Hypertension Canada PowerPoint Presentation

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Dietary Sodium ”Shaking the Habit”

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Hypertension The Silent Killer Sodium The Quiet Food Additive

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Outline Sodium Where do we get it? What does it do? How is it a health risk? Sodium and blood pressure Recommended sodium intake How to reduce your sodium intake Meal makeovers

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Where do we get sodium? Salt Table salt, sea salt, seasoning salts Sodium additives such as Monosodium glutamate(MSG) Baking soda Processed, takeout / restaurant foods

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Sources Of Sodium 5

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Why is sodium in our food ? Prevents food from spoiling. Performs some chemical functions in baking and processing. Adds flavour.

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What does sodium do? In your body: Helps regulate your body’s fluid balance. Too much sodium can increase the amount of water or fluid held in your body. Excess fluid puts extra pressure on your blood vessels causing damage.

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How is sodium a health risk? Increases blood pressure which increases risk for: Stroke Cardiovascular disease Kidney disease Dementia

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Lifestyle risk factors for high blood pressure Obesity High alcohol intake Inactivity Smoking Inadequate vegetable and fruit intake Inadequate milk product intake High dietary sodium intake

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Reducing Sodium Can Lower Blood Pressure and Risk Reducing sodium intake will lower blood pressure. 1 in 3 Canadians with hypertension could have normal pressure if they lowered their sodium intake. Following a low-sodium diet could reduce the risk of heart attack or stroke by 25-30%.

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The lower your sodium intake, the lower your blood pressure will be Sodium restriction is especially important for people… Of African descent Over 45 years of age With conditions such as Diabetes Kidney disease Heart failure

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How much sodium do we need? There are 2 reference points for sodium intake* Adequate Daily Intake (AI) recommended average daily intake Tolerable Upper lntake Level (UL) the highest average daily intake level that is likely to pose no adverse health effects *set by Canadian and US panel for Dietary Reference Intakes , 2005

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Sodium Intake Recommendations Dietary Reference Intakes, IM 2005

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Sodium Intake Recommendations Dietary Reference Intakes, IM 2005

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1500mg or 2300mg doesn’t mean much to me…. 2300mg sodium = 1 level tsp table salt 1,500mg = ¾ tsp table salt Sodium Intake Recommendations

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So how do you think we’re doing meeting those recommendations? What would you guess is the average daily sodium intake for a Canadian adults and children? Sodium Intake of Canadian Adults

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Sodium Intake of Canadian Adults

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Av. Sodium Intake* (mg/day)of Canadian Adults *Does not include sodium added at the table or during home cooking

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The sodium intake of most Canadian children/youth exceeds the UL Health Reports, Vol. 18, No 2, May 2007 Upper Level 1500mg 1900 2200 2300 % above UL

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Why is our sodium intake so high? 1. Less home-cooked meals Busy lifestyle! Want convenience Prepared food is always available

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2. Bigger Portions 21 cups 3 cups Food packages are bigger now than ever. The more we eat, the more sodium we consume.

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3. Heavy Use Of Condiments Ketchup Mustard Soy sauce Salad dressing Relish and pickles Olives Sauces … are all high in sodium

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4. More Processed Foods

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Food industry must reduce sodium in its products 24

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Processing Adds Sodium To Food

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Processing Adds Sodium 1 cup plain pasta 5 mg sodium 1 cup pasta & sauce 800 mg sodium

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Processing Adds Sodium Medium cucumber 2 mg sodium Medium dill pickle 385 mg sodium

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Processing Adds Sodium 1 oz. hard cheese 176 mg sodium 1 oz. processed cheese 407 mg sodium

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Processing Adds Sodium Coffee-milk & sugar 15 mg sodium Cappuccino from mix 250 mg sodium

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Sodium Content of Restaurant Foods

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Reduce Your Sodium Intake At home Plan meals at least a day in advance. Make more meals from unprocessed foods. Gradually decrease the amount of salt used in cooking and at the table (this includes sea salt). Use condiments sparingly.

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Reduce Your Sodium Intake At home Flavour food with lemon juice, fresh garlic, spices, herbs and flavoured vinegars. Try low-sodium seasoning mixes. Cook and bake with vegetable oil rather than butter or margarine. Use tomato paste instead of tomato sauce or soup in recipes.

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Reduce Your Sodium Intake At the grocery store Buy pre-prepared, convenience foods that are low in sodium such as frozen vegetables, frozen shrimp, skinless & boneless chicken breasts and pre-cut salads and fruit. Choose unsalted snack foods such as pretzels, nuts, seeds and crackers.

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Reduce Your Sodium Intake At the grocery store Read food labels and compare sodium content between similar foods Look for foods labelled salt-free, no added salt, low in sodium, or reduced in sodium. Always check the Nutrition Facts table

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Reduce Your Sodium Intake Check the Nutrition Facts table for: The mg sodium per serving (the lower, the better) Choose foods with 200 mg of sodium or less Choose foods with 10% or less Daily Value

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Reduce Your Sodium Intake When eating or “taking” out Choose salads and meals made with foods low in sodium Ask for no salt or MSG to be added during cooking Ask for sauces, spreads or dressings on the side and use sparingly Limit fast foods and take-out meals.

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Lower Sodium Vegetables and Fruit Adults need 8 to 10 servings a day For lower sodium: Choose fresh or frozen vegetables. Limit vegetables with sauce or instant mixes. Try making homemade salad dressing, or use commercial dressings sparingly. Choose low sodium vegetable juices and soups. Enjoy fresh, frozen, canned or dried fruit as a snack and dessert.

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Lower Sodium Grain Products Eat 6 to 8 servings a day 3 servings should be whole grain For lower sodium: Limit pastas and rice with prepared sauces or seasonings. Choose cereals, breads, crackers and pre-packaged baked goods with the lower mg sodium per serving. Use quick-cooking, rather than instant oatmeal.

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Lower Sodium Milk and Alternatives Have 2 to 3 servings a day. Choose lower fat milk and yogurt. For lower sodium: Be aware of higher sodium content of instant puddings, hot chocolate and flavoured coffee mixes. Limit your cheese intake, especially processed cheese slices or spreads.

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Lower Sodium Meat and Alternatives 2-3 servings per day Choose lean meat, fish, poultry Eat legumes, nuts and seeds often For lower sodium: Limit processed, cured, deli, smoked or breaded meats and poultry. Choose fresh, frozen or low-sodium canned fish. Rinse canned lentils, chick peas or beans, or cook your own. Enjoy unsalted nuts and seeds.

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Breakfast Menu Makeover

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Lunch Menu Makeover

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Snack Menu Makeover

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Dinner Menu Makeover

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Sodium Comparison High sodium menu 5485 mg Lower sodium menu 1258 mg

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The Sodium Challenge It requires effort and commitment to eat the recommended sodium levels. If the current trend for convenience continues, the food industry needs to gradually lower sodium/salt content of foods. Health Canada has a Sodium Working Group to develop and implement a Strategy to reduce sodium intake

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Recap: Healthy Eating for a Healthy Blood Pressure Eat a healthy diet according to Canada’s Food Guide. CFG = DASH diet guidelines (Dietary Approaches to Stop Hypertension) Choose lower sodium foods every day

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Dietary Sodium Questions 1. Reducing your intake of salt or sodium may help you lower your blood pressure. TRUE FALSE

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Dietary Sodium Questions 2. Most Canadians have sodium intakes that exceed recommendations for health. TRUE FALSE

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Dietary Sodium Questions 3. Most of the sodium in the North American diet is from salt added at the table. TRUE FALSE

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Dietary Sodium Questions 4. The Nutrition Facts table tells you the number of milligrams (mg) of sodium in the whole package of food. TRUE FALSE

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Dietary Sodium Questions 5. “Instant” packaged foods and fast food restaurant meals generally have a very high sodium content. TRUE FALSE

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For More Information Go to the websites: www.mybpsite.ca www.lowersodium.ca www.healthcanada.gc.ca/foodguide www.dietitians.ca

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DASH Diet Booklet To download or order a copy of the Dietary Approach to Stop Hypertension (DASH) Diet booklet, go to : www.nhlbi.nih.gov/health/public/ heart/hbp/dash/new_dash.pdf

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For your patients – ask them to sign up at www.myBPSite.ca for free access to the latest Information & resources on HBP For health care professionals – sign up at www.htnupdate.ca for automatic updates and on current hypertension educational resources.