Sodium, Diabetes, and Blood Pressure
High blood pressure, or hypertension, is very common among people with diabetes.
High blood pressure, or hypertension, is very common among people with diabetes. In fact, approximately 20 to 60 percent of people with diabetes also have hypertension, which is defined as a blood pressure reading above 140/80mm Hg. Having hypertension can increase your risk of stroke, coronary artery disease, retinopathy, nephropathy, and neuropathy. The blood pressure goal for a person with diabetes is to stay below 130/80 mmHg. Treatment for hypertension includes: lifestyle behaviors such as diet changes, including a low-sodium diet, exercise, weight loss, and medications.
Research shows that higher sodium intakes lead to higher blood pressure readings. In addition, some people have been found to be more "salt sensitive" than others, meaning that their blood pressure rises in response to a high salt intake more than others. Studies have shown that African Americans and people with hypertension or diabetes are generally more salt sensitive than other populations.
"I don't eat that much salt and I don't add it to my food." I hear this frequently from my patients with diabetes and hypertension. What these people often don't realize is that huge amounts of salt can be hidden in the products you buy. High-sodium foods include most processed foods, canned vegetables and soups, pretzels, potato chips, lunch meats, hot dogs, bacon, sauces, bottled salad dressings, and frozen dinners. Even those who don't add salt to their food may take in far too much sodium in processed foods.
One teaspoon of salt contains 2,400 milligrams (mg) of sodium, which is why someone on a low-sodium diet should definitely lose the salt shaker. But a low-sodium diet goes far beyond that. Many foods contain more than 1,000 mg per serving! Reading labels is crucial for anyone following a low-sodium diet. Any food that contains 140 mg of sodium or less per serving is considered a "low-sodium" food.
The average American consumes an estimated 4,000 mg of sodium per day. The American Heart Association recommends that healthy adults eat less than 2,300 mg of sodium a day and the National High Blood Pressure Education Program recommends an intake of less than 2,400 milligrams of sodium per day (2). Hospitals typically limit patients prescribed a low-sodium diet to 2,000 mg per day. The World Health Organization recommends an average daily intake of less than 2,000 mg per day, and urges governments to make efforts to reduce the amount of sodium added to processed foods.
What foods should a person eat on a low-sodium diet? Fresh foods are always best — such as fresh fruit, fresh vegetables, non-processed or cured meats, natural grains, and dried beans. Herbs should be used to flavor foods rather than salt. Experiment with adding fresh or dried oregano, basil, chives, or thyme to your foods. Garlic, onions, peppers, and lemon juice are also great flavor enhancers. No-salt seasoning products such as Mrs. Dash can be used to replace the salt in your salt shakers.
In addition to low-sodium diet, the DASH diet is also an effective dietary treatment of hypertension. It emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts. Stay tuned next month for more information on the DASH diet.
- American Diabetes Association. Treatment of Hypertension in Adults with Diabetes. Diabetes Care 26 (Suppl.1): S80-S82. 2003.
- Dickinson et al. Reducing the Population Burden of Cardiovascular Disease by Reducing Sodium Intake. A Report of the Council of Science and Public Health. Arch Intern Med 167(14): 1460-68. 2007.
- Luft et al. Heterogeneous responses to changes in dietary salt intake:the salt-sensitivity paradigm. Amer J Clin Nutr Vol 65, 612S-617S. 1997.
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