LOW SODIUM EATING PLAN FOR HYPERTENSIONThiseatingplanwillhelpyoukeepyourdailysodium(salt)intakebetween1500and2300mg.Itislowincholesterolraisingfatsandrichinfruits,vegetablesandfibre.

Hypertension occurs when the pressure that your blood exerts on your arteries rises above normal. Blood pressure is measured and reported as the pressure when your heart contracts over the pressure when it relaxes (systolic/diastolic). Normal blood pressure is 120/ 80 mm Hg. Blood pressure is considered high when these pressures are increased above 140/90 mm Hg.

Did you know that 3 out of 10 Canadians with hypertension could have normal blood pressure if they ate less salt?

Tips To Help Reduce Your Blood Pressure – Eat “close to the farm”, the less processed the better! See‘FoodstoChoose’inthefollowingsectionforexamples.

1. Limityoursaltto1500mgperday.See “Salt - Shake the Habit”.2. Eatplentyoffruitandvegetables.Aimfor7ormoreservingseachday.3. Eathighfibre,wholegrainfoods.4. Includelow-fatdairyandalternatives.5. Includequalitylow-fatproteinchoices.6. Limitaddedfat.7. Reducealcoholtolessthan2drinksperday.8. Ifoverweight,alossof10%ofyourweightcanlowerbloodpressure.9. Balancehealthyfoodchoiceswithregularphysicalactivity.

Highbloodpressurecanincreaseyourriskofheartdiseaseandstroke.Areductioninbloodpressureof10/5mmHgcanreduceyourriskofstrokeby38%andheartfailureby50%!Suchareductionisachievablewithachangeinlifestylefactorssuchasimprovingyourdiet,quittingsmokingorbecomingmoreactive.

Did you know that more than 75% of the salt we eat comes from prepared foods including restaurant foods? Little more than 10% comes from what we add in cooking and at the table. Your choices at restaurants and in the grocery store go a long way to reducing your salt intake.

What does 1500 mg of salt look like? It is less than one teaspoon of salt.

Tips to reduce salt (sodium) intake• Homepreparedfreshorfrozenfoodsarebest.Ifusing

cannedfoods,lookforlabelssuchas“noaddedsalt”or“lowsodium”.

• Avoidaddingsalttoyourfoodandomitfromrecipeswherepossible.

• Seasonyourfoodwithherbandspiceblends...see recipe to the right. Checkingredientliststoavoidthosewithsalt.

• Limitcondimentssuchasketchup,mustard,soysauceetc.• Useingredientlists-foodslistingsaltorsodiumatthe

beginningofthelistormultipletimesinthelistarehighinsalt.• Restaurantfoodsareoftenhighinsodium.Trytoavoidfast

foodbutdousetherestaurants’NutritionInformationtoidentifylowersodiumoptions.Wheneatingout,askyourserverifthemealcanbepreparedwithoutaddedsalt.Requestsaucesontheside.

Use the Nutrition Facts table to choose packaged foods with less sodium.

Those with less than 200mg per serving are your best choices. If the product has more than 400mg of sodium per serving look for a lower sodium alternative.

Tips For Eating Away from HomeRestaurantfoodsareknownforhavinghighsaltcontent.Chooseyourmealswisely.Sometipstohelplimityoursodiumwhileeatingoutinclude:• Selectarestaurantinwhichfoodsarepreparedtoyourorderandrequestthatnosaltbeadded.• Choosesaladoversoupasanappetizerandaskfordressingontheside.• Askforfreshorsteamedvegetableswithoutsaucesorbreading.• Grilledorbakedmeat,chickenorfishwithoutsaucesorbreadingarelowersodium.• Avoidbread,biscuitsorcrackerswithvisiblesaltontop.• Limitselectionsthatincludecheese.• Askforfruitbaseddessertswithlittleornopastry.• Manychainrestaurantshavenutritioninformationavailableon-line.Checktherestaurantswebsiteforthesodium

contentofthemenuitemsbeforegoing.Selectitemslowerinsodium.• Balanceoutyourday–ifyoueatoutoften,besuretochooselowersodiumfoodsatthemealsyouprepareathome.

Cheers to lower sugar! Arecentstudyfoundthatcuttingbackonpopandsugarybeveragesmayloweryourbloodpressure.Ratherthanpoporjuice,orderwater,sparklingwater,unsweetendteaorcoffeetocomplementyourmeal.

 

Homemade Herb BlendThismulti-purposesaltfreeseasoningcanreplacethesaltinyourtabletopshakerandisgreatincasseroles,soupsandjustaboutanysavorydishyouwouldotherwisesalt.

1Tbspgarlicpowder1tspeachofdried,crumbled:basil,marjoram,thyme,parsley,savory,sage1tspeachofgroundmace(ornutmeg),onionpowder,pepper½tspcayenne(optional)

Inasmallbowl,mixtogetherallingredientsuntilwellblended.Storeinajarwithatightfittinglidinacool,dryplaceforupto6months.Source:AHALowSaltCookbook-2nded.

General Healthier Eating Guidelines - To Avoid Complications with hypertension. AlsoavailablefromtheOttawaCardiovascularwebsite:HyperlipidemianutritionfactssheetfordetailsonloweringyourcholesterolandWaistingAwaynutritionfactssheetforinformationonachievingahealthyweight.Gotowww.ottawacvcentre.com.• Start withabalancedbreakfastandfollow-upwithabalancedlunchanddinner.• Balance-seePortionstoLiveBybelow.• Addcolourwithfruit and vegetables.Eatyourchoicesmoreoftenthandrinkingthemasjuiceformorefibreandfewer

calories.• Whole grain starchyfoodchoicesincludewholewheatpasta,wholegrainbread,brownrice,wholewheatcouscous,barley,

quinoaoroats.• Aneatingpatternrichinplant-basedfoodsisrichinfibre.Fibrerichfoodsbalancebloodsugar,keepyoufeelingfull,lower

cholesterolandbloodpressure.(andkeepyouregular!)• Proteinchoicesincludelowfatdairyoralternativechoicessuchasmilk,yogurt,cheeseandleanmeatandalternative

choicessuchasleanbeef,pork,chicken,fish,eggs,tofu,beans,lentils,nutsandseeds.• Choosemilk and yogurtwithmilk fat percent (%MF) of 1% or less.Cheeseshouldbe20%MForless.Lowerfatfortified

soymilkisalsoagreatoption.• Lean meatshaveless“marbling”orwhitefatthroughoutthemeat.Removeskinfrompoultry.Usecookingmethodssuch

asgrilling,broiling,poachingorstir-fryinginanon-stickpantoreducefat.Trya“meatless”mealincludingbeans,tofuorlentilsforlessfatandmorefibre.

Portions to Live By • Oneservingofwholegrainsis1/2cupcooked,notthe3or

morecupsservedinmostrestaurants!Toomuchofagoodthingisnotagoodthing.

• FormoredetailsonhealthyportionsseeEating Well with Canada’s Food Guideonlineatwww.healthcanada.gc.ca/foodguide.

Avoid Portion Distortion• Oneservingofwholegrainsis1/2cupcooked,notthe3ormorecupsservedinmostrestaurants!Toomuchofagoodthing

isnotagoodthing.• FormoredetailsonhealthyportionsseeEatingWellwithCanada’sFoodGuideonlineatwww.healthcanada.gc.ca/foodguide.

Prepare for Success• Prepareyourfoodswithlimited added fat, sugar and salt.Avoidfrying.• Addflavorwithfreshordriedherbs,spices,flavoredvinegars,lowfatmarinadesandlightdressings.

Great ideas for cooking with more flavor and less salt, sugar and fat can be found at your local library, book store or on line. The Heart and Stroke Foundation of Canada, the American Heart Association, the Canadian Diabetes Association and Dietitians of Canada all have great collections of healthy recipes available. Try one today.

Fat - Less Quantity, More Quality• Menofhealthyweightshouldkeeptheirdailyfatintaketo70gramsorless.Womenofhealthyweightshouldkeeptheir

dailyfatintaketo60gramsorless.Fruit,vegetablesandwholegrainsarenaturallylowinfat.Keepaddedfatstoaminimum.Usefoodlabelstochoosefoodswithlessfat.

• Chooseliquid or soft fatssuchasoliveoil,canolaoilorsoftnon-hydrogenatedmargarine.Liquidandsoftfatshavelesscholesterol-raisingsaturatedandtransfat.Avoiddeepfriedfoodsandproductswithhydrogenatedoilsintheingredients.Thiswillhelplimityourintakeoftransfats.

• Omega 3fatsarehearthealthyfatsfoundincoldwaterfattyfishincludingsalmon,mackerel,arcticchar,sardines,troutandherring.Two(2)servingsoffishperweekisrecommendedaspartofahealthybalanceddiet.PlantsourcesofOmega3’sincludeflaxseeds,walnutsandvegetablesoilssuchascanola.

Protein

Fruit

Protein

Vegetables

StarchStarch

Breakfast Lunch & Supper

In Moderation - sweets, caffeine & alcohol. • Limit sweets,candy,sugar,jam,honey,syrupregularsoftdrinkandsweetenedfruitdrinks.Cakes,pies,cookies

andmanypre-packagedsnackfoodsarehighincaloriesandlowonnutrients.Savechoicesofthesefoodsforspecialoccasions.

• Drinknomorethanfour (4) cups of coffeeorcaffeine-containingbeveragesperday.Carefulwithwhatyouadd:cream,sugarandflavoredsyrupscanaddalotofcaloriestoyourcup.

• Limit alcohol tolessthan2drinksperday.One(1)drink=12ozbottleofbeer,1.5ozliquor,4ozwine.

Reducing alcohol can promote weight loss and help you lower your blood pressure.

Supplements for Hypertension Control • CheckwithyourDoctor,DietitianorPharmacistbeforestartingasupplement.• HeartHealthyMixture=1/3groundflax,1/3oatbranand1/3psyllium.Use2Tablespoonsperdayaddedtofoods

orbeverages.• Omega3supplementshaveasmalleffectonreducingbloodpressure.Thiseffectisnotstrongenoughto

recommendfishoilsupplementtocontrolhypertension.

Food and Medication Interactions• ReviewyourmedicationswithyourDoctor,DietitianorPharmacist.• Saltsubstitutesbasedonpotassiumsuchas“NoSalt”or“HalfSalt”arenotrecommendedwithsomehypertension

medications.• Cautionwithgrapefruit,grapefruitjuice,pomelos,Sevilleorangesandnaturallicorice(glycyrrhizaeglabra).Certain

medicationsforhypertension,cholesterolandheartdiseaseinteractwiththesefoods.

Move your body, lower your blood pressure • Includingatleast30minutesofbriskactivity,suchaswalking,four(4)

ormoredaysperweekcanloweryourbloodpressure.• Startwithabrisk10minutewalkafewtimesperdayandincrease

graduallyfromthere.• Gentlestretchingexercisesincreaseyourflexibilityandreleasetensionin

yourmusclesandjoints.Aimfor4ormorestretchingsessionsperweek.• Strengthexercisesimprovemuscleandbonedensitykeepingyoustrong

andstable.Includethese2-4timesperweek.• Remembertostartslowlyandconsultyourphysicianbeforestarting

anewexerciseprogram

To Reduce Weight • Eatsmallerportionsoffoodsandrememberthebalanceoffoodsonyourplate:1/4protein,1/4starch(including

potatoes),1/2vegetables• Eat3mealsperday,nomorethan6hoursapart.Don’tskipmeals.Snackwithfruitbetweenmeals.• Choosefoodslowerinfatandsugar.Eatingstrategiesincludinglowglycemicindexchoicescanbehelpful.

Learnmorefromaregistereddietitian.• Aimforamaximumweightlossof1-2lbs(0.5-1kg)perweek.• “Waistloss”isasimportantasweightloss.FortipsonhowtotrimyourwaistseeourWaistingAwaynutrition

factssheet.

For more information on hypertension and healthy eating on the net go to:www.hypertension.ca,www.lowersodium.ca,www.sodium101.ca,www.dietitians.ca

Note: These guidelines are for people wanting to reduce the amount of salt or sodium in their diet. If a salt “restriction” is needed to help control more severe medical conditions, please consult with a Registered Dietitian to develop a more personalized low-salt/sodium meal plan.

Keeping active can lower your blood sugar, cholesterol, blood pressure, help you feel better, relieve tension and stress, improve your muscle tone and help you lose weight!

Vegetables and Fruit – with lots of colour!• Allfruitsandfruitjuices• Anyvegetablesexceptthoseon“Avoid”list• Lowsalttomatoorvegetablejuice• Lowsaltcannedvegetables,tomatosauce,tomato

paste

• Regularcannedvegetables• Pickledvegetables(e.g.sauerkraut)• Tomatoandvegetablejuiceswithmorethan400mg

sodium/serving• Instantorcannedpotatoes

FOODS TO CHOOSE FOODS TO LIMIT OR AVOID

Soup• Homemadesoupsmadewithoutsalt• Lowsodiumbrothorcannedsoups

• Meatextracts(e.g.bouillon,Oxo)• Regularcannedsoups,driedsoupmixes

The DASH Eating Plan – Dietary Approaches To Stop HypertensionFollowingtheDASHEatingPlanhasbeenshowntolowerbloodpressureandcholesterolbyemphasizingfruits,vegetables,andlow-fatdairy.DASHalsoincludeswholegrains,fish,poultryandnutsandbeans.Itislowinredmeats,sweetsandsugar-containingbeverages.

Tips for Following the DASH Eating PlanThenumberofservingsperdaylistedarefora2000calorieeatingplan.Rememberthatifyouaretryingtoloseweightyoushouldchooselower-caloriefoodsfromeachgroupandreplaceservingsofhigher-caloriefoodswithfruitandvegetables.MoredetailsonDASH,includingalowercalorieversion,areavailableonlineatwww.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

Lay a Healthy Foundation of fruit, vegetables and whole grains. Add protein and healthy fat choices. Use sweets sparingly.

Whole Grains• Wholeandmulti-grainbread,cereal,rice,pasta• Mostdrycereals,unsaltedcookedcereals• Unsaltedorlowsodiumcrackers

• Saltedcrackers,breadorrollswithsaltedtops• Packagedbreadcrumbs,breadingmixesandstuffing

mixes• Pre-seasonedriceorpasta“sidedish”packages• Instanthotcereals,wafflesandpancakes

Eating Plan for HypertensionNo added salt/sodium: 1500mgto2300mgofsodiumperdayReadfoodlabelsforsodiumcontent.Lookforlessthan400mgperserving.Lessthan200mgisbest!

Sweets(no more

than 5/week)

What’s a Serving?• 1 cup fat-free or low-fat fruit yogurt• 1/2 cup fat-free or low-fat frozen yogurt• 1 tbsp maple syrup, sugar or jam

• 1/2 cup cooked beans• 1/3 cup nuts• 2 tbsp sunflower seeds

• 1 cup fat-free or low-fat fruit milk or yogurt

• 43 g fat-free or low-fat cheese

• 1 slice bread• 1/2 cup dry cereal• 1/2 cup cooked rice,

pasta or cereal

• 1 cup lettuce• 1/2 cup other

vegetables

• 1 tsp oil or soft margarine• 1 tsp regular mayonnaise• 1 tbsp low-fat mayonnaise• 1 tbsp regular salad dressing• 2 tbsp light salad dressing

• 85 g broiled or roastedseafood, skinless poultry, or lean meat

• 1 medium fruit• 1/2 cup fresh, frozen,

or canned fruit• 1/2 cup dried fruit• 3/4 cup fruit juice

Beans,Nuts,

Seeds(1/day)

Low-FatDairy

(2-3/day)

Grains(preferably whole)

(7-8/day)

Vegetables,Fruits

(8-10/day)

Oils,SaladDressing,Mayo(2-3/day)

Seafood,Poultry,Lean Meat(0-2/day)

Here’showtheDASHdietwouldlooklikeifittooktheshapeofapyramid.Ifyouwanttofollowit,makesureyoupayattentiontotherathersmallservingsizes.

Aservingofgrainsforexample,isjusthalfacupofcereal,pastaorriceora28-gramsliceofbread.That’sfarlessthanatypicalbagel(110to140grams),aservingofmostcereals(onecup),orarestaurant-sizeservingofspaghetti(aboutthreecups).Servingsofseafood,poultry,meat,oils,fruits,andvegetablesarealsopetite.

FOODS TO CHOOSE FOODS TO LIMIT OR AVOID

Seasonings and Condiments • Unsaltedherbs,spicesandseasoningblends• Vanillaextract,lemon,lime,vinegar,cocoa,drymustard• Salt-freecondiments(e.g.salt-freeketchup)• Limitof1tsp(15ml)perdayof:barbeque,steakand

Worcestershiresauces,horseradish,ketchup,preparedmustard,relish,salsa

• Salt,seasalt,saltsubstitutescontainingsalt(e.g.HalfSalt)• Saltedherbsandseasoningblends-checkingredients• Meattenderizers• MSG(mono-sodiumglutamate)• Regularpickles,olivesandrelishes• Soysauceandorientalsauces(e.g.teriyaki)

Milk and Alternatives• Anyexceptthoseon“Avoid”list-chooselowfat• Limitof1.5oz(45g)hardcheeseperday-20%MForless• Limit1cup(250ml)perdayofoneofthefollowing:

buttermilk,maltedmilk,BreakfastAnytimeshake

• Milkshakes,MaltedMilkservingsover1cupperday• Chocolatemilkunlesshomemadewithcocoa• Processedcheeseslicesandspreads

Meat and Alternatives• Anyexceptthoseon“Avoid”list• Chooseleanorlow-fatchoices• Cannedfishwithoutaddedsalt-tuna,sardines• Driedbeans,peas,lentils.• Cannedbeans,rinsewellbeforeusingorchooselowsalt

versions.

• Salted,smoked,curedorpickledmeat,fish,poultryandeggs:luncheonmeats,

• Bacon,ham,sausages,wieners,cannedandsaltedfish• Saltednuts,nutbuttersandseeds• Conveniencefoods-cannedstews,pastas,chili

Fats and Oils• Anyliquidoil-canola,olive,“vegetable”• Non-hydrogenatedsoftmargarine• Limitcommercialsaladdressingto1tbsp(15ml)perday

• Baconfat• Cannedordriedgraviesandsaucemixes• Drymixesforsaladdressingsanddips

Sweets• Anyexceptthoseonthe“Avoid”list(inmoderation) • Commercialcakes,pies,pastries,dessertandinstant

puddingmixes

Snack Foods• Unsaltedpopcorn,unsaltedpretzels• Lowsodiumsnackcrackers

• Saltedchips,cheezies,pretzels,popcornandsnackcrackers

Beverages• Anyexceptthoseonthe“Avoid”list • Watertreatedwithwatersoftener

• Mineralwaterwithsodiumcontentgreaterthan200mgperliter

• SportsbeveragessuchasGatorade-unlessprolonged,intenseactivity

Low Sodium Eating Plan for Hypertension, September 2010DanielleAldous,BSc,RD(FromOriginal,2005:HeleneCharlebois,BSc,RD&JasnaRobinsonDI)©ContinuingMedicalImplementation®Inc.

Ottawa Cardiovascular Centre502-1355BankStreetOttawa,ONK1H8K7Phone: (613)738-1584Email: admin@ottawacvcentre.com

Other Nutrition Fact Sheets Available: EatingPlanforHighCholesterolEatingPlanforCongestiveHeartFailureEatingPlanforType2DiabetesWaistingAway–HealthyWeightManagementPotassiumModifiedEatingPlanPlease visit www.cvtoolbox.com for more information