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

2. 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

3. 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.

4. Hypertension

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

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

7. 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.

8. 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.

9. 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)

10. Blood Pressure Classification
Systolic (mm Hg)
Diastolic (mm Hg)
Optimal
<120 and
<80
Normal
<130 and
<85
High-Normal or
85-90
High
Stage 1 or
90-99
Stage 2 or
Stage 3
>180 or
>110

11. 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

12. 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.

13. 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

14. 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

15. 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

16. 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
( mg/day)
Best food sources are dairy products & legumes.

17. 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 /week 2-3
5/ week
2300 mg
* Per day unless indicated

18. 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 times per week

19. 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

20. 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

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

22. 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.

23. Herbs in hypertension

24. 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.

25. Hibiscus (roselle)

26. 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.

27. 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.