A Teaspoon of Prevention: The Remarkable Impact of Reducing Salt on Blood Pressure

Understanding the Scale of Hypertension

In the United States alone, an astonishing 61.9 million adults are prescribed medication to manage their blood pressure, as reported by the Centers for Disease Control and Prevention (CDC). Hypertension, or high blood pressure, remains a leading health concern globally. But what if a simple dietary change could offer similar benefits to medication? Our primary care doctors in Jupiter want you to know about what an article published in the Journal of the American Medical Association, suggests.

The Study: Salt Reduction Equals Medication?

Conducted by a team from Vanderbilt University Medical Center, Northwestern Medicine, and the University of Alabama at Birmingham, the study observed 213 individuals aged 50 to 75. The participants’ diets were closely monitored, including a week on a low-sodium diet and another on a high-sodium regimen. Surprisingly, reducing salt intake by about one teaspoon a day (equivalent to 2,300 mg of sodium) showed a significant decrease in blood pressure, comparable to the effects of standard blood pressure medication.

Key Findings and Implications

  1. Broad Effectiveness: Dr. Deepak Gupta of VUMC noted that the blood pressure reduction was consistent across various groups – those with normal, controlled, untreated, and uncontrolled hypertension.
  2. Rapid Results: The participants experienced a notable drop in blood pressure within just a week of following the low-sodium diet.
  3. Public Health Impact: Dr. Cora Lewis emphasized the potential widespread benefits, considering the global prevalence of hypertension.
  4. No Side Effects: Dr. Bradley Serwer, reviewing the study, highlighted the advantage of dietary changes over medication, notably the lack of side effects.

The Role of Sodium in Hypertension

Sodium plays a crucial role in maintaining blood pressure levels. It attracts water, leading to increased fluid volume in the bloodstream and, consequently, higher blood pressure. This increased pressure adds strain to the heart, underscoring the importance of managing sodium intake.

Recommendations and Conclusion

The American Heart Association (AHA) recommends adults consume no more than 1,500 mg of sodium per day. This study’s findings reinforce the significance of dietary control in managing blood pressure, even for those already on medication. As hypertension contributes to a range of severe health issues and remains a leading risk factor for death worldwide, reducing salt intake could be a key strategy in improving global health outcomes. As Dr. Gupta puts it, preventing hypertension is crucial for longer, healthier lives. This study demonstrates that sometimes, less is more – especially when it comes to salt.

Celebrate Earth Day With a Climate-Friendly Diet

As we prepare to celebrate the 51st Earth Day this week, our primary care concierge doctors in Jupiter know that many people are looking for ways to be kinder to the Earth without radically altering their entire lifestyle.

One way is to be more mindful of the carbon impact of the foods we eat. As an added bonus, eating more sustainably provides great health benefits, as well.

But you don’t have to make drastic changes to make a difference.

First, Some Facts

The World Economic Forum reports that, in a business-as-usual scenario, emissions from food production alone could use up all of the earth’s 1.5°C to 2°C carbon budget.

The World Health Organization (WHO) says that food production accounts for 20-30 percent of global greenhouse gas (GHG) emissions and as much as 66 percent of water usage.

According to Scientific American (SA), the Environmental Working Group (EWG) found that red meat such as beef and lamb is responsible for 10 to 40 times as many GHG emissions as grains and vegetables.

Livestock farming from cattle alone is estimated to generate about 20 percent of the GHG methane produced in the U.S.

In addition, a 2009 study found that cattle ranching is responsible for 80 percent of the deforestation of the Amazon rainforest.

Finally, SA reports that concentrated animal feeding operations (CAFOs or “factory farms”) can produce as much sewage waste as a small city.

The Wellness Advantage

In addition to the benefits for the planet, this way of eating provides another bonus: From a health perspective, plant-based diets are unquestionably better for the body than a diet high in meat, especially red meat.

According to Harvard Health, “an accumulated body of evidence shows a clear link between high intake of red and processed meats and a higher risk for heart disease, cancer, diabetes, and premature death.”

“The evidence is consistent across different studies,” says Dr. Frank Hu, chair of Harvard’s Department of Nutrition.

On the flip side, plant-forward diets have been shown to support the immune system, reduce inflammation in the body, reduce the plaques associated with Alzheimer’s disease, and improve the gut microbiome.

And, of course, incorporating more plants into your diet reduces the number of antibiotics you’re exposed to.

As SA reports, the widespread use of antibiotics to keep livestock healthy in the unnatural confines of those overcrowded CAFOs has led to the development of dangerous antibiotic-resistant strains of bacteria that can make some common infections impossible to treat.

Different Approaches

As we said, you don’t have to go totally vegan to help the planet or your health. There is an array of climate-friendly (or at least friendlier) diets to choose from.

Vegans, of course, don’t consume any animal products at all.

Vegetarians don’t eat meat but may eat some animal products such as eggs and dairy.

Flexitarians are, as their name suggests, more flexible in what they eat. Closest to vegetarians, they do occasionally consume meat.

Sustainarians eat a mostly plant-based diet but will eat meat if it is locally and humanely raised.

Reducetarians try to eat less meat for a variety of reasons, including their own health, the welfare of animals, and the environmental impact of their food. They’re also concerned with the concepts of biodiversity loss, and their food’s impact on water supplies and food workers.

Climatarians, also known as “climavores,” eat less meat and only a moderate amount of sustainable fish, avoid food waste and “air-flown” food, and choose high-welfare, organic meat.

Regenivores’ diets are similar to those above, especially reducetarians, but focus even more on whether it’s ethically produced. HuffPost reports they take into consideration soil health, workers’ rights, the impact of chemicals on the humans involved in food production, and the treatment of animals throughout the supply chain.

Other Ideas

Kind of confusing, isn’t it? If you don’t want to label your efforts to reduce your carbon footprint but just want to eat more sustainably, Canadian Living offers a simpler approach:

  1. Eat less meat. “A 2016 systematic review shows that following a diet low in animal products has the biggest impact on the environment of any dietary change, reducing GHG emissions and land use up to 70-80 percent, and water uses up to 50 percent,” the magazine reports. Keep in mind that beef has the largest carbon footprint of all animal products.
  2. Eat more plants. For your health and that of the planet, focus on vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils, moderate amounts of seafood and poultry, and little red or processed meat, added sugar, or refined grains.
  3. Reduce food waste. Food waste ends up in landfills, where it generates about 25 percent of Canada’s methane gas. (The U.S. total is approximately 16 percent). Buy only what you need, and make a plan to use up leftovers as much as possible.
  4. Buy local food. This supports local farmers, reduces the need for transporting food long distances, and is more nutritious because fewer nutrients are lost during transit.
  5. Reduce kitchen garbage:
    • Buy/use reusable grocery and produce bags.
    • Carry a reusable water bottle.
    • Use beeswax wraps instead of plastic wrap.
    • Replace washable silicone bags instead of plastic bags.

This Earth Day, you can do your health and the planet a favor just by making a few simple changes to your diet.

For a suggested Earth Day menu, Earthday.org offers a sample here.

Doctor’s Best Diets for the New Year

At the beginning of every new year, it’s customary to make resolutions to improve our lives in some way. Usually near the top of the list of New Year’s resolutions the goal of losing weight. Our primary care concierge doctors in Jupiter certainly applaud that one, because obesity negatively impacts our health in so many areas, from the possibility of type 2 diabetes to heart disease. 

But there are other reasons to adhere to a particular type of diet, which don’t necessarily relate to weight loss. Diet in this sense means a way of eating, whether it’s cultural or just for overall health.

Forbes 2023 Rankings

Forbes Health recently consulted a team of seven nutrition experts to rate 19 diets considering a range of factors, from weight loss to heart health. 

Which one is best for you depends on your reason for trying a new diet. Of the 19 diets reviewed, these made the top 10:

  • Best for overall health: Mediterranean diet, emphasizing fresh fruits, olive oil, nuts, and fish
  • Best non-meat diet: vegetarian, which generally doesn’t allow meat, poultry, or fish
  • Best for heart health: dietary approaches to stop hypertension (DASH) diet, which focuses on fruits, vegetables, whole grains, lean proteins, and low-fat dairy
  • Best commercial diet: Weight Watchers (now known as WW), emphasizing lower calories, with coaching and group support
  • Best commercial diet runner-up: Noom, an app that ranks food according to calories, with coaching and group support
  • Best non-meat diet runner-up: vegan, which allows no animal products of any kind
  • Best diet for flexibility: pescatarian, a type of vegetarianism that also allows fish and other seafood
  • Best diet for holistic health: Ornish diet, low-fat emphasis allowing no meat, fish, or poultry
  • Best diet for a brain boost: MIND diet, a combination of the Mediterranean and DASH diets
  • Best diet for a nutrient boost: Nordic diet, consisting primarily of fish, berries, and winter vegetables, with a small amount of meat and sweets allowed

Other Views

The annual US News listing of best diets includes most of the above diets, in addition to Jenny Craig, Dr. Weil’s anti-inflammatory diet, the Mayo Clinic diet, volumetrics, the nutritarian diet, the South Beach diet, and the Plantstrong diet.

Everyone, it seems, has an opinion on what makes a great diet.

For instance, Dr. Michael Greger told NBC’s TODAY that the worst diet is what he terms the CRAP diet: “calorie-rich and processed foods” that make health problems worse and weight loss impossible.

Instead, he recommends consuming a whole-food, plant-based diet, which is naturally high in fiber and low in calorie density and allows people to eat as much as they want—no calorie counting or portion control needed.

“It’s a diet that minimizes the intake of meat, eggs, dairy, and processed junk, and maximizes the intake of fruits, vegetables, legumes like beans, whole grains, nuts and seeds, mushrooms—basically, real food that grows out of the ground. Those are our healthiest choices,” he told TODAY.

“The strategy is to improve the quality of food rather than restricting the quantity of food,” he added, “so it doesn’t leave you hungry. That’s a diet you can stick with. You get a boost of energy, better digestion, better sleep.”

Skip the Gimmicks

His approach is simple. And in contrast, notice what kinds of diets don’t show up on any of these lists.

The hugely popular keto diet is one example. Studies show that 80 percent of those who try it struggle to stick with it. Why, when it often results in huge and rapid amounts of weight loss?

Because it not only can it cause numerous side effects—body aches, headaches, light-headedness, nausea, fatigue and lethargy, constipation, and brain fog—but because everyone else is eating garlic bread and mashed potatoes (not cauliflower) with gravy and pasta. 

Because, in short, the keto diet is restrictive. It has a long list of very tasty foods that either aren’t allowed or are allowed only in small portions after a certain time.

“When you are on the keto diet, you drastically cut your carbs to only 20 per day. That’s less than one apple!” nutritionist Lisa Drayer, a CNN contributor, told the network.

Bottom Line

Above all, research shows that the most successful diet is the one that you yourself designed because it gives you a sense of control, rather than being at the mercy of a set of restrictive rules.

“You have to have joy and pleasure in food,” Stanford University professor of medicine Christopher Gardner told The Washington Post. He has conducted numerous randomized trials to test the success rate of various diets and found they are essentially the same.

“They agree more than they disagree,” he said. Instead, he counsels, “Limit added sugars and refined grains, and eat more non-starchy vegetables. [I]f you do those two things, you get 90 percent of the benefits.” 

If you enjoy what you eat, you’ll have a much better chance of sticking with it for the rest of your life, he added.

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Insomnia is the most common sleep disorder. But our primary care doctors at MD 2.0 in Jupiter find our patients often don’t let us know when they’re having trouble sleeping. They either decide it’s not a big deal or they think the only remedy we can offer is sleeping pills.

While you might need to use medication in the short term, advances are made every day in the treatment of this potentially harmful condition.

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There are numerous ways to avoid contracting colon cancer (third-most common cancer diagnosed among Americans) from regular colon cancer screenings to a low-fat, high-fiber diet. Now researchers possibly discovered another way.

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DASH Into the New Year for Your Health

If one of your New Year’s resolutions includes improving your overall health, one of the best ways you can achieve that is through a healthy diet. But what exactly does “a healthy diet” mean? Too many people think “eating healthy” means dining solely on rabbit food: carrots, lettuce, and a serving of water on the side. This doesn’t have to be the case. Your concierge primary care doctors at MD 2.0 Jupiter in Jupiter, Florida, prefer to call it “sensible eating,” and the payoffs can be enormous.

Take, for example, Generic Lisinopril, which has been making people healthier for 20 years. Dietary Approaches to Stop Hypertension—the DASH diet—is recommended by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) because of its proven effect on lowering blood pressure in both hypertensive and pre-hypertensive patients.

In addition to improving cardiovascular health, the diet has been shown to help prevent cancer, reduce the incidence of diabetes, and improve kidney health. Finally, and not incidentally, one of the “side effects” of the diet is effective short-term and long-term weight loss. For its general effect on health, U.S. News and World Report has ranked the DASH diet the best diet for seven years in a row.

DASH-DIET

So what are the features of the DASH diet? Rather than strict rules, it provides more in the way of guidelines. These include: eating more fruits and vegetables, beans and nuts, fish, poultry, whole grains, and low-fat or nonfat dairy, and less full-fat dairy products, fatty meats, sugar-sweetened drinks, and sweets. Consumption of less salt (sodium) is also encouraged, but not required. However, many of the recommended foods on the plan are naturally low in sodium, so a good deal of salt reduction occurs incidentally.

The impetus for the research came when medical science was focused solely on the effect of salt on high blood pressure. Researchers who designed the DASH diet wanted to look at the way a diet high in nutrients, not just low in sodium, would impact hypertension. The results were gratifying.

The DASH diet is rich in fiber, calcium, potassium, and magnesium, nutrients which improve the body’s electrolyte balance, thus relaxing blood vessels as well as promoting excretion of excess fluid, both of which result in lower blood pressure. It emphasizes variety, portion size, and natural foods. And by including a good balance of lean protein, it helps satisfy hunger and maintain energy.

The diet was originally developed in the 1990s as part of a research study designed to see whether blood pressure could be reduced through a dietary approach. The results were remarkable. Subjects were able to reduce their blood pressure significantly in just two weeks, and the less salt that was consumed the lower the blood pressure achievement.

Later studies found that the DASH diet also served to lower total LDL and cholesterol, and reduced the risk of coronary heart disease and stroke, even years later.

So, if you’re looking for a diet that will improve your overall health as well as your waistline, you can’t go wrong with the DASH approach. There are myriad books available that provide the specifics, and sample menu plans can easily be found on the Internet. And of course, if you have specific questions about incorporating the DASH approach to healthier living, we can help you tailor the plan’s guidelines to meet your calorie requirements based on your weight, height, gender, age, and activity level.

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