Oil and Cognition: Results from the Three-City Study http://www.hal.inserm.fr/docs/00/41/39/95/PDF/inserm-00413995_edited.pdf

14. Dietary fat types and 4-year cognitive change in community-dwelling older women. http://onlinelibrary.wiley.com/doi/10.1002/ana.23593/abstract

Article courtesy of Olive Oil Times.

What is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors that happen simultaneously to a person. These risks include high blood pressure, high blood sugar, high triglycerides, high cholesterol levels (low good cholesterol HDL), and belly fat—all which increase a person’s risk of heart disease, stroke, and diabetes.

How common is Metabolic Syndrome?

Sad to say, it is VERY common! According to the American Heart Association, 47 million Americans have metabolic syndrome. That's almost a staggering 1 out of every 6 people! The good news is it can be controlled. People with metabolic syndrome are most often overweight or obese. The syndrome runs in families, and is more common among African-Americans, Hispanics, Asians, and Native Americans.

Symptoms of Metabolic Syndrome

Most of the metabolic syndrome risk factors don't have any symptoms. Often, the only outward sign is packing some extra weight in the belly, which usually results in a larger waist.
The only way to find out if you have metabolic syndrome is to meet with your doctor. He or she will check your blood pressure, blood sugar, and cholesterol. It's another reason regular check-ups are the key to staying healthy.

What’s considered a large waist for a woman? 

Women with a waist measuring 35 inches or larger are at risk of metabolic syndrome.

What is considered a large waist for a man? 

Men with a waist measuring 40 inches or larger are at risk of metabolic syndrome.

Treatment of Metabolic Syndrome

Switching up your lifestyle is the preferred treatment of metabolic syndrome, particularly losing weight. Effective weight loss normally includes a specific, tailored program that includes diet and exercise.

There is now a trend toward the use of a Mediterranean diet for metabolic syndrome—one rich in "good" fats (olive oil) and a reasonable amount of carbohydrates and proteins (such as from fish and chicken).

How To Implement the Mediterranean Diet

The Mediterranean diet is palatable and easily sustained. Recent studies have shown when compared to a low fat diet, people on the Mediterranean diet have a greater decrease in body weight, and also had greater improvements in blood pressure, cholesterol levels, and other markers of heart disease, all of which are important in evaluating and treating metabolic syndrome.

To be exact, there is not just one Mediterranean diet. What’s eaten varies significantly from one Mediterranean country to another. However, the shared features of the Mediterranean-style diet include the following:

• Eat lots of fruits and vegetables—a variety of plant foods should cover half your plate.  Include veggies and fruit at every meal, and eat them for snacks too.

• Switch to whole grains—reduce your intake of white foods and choose more brown foods.

• Add nuts, legumes, and seeds—a great source of fiber, protein, and healthy fats. 

• Pass on the butter—replace it with olive oil, which is this diet’s key monounsaturated fat source.

• Flavor foods by using herbs and spices instead of salt.

• Choose low-fat dairy products—reduce your intake of ice cream, whole or 2% milk, and cheese.

• Eat fish at least twice a week.

• Very little red meat or processed meat is eaten—substitute with chicken (and fish).

• Eggs are eaten zero to four times a week.

• Wine is drunk in moderate (or low) amounts.

• Eliminate refined carbohydrates—avoid “enriched” foods.

Bottom Line: The Mediterranean diet is shown to be an anti-inflammatory diet, which helps fight diseases related to chronic inflammation, including metabolic syndrome. 

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutriitonist for Healthy Goods

References:

1. American Heart Association:  Mediterranean Diet 
2. Babio N, et al. Mediterranean diet and metabolic syndrome: the evidence. Public Health Nutr. 2009 Sep;12(9A): 1607-17.