Susan Weiner Nutrition

As a nutritionist and Certified Diabetes Educator I am constantly looking at ways to help people battle obesity, heart disease, hypertension and diabetes. As we continue to deal with our expanding waistlines, we need to add sodium to our list of dietary concerns.

Even the politicians are jumping on the salt cutting band wagon. New York City Mayor Michael Bloomberg asked restaurants to voluntarily reduce the sodium content of foods by 25 % over the next five years. Not to be outdone by the east coast,  San Francisco Mayor Gavin Newsom (who already suggested his city reduce sugar consumption) is looking into ways to apply Mayor Bloomberg’s suggestion on salt reduction. I believe it’s time we start paying close attention to salt and its effects on health.

High blood pressure (aka hypertension) is very common among people with diabetes. Blood pressure (which is the force of blood against the artery walls) is measured in millimeters of mercury. Systolic pressure (heart beats) over diastolic pressure (the heart relaxing between beats), defines blood pressure.  If your blood pressure reading is above 140/80mm Hg, you are considered to have hypertension. Actually if you have diabetes the recommendation is to reduce your blood pressure below 130/80mmHg. Elevated blood pressure can increase your chance of developing a stroke, heart attack, coronary artery disease and nephropathy.

Sodium is a mineral (just like potassium and calcium). Although we do need a little bit of sodium in our diets (it can help maintain fluid balance in the body), we get way too much sodium (usually in the form of salt) and not enough of other very important minerals. 1 teaspoon of salt contains 2,400 milligrams of sodium. Foods that have 140 mg of sodium or less per serving are considered to be  ”low sodium” foods. The average American consumes about 4,000 mg of sodium per day while the American Heart Association recommends that healthy adults limit sodium to 2,300 mg per day, the National High Blood Pressure Education Program suggests less than 2,400 mg per day and the World Health Organization recommends less than 2,000 mg daily. That means there is no room for using your salt shaker. Toss it out!!

The DASH program (Dietary Approaches to Stop Hypertension) was developed based on findings by the National Heart, Lung, and Blood Institute (NHLBI) and emphasizes an eating plan rich in  fruits, vegetables, lean protein, unsalted nuts and whole grains. The DASH program limits simple sugars and is rich in potassium, magnesium, calcium, lean protein, low fat dairy products and fiber. By increasing fruits, veggies and unsalted nuts the overall nutritional density of the diet is improved, promoting better health while encouraging weight control (which is key in controlling blood pressure). In my opinion people with diabetes should closely consider their carbohydrate intake on the DASH diet (or any other program) to help properly manage blood sugar levels. As always, it’s a balancing act.

In order to control your blood pressure, please consider making some important lifestyle changes:

1. Achieve and maintain a healthy weight. Contact a registered dietitian  to begin a safe weight reduction program.

2. Increase your physical activity level! Start moving. Find something you enjoy doing physically (find a buddy and start walking today). Swim, try an cardio workout DVD, ride your bike… but start moving! Remember, if you have not been physically active in a while, you must consult your doctor before starting an exercise program.

3. Reduce the amount of sodium in your diet. Eat out less. Cook more! Buy less processed foods.

4. Reduce your consumption of alcoholic beverages.

5. If your doctor prescribed medication for your blood pressure, please take it as recommended.

6. Read food labels. Many foods contain hidden forms of sodium such as;  MSG (monosodium glutamate), baking soda, seasoned salts, salty marinades and of course canned and many frozen processed foods. Remember that sea salt and kosher salt still contain salt.  The list goes on and on!

7.  Drink water. Yes plain water. Reducing the salt, increase the water and the fiber and watch the pounds melt off!

8. Try to choose lower sodium foods when possible. Remember fresher is usually better (less sodium and more nutrition). If you do buy canned foods (such as canned tuna or beans), please rinse off the product with cold water.

9. Uses spices instead of salt. Since I already convinced you to throw out the salt shaker, buy all new spices and herbs. Squeeze fresh lemon on your fish and chicken to seal in the natural flavor. Enjoy the full flavor of your food!

10. Limited foods which are cured (such as bacon) or packed in a brine (such as pickles or olives) or smoked. Canned soups are also packed with salt.  These are super salty foods! Use them only for special occasions.

11. Choose fruits and vegetables instead of salty snack foods. Natures snacks provide you with  much needed potassium, which will help keep your blood pressure in check.

Please don’t be overwhelmed when trying to reduce the amount of sodium in your meal plan. Try to incorporate one or two good habits at a time. In a few weeks you will see a significant reduction in your weight and sodium intake. It is also important to increase your potassium intake while improving your  physical activity level to help achieve a normal blood pressure. Habits that were developed over many years can’t be changed in an instant. So talk a walk today, throw out the salt shaker and snack on a few raw veggies. Let me know how you are doing in a few weeks. Remember, good health happens one habit at a time.