Webinar Team and Today s Presenters. Beyond Sodium: Food and Nutrients that Impact Blood Pressure

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1 Beyond Sodium: Food and Nutrients that Impact Blood Pressure Download session materials and view archived sessions at Upcoming Essentials of Blood Pressure Management Sessions: April 19: Medications and Blood Pressure - Dr. Rhonda DeHoff, UF College of Pharmacy May 3: Blood Pressure, Kidneys and Complications Talking With Children About Money Wednesday, April 25 Did you know children as young as 2 can learn basic money management concepts? We will discuss strategies and tools for talking with children about money. Our discussion will include age appropriate money management practices and activities to teach children how to be smart with money. Registration: University of Florida IFAS Extension Institute of Food and Agricultural Sciences (IFAS) Part of federal-state-county partnership dedicated to developing knowledge in agriculture, human and natural resources, and the life sciences, and enhancing and sustaining the quality of human life by making that information accessible. IFAS includes: Teaching Research Extension Extension Outreach from IFAS at local level All 67 counties in Florida have an Extension presence Most have a Family & Consumer Sciences Agent 1 2 Beyond Sodium: Food and Nutrients that Impact Blood Pressure Webinar Team and Today s Presenters Wendy Dahl, Ph.D. Associate Professor and Extension Specialist UF/IFAS Food Science & Human Nutrition Depart. wdahl@ufl.edu Julie England, M.S.,CFCS Seminole County FCS & Food Systems Extension Agent julieeng@ufl.edu Wendy Wood Lynch, M.S. Putnam County FCS Extension Agent wendyw74@ufl.edu 3 4 1

2 Essentials of Blood Pressure Management Today s Outline Lifestyle is key to management Physical activity Stress management Restrict alcohol consumption Quit smoking Reduce weight if needed or maintain healthy weight Nutrition Salt and alcohol Novel blood pressure lowering foods Dietary patterns for lowering blood pressure 5 6 Blood pressure and salt (sodium chloride) Excess salt intake is associated with higher blood pressure in some people but not all. Complex environmental and genetic causes Salt accumulates in the skin and also damages the lining of the blood vessels leading to cardiovascular and kidney disease not only due to blood pressure. Salt sensitivity When blood pressure increases with a higher salt diet Almost half of Americans are hypertensive, salt sensitive or both 7 Felder et al. Curr Opin Nephrol Hypertens Jan; 22(1):

3 Recommendations for sodium intake Shocking Sodium Contents! Adequate intake: 1500 mg per day (lower intake increases risk) Upper Limit < 2300 mg per day of sodium ~ 1 tsp 1 large pickle = 1900 mg 2 oz ham = 500 mg Hamburger = 500 to Burrito Bowl = mg Salsa = 100+ mg/tbsp 12 pizza = 6000 mg Chicken soup = 850 mg/cup Institute of Medicine. Strategies to reduce sodium intake in the United States For more information: Shopping for Health: Sodium at Alcohol consumption Men moderate (<15 drinks/week) and excessive (>15 drinks/week) alcohol consumption blood pressure Women excessive alcohol intake (>10 drinks/week) blood pressure a 3x risk compared to non-drinkers Women binge drinkers(2-3 x per month) 70% increased risk of high blood pressure What candy increases blood pressure? Luis et al Phytomedicine Jan 15;39:

4 Beetroot juice for blood pressure? Drinking a glass of beetroot juice each day was studied in people with hypertension How does beetroot juice work? Nitrate intestine blood salivary gland saliva mouth Mmm great tasting beetroot juice! Clinic and home blood pressure was reduced also stiffness of the arteries Dietary nitrate may be an affordable, readily-available way of helping to treat hypertension bacteria convert nitrate to nitrite intestine blood nitrite to NO Nitric oxide (NO) relaxes arteries which lowers blood pressure Healthy food sources of nitrate (3 oz.) Food Groups and Risk of Hypertension 1 oz of whole grains 3+ oz of fruit 1 oz nuts 1 cup dairy > 3 oz meat 1½ oz processed meat Schwingshackl et al Adv Nutr Nov 15;8(6):

5 Do other dietary patterns work for BP? Dietary Approaches to Stop Hypertension (DASH) Dietary patterns characterized by high consumption of fruit, vegetables, whole grains, legumes, seeds, nuts, fish, and dairy and low consumption of meat, sweets, and alcohol resulted in significant reductions in blood pressure. The DASH Diet, Mediterranean Diet, and the Nordic Diet! Ndanuko, Rhoda N et al. Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Advances in Nutrition 7.1 (2016): PMC. Web. 3 Apr DASH Recommends: Vegetables Fruits Low Fat or Fat Free Dairy Products Whole grains DASH Recommends: Fish Poultry Beans Nuts Vegetable Oils

6 DASH Limits: Sodium 2,300 or 1,500 mg Sweets Sugar-Sweetened Beverages Red Meats DASH Limits: Saturated Fats Trans Fats Tropical Oils Coconut Palm Kernel Palm Oils DASH Calcium Magnesium Potassium

7 DASH: Calcium DASH: Magnesium Recommendation 1,000 mg 1,200 mg/day Sources Dairy Fortified Cereals Fortified Orange Juice Ready to Eat Cereals Recommendation mg/day Sources Beans Dairy Nuts Vegetables Whole Grains Potassium Recommendation 4,700 mg/day Sources Legumes Dairy Vegetables Fruits DASH Daily and weekly goals based on calorie level and serving sizes Sedentary, Woman, Age 32 Calorie Needs: 1,800 Grains 6 servings Vegetables 4-5 servings Fruits 4-5 servings Fat-Free or Low-Fat Dairy 2-3 servings Lean Meats, Poultry or Fish 6 or less Nuts, Seeds, Legumes 4 per week Fats & Oils 2-3 Sweets/Added Sugars 5 or less per week

8 DASH: Serving Sizes DASH: Serving Sizes Grains 1 slice of bread ½ cup dry cereal ½ cup cooked rice or pasta Vegetables 1 cup raw, leafy vegetables ½ cup cooked or cut-up raw vegetables ½ cup vegetable juice Fruits 1 medium fruit ¼ cup dried fruit ½ cup frozen, canned or cut-up fresh fruit Fat-free or Low-fat dairy 1 cup milk or yogurt 1.5 oz cheese (check the sodium content) Lean meats, poultry, and fish 1 oz cooked meat, poultry, or fish 1 egg or 2 egg whites Nuts, seeds, and legumes 1/3 cup or 1.5 oz nuts 2 Tbsp peanut butter 2 Tbsp or ½ ounce seeds ½ cup cooked dry beans or peas Fats and Oils 1 tsp margarine or vegetable oil 1 Tbsp mayonnaise 2 Tbsp salad dressing Sweets 1 Tbsp sugar, jelly, or jam 1 cup lemonade Mediterranean Diet Lifestyle not a diet Plant-based, not vegetarian Incorporates foods you enjoy Many options, no one specific diet 31 8

9 Non-Diet Recommendations Health Benefits of Mediterranean Diet Regular physical activity Adequate rest Social and cultural values of meals Biodiversity Seasonality Eco-friendly products Culinary activities Reduced risk of: Cardiovascular disease Obesity High blood pressure Metabolic syndrome Dementia Some forms of cancer Blood Pressure Six studies totaling more than 7,000 people People that followed the Mediterranean Diet pattern for at least 1 year reduced both the systolic BP and diastolic BP levels in individuals with normal BP or mild hypertension. Focus on Fresh and Seasonal Foods Fruits Vegetables Whole grains Legumes Nuts Fish Lean meat Healthy fats Nissensohn M et al The Effect of the Mediterranean Diet on Hypertension: A Systematic Review and Meta-Analysis. J Nutr Educ Behav

10 General Recommendations Daily Dairy 2 servings (preferably low fat) Olives/Nuts/Seeds 1 to 2 servings Water and healthful beverages Herbs/Spices/Garlic/Onions (less added salt) Weekly Potatoes 3 servings White meat - 2 servings Fish and seafood 2 servings Eggs 2 to 4 Legumes 2 servings Red meat 2 servings Processed meats 1 serving Downloadable handouts, videos and recipes on the website The New Nordic Diet New Nordic Diet Foods Emphasized Based on food from Nordic region Not a traditional Nordic diet Eating seasonally Environmentally friendly Can result in: Weight loss Improved BP Fruit and Vegetables especially berries, cabbages, root vegetables, and legumes Potatoes Fresh herbs Plants and mushrooms gathered from the wild Nuts Whole grains rye, barley, and oats Meats from livestock and game Fish and shellfish fatty fish such as salmon, mackerel, and herring Seaweed Mithril, C., Dragsted, L. O., Meyer, C., Blauert, E., Holt, M. K., & Astrup, A. (2012). Guidelines for the new nordic diet. Public Health Nutrition, 15(10), The American Journal of Clinical Nutrition, Volume 99, Issue 1, 1 January 2014, Pages 35 45,

11 Vegetarian Diet What is the Best Eating Plan for You? Generally lower BP than omnivores Possible differences between vegetarians and omnivores Lower body weight Reduced consumption of total fat and saturated fat Consume more fiber Higher potassium intake DASH Mediterranean New Nordic Other? Berkow, S. E., & Barnard, N. D. (2005). Blood pressure regulation and vegetarian diets. Nutrition Reviews, 63(1), The Best Plan is One That Works for You Planning Ahead is Vital Plan meals for most of the week Include planned-overs for lunch Cook once - eat 2 times or more Doesn t have to be cooked Create a book or file of favorite go-to recipes Make family favorites healthier Grab and go snacks Apples Plastic Wrap Cereal Milk Laundry detergent

12 Ideas to Increase Your Veggies (Fruits & Legumes too!) Shop Wisely Cook More Meals at Home Make Healthier Choices Away from Home Commit to a Change for Improved Health Lifestyle changes have a cumulative effect Your small change can have positive affect on those around you 47 12