My wonderful hubby isn’t normally the target of my blogs, but against his knowledge, he is today. He suffers from high blood pressure (aka: hypertension). He has been told it is genetic, handed down from his father, and has actually had an issue with it since college, but only got serious about taking care of it in his late 20’s. Regardless of the cause, he has been seen by the appropriate health care practitioners to rule out any other causes, he takes blood pressure medication, exercises (when he feels like it!), and has made some dietary changes to reduce his risk of adverse health outcomes. If you haven’t heard, there’s a direct and consistent relationship between blood pressure and cardiovascular disease and stroke.

Luckily for him he lives with a nutritionist, haha. I’ve been pleasantly surprised, he has only had perfect cholesterol and triglyceride blood tests since I've known him, so when tweaking his diet, we primarily focused on sodium (salt) and potassium.

Excess sodium intake is not only linked to high blood pressure, but is also linked to kidney stones, asthma, osteoporosis, and gastric cancer. A diet high in fruits and vegetables (good sources of potassium) and fat-free or low-fat dairy foods can help lower systolic blood pressure by more than 10 points in people with high blood pressure.

The American Heart Association’s Sodium Recommendations:

New studies reinforce recommendations to limit sodium intake to less than 1,500 milligrams (mg) per day. This is a big decrease from previous American Heart Association recommendations of 2300 mg a day, and quite honestly, 1,500 mg is very hard to achieve! See my recommendations and strategies for coming close to achieving it.

Why Did the American Heart Association Change its Sodium Recommendations?

One in 10 Americans will develop high blood pressure in their lifetime, and over-consumption of sodium is strongly linked to the development of high blood pressure.

Data from the U.S. Centers for Disease Control (CDC) released in 2009 showed 70% of the U.S. population is salt sensitive, which means their blood pressure is prone to rise in response to excess sodium in their diet. In addition, 97%of all children in the U.S. are eating too much salt, putting them at early risk for high blood pressure.  

Lifestyle Recommendations for People with High Blood Pressure:

• Adopt a healthy lifestyle, which includes reducing excess body weight, increasing physical activity, lowering alcohol intake, increasing dietary potassium intake (assuming normal kidney function), and reducing salt intake.

• Reduce salt intake to less than one teaspoon of salt per day (approximately 1550 mg of sodium a day).

Strategies to Reduce Sodium Intake:

• Cook your food from scratch when possible (ie: make your own salad dressing vs. purchasing it).

• Choose foods normally processed without salt and foods labeled ‘no added salt’ or ‘low salt’ (‘low salt’ means no more than 120 mg of sodium per 100 g).

• Choose ‘reduced salt’ products if these are the lowest salt options available.

• Avoid high salt processed and prepared foods.

• Avoid salty snacks. If salt is visible on the food, it’s definitely high in salt (ie: pretzels, chips, crackers, nuts). Choose unsalted version.

• Ditch the salt shaker. Avoid adding salt during cooking and at the table.

• Food in restaurants is almost always higher in sodium than what you might make at home. Foods typically high in sodium: Chinese food, Thai food, Italian food, Mexican food.

• When using spices, read the ingredients and avoid spices with salt in them. For example, if you use a poultry seasoning, find one without salt. Choose garlic powder, not garlic salt. Choose onion powder, not onion salt, etc.

• If you chose a salt substitute, potassium chloride salt substitutes should be avoided in people with renal dysfunction or in those who are taking potassium-sparing diuretics. Talk to your health care provider about salt substitutes.

What about Potassium?

Eating potassium-containing foods is important (if you have fully functioning kidneys). Please don't go to your local nutrition supplement store to buy a potassium supplement. It can be toxic. I suggest getting potassium from food. The recommendation is to eat 5-10 servings of fruits and vegetables every day. A serving is ½ cup of cooked, canned, and frozen produce and 1 cup of fresh produce. Basically, eat fruits and/or vegetables at every meal. Just to reinforce, if you eat a large serving of a fruit or vegetable, it counts as more than 1 serving. (ie: 2 cups of cooked broccoli on your plate counts as 4 servings).

High Potassium Foods:

Apples, Apricots, Artichoke, Asparagus, Bananas, Brazil Nuts, Brown Rice, Cabbage, Corn, Cantaloupe, Dates, Figs, Green Beans, Green Pepper, Honeydew, Kiwi, Iceberg Lettuce, Romaine Lettuce, Legumes, Lima beans, Nectarine, Oranges, Orange Juice, Papaya, Peaches, Peas, Potatoes, Sweet Potatoes, Prunes, Pumpkin, Raisins, Roasted Peanuts with skin, Spinach, Squash, Strawberries, Wheat Bread, Winter Squash, Tomatoes (all forms: dried, sauce, paste, etc.), Celery, Avocado, Carrots, Broccoli, Watermelon, All Beans (Kidney, Pinto, Lima), Black eyed peas, Lentils, Almonds, and Dairy Products.

Additional Information:

• If you adopt a low salt diet, follow up with your health care provider because the dosage of both antihypertensive medication and lithium carbonate may need to be reduced.

• The combination of diuretic treatment and low dietary salt intake may result in unacceptable volume depletion and hyponatremia.

• Dietary salt restriction is inappropriate in people with salt-wasting forms of renal and gastrointestinal disease.

• Women who become pregnant should continue their usual level of dietary salt intake.

Bottom Line: With some determination and experimentation, it is possible to reduce your sodium intake, and although you may not reach 1500 mg/day, any reduction is a good start. Don’t forget about boosting your fruit and veggie intake for potassium, which also helps lower blood pressure.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. Institute of Medicine. Appel LJ, Baker DH, Bar-Or O, Minaker KL, Morris RC, Resnick LM, Sawka MN, Volpe SL, Weinberger MH, Whelton PK (Panel on Dietary Reference Intakes for Electrolytes and Water). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press;2005.

2. Heart Foundation. Salt and Hypertension (Professional Paper)