Written by Susan Schachter, MSRDN

In our last installment of The Circulatory, we took a look at how we were doing with our New Year’s resolutions as they pertain to achieving/maintaining a healthy weight. Look at any top 10 list of New Year’s resolutions and you’ll see exercise right up there at the top of that list, along with healthier eating/weight loss. 

So today, let’s take a look at exercise. How, specifically, does exercise help us control our blood pressure?

Lack of exercise/physical activity usually leads to a higher resting heart rate. This means the heart is pounding more and exerting more pressure against the blood vessel walls.

Now, you might say, but isn’t my heart working harder when I exercise? Yes, but that is for a discreet period of time—20 minutes, 40 minutes, 60 minutes, 90 minutes—which when done regularly can have the impact of lowering your resting heart rate. That means the force against your blood vessel walls is decreasing for the remaining 22-23 hours of the day!

We all know that maintaining a healthy bodyweight can assist us in normalizing our blood pressure. We also know that exercise burns calories, which can help us lose weight or maintain a healthy bodyweight. But even though exercise doesn’t burn enough calories to give us the “go ahead” to eat whatever we want, it does help create a ‘Virtuous Cycle” in which we feel as though we’re doing something “good” for ourselves. This might make us more protective of trying to not “undo” the good we’ve done by exercising. 

Recent research in Sweden showed that stroke patients who reported engaging in at least 2 hours of moderate activity/week or 4 hours of light activity/week (like walking) were less likely to have had a severe stroke than patients who were physically inactive. They concluded that exercise may help make brains more resilient. 

Exercise helps improve our circulation by increasing the amount of blood, oxygen and nutrients to our organs: our hearts, our kidneys, our brains, our genitals. And each of these organs can be negatively affected by high blood pressure! High blood pressure is implicated in heart attack, stroke, kidney failure, dementia, and erectile dysfunction. Exercise can help us keep our blood pressure in check and nourish these organs with blood, oxygen and much needed nutrients. 

I know it’s not always easy to get oneself to exercise. I too, sometimes have to wrestle myself out of bed to do it. Here are a few helpful tips: 

1. Make an appointment with yourself
2. Enlist a workout buddy
3. Wearable devices that record your movement can be extremely motivating for many people
4. Try to think of something that’s fun for you
5. Join a competitive group
6. Remember this mantra: “mind over mattress”

Exercise is one part of a healthy lifestyle that can naturally contribute to normalizing your blood pressure. Try to make it fun!

Here’s to your health!

Written by Susan Schachter, MSRDN

As you know, our New Year’s resolutions are now about 2 months old. For some of us, it’s time for a tune up!

An extremely important aspect of blood pressure normalization (which so many of us resolve to undertake as one of our New Year’s resolutions) is achieving/maintaining an ideal body weight.

Excess weight that we carry around can stress our circulatory system in its effort to supply blood to all of the tissues and organs we need to live a healthy life. The same is true for excess inches around our waist, which can create tension in our blood vessels. Both of these can negatively impact our blood pressure. 

What’s too much weight around your waist?

• Men*: Waist measurement of 40 inches or greater; and
• Women*: Waist measurement of 35 inches or greater.

*This may skew to a lower number dependent on ethnicity

Moreover, extra pounds may also effect breathing while we sleep, which can raise our blood pressure. 

Achieving and maintaining a healthy weight necessitates a multi-faceted approach. One extremely helpful tool in this process is environmental control. So, what does that entail?

Everyone has self-discipline sometimes. But no one has it all of the time! If what tempts you is in your home, work, or car, it probably calls your name… maybe even out loud! 

For instance, I love bread pudding. Do I sometimes eat it? Sure! When I’m in a restaurant, I might share a serving with my husband. Why do I eat it? Because I’m human… and, as with most humans, I love to eat foods that I love to eat! Food is for nutrition and pleasure, after all.

But do I keep bread pudding in my environment? Nope! If I do, it will call my name at all times of the day. Worse, if I’m tired, hungry, upset or I just see or smell it… I will cave in and eat it!

So what’s the answer to my problems (as well as yours)? We should keep out the foods and beverages that trigger us and bring in the ones that support our good health. You’ve heard of “out of sight, out of mind”? Well, this one is “out of sight, out of blood stream”.

That said, take heart. If you have high blood pressure and your weight is higher than what is recommended for your age, height, and gender, eight different studies have shown that losing as little as 11 pounds can decrease your systolic pressure by more than 4 points and diastolic by 3 points. 

So, what can you do to support your efforts for healthy weight/blood pressure maintenance?

Start to control your environment!

You know which high sodium, high calorie, high (unhealthy) fat, high sugar foods and beverages undermine your healthy weight and healthy BP efforts. So take them out of your home, work, and car! It doesn’t mean that you can never eat them. It just means that you can have a controlled portion in a controlled environment, where it won’t be calling your name day and night.

You know from previous installments of The Circulatory which foods and beverages are healthy for people trying to lower their weight and blood pressure. Bring those into your environment!

Here’s to your health!

Written by Susan Schachter, MSRDN

If you’re among the nearly half of American adults who have received a diagnosis of hypertension, you may recall that one of the first things your healthcare professional told you was to limit your sodium intake (as discussed in our previous blog post). However, there is also an abundance of research linking an increased incidence of hypertension with low levels of potassium—so much so that researchers are now suggesting that naturally increasing your potassium levels may be as important as decreasing your sodium levels.

Potassium’s roles in our body are numerous. In terms of hypertension, there are two I’d emphasize:

1) Potassium has the ability to lessen the effects of sodium. The more potassium we eat, the more sodium we pass out of our body through urine.

2) Potassium helps lessen tension in our blood vessel walls, which in and of itself helps to lower our blood pressure.

So How Much Potassium Do I Need and How Should I Get It?

The recommended intake for potassium is 4700mg/day. That’s actually a pretty manageable amount. But the important part is that you get that potassium from the food you eat… not from supplements.

Generally speaking, one won’t get more potassium than they need if they get it all from food. There are some exceptions to this rule—for instance, if you develop kidney disease, you might need less potassium in your diet—but they aren’t common. That being said, the reverse is also true: one can overdo it if they take potassium supplements and/or use salt substitutes that contain potassium chloride. 

Potassium is largely found in fruits, vegetables, low fat dairy and fish. If you’re eating a diet that includes a lot of processed foods, then there’s a good chance that you’re not getting enough potassium.

Generally, the recommendation is that we eat five times more potassium than sodium. Most of us eat a diet so filled with sodium that we only get two times as much potassium as sodium.

The DASH Way of Life

DASH stands for Dietary Approaches to Stop Hypertension. Originally designed to lower blood pressure, the DASH approach to eating has ranked as US News and World Report’s best diet 8 years in a row, occasionally tying for first place with the Mediterranean Diet. There are two kinds of DASH diet: the Standard DASH (2300mg sodium) and the Lower Sodium DASH (1500mg sodium). 

Sticking to DASH is great for normalizing blood pressure, but it also has added health-enhancing benefits, like aiding weight loss, lowering cholesterol and managing/preventing diabetes.

What makes DASH workable is that it’s flexible. It’s a way of life as opposed to a “restrictive” time-limited “diet”. It’s a way of eating that each and every one of us, with or without hypertension, would be better off adopting.*

To set you up for success at normalizing your blood pressure, I’m providing you with a pair of free and useful resources. First is a link to the DASH Eating Plan, which will help you navigate the rules that come with adhering to DASH. Second is a link to some delicious and healthy DASH recipes, which should help you incorporate DASH into your life right away.

Here’s to your health!

* Note we have one point of difference with the DASH plan: we discourage inclusion of margarine among acceptable fats and oils, given that their fat content is hydrogenated.

Written by Susan Schachter, MSRDN

February is American Heart Month, a national observance that’s meant to remind people around the country to focus on their hearts and promote better heart health within their communities. And as you know, normalizing your blood pressure is of major importance to your heart health. 

But as most of us know, one key component of blood pressure normalization is our sodium intake.

Simply put, sodium is everywhere—it’s in our packaged and prepared foods, fast foods, condiments, even some salads! So why is it so inescapable?

Well, that’s because it’s important. Sodium helps keep a balance of pressure between the inside and outside of our cells. It’s also necessary for nerve conduction and muscle contraction.

But even though it’s important to get sodium in your diet, it’s even more important that you ingest it in the right amount!

After all, sodium itself doesn’t cause high blood pressure, but in excess it can contribute to the condition. Water is attracted to sodium, so the water moves towards the sodium in our bloodstream and increases the total volume of blood. To circulate this increased blood volume, the heart has to pump harder. This increases the pressure in the arteries… which results in high blood pressure.

This is a problem, because even though sodium is crucial for life, most Americans consume way too much sodium. 

WHAT’S THE APPROPRIATE AMOUNT OF SODIUM TO CONSUME?

If you have high blood pressure, the appropriate amount of sodium consumption is no more than 1500 mg a day. But according to the Centers for Disease Control, about 90% of Americans 2 years old or older consume too much sodium. The average daily amount consumed is 3400mg.

Additionally, most of the sodium you consume is not from the saltshaker on your kitchen table; instead, it sneaks its way into your diet, hiding out in places you had no idea it existed. 

Here are some of its favorite S-NEAKY places in which it hides:

• Soups (particularly canned and dried mixes)
• Sauces (ketchup, bottled sauces, dried mixes)
• Smoked meats and fish
• Sauerkraut and pickled foods
• Sodium processed deli/luncheon meats (salami, bologna, turkey, corned beef, ham, bacon)
• Snack chips and crackers (corn chips, potato chips, pretzels, peanuts, crackers)
• Seasonings (yeast extract, monosodium glutamate, mustard, Adobo, Accent)
• Sweetener- Sodium Saccharin (Sweet and Low)
• Some medications (over the counter and prescription)
• Soda (regular and diet) 

AS WELL AS….

• Bread                                             
• Packaged foods
• Frozen entrées
• Cheese
• Mouthwash
• Canned/jarred vegetables, beans, sauces, olives
• Processed foods
• Ready-to-eat cereals
• Canned tuna
• Toothpaste

So, where do we start?

First, when you’re shopping, be sure to check serving sizes and servings per container. I had a client who purchased a packaged corn muffin whose label stated that it had 295mg of sodium per serving. Most of us would assume that a serving would be the whole muffin, but the label stated that a serving is ½ muffin. Ridiculous, right? Who eats half a muffin? That client didn’t read the label carefully and consumed close to 600mg of sodium in that one muffin—close to half of what they should have consumed for the entire day. 

Secondly, read labels carefully! These terms will help you know how much sodium any given product contains:

Best choices

• Sodium-free or salt-free. Each serving in this product contains less than 5 mg of sodium.
• Very low sodium. Each serving contains 35 mg of sodium or less.
• Low sodium. Each serving contains 140 mg of sodium or less.

What the other sodium label claims mean

• Reduced or less sodium. The product contains at least 25 percent less sodium than the regular version.
• Lite or light in sodium. The sodium content has been reduced by at least 50 percent from the regular version.
• Unsalted or no salt added. No salt is added during processing of a food that normally contains salt. However, some foods with these labels may still be high in sodium because some of the ingredients may be high in sodium.

Also, as you might imagine, fresh foods such as vegetables, fruits, beans, lean proteins (not deli meats), whole grains, unsalted nuts/seeds should fill up most of your plate.

So despite the fact that sodium is everywhere, these tips—when combined with the proper amount of vigilance—should make it hard for sodium to sneak past you in the future.

Next time we’ll take a look at the importance of consuming potassium in food (not supplements!) as well as the DASH diet (Dietary Approaches to Stop Hypertension).

Written by Susan Schachter, MSRDN

In early 2018, the American College of Cardiology and the American Heart Association set new guidelines to define normal, elevated, and high blood pressure:

So what does this mean for me? Well, the bad news is that more of us (46% of American adults) now have blood pressure that is not within the “normal” range. But the good news is that these guidelines are stricter so that you can more easily understand when you’re in serious medical trouble vs. when you’re merely at increased risk of being in medical trouble. 

According to Dr. Paul K. Whelton, lead author of the new lower blood pressure guidelines, “[Once your blood pressure has reached 130/80,] you’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure. We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”

Now, how do we implement these “yellow light non-drug approaches” (aka lifestyle changes) with the goal of facilitating our body’s health?

1. Use food to nourish ourselves
2. Increase our potassium intake (from real food, NOT from supplements)
3. Decrease our sodium intake
4. Manage our weight
5. Address our stress with patience and kindness for ourselves
6. Include exercise for our circulation, fitness, and emotional expression/stress management
7. Stop the use of tobacco products
8. Moderate our alcoholic beverage intake

We will address each of these in future issues of The Circulatory. Today let’s focus on the first non-drug approach: Using food to nourish ourselves.

This can help us work on numbers 2, 3 & 4 as well, by assisting us in increasing our potassium, decreasing our sodium and managing our weight, all through nourishing food.

A) It is important to include food in our diet that is naturally high in healthy nitrates, or is high in substances that enhance the body’s ability to convert nitrates to nitric oxide. This is because of nitric oxide’s role in dilating blood vessels, which helps to normalize blood pressure. And what foods are great for this? Beetroot and pomegranate (not the sodium nitrites in processed meats!).

B) It is important to increase your intake of naturally occurring potassium, as well as to help our body hold onto potassium. This is because of potassium’s role in helping the body to excrete excess sodium. Potassium also has a role in lessening tension in our blood vessel walls. Both of these actions help to normalize blood pressure. Foods that are high in potassium include hibiscus, fruits, and vegetables.

C) It is important to include foods that contain natural anti-inflammatories. This is because anti-inflammatories help to prevent or lessen inflammation and can help in the prevention of scarring and stiffness of blood vessel walls. This too, can help to normalize blood pressure. Foods that contain natural anti-inflammatories include hibiscus, beetroot, pomegranate, tart cherries, and cranberries. (Sensing a theme here?)

D) It is hard to overstate the importance of including magnesium in your diet. It’s got an incredible ability to relax blood vessels, which can, in turn, help to normalize blood pressure. Foods that are high in magnesium include nuts, seeds, whole grains, dark leafy greens, and some types of fatty fish.

Written by Susan Schachter, MSRDN

1. Alcohol Elevates Your Blood Pressure

When it comes to controlling our blood pressure, we know that moderating our alcohol intake is an important lifestyle choice.

More than one or two drinks in one sitting temporarily creates a rapid rise in your BP. If you already have high BP, this rapid rise could cause a stroke.

Unsurprisingly, repeated binge drinking can create long-term elevations of BP. According to the CDC, binge drinking is defined by a person having a blood alcohol level of .08% or more, which usually corresponds to 5 or more servings on a single occasion for men and 4 or more on a single occasion for women, generally within 2 hours. That could be the equivalent of 2 cocktails!

2. You May Not Know That You’ve Been Drinking Too Much

What is one serving of alcohol?

• 5 oz wine
• 12 oz beer
• 8 oz malt liquor
• 1.5 oz 80 proof “shot” distilled spirits or liquor (i.e. gin, rum, vodka, whiskey)

What is drinking in moderation?

• Up to one serving/day for women*
• Up to two servings/day for men*

Most of us don’t realize that bars and restaurants give you a “generous pour”. When drinking outside the home, it’s not unusual for a glass of wine to contain 1.5 servings or for a cocktail to contain 3 servings. Even in our homes, most of us have wine glasses that are much larger than people used to use back in the day, and an optical illusion is created. We think we’re drinking less than we actually are drinking!

*NOTE: This should be counted per day, not averaged over the course of a week.

3. After Partaking in Dry January, You’re More Likely to Drink Less 

As you might know, lots of people make it their New Year’s Resolution to give up alcohol for the month of January. However, if you’re one of these people who partakes in “Dry January”, you might be wondering “are there any benefits beyond that month?” or “what if I don’t do an entire month?”

In a 2018 study by the University of Sussex in England, these questions drove the research. Results showed that in the months following the study, on average, the number of drinking days per week decreased, the amount of alcohol consumed on any given day decreased, and the frequency of being drunk decreased. While these results were slightly diminished for those that didn’t complete the entire month, they too experienced the benefits of abstaining from alcohol.

4. Even If You Don’t Abstain From Drinking, There Are Still Some Things You Can Do to Lower Your Alcohol Consumption

1. If you’re in a restaurant/bar, don’t eat salty snacks because they can raise your blood pressure AND they will make you thirsty which can lead you to want to drink more. 
2. Don’t drink on an empty stomach, because it can affect you more quickly, and the wisdom of your drinking and eating choices may be compromised.
3. Try adding club soda to your wine (spritzer) or to your “shot”.
4. Try having your drink at the end of your meal as dessert (or after you’ve ordered dessert), so that it won’t impact your food choices and you will only be having 1 drink. 
5. When you’re home, take out a measuring cup, measure out 5 oz, and then pour it into a wine glass (hopefully one that approximates the size used outside of your home). Take a look at what level the wine comes to in the glass. That’s a serving of wine. Now you’ll know how to approximate how much you’re drinking when you’re out of the house.