1. Sodium and Potassium in Your Diet The role it plays in high blood pressure Information Provided To You By: JFHQ Occupational Health Office Nutrition For Everyday Series- Lesson 3

2. Why Should I Care About High Blood Pressure? I Don’t Feel Bad… Coronary Risk Factors: High Blood Pressure Tobacco Use (any kind) Elevated Cholesterol Total Elevated Glucose (Blood/Urine) Increased Body Mass Index (BMI) Did you know if you have one of these factors, you are likely to develop more than one of them over time? They tend to travel in packs… Adult Body Mass Index (BMI) calculator- Check out what your BMI number is. You may be shocked! http://www.cdc.gov/ nccdphp/dnpa/bmi Well, because it is one of the Coronary Risk Factors

3. What is High Blood Pressure (B/P)? Normal B/P= 120/80 High B/P= 140/90 or higher Blood Pressure can be controlled by: Healthy weight Being Active Consumption of low sodium foods, as determined by a healthy eating plan Only drink alcohol in moderation Did you know that if you follow the above guidelines, you could PREVENT High B/P? If you are already prescribed medication for high blood pressure, it can be controlled if taken according to Doctor’s orders.

4. The Sodium-Potassium Relationship… Sodium: Increases blood pressure by retaining fluid. Potassium: Decreases blood pressure by reducing blood volume with the excretion of water through kidneys, which reduces the strain or “pressure” on the arterial walls. But how? The kidneys regulate potassium levels. The more potassium in the body, then the more sodium to be excreted. If a person has low potassium levels, the existing sodium is more likely to hold on to the water in the body, therefore aggravating some medical conditions. Fluid Balance: Potassium and Sodium work together to maintain the body’s fluid balance. People who tend to have high levels of sodium should include more potassium in their diets. Excessive exercise, alcoholism, malnutrition, taking medications such as diuretics and uncontrolled diabetes can cause dangerous lows in potassium levels.

5. What are my choices when it comes to Potassium in foods? *Most fruits & veggies have high potassium content* So, why are only 33% of Americans meeting the recommended daily allowance of 4,700mg of potassium each day? Because we are getting our potassium from processed foods, which are less healthy sources and we are not eating enough fruits and vegetables. According to the American Dietetic Association Veggies/Fruits- Potatoes, spinach Brussels sprouts, avocados Tomato juice and sauces Sweet potatoes Beans (white, lima, kidney) Bananas, oranges, cantaloupe, grapefruit and apricots Other sources- Yogurt Clams Halibut OJ and milk Raisins, prunes

6. Where’s The Potassium? Nuts, seeds, and legumes Cooked soybeans, 1/2 cup, 440mg Cooked lentils, 1/2 cup, 370mg Cooked kidney beans, 1/2 cup, 360mg Cooked split peas, 1/2 cup, 360mg Almonds, roasted, 1/3 cup, 310mg Walnuts, roasted, 1/3 cup, 190mg Sunflower seeds, roasted, 2 Tbsp, 124mg Peanuts, roasted, 1/3 cup, 120mg Lean meats, fish, and poultry Fish (cod, halibut, rockfish, trout, tuna), 3 oz, 200-400mg Pork tenderloin, 3 oz, 370mg Beef tenderloin, chicken, turkey, 3 oz, 210mg Fruit Banana, 1 medium, 420mg Apricots, 1/4 cup, 380mg Orange, 1 medium, 237mg Cantaloupe chunks, 1/2 cup, 214mg Apple, 1 medium, 150mg Low-fat or fat-free milk products Milk, 1 cup, 380mg Yogurt, 1 cup, 370mg Vegetables Potato, 1 medium, 926mg Sweet Potato, 1 medium, 540mg Spinach, cooked, 1/2 cup, 290mg Zucchini, cooked, 1/2 cup, 280mg Tomato, fresh, 1/2 cup, 210mg Kale, cooked, 1/2 cup, 150mg Romaine lettuce, 1 cup, 140mg Mushrooms, 1/2 cup, 110mg Cucumber, 1/2 cup, 80mg

7. Where’s The Sodium? Whole and other grains and grain products Cooked cereal, rice, pasta, unsalted, 1/2 cup, 0-5mg Ready-to-eat cereal, 1 cup, 0-360mg Bread, 1 slice, 110-175mg Vegetables Fresh or frozen, cooked without salt, 1/2 cup, 1-70mg Canned or frozen with sauce, 1/2 cup, 140-460mg Tomato juice, canned, 1/2 cup, 330mg Fruit Fresh, frozen, canned, 1/2 cup, 0-5mg Low-fat or fat-free milk and milk products Milk, 1 cup, 107mg Yogurt, 1 cup, 175mg Natural cheeses, 11/2 oz, 110-450mg Process cheeses, 2 oz, 600mg Nuts, seeds, and legumes Peanuts, salted, 1/3 cup, 120mg Peanuts, unsalted, 1/3 cup, 0-5mg Beans, cooked from dried or frozen, without salt, 1/2 cup, 0-5mg Beans, canned, 1/2 cup, 400mg Lean meats, fish, and poultry Fresh meat, fish, poultry, 3 oz, 30-90mg Tuna canned, water pack, no salt added, 3 oz, 35-45mg Tuna canned, water pack, 3 oz, 230-350mg Ham, lean, roasted, 3 oz, 1,020mg

8. Tips to Reduce Salt Intake Think Fresh Reduce the processed foods in your diet. Replace your usual side dishes, with a vegetable or fruit at every meal. Fresh or frozen are good choices. Enjoy home-prepared Foods You will know what is in your food. It will allow you to control how much is in your food. Ask for low-sodium foods when you eat out Restaurants can prepare them upon request. They can serve sauces and dressings on the side, so you can use less. Choose dairy & protein foods with lower sodium Cheeses have more sodium than fat-free/low-fat milk or yogurt. Choose unsalted nuts and seeds. Fresh meats have less sodium than deli meats, sausages, and canned products. We should not exceed 2,300 milligrams (mg) per day This adds up to approximately 1 teaspoon (tsp)! 51 years old or older African Americans Have High B/P already Diabetes Chronic Kidney Disease * REDUCE to 1,500 mg per day, if you meet any of the following criteria!! Did you know McDonald’s Big Mac has 1007mg Sodium?

9. More Tips… Adjust your taste buds Cut back slowly and pay attention to the natural tastes of various foods. Your taste for salt will lessen over time. Skip the salt when cooking Take the salt shaker OFF the table and kitchen counter. Experiment with spices, herbs, garlic, vinegar, or lemon juice or use NO Salt seasoning mixes. Read the Label Nutrition Fact Labels on foods are helpful. Look for “low sodium”, “reduced sodium” or “no salt added”. Pay attention to condiments Soy sauce, ketchup, pickles, olives, salad dressings, and seasoning packets are high in sodium. Buy the low sodium versions of your favorites. Use a portion of the flavor packet instead of the entire one. Substitute carrots or celery for olives or pickles. Reduce the use of “Instant” foods Rinse canned foods, such as tuna, to remove some of the sodium Cut back on frozen dinners, pizza, packaged mixes, salad dressings and canned soups and broths. Choose ready to eat breakfast cereals that have lower sodium Boost Potassium (K) Intake: Doing so, may drop your Blood Pressure (B/P).

10. Read the Food Label --Helps you choose foods lower in sodium, as well as calories, saturated fat, total fat, and cholesterol. The label tells you: Number Of Servings The serving size is in cups. The package contains about 3 servings. Amount Per Serving Nutrient amounts are given for one serving. If you eat more or less than a serving, add or subtract amounts. For example, if you eat 1 cup of peas, you need to double the nutrient amounts on the label. Percent Daily Value Percent Daily Value helps you to compare products and tells you if the food is high or low in sodium. Choose products with the lowest Percent Daily Value for sodium. Nutrients You'll find the milligrams of sodium in one serving. Frozen Peas Serving Size ½ cup Servings Per Container about 3 Amount Per Serving Calories 60 Calories from Fat 0 % Daily Value* Total Fat 0g 0% Saturated Fat 0g 0% Cholesterol 0mg 0% Sodium 125 mg 5% Total Carbohydrate 11g 4% Dietary Fiber 6g 22% Sugars 5g Protein 5g Vitamin A 15% Vitamin C 30% Calcium 0% Iron 6% * Percent Daily Values are based on a 2,000 calorie diet.

11. Food Labels Have A Language Of Their Own Phrase 1. Sodium free or salt free 2. Very low sodium 3. Low sodium 4. Low-sodium meal 5. Reduced or less sodium 6. Light in sodium 7. Unsalted or no salt added What It Means- 1.Less than 5 mg per serving 2.35 mg or less of sodium per serving 3.140 mg or less of sodium per serving 4.140 mg or less of sodium per 31/2 oz (100 g) 5.At least 25 percent less sodium than the regular version 6. 50 percent less sodium than the regular version 7. No salt added to the product during processing (this is not a sodium-free Taken From: Your Guide to Lowering Your Blood Pressure With DASH

12. Don’t Forget The Exercise! It only takes 30 MINUTES a day 30 minutes daily of brisk walking could keep you off B/P medication Exercise helps your medication to work better If you do not have high B/P, but are inactive, you are more likely to develop it 1.Set a schedule & stick to it 1.Get a friend or family member to join you 2.Cross-train 3.Set goals 4.Reward yourself

13. Catch us for Healthy Recipes! We will bring healthier versions of your favorites through this education series in the near future. Submit your ideas for topics to Capt Amy Blow at amy.blow@us.army.mil amy.blow@us.army.mil Questions?

14. REFERENCES: Your Guide to Lowering High Blood Pressure, U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute. 10 Tips; Nutrition Education Series, U. S. Department of Agriculture, Center for Nutrition Policy and Promotion. Hungry Girl’s Death by Chocolate Cupcakes, Hungry Girl Inc, http://www.hungry- girl.com, 18034 Ventura Blvd. #503, Encino, CA 91316.http://www.hungry- girl.com