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.

Improve Memory with Exercise

Deep within our brain the hippocampus has an important role in controlling our long-term memory, emotions, and spatial navigation. In the first study of its kind, researchers in Australia and the UK examined the impact of aerobic exercise on the hippocampus in humans.

Brain scans from 737 participants were reviewed before and after an exercise program. Participants ranged from 24-76 years of age and included health people, those with mild Alzheimer’s, people with depression, and people with schizophrenia.

Exercise programs included aerobic exercise on a stationary bike, walking, or running on a treadmill 2-5 times per week for 3-24 months. 

While our brain typically shrinks about 5% per decade after the age of 40, researchers found a significant increase in the size of the left area of the hippocampus in study participants. Researchers believe physical exercise is one of the “proven” ways to maintain brain size and function as we get older.

With exercise the body produces brain-derived neurotrophic factor which appears to reduce the deterioration of the brain. Over time this may be why aerobic exercise prevents age-related mental decline.

Indirectly exercise can help you get better sleep, improve your mood, and reduce stress and anxiety; problems which can contribute to mental impairment.

Researches are optimistic regular aerobic exercise might reduce Alzheimer’s and dementia, although more research is needed to establish such benefits.

Maintain Don’t Gain

Thanksgiving Survival Plan

• Eat a normal breakfast and a light lunch. Avoid skipping meals because it slows down your metabolism and increases hunger causing you to overeat later on.

• Wake up early and exercise to burn off extra calories you will be eating and to alleviate some holiday stress.

• Stick to water or sparkling water instead of sweetened beverages. Limit alcohol intake and pick light beer or wine instead of mixed drinks, eggnog, or punch which can be over 500 calories each.

• Limit appetizers to lower calorie options like fresh vegetables and shrimp cocktail. Make a point not to stand near food to reduce nibbling temptation. 

• If you know you will not find any healthy choices bring a healthy side dish or salad to share.

• Survey the entire table before placing food on your plate. Decide which foods are worth eating and which you should ignore. Stick to your decision, don’t waste calories on foods you don’t love. 

• Put a small portion on your plate. You can go back for more if you love it and are still hungry. 

• Pace yourself and be aware of what you are eating. Eat slowly to savor the taste and texture of your food. Talk more to eat less. 

• Eat until you are satisfied but not full. Leave some food behind on your plate, especially if you did not love eating it. Drop out of the “clean plate” club mindset. 

• 400 calories for a slice of pie can be a big problem. Don’t feel obligated to have dessert if you don’t want any. Avoid “extras” such as ice cream. Try 1-2 cookies or a slice of cake instead of pie, or eat less of the pie crust. 

• Don’t feel guilty! Holiday’s should be celebrated with family and friends. Treat yourself in moderation and understand one meal has a minor impact when you are good all week.

Splenda and Diabetes Risk

Splenda (also known as sucralose) is a zero calorie sweetener that satisfies a sweet tooth without the guilt...although research shows it may be doing more harm than good.

One study from Washington University School of Medicine found obese people without diabetes experienced 20% higher insulin levels after consuming Splenda compared to consuming water before a glucose-tolerance test. How could this be when Splenda is zero calories? Some findings show receptors in the mouth and in the GI track detect sweetness which stimulate the release of insulin. Over time, excessive insulin secretion could lead to insulin resistance, a hallmark of type 2 diabetes.

Another study from Adelaide Medical School in Australia found healthy normal weight people who consumes sucralose for two weeks had a change in glucose absorption, insulin and gut peptides, and blood glucose levels which increased their risk for type 2 diabetes.

According to a study published in the Diabetes Care Journal daily consumption of diet soda (which includes artificial sweeteners such as sucralose, aspartame, saccharin, etc.) was associated with a 67% greater risk of type 2 diabetes compared to non-consumers. Daily consumption also increased risk of metabolic syndrome by 36%. Metabolic syndrome is a group of conditions (high blood pressure, high blood sugar, abnormal cholesterol, and a large waistline) that increase risk of cardiovascular disease.

Other studies have highlighted the negative impact of diet soda and weight. A 10-year study from University of Texas found people who drank two or more diet sodas daily had six-times the waistline compared to those who never drank diet soda. Researchers speculate diet soda may actually stimulate appetite and cause a person to eat more later in the day.

Researches from Boston University School of  Medicine followed over 4,000 people over the course of a decade and found people who drank at least one diet soda daily were three times as likely to develop both stroke and dementia. Consumption of regular soda had no increase in stroke or dementia risk, although researchers are quick to state water is the best fluid to drink instead of sugar or alternatively sweetened beverages.

Splenda carries consequences and is not a good substitute for people trying to live a healthier lifestyle. In fact the research is showing real sugar might be better than artificial sweeteners despite having calories. The best beverages to drink regularly are water, seltzer, and unsweetened tea. When it comes to added sugar men should limit their intake to 3 tablespoons (37 grams) daily and women should limit their intake to 2 tablespoons (25 grams) daily.

Romanesco or Space Broccoli?

Spiral-shaped florets, florescent lime-green hue, Romanesco looks more like a vegetable from Star Wars than something people eat on planet earth.

What might look like a new vegetable surfacing at your farmer’s market, Romanesco has been grown in Italy since the 16th century. It was likely crossbred by farmers to create a striking vegetable with crunch and delicate flavor.

Similar to broccoli and cauliflower, the Romanesco is easier to digest. It is rich in zinc, vitamin C, vitamin K, fiber, and carotenoids. It provides antioxidant and anti-inflammatory benefits. Studies have found Romanesco to be high in kaempferol, a flavonoid that inhibits cancer cell growth and induces cancer cell death. Kaempferol has also been shown to prevent arteriosclerosis by inhibiting oxidation of cholesterol.

When shopping for Romanesco look for dense and heavy heads with bright green color. The stem should be firm; avoid any signs of wilting. It should keep about a week in the refrigerator.

Romanesco can be eaten just like cauliflower. Try serving it raw along with hummus or tossed into a salad, sautéing or roasting it with olive oil and garlic, or steaming it for an easy side dish. It cooks fairly fast so be sure not to overcook it; you want to keep its shape.

Spicy Romanesco with Lemon and Capers

Serves: 4

130 calories per serving

Ingredients:

1 head Romanesco, cut into florets

3 tbs extra virgin olive oil

2 tbs lemon juice

1 tsp lemon zest

1 tbs capers, minced

1 tsp red pepper flakes

Freshly ground black pepper

Directions: Preheat oven to 425⁰F. On a baking sheet lined with parchment paper toss the Romanesco with 2 tbs olive oil. Roast for 10 minutes, stir, and roast for another 10 minutes until browned and tender. Meanwhile in a medium sized bowl whisk together remaining olive oil, lemon juice, lemon zest, capers, red pepper flakes, and freshly ground black pepper to taste. Remove Romanesco from the oven and toss in dressing before serving.

Metabolic Adaptation: How eating too little can damage metabolism

Metabolic Adaptation describes how the body fights to maintain equilibrium and prevent starvation. It was very helpful back in our caveman days but a real problem today for people who need to lose weight.

As you lose weight your body adapts to conserve energy and be more efficient. With less body weight, resting metabolic rate decreases and you do not burn as many calories when exercising. With less food intake thermogenesis lowers. Hormones increase to stimulate appetite and stress from eating too little can cause higher levels of cortisol in the body.

As metabolic adaptation occurs weight loss reaches a plateau. At this point weight loss can continue only if you add more exercise or reduce calories even more. If calorie intake is already very low and exercise volume is very high you reach a limit where it is not safe, realistic, or advisable to continue such extremes. If you stop your routine weight gain is common. 

A good example of metabolic adaptation comes from research on The Biggest Loser. Researchers measured 14 participants metabolic rate at the start and end of the show. On average metabolic rate decreased by 610±483 calories. Following up 6 years later 13 of the 14 participants gained weight, although most kept at least 10% of their weight off. Metabolic rate remained low and did not go back to normal as their weight increased. Overall metabolic rate was 500 calories lower than what would be expected in people of similar height, weight, and age.

To minimize metabolic adaptation it is recommended to decrease calories gradually to support 1-2 pounds of weight loss per week rather than crash dieting for rapid weight loss. Eat protein rich foods at each meal and snack since protein has the highest thermic effect, provides satiety, and helps retain more lean muscle mass. In addition to cardio, make sure you strength train at least twice per week since lean muscle increases metabolism. Get enough sleep for the body to recover and work on stress management.

As weight loss starts to plateau make additional modest adjustments to continue losing. The ultimate goal is to develop healthy routines that are sustainable long term and help you feel energized and healthy. Understand that weight loss is not easy. We generally overestimate the amount of calories we burn and underestimate the amount of calories we consume. Work on  accuracy before assuming your metabolism is damaged.

Interested in Nutrition Counseling? We can calculate your calorie target and create a customized nutrition plan to help you reach your goals. Contact me to schedule your appointment.

Are We Getting Healthier? Update on U.S. Obesity Rates

Back in 2000 no states had obesity rates over 25%. Today 47 states are over 25% causing a big need for concern. Fortunately, obesity rates are stabilizing in adults and kids. Progress is being made in the fight against obesity and hopes of furthering nutrition education and public health funding can continue efforts into the future.

Last year was the first time the State of Obesity: Better Policies for a Healthier America report showed a decline in obesity rates. Encouraging reports for this year again show a decline in one state (Kansas), an increase in four states (Colorado, Minnesota, Washington, and West Virginia), with all other states staying stable.

Based on data from the Centers for Disease Control, the highest obesity rates are in the South, Midwest, and in adults without a college education and income below $15,000 per year.

The most obese states are:

1. West Virginia 37.5%

2. Mississippi 37.3%

3. Alabama and Arkansas 35.7%

4. Louisiana 35.5%

The least obese states are:

1. Colorado 22.3%

2. The District of Colombia 22.6%

3. Massachusetts 23.6%

4. Hawaii 23.8%

5. California 25%

Pennsylvania ranks 25th most obese at 30.3% and New Jersey ranks 36th most obese at 27.4%.

The fight against obesity is far from over but small changes every day can lead us to a healthier future.