Hypertension

3 foods your patients with high BP should avoid

Given the power of lifestyle changes to get hypertension under control, do you know the top three foods you should tell patients with high BP to avoid?

Most people know that salt is a big contributor to hypertension. But the three biggest sources of sodium for American patients on a day-to-day basis likely don’t come to mind immediately. It’s not a topic covered in medical school.

And it may surprise you that the salt shaker on the table doesn’t rank in the top three.

As the medical community increasingly recognizes the importance that diet plays in a patient’s overall health, an interactive, three-hour online nutrition course from the nonprofit Gaples Institute for Integrative Cardiology is helping physicians gain the insight they need to help patients improve their nutrition and, in turn, improve their well-being.

AMA members are eligible for a 20 percent discount on the Gaples CME modules. Contact the Unified Service Center for the discount code at (800) 262-3211 or [email protected]. The enduring educational activity is eligible for AMA PRA Category 1 Credit™.

The course also is available through the AMA Ed Hub™, your center for personalized learning from sources you trust, including collections of CME modules on hypertension and lifestyle behaviors.

The stealthy trio to elude

Physicians who take the Gaples Institute course learn that bread, processed meats and pizza are the three largest sources of sodium intake in the U.S. diet.  

Although an individual serving of one of these foods may not contain as much salt as a serving of soup or a salty snack, bread, processed meats and pizza top the list because the large number of servings of these foods that Americans typically consume, said Stephen Devries, MD, a cardiologist and executive director of the nonprofit Gaples Institute.

“I recently spoke at a medical conference and asked the 800 clinicians in the audience how many could estimate the number of milligrams of sodium they consumed the previous day—not a single hand went up. It’s not an easy number to know. So rather than emphasizing a single daily total for sodium consumption, it’s best to advise patients to cut back on foods that are high in sodium,” Dr. Devries said.

So what should patients eat?

Talking about foods to avoid is only part of the equation, Dr. Devries said.

“It’s most helpful to not only advise patients to minimize their intake of high sodium foods, but also to suggest that they replace them with healthier choices,” he said, noting that fresh fruits and vegetables are always good options.

To cut sodium when eating meals at a restaurant, Dr. Devries suggests patients ask for a low-salt version of the entree if the restaurant is preparing the food from scratch. Also, patients would do well to ask for sauces on the side.

“Sauces are typically loaded with salt,” Dr. Devries said. “By ordering restaurant meals with sauces on the side, it’s easier to keep the salt load in check.”

Because restaurant-prepared food is typically high in sodium and calories, he also recommends that patients eat at home more often so they can, among many other health benefits, control their salt intake. Premade meals are typically loaded in salt. The best strategy is to start with foods that don’t have or need labels, such as vegetables, beans and intact whole grains. Make or buy low-salt soups and add pepper or other spices for flavor. And instead of a sandwich, eat the meal as an open-faced version to cut down on the bread intake.

Dr. Devries also suggests seeking out foods that are high in potassium because they tend to reduce blood pressure. Foods rich in potassium include red and black beans, spinach, avocados, citrus fruits and bananas.

“It doesn’t take long for dietary changes to make a big impact on health­­—for high blood pressure, impressive changes can be seen in as little as two weeks,” Dr. Devries said, referring to a study done on the DASH diet, a dietary pattern that promotes eating the right foods to prevent and control hypertension. A study of the DASH diet found that after just two weeks, patients saw their blood pressure drop an average 11 mm Hg.