1. 2008 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA Dietary Sodium and Blood Pressure Endorsed by

2. 2 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Hypertension The Silent Killer Sodium The Quiet Food Additive

3. 3 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Outline  Sodium  Where do we get it?  What does it do?  How is it a health risk?  Sodium and hypertension  Recommended sodium restriction  How to reduce your sodium intake  Meal makeovers

4. 4 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Where do we get sodium?  Salt  Table salt, sea salt, seasoning salts  Sodium additives  Eg. MSG  Processed foods

5. 5 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 What does sodium do? In food:  Prevents food from spoiling.  Performs many different functions in processed foods.  Adds flavour.

6. 6 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 What does sodium do? In your body:  Helps regulate your body’s fluid balance.  Too much sodium can increase the amount of water or fluid held in your body.  Excess fluid puts extra pressure on your blood vessels causing damage.

7. 7 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 How is sodium a health risk?  Increases the risk of hypertension (high blood pressure).  Hypertension increases risk for:  Stroke  Heart attack  Kidney disease  Dementia

8. 8 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Changes Can Lower Blood Pressure and Risk  Eating a low sodium, well balanced diet is as effective as taking a blood pressure medication.  1 in 3 Canadians with hypertension could have normal blood pressure if they lowered their sodium intake.  Following a low-sodium diet could reduce the risk of heart attack or stroke by 25-30%.

9. 9 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Sodium restriction is especially important… For those people:  Of African descent  Over 45 years of age  With high blood pressure

10. 10 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Adequate Sodium Intake For Adults AgeSodium intake per day (mg) 9-50 years1500 50-70 years1300 Over 70 years1200

11. 11 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Recommended Sodium Restriction 2300 mg per day or less

12. 12 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Sodium Intake of Canadian Adults 2680 mgWomen 3575 mgMen Average Daily Sodium Intake Gender

13. 13 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Why is our sodium intake so high?  Busy lifestyle!  Want convenience  Less home-cooked meals

14. 14 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008

15. 15 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Bigger Portions 21 cups3 cups The more we eat, the more sodium we consume.

16. 16 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Increased Use Of Condiments  Ketchup  Mustard  Soy sauce  Salad dressing  Relish and pickles  Olives  Sauces

17. 17 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 More Processed Foods

18. 18 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Sources Of Sodium

19. 19 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Processing Adds Sodium To Food FoodSodium (mg) FoodSodium (mg) Plain pasta 5Pasta & sauce 800 Cucumber 2Dill Pickle 385 Fresh salmon 56Canned salmon 272 Cheddar cheese 176Processed cheese 407 Coffee – cream & sugar 15Cappuccino – from mix 250

20. 20 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Sodium Content of Restaurant Foods Menu ItemSodium (mg) Breakfast Egg Sandwich840 Chicken Caesar Salad570 12” Pepperoni Pizza5960 Deluxe Cheeseburger & Medium Fries1910 Fried Chicken Dinner2280

21. 21 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake  Choose fresh, unprocessed foods.  Gradually decrease the amount of salt used in cooking and at the table (this includes sea salt).  Use condiments sparingly.

22. 22 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake  Flavour food with lemon juice, fresh garlic, spices, herbs and flavoured vinegars.  Try low-sodium seasoning mixes.  Use oil, rather than butter or margarine for cooking.

23. 23 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake  Limit “instant” foods.  Buy pre-prepared foods that are low in sodium such as frozen vegetables and pre-cut salad.  Plan meals at least a day in advance. Find quick meal ideas in cookbooks and on-line.

24. 24 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake  Read food labels.  Look for the words “sodium” or “salt” in ingredient lists.  Look for foods labelled salt-free, no added salt, low in sodium, or reduced in sodium.

25. 25 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake Check the Nutrition Facts Table for:  The mg sodium per serving (the lower, the better)  The % Daily Value (aim for 10% or less)

26. 26 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake  Limit how often you eat in restaurants.  Restrict fast foods and take-out meals.  Look for unsalted snack foods such as chips, pretzels, nuts, seeds and crackers.

27. 27 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake Vegetables and Fruit  Choose fresh or frozen vegetables.  Limit vegetables with sauce.  Try making homemade salad dressing, or use commercial dressings sparingly.  Enjoy fresh, frozen, canned or dried fruit.

28. 28 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake Grain Products  Limit packaged pastas and rice with powdered sauce or seasoning.  Use quick-cooking, rather than instant oatmeal.  Look for low-sodium soups.  Choose breads, crackers and baked goods with the lower mg sodium per serving.

29. 29 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake Milk and Alternatives  Choose lower fat milk and yogurt.  Be aware of higher sodium content of instant puddings, hot chocolate and flavoured coffee mixes.  Limit all cheese, especially processed cheese slices or spreads.

30. 30 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Reduce Your Sodium Intake Meat and Alternatives  Limit processed, cured, smoked or breaded meats and poultry.  Choose fresh, frozen or low-sodium canned fish.  Rinse canned lentils, chick peas or beans, or cook your own.  Enjoy unsalted nuts and seeds.

31. 31 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Breakfast Menu Makeover Food High Sodium Sodium (mg) Food Low Sodium Sodium (mg) Commercial raisin bran muffin – large Butter – 2 pats Flavoured coffee – 16 oz. 800 75 300 Multigrain bread – 2 slices Peanut butter – 1 Tbsp Banana Black coffee 300 75 1 0 Total1025376

32. 32 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Lunch Menu Makeover Food High Sodium Sodium (mg) Food Low Sodium Sodium (mg) Multigrain bread – 2 slices Deli meat – 2 oz. Cheddar cheese – 1 oz. Mustard – 1 tsp. Dill pickle 300 765 176 56 385 Multigrain bread – 2 slices Leftover roast beef – 2 oz. Lettuce and cucumber Mustard – 1 tsp. Carrot sticks 300 37 0 56 60 Total1682453

33. 33 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Snack Menu Makeover 20460Total 0 0 5 15 Apple Handful of natural almonds Air popped popcorn with low- sodium seasoning – 6 cups Cola – 12 oz. 100 345 15 Chocolate chip cookies – 2 Nacho chips – 20 Cola – 12 oz. Sodium (mg) Food Low Sodium Sodium (mg) Food High Sodium

34. 34 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dinner Menu Makeover Food High Sodium Sodium (mg) Food Low Sodium Sodium (mg) Fast food chicken burger Medium french fries Ketchup – 1 Tbsp. Milkshake – 16 oz. 990 540 110 350 Grilled chicken breast Baked potato Sour cream – 1 Tbsp. Tomato slices – 6 Steamed broccoli – 1 cup Milk – 8 oz. 64 33 6 11 25 122 Total1990261

35. 35 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Sodium Comparison  High sodium menu 5157 mg  Lower sodium menu1110 mg

36. 36 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 The Sodium Challenge  There is no satisfactory “sodium substitute”.  The food industry needs to gradually lower sodium/salt content of foods.  Companies are starting to reduce the sodium content of their products.

37. 37 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Advice for Lowering Your Blood Pressure  Aim for a sodium intake of less than 2300 mg a day.  Eat well according to Canada’s Food Guide.

38. 38 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Questions 1. Reducing your intake of salt or sodium may help you prevent high blood pressure. TRUE FALSE

39. 39 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Question 2.Your blood pressure may be more sensitive to the effects of sodium if you are over 45 years old. TRUE FALSE

40. 40 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Questions 3. Most of the sodium consumed by Canadians is from salt added at the table. TRUE FALSE

41. 41 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Questions 4. You should aim to eat less than 2300 mg of sodium a day. TRUE FALSE

42. 42 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Questions 5. The Nutrition Facts table tells you the number of milligrams (mg) of sodium in the whole package of food. TRUE FALSE

43. 43 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 Dietary Sodium Questions 6. “Instant” packaged foods and fast food restaurant meals generally have a very high sodium content. TRUE FALSE

44. 44 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 For More Information  Go to www.hypertension.cawww.hypertension.ca  Click on Public  Then click on Lifestyle Choices

45. 45 BLOOD PRESSURE CANADA PRESSION ARTÉRIELLE CANADA 2008 For Low-Sodium Cooking Suggestions and Recipes  Go to:  www.dialadietitian.orgwww.dialadietitian.org  www.calgaryhealthregion.ca