IOM Report: Simple Diet Strategies Can Reduce High Blood Pressure

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The Institute of Medicine (IOM) issued a report that reinforces the message that high blood pressure poses the single, greatest risk factor for cardiovascular disease and is responsible for the deaths of one in six adults each year. The prevalence of people with high blood pressure could be reduced by as much as 22% of people made some simple dietary changes.

The report, “A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension” also states that the total direct and indirect costs of high blood pressure on the healthcare system were estimated to be at $73.4 billion in 2009. By bringing blood pressure to within normal limits, the IOM estimates a savings of nearly $17.8 billion annually.

“High blood pressure is a ticking time bomb,” said Ross Simpson, Jr., MD, PhD, MPH, director of the preventive cardiology program and a professor of medicine in the division of cardiology at the University of North Carolina and the principal clinical coordinator for The Carolinas Center for Medical Excellence. “This is a condition that takes a significant toll on your heart and brain. It increases the risk of stroke and a heart attack, and it dramatically increases the risk for kidney failure. Uncontrolled hypertension has a myriad of effects throughout the body.”

Blood pressure is considered high if it is consistently above 140 over 90. “The risk for heart attack and stroke doubles for every 10-point increase in diastolic blood pressure,” Dr Simpson said. “The nice thing about it is if you control your blood pressure and bring it back to normal, you lower your risk for a heart attack.”

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A recent article in the New England Journal of Medicine found that by reducing salt intake by 3 grams a day (many Americans eat about 6 grams per day), new cases of heart disease, stroke, and heart attack would significantly drop. Another study from the Annals of Internal Medicine quantified this by finding that too much salt is responsible for at least 100,000 deaths each year in the United States and that if Americans reduced sodium intake by 9.5%, 513,885 strokes and 480,358 heart attacks would be prevented among adults ages 40 to 85.

More than 75% of Americans consume greater than the recommended sodium intake of 2300 milligrams (2.3 grams). Most people are advised to remove the salt shaker from the table and not add any salt to cooking, but these only accounts for about 11% of a person’s total sodium intake for the day. A greater impact could be found by reducing or eliminated the number of packaged and processed foods one eats, which contributes 77% of a person’s total salt consumption.

Sodium is an acquired taste. Especially when combined with sugar and fat, salt can stimulate neurons in the brain that release dopamine, a chemical that motivates behavior and makes us want to eat more. But the good news is that it takes only about 8 to 12 weeks to shift this taste preference by gradually decreasing sources of sodium in the diet.

The American Heart Association reports that the major food sources of sodium include tomato sauce, soups, condiments, canned foods and prepared mixes. For reducing sodium, the AHA recommends the following tips:

• Learn to read nutrition labels and aim for a 10% reduction in what you are currently eating to start. If you normally eat 4,000 milligrams each day, start with a goal of 3,600 for the first week, then 3,200 the second, and so on until you gradually reach 2,300 milligrams.
• Understand the nutrition health claims. Sodium-free means that the product has less than 5 milligrams of sodium per serving. Reduced sodium means the usual sodium level is reduced by 25% (but may still be considered a high-sodium food).
• Choose fresh or frozen over canned food items when possible. Avoid using prepared foods out of convenience, and prepare fresh foods using simple recipes or quick cooking methods to save time.
• Select unsalted nuts or seeds, dried beans, peas and lentils.
• Limit salty snacks like chips and pretzels. Snack on fresh fruits and vegetables instead.
• Don’t use the salt shaker. ¼ teaspoon of salt contributes 575 milligrams of sodium. Use the pepper shaker or experiment with sodium-free herbs and spices.
• Eat more foods at home where you can control the amount of sodium in the food. When eating out, request that the dish be prepared without salt.

For more information about “A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension,” visit www.nap.edu.

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