Sodium intake affects on heart vessels

Learn your sodium intake,read food labels. Do the math. How much are you getting on a daily basis?

medwireNews: Restricting salt intake reverses vascular endothelial dysfunction in people with moderately increased blood pressure (BP), shows a randomized study published in the Journal of the American College of Cardiology. To read more on this go to link at the bottom of this page.

How Sodium Causes Fluid Retention

The job of the kidneys is to filter the excess sodium into the urine so that the body can get rid of it. Many with heart disease and diabetes kidneys cannot handle all the extra work. The kidneys become less efficient at filtering the blood stream. This causes excess sodium to enter the bloodstream. Sodium attracts water to it and effect known as being osmotic. Water follows the sodium  and is drawn into the bloodstream. Excessive salt keeps the circulatory volume higher than it should be, creating and increased pressure in the blood stream and pressing on the blood vessel walls. The stress of the pressure on the walls creates thickening and narrowing of the vessel, leaving less space for the fluid in the blood vessels and raising resistance.  The body then requires higher pressure to move blood to the organs. The heart has to pump against this high pressure system.

I equate it to trying to blow up one of those kids balloons that is turned into animal shapes. They are really tough to blow air into, your cheeks get really sore – this is the resistance of air, similar to the resistance pressure of blood in the arteries. If you stretch the balloon (relax the arteries) then there is less resistance in blowing up the balloon (filling the artery with blood). Twenty percent  of the blood pumped from the heart goes  first to the kidneys.  High blood pressure within the kidneys cause  damage to the heart and to the vascular system in the kidneys. Salt makes you thirsty so limit salty foods, especially if on a fluid restriction.

I once had a patient who lost 45 lbs simply from adhering to low sodium diet. He had a very weak heart with only 10% ejection fraction meaning very limited pumping ability. So a weak heart and sodium in the diet made him retain fluid more than most. He began to measure and count sodium with every meal for a few months and was shocked by how much sodium he consumed even though he thought he ate pretty healthy. By reading labels, doing the math every day and making changes such as eating out less, ordering special, reviewing his medication he lost the fluid and added years to his life, not to mention the improved quality of life with less shortness of breath and fatigue by easing the workload of the heart.

                                  

According to the American Heart Association, eating more than the recommended 1500 milligrams a day puts you at direct risk of high blood pressure. Yet in America we consume an average of 3400 milligrams a day; more than twice what we should. While people with hypertension, heart and kidney disease are always advised by doctors to eat less salt, the AHA wants all of us to do this, whether or not our blood pressure is currently in the normal range.

http://newsroom.heart.org/news/change-your-salty-ways-in-only-241917

http://www.medwirenews.com/463/103163/Dietetics/Multiple_vascular_benefits_in_salt_restriction.html

Holiday Sweets

http://nomoreaddedsugar.com/2011/12/why-is-santa-fat-infographic/

The average American consumes 50 pounds of cookies a year and a lot of these will be consumed over the holidays.

How much added sugar is in a cookie? That all depends on the cookie of course but one little Oreo is 7 grams of added sugar. A homemade cookie can contain twice that.

So when you are craving cookies, how about clementines, grapes, pomegranate,  chestnuts, almonds dusted in chocolate powder, a cup of cinnamon tea, flavored coffee. If you do indulge try to keep in mind serving sizes. Follow it up with a walk or using some weights.

Do you eat vegetable and legumes?

While working in cardiac rehabilitation I regularly reviewed patients diets. One very consistent issue was lack of eating enough dietary fiber. Many do not get adequate intake of vegetables, legumes and seeds. It wasn’t uncommon for a significant other to shake their head and report their loved one never eats vegetables, or if they do it is only one or two types, such as corn, and carrots. When discussing intakes of legumes, you would see many look at you with that what is she talking about face.

Beans, dried beans, chick peas, soy beans, lentils, kidney beans.

All of these foods are chocked full of fiber and protein, and are loaded with nutrition including potassium, iron, magnesium, B vitamins. So how does one incorporate eating more legumes in their diet? Start slowly, to avoid gas issues, unless your house is full of teenagers who think it is hilarious to see who can produce the loudest and stinkiest farts.

Add chickpeas, black beans or kidney beans to salads. Mix lentils into your rice dishes. Throw a handful into soups. When making foods  such as sloppy joes, or tacos make with half the amount of meat and add in  a cup or two of pinto, black, white or navy beans.   Hummus is a great way to incorporate legumes. Use as a dip for vegetables, put on a Wasa or Rye crisp cracker.  Use beans as a base for casseroles. Soups are a great way to add beans and legumes.  If your beans are coming out of a can, rinse them first, this will reduce the sodium in them by almost half. Dried beans are very inexpensive, therefore try to get into a habit of one to two times per week soaking and cooking up a batch. A favorite snack may be roasted chickpeas. I like to season them up with olive  oil, cumin and chili peppers, but also use a Tuscon blend seasoning, or garlic and onion powder/salt.Lentils sprout very easily. Try putting a in a jar, cover with water, rinse with new water daily and in three days you will have lentil sprouts to add to your salads.  A side dish this week was roasted chickpeas, brussel sprouts and cauliflower. Roast each, but not until mushy, keep the crunch, then toss in a bowl with seasoning of choice and fresh parsley. Even the kids will eat this dish. How Fiber Works Infographic

Nuts, seeds, and legumes 3-4 servings per week for 1600 calorie diet 4-5 servings per week for 2000 calorie diet
  • 1/3 cup or 1 and 1/2 oz nuts
  • 2 Tbsp peanut butter
  • 2 Tbsp or 1/2 oz seeds
  • 1/2 cup dry beans or peas



 

 

 

 

 

There is very good evidence that eating legumes lowers the risk for heart disease.

Research by a group looking at almost 10,000 men published in November 2001 showed that even one serving of lentils or chick peas a week lowers the risk of heart disease. And the best part is that the more you eat, the lower the risk. Eating legumes 4 times or more per week reduces the risk of heart disease by as much as 22%.

The risk of developing diabetes or heart disease is lower when legumes are regularly eaten instead of protein foods that are high in fat, such as meats and cheeses and other whole-milk dairy produces, and refined carbohydrates that are low in fiber, such as baked goods made with sugar and white flour.

Some people avoid beans due to the intestinal gas or bloating they may produce. But if you gradually increase the amount of beans you eat over several weeks, you can overcome that concern. Soak beans for 8 to 12 hours, replacing the water every few hours, and this also helps. Slow cook them, to help reduce the gas-forming compounds. Adding a little baking soda will also help, or you can buy enzyme products at the drug store that break down the gas-forming parts of the bean. Note: Since legumes have high amounts of fiber, it is very important to drink plenty of fluids, especially water, to avoid constipation as you increase them in your diet.

 

legumes

Oh yeah I mentioned vegetable earlier didn’t I?

Well as I tell my kids I don’t care if they aren’t your favorite food, they are a very important part of a healthy diet.  Learn to like them. Branch out, try different vegetables. Fresh is best, followed by frozen, and lastly canned. We joined a CSA this year. This is a community sustained agriculture program where you own a share of the farm. You get a box full of vegetable every week. So when meal planning we start with what fresh vegetables are on hand? What needs to be used first and plan the meals around the vegetables. Now how many heart patients do this? Initially not many, but after suffering a heart problem many are open to trying it. Get on the web and look up recipes that include veggies you have on hand or are willing to use. Break out of the old cooking methods, try roasting, grilling, satisfying, steaming, fresh.  Again they might not be your favorite part of the meal, but such an important part. About half your plate should be veggies. When you are in need of a snack, make sure it includes vegetables.  Neufchatel cheese – mixed with your favorite spices, or veggies such as dried tomatoes and dried peppers, chives and garlic,  together with fresh-cut veggies are a good snack to always have on hand. Take one day to prepare a boat load of fresh veggies every week so they are on hand, and an easy go to snack item.

Vegetables

Eat a variety of colors and types
3-4 servings per day for 1600 calorie diet 4-5 servings per day for 2000 calorie diet
  • 1 cup raw leafy vegetables (about the size of a small fist)
  • 1/2 cup cut-up raw or cooked vegetables
  • 1/2 cup vegetable juice

Reducing the risk for a second heart attack

Many patients come through their heart procedures and feel they are cured. Unfortunately for most, heart disease is a chronic progressive disorder of the arteries in which deposits of cholesterol, calcium, and abnormal cells (that is, plaques) build up on the inner lining of the arteries.  Heart disease usually progressively deteriorates over time, whether due to normal bodily wear or lifestyle choices such as exercise or eating habits. This is a hard concept to grasp, and it doesn’t mean it is a death sentence either.

You can do everything right and still have further heart issues.

When patients struggle with this, I point out doing everything right may be why they survived, as approximately 50% of people do not survive their first heart attack.   It is so important for each person to know their body’s signs and symptoms and not ignore them. We don’t really know what makes coronary artery disease aggressive, there seems to be several factors. These factors include inflammation, c- reactive proteins, genetics, lifestyle to name a few.

Some patients will have multiple issues for years requiring frequent interventions and then be fine for many years before having another issue. On average coronary artery bypass  grafts  10 years out will be 50% blocked. Some patients will go 20-30 years before needing another intervention, yet others may not even go a week or month before having symptoms. Thirty percent of open heart surgery patients will continue to have angina symptoms after surgery. The drug eluding stents have  much lower rates of re-stenosis than the bare metal stents which average 25-30% re-stenosis rates, but in both cases the vessels often continue to develop blockages in other locations in the artery. If the bare metal stents are going to re-stenos the usually do so in the first 3-6 months.  It is vital to stay on the platelet inhibitors – Plavix (clopidogrel) as prescribed to prevent complications. Frequently second heart attack occur when patients stop taking their platelet inhibitor medication.

 

Try to adhere to lifestyle changes that will reduce your long-term risk after another heart attack. These  are known  risk factor reduction measures and they include achieving and maintaining an optimal weight, beginning a heart-friendly diet, ending tobacco use, achieving excellent control of diabetes and high blood pressure, and adhering to regular exercise. Lifestyle changes are much more challenging to start and adhere to.  If it were only as easy taking a pill. Keep your risk factors in the best control possible. Try to get blood pressure, blood sugar, cholesterol numbers to national guidelines. Exercise regularly. Eat a rainbow of color in fresh fruits and vegetables each day. Don’t let stress effect your health, manage your stress as best as possible, consider counseling.  

Listen to your body are symptoms creeping up on you?

Be on the lookout for new symptoms, for changes in energy patterns, note if you are becoming less active due to fatigue. I believe many can stave off a second heart attack if they are very tuned in to their bodies signals. Keep a diary or log of your symptoms, look or patterns especially increasing fatigue, increasing shortness of breath, increased use of nitroglycerin,  episodes of sudden weakness or profuse sweating. If you note a pattern don’t wait, contact your healthcare practitioner to discuss. They key is to prevent any further loss of heart tissue by preventing another heart attack. If you think you may be having another heart attack follow the emergency steps listed below:

  • Call 911 and describe what symptoms you’re feeling and where you are located.

  • Chew an aspirin (325 mg) at the first sign of an attack. Aspirin makes blood platelets less likely to stick to each other, assisting blood flow and reducing clots. Chewing the aspirin gets it into your blood stream much faster than if you drink it down with water.