Keeping the Pressure Down

Ashley Benedick,    
Dietetic Intern    

Bay Pines VA Healthcare System

May is National High Blood Pressure Education Month. According to the U.S. Department of Health and Human Services about 68 million Americans or 1 out of every 3 adults are living with high blood pressure, otherwise known as hypertension. High blood pressure is classified as 140/90 or higher. High blood pressure is often known as the “silent killer” because there are often no symptoms. However, in time high blood pressure can lead to numerous health conditions including heart disease, stroke, and diabetes. High blood pressure can be controlled with proper diet and exercise. It is important to know how to achieve a healthy blood pressure to decrease the risks of chronic health problems.

Following the DASH (Dietary Approaches to Stop Hypertension) diet has been shown to reduce blood pressure. This dietary approach emphasizes eating low sodium foods, increasing fruits and vegetables, low fat or non-fat dairy, and incorporating whole grains. The healthy eating plan is high in fiber, low to moderate in fat, and rich in calcium, magnesium, and potassium.

Here's a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet.

Grains (6 to 8 servings a day)
Grains include bread, cereal, rice and pasta. One serving of grains would include 1 slice whole-wheat bread, 1 ounce (oz.) dry cereal, or 1/2 cup cooked cereal, rice or pasta. Focus on whole grains because they have more fiber and nutrients than do refined grains. Look for products labeled "100 percent whole grain" or "100 percent whole wheat."

Vegetables (4 to 5 servings a day)
Carrots, broccoli, sweet potatoes, greens, tomatoes and other vegetables are good sources of fiber, vitamins, and such minerals as potassium and magnesium. A serving would be 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.

Fruits (4 to 5 servings a day)
Fruits are a great choice since they need little preparation to become a healthy part of a meal or snack. They too are packed with fiber, potassium and magnesium and are typically low in fat. Avocados and coconuts are two exceptions. One serving would include 1 medium fruit or 1/2 cup fresh, frozen or canned fruit.

Dairy (2 to 3 servings a day)
Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. Make sure those choices are low-fat or fat-free because otherwise they can be a major source of fat. Examples of one serving include 1 cup fat free (skim) or 1% milk, 1 cup yogurt or 1 1/2 oz. cheese.

Lean meat, poultry and fish (6 or fewer servings a day)
Meat is a rich source of protein, B vitamins, iron and zinc. Even lean varieties contain fat and cholesterol, so keep an eye on how much you eat. A serving would include 1 oz. cooked skinless poultry, seafood or lean meat, 1 egg, or 1 oz. water-packed, no-salt-added canned tuna.

Nuts, seeds and legumes (4 to 5 servings a week)
Another rich source of fiber, potassium, magnesium, and protein include foods like almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family. Serving sizes are small and to be consumed weekly because these foods are high in calories. Examples of one serving include 1/3 cup (1 1/2 oz.) nuts, 2 tablespoons seeds or 1/2 cup cooked beans or peas.

Fats and oils (2 to 3 servings a day)
The DASH diet strives for a healthy balance of fats. While fat helps your body absorb essential vitamins and helps your body's immune system, too much fat increases your risk of heart disease, diabetes and obesity. To help you moderate the amount of fat you consume, choose small portions. Examples of a serving include 1 teaspoon soft margarine, 1 tablespoon low-fat mayonnaise or 2 tablespoons light salad dressing.

Sweets (5 or fewer a week)
You don't have to give up sweets entirely while following the DASH diet. Enjoy them in small amounts. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet or 1 cup (8 oz.) lemonade.

In addition to a healthy diet, physical activity and achieving a healthy body weight can help decrease blood pressure. The American Heart Association recommends 150 minutes of moderately intense aerobic physical activity per week and muscle strengthening activity at least 2 times a week. Aerobic exercise could be done for 30 minutes, 5 days a week. There are a wide variety of aerobic exercises to try: biking, jogging, aerobic class, swimming, or brisk walking.

Achieving a healthy diet and healthy body weight can help reduce blood pressure and prevent hypertension. By reducing sodium intake, eating a healthy diet, and increasing physical activity, many health complications can be avoided.

Pinellas County Extension has information and programs to help people manage their blood pressure. Call us at 727-582-2100 to arrange a program for your group.

References:
http://www.cdc.gov/features/highbloodpressure/
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Physical-Activity-and-Blood-Pressure_UCM_301882_Article.jsp
http://dashdiet.org/
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

Fiber: Start Roughing It!

By Elizabeth Ledoux, Dietetic Intern, Bay Pines Health Care System
Pinellas County Extension, Family & Consumers

Fiber is one of those nutrients that we know is important but remains a mystery to us. So…what is fiber? What are the best sources? What are its health benefits? This article will answer these and other questions associated with fiber.

The term dietary fiber refers to carbohydrates that are not digested. Fiber is found in all plant foods, including fruits, vegetables, grains, and legumes. Not all fiber is the same. Soluble fiber dissolves in water forming a gel-like substance. Sources include: oats, legumes, apples, berries, nuts, and seeds. Insoluble fiber does not dissolve in water. It plays an important role in increasing the movement of material through your digestive tract and bulking up your stool. Sources include: whole grains, bran, seeds, tomatoes, cucumbers, and carrots. These differences are important as it relates to fiber’s role in health benefits. Fiber reduces the risk of developing heart disease and diabetes and is involved in bowel disorders and weight control.

Fiber and Heart Disease
Coronary heart disease is the leading cause of death for both men and women in the United States. High intake of dietary fiber has been linked to lowering the risk of heart disease. A Harvard study of male health professionals found that a high total dietary fiber (particularly cereal fiber) intake was linked to a 40% lower risk of coronary heart disease. A related study of female nurses produced similar findings. Furthermore, a strong predictor of heart disease is abnormal blood cholesterol lab values. It appears that soluble fiber reduces the absorption of cholesterol in your intestines by binding with bile, a substance produced in the liver. Your body then gets rid of it.

Fiber and Type 2 Diabetes
A high-fiber diet can be beneficial in getting your blood sugars under control. Keeping blood sugars stable is a goal everyone would benefit from. If you do have type 2 diabetes, this could be the way to keep it under control. If you don't have it, this could be the way to prevent it. Research has shown that high-fiber diets can aid in prevention. A recent study showed reductions in blood sugar values with the use of a high fiber supplement in overweight and obese individuals without diabetes. Soluble fiber has been found to produce significant reductions in blood sugar. For those with diabetes, increasing your fiber now can prevent long-term complications from diabetes and can decrease insulin requirements.

Fiber and Bowel Disorders
With the introduction of white flour came an increased prevalence of bowel disorders such as diverticulosis, hemorrhoids, and irritable bowel syndrome (IBS). Studies have shown that a high-fiber diet helps to prevent diverticulosis, a condition that occurs when small pouches (diverticula) push outward through weak spots in the colon. A diet high in fiber will decrease the risk of complications if you have it. The same has been found for IBS and current treatment guidelines for IBS include following a high fiber diet. The bulk that fiber provides is thought to help prevent the pain often associated with IBS and aids in regularity.

Fiber and Weight Control
There is some evidence that "bulking up" could lead to slimming down. One of the reasons that fiber may have an impact on body weight is its ability to slow the movement of food through the intestines. This increase in time that foods stay in the intestines has been shown to reduce hunger feelings and overall food intake.

Fiber is an important part of a healthy diet, and you should consume the recommended amount of 21-38 grams of dietary fiber per day. Most of us eat only 15 grams of dietary fiber a day. The best sources are fresh fruits and vegetables, nuts and legumes, and whole-grain foods. Here are some tips to help you increase your fiber intake:

• Eat whole fruits instead of drinking fruit juices.
• Replace white rice, bread, and pasta with brown rice and whole-grain products.
• Choose whole-grain cereals. Check out http://www.wholegrainscouncil.org/ for more information on whole grains.
• Snack on raw vegetables instead of chips or crackers.
• Substitute legumes (beans and peas) for meat two to three times per week.
• Experiment with recipes that use whole grains and legumes.

Find out the fiber content of your favorite foods at: http://library.umsmed.edu/pe-db/pe-fiber-food.pdf