Eat Right to Help Lower Your High Blood Pressure [Graphics Omitted] National Institutes of Health National Heart, Lung, and Blood Institute National High Blood Pressure Education Program NHLBI Obesity Education Initiative The National High Blood Pressure Education Program and the NHLBI Obesity Education Initiative are coordinated by the National Heart, Lung, and Blood Institute, National Institutes of Health. What is High Blood Pressure? My doctor told me I have high blood pressure. What is high blood pressure? It means that my heart has to pump harder than it should to get blood to all the parts of my body. This raises my chances for a stroke, and heart and kidney problems. Does that mean you could have a stroke, heart attack or kidney failure? Yes. But if I lower my pressure, I will lower my chances. You should ask about your blood pressure too. That is a good idea. I will go and get my pressure checked. You Can Lower Your Blood Pressure If it is high, can you really lower it? Yes. That is the good news. The doctor told me to: * lose weight, since I weigh too much. * be more active. * eat fewer foods high in salt and sodium. * cut back on alcohol. The doctor told me what foods to eat and gave me a booklet. This will remind me what to do - to eat some foods more often and others less often. I feel better knowing that you can lower your blood pressure. Lose Weight First I need to lose weight. Here is what I need to do: * eat less fat and calories. This is a good first step. * cut back on foods high in sugar like soda and candy. * eat smaller amounts of foods at meals. * eat fewer snacks during the day. My blood pressure will probably go down when I lose weight. Foods High in Fat Fats and oils (like butter, margarine, vegetable oils, lard, fat back, salt pork, meat drippings, gravy) Fatty meats (like hot dogs, bacon, bologna, salami, corned beef, regular ground beef, ribs, sausage) Whole milk, 2% milk, cream, ice cream Most cheeses (like cream cheese, cheddar, American) Many snack foods (like chips and nuts) Fried foods (like fried chicken and french fries) Most cakes, pies, and pastries Many cookies Most fast foods Be More Active Next, I need to be more active. Being more active also will help me to lose weight and help my blood pressure go down. To Be More Active Everyday Take a walk Use the stairs Get off the bus one or two stops early Park farther away from the store Go for a bike ride Work in the garden Go dancing These are things that would make me feel better too. For sure. Doing them with a friend will help me to do them. We can start today. How about taking a walk with me after dinner. Fix Foods The Low-Sodium Way I need to cut down on salt and salty foods. Eating less salt and sodium also can help my blood pressure go down. I know about salt. But what is sodium? I see it on labels all the time. Sodium is a part of salt. It also is a part of mixtures used to flavor and preserve foods. How can we fix good tasting foods with less salt and sodium? Listen to these tips: * Try to cook from scratch. Start with foods low in salt and sodium. * Use herbs, spices, and fruit juices to season food. * Do not add salt to your food when cooking or at the table. * Rinse canned foods like tuna and canned vegetables to remove salty juices. Shake On The Herbs And Spices basil bay leaf chili powder cinnamon cumin curry powder dry mustard garlic powder, not garlic salt onion powder, not onion salt oregano paprika parsley pepper, black and red poultry seasoning thyme no-salt spice blends (try the recipe for Hot 'N Spicy Seasoning) Some of these herbs and spices sound good. Tonight, I will bake the chicken with some lemon juice and oregano. And in the rice, I will add lots of parsley instead of salt for flavor. Adding herbs will help us to cut back on sodium. And, the food will still be tasty so we won't miss the salt. Fixing foods this way seems easy enough. I bet we can have some pretty good meals. This recipe for Hot 'N Spicy Seasoning also sounds good. Maybe I will try it next week. Hot 'N' Spicy Seasoning 1/4 cup paprika 2 tablespoons oregano 2 teaspoons chili powder 1 teaspoon garlic powder 1 teaspoon black pepper 1/2 teaspoon red pepper 1/2 teaspoon dry mustard Mix all of the above in a bowl. Store in airtight container. Tastes good on meat, poultry, or fish. Instead of salt, sprinkle some on the food and then cook it as you usually do. Or, mix some with plain bread crumbs and then coat the meat with the crumbs. If you like it very spicy, use more. We could start packing our lunches and snacks for work. It is cheaper than buying lunch and this way we get what is good for us. A lot of food you eat out is high in fat, calories, and sodium. Snack On... Bagels, raisin toast, or English muffins with jelly and a little margarine Air-popped popcorn with no salt or butter unsalted pretzels and crackers Low-fat cookies (animal crackers, fig bars, gingersnaps) Fruits, vegetables Fruit juices and drinks Nonfat frozen yogurt, sherbet, popsicles Hard candy, jelly beans Instead Of... Salted popcorn with butter Salted pretzels and crackers Salted chips French fries Pork rinds What about breakfast? I know sausage, bacon, and biscuits are high in sodium and fat. We can have some cereals, toast, and fruits for breakfast. They are quick to fix and easy to clean up. We could even have leftovers from dinner for breakfast. I like those ideas. We should think about how to put this together. Menu Ideas Breakfast Shredded wheat with banana Skim or 1% milk Toast with a little margarine Coffee with skim or 1% milk Lunch Lean roast beef sandwich on whole wheat bread with lettuce and tomato (easy on the mayonnaise) Fig bar cookies Apple Skim or 1% milk Snack Orange Dinner Spaghetti with turkey meat sauce Steamed green beans with oregano Green salad with cucumber, tomato, carrots, and a small amount of oil and vinegar dressing Skim or 1% milk Nonfat frozen yogurt Snack English muffin with jelly and a little margarine Recipe Spaghetti with Turkey Meat Sauce 1 teaspoon olive oil 1 pound ground turkey 1 can (28 ounce) tomatoes, cut up 1 cup chopped green pepper 1 cup chopped onion 2 cloves garlic, minced 1 teaspoon oregano 1 teaspoon pepper 1 pound spaghetti Heat oil in a large skillet. Add turkey; cook for 5 minutes, stir a few times. Drain fat. Stir in tomatoes with their juice, green pepper, onion, garlic, oregano, and pepper. Boil; turn down heat. Put lid on pan and let cook on low heat for 15 minutes. Stir a few times. Take off cover; cook on low heat for 15 minutes more. In another pot, cook spaghetti in boiling water for 15 minutes. Do not add salt. Drain well. Serve sauce over spaghetti. These meals sound like something I would like to eat. They do sound pretty good. Buy Foods Low in Sodium Most of the foods in these meals are easy to find in the store. But, we will need to change some of the foods we buy. How do you know if foods are high in sodium? Sometimes you can taste it. And sometimes you cannot. Your food will have more sodium if you add salt to it. Also, foods that you buy already made can be higher in sodium, like some TV dinners. I know foods like lunch meats and cheese are salty because I get thirsty after I eat them. They are also high in fat. When I shop, I always try to buy the food that has the least amount of sodium. I look on the label for the words sodium or salt. The food may be high in sodium if these words are listed first or a couple of times. Ingredients: wheat flour, salt, sodium sulfate, malt Also, the amount of sodium is listed on the label. Nutrition Information Serving size...................... calories.......................... fat............................... sodium............................50 mg Foods marked no salt added, low sodium or reduced sodium are good to buy. Buy More Often... Chicken and turkey (take off skin) Fish Lean cuts of meat Skim or 1% milk, evaporated skim milk Cheeses lower in fat and sodium (like low-fat cheddar, part- skim mozzarella) Low-fat or nonfat yogurt Margarine, vegetable oils, vinegar Fresh, frozen, or canned fruit Fresh, frozen, or no salt added canned vegetables Plain rice and pasta English muffins, bagels, loaf breads, tortillas, pita Cold (ready-to-eat) cereal and cereals cooked on the stove Spices and herbs Buy less often... Fatty cuts of meat Smoked foods Lunch meats, bacon, and sausage Buttermilk Most cheese spreads and cheeses Most salad dressings Fat back, salt pork Toppings and sauces (like ketchup, mustard, butter, gravy, and barbecue, soy, and cheese sauces) Regular canned soups, instant soups Regular canned vegetables Instant hot cereals Pickles and olives Salty crackers and salty snack foods Garlic salt, celery salt, and onion salts Cut Back On Alcohol The doctor also said I need to cut back on alcohol. How much do you need to cut back? The most I can have is 1 or sometimes 2 drinks a day. A small glass of wine, one can of beer, or a shot of liquor counts as one drink. I really do not mind. Lowering my blood pressure is more important than having a beer. You May Need Medicine What if your blood pressure does not go down? The doctor said I will have to take medicine everyday to help lower my pressure. The medicine will work better if I lose weight, eat right, and be more active. I heard that the medicine can make you feel sleepy. If the medicine bothers me, the doctor can either change it or change the amount. Will the medicine cost a lot? There are many kinds. I can ask the doctor to give me one that works for me and costs the least. Speak Up and Ask When the doctor gives any medicine for high blood pressure, ask about: * when to take it. * what to eat or drink with it. * what other medicine is OK to take at the same time. Expect Your Blood Pressure To Be Lower It seems like you have a really big role in lowering your blood pressure. You can eat foods lower in sodium, lose weight, be more active, cut back on alcohol, and take your medicine. And my doctor can help me too. I will have my blood pressure checked again in a few weeks to see how I am doing. I may have to make more changes if it is not low enough. I think I am well on my way to lowering my blood pressure. Get More Help Ask your doctor, dietitian, or nurse for more help in choosing foods and fixing meals. You can also get more information from: National High Blood Pressure Education Program P.O. Box 30105 Bethesda, MD 20824-0105 My Blood Pressure Date_______________Reading_____________ Notes___________________________________________________ _________________________________________________________ Date_______________Reading_______________ Notes______________________________________________________ ____________________________________________________________ Date________________Reading_______________ Notes_______________________________________________________ ____________________________________________________________ Foods To Choose When You Shop Fruits and Vegetables Fresh, frozen, canned, or dried fruits (like oranges, apples, bananas, grapes, berries, prunes, peaches, melon, fruit cocktail) Fresh, frozen or no salt added canned vegetables (like green beans, carrots, greens, zucchini, cabbage, tomatoes, broccoli, squash) Fresh, frozen or canned fruit juices Breads, Cereals, Pasta, Rice, Dry Peas and Beans Sliced breads (like wheat, rye, or white) Sandwich buns, dinner rolls, pita breads, English muffins, bagels Taco shells, plain tortillas Unsalted low-fat crackers (like graham crackers) Cooked hot cereals (not instant) Rice Pasta (like plain noodles, spaghetti, macaroni) Dry peas and beans (like split peas, black-eyed peas, chick peas, kidney beans, navy beans, lentils, soybeans) Herbs and Spices Choose one from the list above. Write it on the line to remind you to pick it up. ____________________________________________________________ Foods To Choose When You Shop Tear off this list and take it along when you shop. Choose these foods more often. Meat, Poultry, Fish, and Shellfish Chicken or turkey Fish Lean cuts of meat Beef: round, sirloin, chuck arm, loin Pork: leg, shoulder, tenderloin Lean ham and extra lean ground beef Dairy Products Skim or 1% milk Low-fat or nonfat yogurt Cheeses lower in fat and sodium Fats and Oils (Use only small amounts) Margarine (liquid, tub, stick, or diet) Oils (like canola, corn, safflower, olive, peanut, or sesame oil) Sweets and Snacks (Don't choose these too often, if you are watching your weight. Some may be high in calories) Popsicles, frozen yogurt, sherbet Angel food cake Fig bar cookies, gingersnaps, animal crackers, vanilla wafers, jelly beans, hard candy Plain popcorn, unsalted pretzels DISCRIMINATION PROHIBITED: Under provisions of applicable public laws enacted by Congress since 1964, no person in the United States shall, on the grounds of race, color, national origin, handicap, or age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity (or, on the basis of sex, with respect to any education program or activity) receiving Federal financial assistance. In addition, Executive Order 11141 prohibits discrimination on the basis of age by contractors, and subcontractors in the performance of Federal contracts, and Executive Order 11246 states that no federally funded contractor may discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Therefore, the National Heart, Lung, and Blood Institute must be operated in compliance with these laws and Executive Orders. For sale by the U.S. Government Printing Office Superintendent of Documents Mail Stop: SSOP, Washington, DC 20402-9328 ISBN 0-16-038127-4 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health NIH Publication No. 92-3289 November 1992