Tuesday, December 12, 2017

Cheers to That!

A new review published in The BMJ found coffee consumption might reduce risk of various cancers, liver, neurologic, and metabolic conditions. 

Data from 201 meta-analyses of observational research with 67 health outcomes and 17 meta-analyses of interventional research with 9 health outcomes were studied. Overall coffee consumption was associated with benefit rather than harm, with the largest reduction of risk coming from consumption of 3-4 cups per day compared to zero coffee consumption. This included all-cause mortality, cardiovascular disease, and cardiovascular mortality. High consumption was also correlated with lower risk of several cancers, liver conditions, metabolic conditions, and neurologic conditions.

The only exception was during pregnancy where high coffee intake was associated with low birth weight, preterm babies, and pregnancy loss.    Outside of pregnancy evidence suggests up to four cups of coffee per day might reduce risk without causing harm. Let’s cheers to that!

Tuesday, December 5, 2017

How to Lower Your Blood Pressure

Last month the American Heart Association, American College of Cardiology, and seven other groups updated the national guidelines for blood pressure goals. The new guidelines define normal blood pressure as less than 120/80 mm Hg and high blood  pressure at or above 130/80 mm Hg. 

While there remains contention among many specialists, the national guidelines encourage lifestyle change for Stage 1 hypertension in the 130/80 to 139/89 mm Hg range unless the patient has cardiovascular disease or is at higher cardiovascular risk; in which case medication may be necessary. For those with blood pressure 140/90 mm Hg or higher medication along with lifestyle change is encouraged.

Lifestyle change encompasses diet, exercise, and behaviors. The diet with the greatest documented health benefits for hypertension is the DASH Diet (Dietary Approach to Stop Hypertension) which has been shown to lower blood pressure in as little as 14 days and one study showed after 4 months dropped blood pressure by 20 mm Hg in some participants.

The DASH Diet is rich in fruits, vegetables, fat-free/low fat dairy, whole grains, fish, poultry, beans, seeds, and nuts. It is low in sodium, sugar, red meat, and saturated fat. By combining foods rich in potassium, magnesium and calcium while limiting sodium, greater blood pressure control is achieved.

To help lower blood pressure it is encouraged to limit sodium to less than 1500mg/day, that is less than 1/2 tsp of salt...including “hidden” sources in soup, restaurant/take-out food, tomato sauce, cheese, bread, and salad dressing. Read food labels and avoid anything over 300mg/serving. If it tastes salty or you can see salt you should avoid it.

On the positive side you can enjoy many foods rich in potassium, magnesium, and calcium such as spinach, pumpkin seeds, halibut, almonds, cashews, unsalted beans, low fat/nonfat yogurt, bananas, oranges, and sweet potatoes to name a few.

The DASH diet is not necessarily designed for weight loss, however cutting calories and getting to a healthy weight helps lower blood pressure. One study showed for every 2.2lbs lost a person can drop systolic blood pressure by 1mm Hg.

Living an active lifestyle can help lower blood pressure, especially when engaging in aerobic exercise such as fast walking, biking, jogging, basketball, etc. It is recommended to exercise at least 150 minutes per week at 65% or higher of your maximum heart rate; although if you are new to exercise start out slow and build up to that over a few weeks. 

Avoid smoking and if you consume alcohol frequently cut back; high alcohol intake can increase blood pressure. Interestingly though, drinking less than two drinks per day for men and less than one drink per day for women has been shown to decrease blood  pressure in some studies. It is not recommended to start drinking if you currently do not, but if you enjoy an occasional libation that is likely okay.