DICKINSON, N.D. — High blood pressure, also known as hypertension, is a serious health concern for millions of Americans. It has been linked to dementia, complications in pregnancy and is the leading cause of stroke — a growing concern for young people. According to the Centers for Disease Control and Prevention, close to one-third of U.S. adults who have hypertension are not aware because it’s often asymptomatic.
Monitoring sodium consumption is key to maintaining healthy blood pressure, said Rachel Iverson, a registered dietitian and board certified sports dietitian with Sanford Health in Bismarck. Iverson said heavily processed foods such as Hamburger Helper, boxed macaroni and cheese, canned soup and frozen dinners often contain unhealthy levels of sodium; the reason being that salt is used as a preservative to extend shelf life. Yet, there are high sodium products whose heart stopping saltiness tends to stay under a consumer’s radar.
“You think about things that are treated with salt, such as cottage cheese. They use sodium to stop the curding process — the creation of curds so it has that nice texture. So cottage cheese has about 500 milligrams of sodium per cup,” she said.
When done right, food prepared at home is much healthier than processed food.
“Generally, you’ll eat less sodium if you’re cooking at home if you stop adding salt to your food, which I know is hard — especially if you like a good steak,” Iverson said.
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When using canned food such as green beans, she recommended rinsing them because so much sodium is used as a preservative in the canning process. She also pointed to the Dietary Approaches to Stopping Hypertension ( DASH ) plan.
“That’s going to be grain products like whole grains, 100% whole wheat bread, popcorn, quinoa and brown rice. Those are all going to be whole grains. Oatmeal is great. That diet is also pretty high in healthy fats, so things like nuts,” she said. “I recommend up to nine servings of produce a day because again, fruits and veggies generally don’t have a ton of sodium.”
The average person should be consuming between 2,100 to 2,300 milligrams of sodium per day. This can be difficult to track, so she suggested breaking it down into more easily measured components.
“Most Americans get significantly higher than that, and average around 4,000 milligrams a day,” Iverson said. “I have a rule for patients who are working on lowering sodium, take about 500 milligrams of sodium per meal and 250 milligrams per snack. That way if you have three meals and one or two snacks a day, you should be well within those limits.”
With that in mind, she said you shouldn’t be too hard on yourself for occasionally exceeding those limits.
“If you go over on those, that doesn’t mean the whole day is blown and you should just order movie theater butter popcorn. When you bring it back to that 500 and 250, it becomes a much more sustainable change,” she said.
About 50% of the cause of high blood pressure is genetics while the other half is attributable to a person’s lifestyle, she said, adding that exercise is important but has limited potential in mitigating or reducing hypertension risk.
“Exercise, that allows you to sweat. Some of the different electrolytes involved, or maybe things like magnesium like calcium, potassium, and sodium. All those play a role, but sodium tends to have the highest impact on blood pressure specifically. So that's really what we focus on,” she said. “Genetically, your body might just retain more solutes, your kidneys might function differently, you might have more thirst cues or you might just sweat more frequently. So sweating will generally decrease a little bit of high blood pressure, but it's not really a solution because we don't usually sweat out enough solutes to have a significant impact unless you're training for a marathon in a hot condition.”
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Gabrielle Hartze is a registered dietitian with CHI St. Alexius Health in Dickinson. Hartze said patients should consult their doctor about appropriate levels of protein consumption based on age and activity level among other factors.
“Those that are consuming more protein than their body actually requires, they just end up storing it as fat so it just leads to weight gain. The weight gain then leads to that likelihood of increased blood pressure,” she said.
She also agreed with Iverson that grains are essential, and emphasized the importance of whole grains such as barley or oatmeal over those that are refined such as white flour products.
“Refined grains, those are processed grains. So they remove the bran and the germ which means that there's less iron, B vitamins and fiber,” Hartze said.
For more information about living a nutritionally healthy lifestyle, check out the U.S. Department of Agriculture recommendations at myplate.gov .
