I Love Salt, but actually its breaking my heart !! DASH DIET

Dietary Approaches to Stop Hypertension What is DASH? DASH, stands for : It is a dietary pattern recommended by the U.S. National Heart, Lung, and Blood Institute to prevent and control hypertension. It has been proven to lower the blood pressure and cholesterol. It is also associated with lower risk of several types of cancer, heart disease, stroke and can reduce the risk of developing diabetes. Dietary Approaches to Stop Hypertension

Who should reach for DASH? The DASH diet is especially recommended for people with hypertension (high blood pressure) or prehypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health (Dietary Approaches to Stop Hypertension). It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potassium, calcium, and magnesium.

Hypertension

Factors Influencing Blood Pressure Cardiac Output Systemic Vascular Resistance x = HR SNS/PNS Vasoconstriction/vasodilation Fluid volume Renin-angiotensin Aldosterone ADH

Hypertension is: Hypertension is sustained elevation of BP Systolic Blood Pressure ≥ 140 mm Hg Diastolic Blood Pressure ≥ 90 mm Hg

Hypertension problems Makes your Heart work too hard. Increases the pressure on the walls of arteries and can cause hardening of arteries. If left untreated, can cause heart failure, kidney disease, and blindness. Increases risk for heart disease and stroke.

Untreated Hypertension Target Organs that are Damaged: Heart – heart attack and CHF Brain - cerebrovascular disease Kidneys - renal failure Arteries - vessel plaque and stroke Eyes - Can cause blood vessels to burst and bleed in the eye.

Causes of Hypertension Genetic factors Being overweight or obese High salt intake Narrowing or stiffening of the arteries (Aging) Stress Too much alcohol Organ system disorders (kidney)

Blood Pressure Classification Systolic (mm Hg) Diastolic (mm Hg) Optimal <120 and <80 Normal <130 and <85 High-Normal 130-139 or 85-90 High Stage 1 140-159 or 90-99 Stage 2 160-179 or 100-109 Stage 3 >180 or >110

Treatment goals Maintaining BP Less than 140/90 Less than 130/80 if a diabetic patient Ideally 120/80 or less Lifestyle Changes when over 135/85

Non-pharmacologic way of hypertension management DASH DASH diet (Dietary Approaches to Stop Hypertension) Non-pharmacologic way of hypertension management Strategy Adequate Calcium, Potassium, Magnesium. High in whole grains, fruits, vegetables, and low-fat dairy. Low in red meat, sweets and sugar beverages. Low in saturated and trans fat, cholesterol.

Mineral intake in Hypertension Potassium values in some foods: Avocado: 1 whole: 1,067 milligrams Winter squash,1 cup, cooked: 896 mg Sweet potato, medium, baked with skin: 694 mg Potato, medium, baked with skin: 610 mg Yogurt, fat-free, 1 cup: 579 mg 100% orange juice, 8 ounces: 496 mg Broccoli, 1 cup, cooked: 457 mg Cantaloupe, cubed, 1 cup: 431 mg Banana, 1 medium: 422 mg Potassium Clinical trials and meta- analyses indicate potassium (K) supplementation lowers BP Experts suggest 4,700 milligrams of dietary potassium a day for adults as part of a balanced diet Best sources are fruits and vegetables

Mineral intake in Hypertension Sodium The American Heart Association recommends no more than 2,300 milligrams (mg) a day for most adults (better 1,500 mg of sodium a day). One teaspoon of table salt has about 2,300 mg of sodium. (2/3 teaspoon of table salt has about 1,500 mg of sodium). more than 70 percent of the sodium Americans eat comes from packaged, prepared and restaurant foods — not from table salt. You can find the amount of sodium in your food by looking at the Nutrition Facts label. Sodium-free – Less than 5 milligrams of sodium per serving and contains no sodium chloride Very low sodium – 35 milligrams or less per serving Low sodium – 140 milligrams or less per serving Reduced (or less) sodium – At least 25 percent less sodium per serving than the usual sodium level Light (for sodium-reduced products) – If the food is “low calorie” and “low fat” and sodium is reduced by at least 50 percent per serving Light in sodium – If sodium is reduced by at least 50 percent per serving sodium-related terms used on food packages

Mineral intake in Hypertension Magnesium Evidence suggests an association between lower dietary magnesium intake and high blood pressure Food sources are nuts, beans, vegetables and Green leafy vegetables, such as spinach. Age Male Female Birth to 6 months 30 mg* 7–12 months 75 mg* 1–3 years 80 mg 4–8 years 130 mg 9–13 years 240 mg 14–18 years 410 mg 360 mg 19–30 years 400 mg 310 mg 31–50 years 420 mg 320 mg 51+ years

Mineral intake in Hypertension Calcium American Heart Association Statement Increasing calcium intake may preferentially lower blood pressure in salt-sensitive people Benefits more evident with low initial calcium intakes (300-600 mg/day) Best food sources are dairy products & legumes.

DASH Diet Pattern Food Group Grains Vegetables Fruits Low-fat or fat free dairy Meats, poultry, fish Nuts, seeds, dry beans and peas Fats and oils Sweets Sodium Servings* 6-8 4-5 2-3 less than 6 4-5/week 2-3 5/ week 2300 mg * Per day unless indicated

Dash Diet Slowly increase intake of fruits and vegetables to 8 or more per day Three servings of low fat and non-fat dairy products a day Nuts, seeds and dried beans 4-5 times per week

Dash Diet (contin.) Remove salt shaker Add little if any salt to cooking Buy more fresh or plain frozen “no added salt” veggies Use more herbs and spices instead of table salt. Use fresh poultry, lean meat, and fish

Dash Diet (contin.) More whole grain cereals and breads 6 ounces or less of meat, fish or poultry per day Small amounts of liquid or soft margarine or oil

Fibers Getting the recommended daily amount, 22 - 34 grams for adults, helps you feel full and promotes good digestion.

Fats and oils (2 to 3 servings a day) Fat helps your body absorb essential vitamins and helps your body's immune system. The DASH diet strives for a healthy balance by providing 30 percent or less of daily calories from fat, with a focus on the healthier unsaturated fats. Examples of one serving include 1teaspoon soft margarine, 1tablespoon low-fat mayonnaise or 2 tablespoons light salad dressing. Avoid trans fats common in processed foods as crackers, baked goods and fried items.

Herbs in hypertension https://www.amazon.com/Blood-Pressure-Supplement-NON-GMO-Gluten/dp/B01BLRUGHC

Hibiscus (roselle) Acts as a natural ACE inhibitor, exerts a relaxing effect on the smooth muscles surrounding blood vessels to let more blood through more easily and reducing the blood pressure. Additionally, it may also have an effect on the heart rate, diuretic effect for further reducing the blood pressure. Both human and animal studies have shown the antihypertensive effect of roselle and there are few side effects to be concerned with.

Hibiscus (roselle)

Garlic (Allium sativum) The active component in garlic is called allicin. It works by increasing the production of nitric oxide in the body, which causes the smooth muscles surrounding the blood vessels to relax and the blood vessels to get larger. Garlic reduces prostaglandin E2 and thromboxane B2 levels and has antihyperlipidemic effects. Garlic is a rich source of highly bioavailable selenium; this may be the garlic’s antioxidant property important for health.

Ginger This is another powerful remedy for hypertension; ginger root has been used for centuries to improve the circulation of blood, it relaxes the blood vessels and the muscles surrounding them. It is a common kitchen spice so it can be added generously to meals. Ginger and lemon tea daily intake, destroys body fats efficiently and enhances the immune system.