2010 Dietary Sodium Shaking the Habit. 2 Hypertension Canada 2010 Hypertension The Silent Killer...

2010

Dietary Sodium

”Shaking the Habit”

2Hypertension Canada

2010

HypertensionThe Silent Killer

SodiumThe Quiet Food Additive


2010Outline

Sodium Where do we get it? What does it do? How is it a health risk?

Sodium and blood pressure Recommended sodium intake How to reduce your sodium intake Meal makeovers


2010Where do we get sodium?

Salt Table salt, sea salt, seasoning salts

Sodium additives such as Monosodium glutamate(MSG) Baking soda

Processed, takeout / restaurant foods


2010Sources Of Sodium

5


2010Why is sodium in our food ?

Prevents food from spoiling.

Performs some chemical functions in baking and processing.

Adds flavour.


2010What does sodium do?

In your body: Helps regulate your body’s fluid balance.

Too much sodium can increase the amount of water or fluid held in your body.

Excess fluid puts extra pressure on your blood vessels causing damage.


2010How is sodium a health risk?

Increases blood pressure which increases risk for: Stroke Cardiovascular disease Kidney disease Dementia


2010

Lifestyle risk factors for high blood pressure

Obesity High alcohol intake Inactivity Smoking Inadequate vegetable and fruit intake Inadequate milk product intake High dietary sodium intake


2010

Reducing Sodium Can Lower Blood Pressure and Risk

Reducing sodium intake will lower blood pressure. 1 in 3 Canadians with hypertension

could have normal pressure if they lowered their sodium intake.

Following a low-sodium diet could reduce the risk of heart attack or stroke by 25-30%.


2010 The lower your sodium intake, the lower your blood pressure will be

Sodium restriction is especially

important for people… Of African descent Over 45 years of age With conditions such as

Diabetes Kidney disease Heart failure


2010How much sodium do we need?

There are 2 reference points for sodium intake*

Adequate Daily Intake (AI) recommended average daily intake

Tolerable Upper lntake Level (UL) the highest average daily intake level that is likely to

pose no adverse health effects

*set by Canadian and US panel for Dietary Reference Intakes , 2005


2010

Sodium Intake Recommendations

Age (years) AI (mg/day) UL(mg/day)

1-3 1000 1500

4-8 1200 1900

9-13 1500 2200

Dietary Reference Intakes, IM 2005


2010


Age (years) AI (mg/day) UL(mg/day)

14-50 1500 2300

50-70 1300 2300

Over 70 1200 2300

Dietary Reference Intakes, IM 2005


2010

1500mg or 2300mg doesn’t mean much to me….

2300mg sodium = 1 level tsp table salt

1,500mg = ¾ tsp table salt



2010

So how do you think we’re doing meeting those recommendations?

What would you guess is the average daily sodium intake for a Canadian adults and children?

Sodium Intake of Canadian Adults


2010Sodium Intake

of Canadian Adults

2680 mgWomen

3575 mgMen

Average Daily Sodium Intake

Gender


2010Av. Sodium Intake* (mg/day)

of Canadian Adults

0500

1000150020002500300035004000

20-39yr 40-59yr

60 yr +

Men Women Total

*Does not include sodium added at the table or during home cooking


2010

The sodium intake of most Canadian children/youth

exceeds the UL

Health Reports, Vol. 18, No 2, May 2007

0

20

40

60

80

100

1-3 yr 4-8 yr 9- 13yr 14-18 yr

Male

Female

M & F

Upper Level 1500mg 1900 2200 2300

% above UL


2010

Why is our sodium intake so high?

1. Less home-cooked

meals Busy lifestyle! Want convenience Prepared food is always

available


20102. Bigger Portions

21 cups3 cups

Food packages are bigger now than ever. The more we eat, the more sodium we consume.


20103. Heavy Use Of Condiments

Ketchup Mustard Soy sauce Salad dressing Relish and pickles Olives Sauces

… are all high in sodium


20104. More Processed Foods

0100200300400500600700800900

1000

freshtomato

tomatopaste

cannedtomato

tomatosauce

tomatosoup

sodium (mg)


2010

Food industry must reduce sodium in its products

24


2010Processing Adds Sodium

To Food

Natural Food

Sodium (mg)

Processed Food

Sodium (mg)

Plain pasta 5 Pasta & sauce 800

Cucumber 2 Dill Pickle 385

Fresh salmon 56 Canned salmon 272

Cheddar cheese 176 Processed cheese 407

Coffee – milk & sugar

15 Cappuccino – from mix

250



1 cup plain pasta

5 mg sodium1 cup pasta & sauce

800 mg sodium

0100200300400500600700800

Pasta Pasta&Sc

mg Sodium



Medium cucumber

2 mg sodium

Medium dill pickle

385 mg sodium



1 oz. hard cheese

176 mg sodium

1 oz. processed cheese

407 mg sodium



Coffee-milk & sugar15 mg sodium

Cappuccino from mix

250 mg sodium


2010

Sodium Content of Restaurant Foods

Menu Item Sodium (mg)

Breakfast Egg Sandwich 840

Chicken Caesar Salad 570

12” Pepperoni Pizza 5960

Deluxe Cheeseburger & Medium Fries 1910

Fried Chicken Dinner 2280


2010Reduce Your Sodium Intake

At home Plan meals at least a day in advance.

Make more meals from unprocessed foods.

Gradually decrease the amount of salt used in cooking and at the table (this includes sea salt).

Use condiments sparingly.



At home Flavour food with lemon juice, fresh

garlic, spices, herbs and flavoured vinegars.

Try low-sodium seasoning mixes. Cook and bake with vegetable oil rather

than butter or margarine. Use tomato paste instead of tomato

sauce or soup in recipes.



At the grocery store Buy pre-prepared, convenience foods

that are low in sodium such as frozen vegetables, frozen shrimp, skinless & boneless chicken breasts and pre-cut salads and fruit.

Choose unsalted snack foods such as pretzels, nuts, seeds and crackers.



At the grocery store Read food labels and compare sodium

content between similar foods

Look for foods labelled salt-free, no added salt, low in sodium, or reduced in sodium.

Always check the Nutrition Facts table



Check the Nutrition Facts table for:

The mg sodium per serving (the lower, the better) Choose foods with 200 mg of sodium or less Choose foods with 10% or less Daily Value



When eating or “taking” out Choose salads and meals made with

foods low in sodium Ask for no salt or MSG to be added

during cooking Ask for sauces, spreads or dressings on

the side and use sparingly

Limit fast foods and take-out meals.


2010

Lower Sodium Vegetables and Fruit

Adults need 8 to 10 servings a day

For lower sodium: Choose fresh or frozen vegetables. Limit vegetables with sauce or instant mixes. Try making homemade salad dressing, or

use commercial dressings sparingly. Choose low sodium vegetable juices and

soups. Enjoy fresh, frozen, canned or dried fruit as

a snack and dessert.


2010Lower Sodium Grain Products

Eat 6 to 8 servings a day 3 servings should be whole grain

For lower sodium: Limit pastas and rice with prepared

sauces or seasonings. Choose cereals, breads, crackers and

pre-packaged baked goods with the lower mg sodium per serving. Use quick-cooking, rather than instant

oatmeal.


2010

Lower Sodium Milk and Alternatives

Have 2 to 3 servings a day. Choose lower fat milk and yogurt.

For lower sodium: Be aware of higher sodium content of

instant puddings, hot chocolate and flavoured coffee mixes.

Limit your cheese intake, especially processed cheese slices or spreads.


2010

Lower Sodium Meat and Alternatives

2-3 servings per day Choose lean meat, fish, poultry Eat legumes, nuts and seeds often

For lower sodium: Limit processed, cured, deli, smoked or breaded meats and poultry. Choose fresh, frozen or low-sodium canned fish. Rinse canned lentils, chick peas or beans, or

cook your own. Enjoy unsalted nuts and seeds.


2010Breakfast Menu Makeover

Menu 1,Higher Sodium

Sodium(mg)

CFG Menu+ Lower Sodium

Sodium(mg)

Commercial raisin bran muffin – largeButter – 2 pats

Flavoured coffee – 16 oz.

800

75

300

Multigrain bread – 2 slices

Peanut butter – 1 Tbsp

Banana

Coffee with 2oz 1% milk

300

75

1 32

Total 1175 408


2010Lunch Menu Makeover

Menu 1 ,High Sodium

Sodium (mg)

CFG MENU +Lower Sodium

Sodium (mg)

White pita bread – 1 smallDeli meat – 2 oz.Cheese slice – 1

Mustard – 1 tsp.Dill pickle

322

765332

56385

Multigrain bread -2 slicesLeftover roast beef – 2 oz.Lettuce and cucumberMustard – 1 tsp.Carrot sticksLow fat, fruit yogurt – 175g

300

37 0 56 60

123

Total 1860 576


2010 Snack Menu Makeover

9460Total

0 4

50

Apple Handful of natural almonds

Air popped popcorn with low-sodium seasoning – 6 cupsWater – 12 oz.

100

345

15

Chocolate chip cookies – 2

Nacho chips – 20

Cola – 12 oz.

Sodium (mg)


Sodium (mg)

MENU 1 +Higher Sodium


2010Dinner Menu Makeover

MENU 1 +Higher Sodium

Sodium (mg)


Sodium (mg)

Fast food chicken burger

Medium french fries

Ketchup – 1 Tbsp.

Milkshake – 16 oz.

990

540

110

350

Grilled chicken breast – 75gBaked potato Plain Yogourt – 1 Tbsp.

Tomato slices – 6Steamed broccoli – 1 cupCanned peaches-1/2 cupMilk 1% – 8 oz.

6433

10

11

25 5

122

Total 1990 270


2010Sodium Comparison

High sodium menu 5485 mg

Lower sodium menu 1258 mg


2010The Sodium Challenge

It requires effort and commitment to eat the recommended sodium levels.

If the current trend for convenience continues, the food industry needs to gradually lower sodium/salt content of foods.

Health Canada has a Sodium Working Group to develop and implement a Strategy to reduce sodium intake


2010

Recap: Healthy Eating for a Healthy Blood Pressure

Eat a healthy diet according to Canada’s Food Guide.

CFG = DASH diet guidelines(Dietary Approaches to Stop

Hypertension)

Choose lower sodium foods every day


2010Dietary Sodium Questions

1. Reducing your intake of salt or sodium may help you lower your blood pressure.

• TRUE • FALSE



2. Most Canadians have sodium intakes that exceed recommendations for health.

• TRUE• FALSE



3. Most of the sodium in the North American diet is from salt added at the table.

• TRUE• FALSE



4. The Nutrition Facts table tells you the number of milligrams (mg) of sodium in the whole package of food.

• TRUE• FALSE



5. “Instant” packaged foods and fast food restaurant meals generally have a very high sodium content.

• TRUE• FALSE


2010For More Information

Go to the websites:

www.mybpsite.cawww.lowersodium.ca

www.healthcanada.gc.ca/foodguidewww.dietitians.ca


2010DASH Diet Booklet

To download or order a copy of the Dietary Approach to Stop Hypertension (DASH) Diet booklet, go to :

www.nhlbi.nih.gov/health/public/

heart/hbp/dash/new_dash.pdf


2010

For your patients – ask them to sign up at www.myBPSite.ca for free access to the latest Information & resources on HBP

For health care professionals – sign up at www.htnupdate.ca for automatic updates and on current hypertension educational resources.

2010 Dietary Sodium Shaking the Habit. 2 Hypertension Canada 2010 Hypertension The Silent Killer...

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Transcript of 2010 Dietary Sodium Shaking the Habit. 2 Hypertension Canada 2010 Hypertension The Silent Killer...