Facts about Blood Pressure and Sodium Hechos sobre la Presión Arterial y el Sodio

Transcription

1 Facts about Blood Pressure and Sodium Hechos sobre la Presión Arterial y el Sodio UCLA Stroke Community Symposium July 10, 2014 Arleen F. Brown, MD, PhD Professor of Medicine/ Profesora de Medicina Geffen School of Medicine at UCLA

2 Acknowledgements Los Angeles Stroke Prevention/Intervention Research Program in Health Disparities (SPIRP) (NIH/NINDS U54: 1U54NS ) (PI: Vickrey) UCLA Clinical and Translational Science Institute NIH/NCATS/UCLA CTSI Grant # UL1TR (PI: Dubinett)

3 Overview The role of salt in the human diet Why is Sodium Important? Why is Sodium Dangerous? The Impact of Lowering Sodium in the Typical U.S. Diet Where Does the Salt in the Typical Diet Come From? Myths and Facts About Salt Simple strategies for reducing the salt in your diet: a 3 week plan

4 Salt of the earth Worth his/her salt The Value of Salt Let your speech always be gracious, seasoned with salt, so that you may know how you ought to answer each person. Colossians 4:6 Let there be work, bread, water and salt for all. Nelson Mandela

5 A History of Salt in the Human Diet For millions of years, our ancestors ate a diet that had less than 250 mg of salt daily 5000 Years ago the Chinese discovered that salt could be used to preserve food Huge impact economically and on health Could store/preserve food in winter months Result was more settled communities Salt was the most taxed and traded commodity in the world

6 More on the History of Salt... Early 1800s: Invention of the deep freezer and the refrigerator Salt was no longer required as a preservative Initially, decreased salt consumption, but. Early to mid 1900s: invention of new methods for processing foods that often used high levels of salt and other preservatives Dramatic rise in the consumption of salt; Our daily salt intake is now almost 35 times more than our ancestors

7 Salt Intake - Then... and Now. Average Daily Intake of Sodium Recommendation Range mg per day 3400 mg Women 2920 mg Men 4160 mg 100 mg 5000 years ago Today Today *Recommendation: mg sodium per day

8 How Much Sodium is in Salt? 1 teaspoon of salt = 2325 mg of sodium More than the maximum recommended/day

9 Why is Sodium Important? Our bodies need salt Sodium is essential to many bodily functions: Helps to maintain the right balance of fluids in the body Helps to control blood pressure Helps to transmit impulses along the nerves Contributes to the contraction and relaxation of muscles but we don t need very much sodium 1500 mg to 2300 mg per day (less than a teaspoon)

10 How Your Body Processes Sodium Kidneys naturally balance the amount of sodium stored in your body When your body s sodium levels are low, the kidneys hold on to sodium When your body s sodium levels are high, the kidneys excrete the excess salt in your urine Sometimes, the kidneys cannot eliminate enough sodium and your body holds on to water He and MacGregor, J Hum HTN, 2009

11 What is the Impact of High Levels of Dietary Sodium? When your kidneys cannot eliminate enough sodium and your body holds on to water: There is an increase in your blood volume Your heart has to work harder Higher risk of heart disease Rise in the pressure in your arteries Higher blood pressure Leading to higher risk of: Stroke Heart attack Heart failure Kidney disease He and MacGregor, J Hum HTN, 2009

12 Impact of Sodium Reduction 1200 mg per day If everyone in the U.S. decreased dietary sodium intake by 1200 mg/day, there would be: 32,000 to 66,000 fewer new strokes 54,000 to 99,000 fewer new or recurrent heart attacks 44,000 to 92,000 fewer deaths $10 billion to $24 billion saved in health care costs Bibbins-Domingo, NEJM, 2011

13 Impact of Sodium Reduction 400 mg per day* If everyone in the US decreased dietary sodium intake by 400 mg/day, there would be: 11,000 to 23,000 fewer new strokes 18,000 to 35,000 fewer new or recurrent heart attacks 15,000 to 32,000 fewer deaths *About 20 small pretzels or a ½ bag of potato chips Bibbins-Domingo, NEJM, 2011

14 Salt Intake Over the Life Span: Childhood Birth to 6 months: low salt intake 6-9 months of age: salt intake increases when babies start solid food months old: excess intake Children and adolescents: high salt intake due to processed foods Programming effect on blood pressure: Risks: Early life salt intake is associated with higher blood pressure into the 3 rd and 4 th decades of life Benefits: Lowering blood pressure early in life is associated with lower blood pressure 15 years later Frisoli et al., Am J Med, 2012

15 Salt Intake Over the Life Span: Older Adults Older adults have high rates of hypertension and are more sensitive to salt, so can benefit even more than younger adults from lowering salt intake Low sodium diet 1500 mg / day 0 Decrease in Systolic Blood Pressure (mm Hg) Younger (23-40 years old) Older (55-76 years old) Frisoli et al. Am J Med,

16 Where does the salt in our diets come from? Americans eat more than 3400 mg of sodium each day Where does this sodium come from? 65% from food bought in supermarkets, grocery stores, etc. 25% comes from restaurants 10% comes from home cooking and at the table

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18 Funny, They Don t Taste Salty.

19 Myths and Facts About Salt 1. Eliminate sodium completely for good health 2. Reducing salt in your child s diet can lower his or her blood pressure later in life 3. Sea salt has less sodium than table salt 4. I usually don t salt my food, so I don t eat too much sodium 5. High levels of sodium are found only in food 6. Lower sodium foods have no taste 7. My blood pressure is normal, so I don t need to worry about how much sodium I eat 8. I don t eat a lot of salty food, so I don t eat too much sodium

20 Myths and Facts About Salt You should eliminate sodium completely for good health Sodium is an essential nutrient that helps to maintain the balance of fluid in your body, controls blood pressure, and helps to make nerves and muscles work properly.

21 Myths and Facts About Salt Reducing salt in your child s diet can lower his or her blood pressure later in life Lowering salt intake to recommended ranges early in life can lead to lower blood pressures more than a decade later.

22 Myths and Facts About Salt Sea salt has less sodium than table salt Although the flavor, color, and texture differ, both sea salt and table salt contain about 40% sodium

23 Myths and Facts About Salt I usually don t salt my food, so I don t eat too much sodium More than 75% of sodium Americans eat come from processed foods, not the salt shaker It is important to read food labels

24 Myths and Facts About Salt High levels of sodium are found only in food Some over-the-counter medications contain high levels of sodium One Alka Seltzer tablet contains 567 mg sodium Read drug labels carefully Some companies produce low-sodium, over-the-counter medications

25 Myths and Facts About Salt Lower sodium foods have no taste As an alternative to salt, try to use spices, herbs, and citrus to enhance the natural flavor of foods

26 Myths and Facts About Salt My blood pressure is normal, so I don t need to worry about how much sodium I eat Even for people who do not have high blood pressure, a lower sodium diet can: Blunt the rise in blood pressure that occurs with age Decrease your risk of kidney disease, heart disease, and stroke

27 Myths and Facts About Salt I don t eat a lot of salty food, so I don t eat too much sodium Many foods have high levels of sodium naturally or added 1. Cheese 2. Cold cuts and cured meats 3. Bread 4. Poultry 5. Pizza 6. Sandwiches

28 General Tips for Lowering the Sodium in Your Diet Vegetables Buy fresh, frozen (without sauce), or no-salt-added canned vegetables Meat, Poultry, Fish Buy fresh, lean cuts, not canned or processed Check poultry and pork to see if saline or salt solution was added Limit sauces, mixes, and instant products Limit flavored rice, ready-made pasta Read Nutrition Labels closely Check portion size Check sodium content

29 Change Your SALTY Ways Three Week Plan: Week 1 Week 1: Learn to read and understand food labels Look for lower sodium items, starting with: breads/rolls/tortillas cold cuts/cured meats soy sauce Track your sodium consumption Sodium in 1 Tablespoon: 575 mg 920 mg

30 Change Your SALTY Ways Three Week Plan: Week 2 Week 2: Pizza & Poultry Make changes to the items you eat regularly Pizza: decrease the cheese and meats add vegetable toppings instead Poultry: use fresh rather than fried, canned, or processed 1150 mg/ slice 690 mg/ slice

31 Change Your SALTY Ways Three Week Plan: Week 3 Week 3: Soups and Sandwiches One cup of chicken noodle soup can have up to 940 mg of sodium Check labels and try the lower sodium varieties Use lower sodium meats, cheeses, and condiments Switch out meats and cheeses for vegetables for healthier sandwiches

32 Extreme Sandwich Makeover

33 Change Your SALTY Ways In 3 weeks, you can Change your taste for sodium Start enjoying foods with less sodium Reduce bloating puffiness

34 Thank You! Questions?