 Excess sodium is one of the main contributors to high blood pressure and comes mainly from salt. While most of us think of salt coming from a shaker, in reality, 70% comes from our food. Some of the foods highest in sodium are from processed and preserved foods like those which come in bags or boxes (think of cereals, crackers, chips and snack foods). Store-bought breads and baked goods are also made with a lot of salt. Preserved meats like cold-cuts and cheese are also major sources. Remember that our ancestors used salt as a preservative and it’s used for the same thing today.
Here are some fun observations: The highest single food source of sodium for the typical American teen is pizza. Can you think of why? It’s the cheese and the pepperoni along with the dough and red sauce, all of which are loaded with salt. The primary source of excess sodium in those over age 50 is……….bread. Surprised? I sure was. The reason is that salt not only makes bread taste better, it’s also a preservative. Think about how long that loaf has to last on the shelf by the time it gets from the bakery to your pantry. How about the biggest source of salt in adults between the ages of 20 and 50? It’s chicken. Another big surprise. Chicken carcass are often injected with salt water to plump them up to make them more appealing to the consumer and also to increase their weight so they can charge more. In an article published in the Journal of the American Medical Association (JAMA) on November 11, 2023 the majority of those who cut down their salt intake decreased their systolic blood pressure by 8 points in just one week. Once again, that’s about the same amount as we’d expect with prescription medications. Amazing! The American Heart Association recommends less than 1,500 mg of sodium a day, that’s about 3/4 of a teaspoon. The average American, on the other hand, consumes closer to 3,500 mg a day. Alcohol has been shown to increase blood pressure. In a July 2003 study which included almost 20,000 subjects across 7 countries followed for 5 years showed that in those who drink as little as one alcoholic beverage a day (that’s about one beer, 5 oz of wine or 1.5 oz of spirits) had systolic pressures 5 points higher and diastolic pressures over 3 points higher than those who did not drink any alcohol. What about the reports from years past that alcohol is good for the heart? Well, with further research that myth has been debunked. Most of those studies were looking at wine. It turns out that the benefits seen in those studies were probably due to other lifestyle factors (like healthier eating and exercise). Any direct benefit from the wine itself was probably due to the grapes (especially the grape peal) and not the alcohol itself. Alcohol can also be a significant source of excess calories which can contribute to weight gain, which itself can cause hypertension. Some foods can have a profound effect on lowering blood pressure; one of my favorites is ground flaxseed (linseed). In an article published in the journal Hypertension, by the American Heart Association, in December of 2013, those who had high blood pressure lowered their systolic pressure by 15 points and their diastolic pressure by 7 points after 6 months of taking 30 grams of ground flaxseed a day, that’s about 2 tablespoons. I don’t know of any other single food or medication that has been shown to be as effective at lowering blood pressure. In the October 2010 issue of the American Journal of Nutrition researchers reported the effect of grain on blood pressure. They found that those who ate three servings of whole grains (in this study they used wheat and oats) per day decreased their systolic blood pressure by 6 point and diastolic by 3 point. That’s without any other change in their diet, just by adding some healthy grains. How about some homemade oatmeal for breakfast and whole wheat bread on that lunchtime sandwich? Nitric Oxide (or NO, for short) is a compound that dilates blood vessels. It’s the active ingredient in nitroglycerin, the medication we doctors often prescribe to those who have had a heart attack to take if they develop chest pain. The lining of the blood vessels (knows as the endothelium) also produces NO to keep the vessel open and the blood flowing freely. The enzyme that produces NO is called NO-synthase. This enzyme can be damaged and rendered ineffective by toxic compounds called free radicals which cause damage by a process called oxidation. That’s why it’s important to fight back by filling our bodies with anti-oxidants which destroys free radicals and prevents oxidation. The USDA tested hundreds of foods and found those with the highest antioxidant properties are spices. Next come beans and nuts, followed by berries, fruits and veggies. Some foods are full if nitrates, which can be converted to NO in our bodies, and have also been shown to lower blood pressure. One of those is beet juice, which researchers in 2013 in the Journal of Applied Physiology showed could decrease systolic blood pressure by 8 points after 4 weeks of drinking 1/2 cup a day. At the end of the experiment the subjects blood pressures were continuing to trend downward, so who knows what the final effect would have been if the experiment had gone longer. Why limit it to beet juice, however, why not just eat the whole beet, which I bet is a whole lot easier to find. Other foods have been shown to produce even more NO and include things like Swiss chard, beet greens, lettuce, arugula, rhubarb, cilantro and basil. Now if you’re keeping track you may have noticed I mentioned berries (strawberries included) as good antioxidants and rhubarb as a good source of nitrates—anyone else thinking what I’m thinking? Hmm, now if we could just figure out a way to bypass most of that pesky refined sugar and shortening in a rhubarb pie and we’ll really have something! I wonder how it would taste with arugula, cilantro and basil? Ya, no! As you can see, some of these changes can have drastic results on your blood pressure. While I highly recommend a healthy diet for everyone, some of you may need to be particularly careful before going “all-in” with drastic changes. This is especially true for those of you who are taking blood pressure pills, blood thinners (like warfarin) or have certain heart condition like heart failure. I don’t recommend stopping any medication without medical supervision, since some of them may also be given for other important reasons in addition to blood pressure. It’s always best to seek the guidance of your healthcare provider before making drastic changes and definitely before stopping or changing any medication. Until next month, continue Living Well. ~ Dr. Smithson (Published in the Baker City Herald, 26 March 2024)
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