Managing High Blood Pressure with the Dash Diet Presentation by: Karen A. Ridings, M.S.,R.D., Family Consumer Sciences Agent, Virginia Cooperative Extension, Frederick County According to the American Heart Association an estimated 9 in 10 Americans will develop high blood pressure in their lifetimes.(1) High blood pressure is a risk factor for cardiovascular disease (CVD) – the leading cause of death and disability worldwide. Two eating patterns that are endorsed by the 2010 Dietary Guidelines for Americans are the USDA Food Patterns and their vegetarian adaptations and the DASH (Dietary Approaches to Stop Hypertension) Eating Plan (2) American Association Fact Sheet: Salt: Reducing Sodium in the Diet of American Children (http://www.aahperd.org/aahe/about/updates/upload/AHA-Sodium-in-Children-2011.pdf) Executive Summary – Dietary Guidelines for Americans, 2010

What is high blood pressure? Category Systolic Diastolic (mmHg) (mmHg) Result Normal < 120 <80 Good for you! Prehypertension 120-139 or 80-89 Make changes in what you eat, drink, and be physically active High blood pressure is defined as a BP higher than 140/90 mmHG (1 out 3 American Adults) Many American adults suffer from pre-hypertension, 120-139/80-90, which increases their chances of developing hypertension and its complications Systolic = Top number – when heart beats Diastolic = Bottom number – when heart relaxes Resources: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/dash_brief.pdf Hypertension 140 or higher or 90 or higher Seek medical advice

What factors may contribute to HBP? AGE Diabetes Heredity Race or ethnicity Behaviors : Stress, Weight, Physical Inactivity, Alcohol, Tobacco, Diet Age – Adults over 55 years of age have a 90% chance of developing HBP over their lifetime. Diabetes increases risk Ethnicity: Greater risk for African Americans and Mexican Americans Behaviors: Stress Overweight Inactivity – involvement in moderate exercise Alcohol – not drinking in moderation Smoking Diet – not following a heart healthy diet that includes reduced salt and sodium, reduced saturated and trans fats, reduced cholesterol, and rich in nutrients associated with lowering BP (potassium, magnesium, calcium, protein , and fiber.

High Blood Pressure puts you at greater risk for… HEART DISEASE STROKE DAMAGE TO KIDNEYS OR EYES HBP makes your heart work too hard and stiffens the walls of your arteries. This can impact all of your organs. Heart Disease - heart attack Stroke – hemorrhage in the brain Kidneys – reduced functioning Eyes - blindness

WAYS TO CONTROL HBP Achieve healthy body weight Reduce sodium and salt in your diet If you drink, do so in moderation Stop smoking Exercise – at least 30 minutes per day of moderate activity = a level where you can still talk but not very much Be kind to your heart

DASH DIET Two key studies by National Heart, Lung, Blood Institutes showed that blood pressured can be reduced with the DASH DIET…. D – Dietary A – Approaches to S – STOP H- Hypertension The DASH diet is endorsed by the American Heart Association , 2010 Dietary Guidelines for Americans, National Heart, Lung, Blood Institutes The Dietary Approaches to Stop Hypertension has effectively reduced blood pressure and has now been found to reduce heart failure according to a study conducted by the Cardiovascular Epidemiology Research Unit at Beth Israel Deaconess Medical Center in Boston, Massachusetts. This 7-year observational study followed 36,019 women between the ages of 48 and 83. The results, reported in the May 2009 issue of the "Archives of Internal Medicine," show women who ate a diet most resembling the DASH diet plan had a 37 percent lower rate of heart failure after an adjustment for a number of factors including smoking, body mass index and high blood pressure. (http://www.bidmc.org/News/InResearch/2009/May/DASHDIET.aspx)

What is the DASH DIET ? Lower in Saturated Fats, Cholesterol, Total Fat, Sodium Rich in Fruit, Vegetables, Fat Free Milk Products, Whole Grains, Lean Protein, Beans, Seeds, Nuts Rich in Potassium, Magnesium, and Calcium

Getting Started What’s on your plate? Ask participants to assess their eating habits for 1 day or 1 meal. Form is available in : www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf (Your Guide to Lowering your Blood Pressure with Dash – p. 26)

What are your goals? Reduce your sodium and salt? Achieve and maintain a healthy weight? Increase physical activity? Reduce your consumption of alcohol? Reduce unhealthy fats? Sodium recommendations from 2010 Dietary Guidelines: - General public – 2300 mg - 1500 mg for persons 51 and older, African Americans or anyone who has hypertension, diabetes, or chronic kidney disease. Healthy Weight – have group calculate BMI with chart Physical Activity Recommendations: Adults – 30 minutes per day at least 5 days per week of moderate activity, Children – 60 minutes per day Alcohol (ETOH) – 1 drink for women per day, 2 drinks for men per day Reduce saturated and trans fats, and cholesterol.

Plan a menu Tips for Changes: Add a vegetable and fruit to a meal Increase use of fat free or low fat milk products Limit lean meats to 6 ounces per day Include 2 or more vegetarian style meals/week Try a new whole grain such as whole wheat pasta For snacks and dessert try fruit or other foods low in saturated fats, sugar, salt and calories. Use fresh, frozen, or low sodium canned fruit and vegetables

Read your labels Review label reading. Focus on sodium. “ Read the Nutrition Facts labels on foods to compare the amount of sodium in products. Look for the sodium content in milligrams and the Percent Daily Value. Aim for foods that are less than 5 percent of the Daily Value of sodium. Foods with 20 percent or more Daily Value of sodium are considered high. You can also check out the amounts of the other DASH goal nutrients. “ Labels: Sodium Free = 5 mg or less Very Low Sodium = 35 mg or less Low Sodium = 140 mg or less Reduced or Less Sodium = Sodium reduced by 25% or more

Add Spice to Your Life Anise Basil Mint Parsley Pepper Rosemary, Sage Thyme Tarragon Etc. Provide handouts regarding cooking with spices to reduce sodium. The sky is the limit!! Use your imagination!

DASH to Good Health Today!