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31 January 12
Dietary Control of Blood Pressure – It’s Not Just About Sodium Controlling blood pressure can be accomplished by exercise, losing weight if overweight, diet, and/or medication. Although most messages we hear about dietary control of hypertension focus on salt or sodium reduction, it is only one of four important minerals that affect blood pressure control. Ideally, our eating plan will limit sodium but it will, just as importantly, contain a good supply of three minerals important in controlling blood pressure: magnesium, potassium, and calcium. This recommendation is based upon extensive research behind the National Heart Lung and Blood Institute’s “Dietary Approaches to Stop Hypertension” or DASH Eating Plan.  DASH Eating Plan You might recall seeing the DASH Eating Plan as U.S. News & World Report’s winner of both the “Best Diets Overall” and “Best Diets for Healthy Eating” categories in their annual survey. This survey uses health experts to rank eating plans by various categories, including the two listed above as well as “Best Weight-Loss Diet,” “Best Diabetes Diet,” “Best Heart Healthy Diets,” “Best Commercial Diet Plans,” and “Easiest Diets to Follow.” In all categories except for the one that was not applicable (“Best Commercial Diet Plan”), DASH placed in the top ten for all rankings.   So, what is the DASH Eating Plan? The food groups that get star billing are nuts, seeds, legumes, fruits, vegetables, whole grains, low-fat dairy and lean proteins. Foods high in added sugars are the most severely restricted of all. Following this plan results in a nutrient intake that is high in magnesium, calcium, potassium, and fiber, generous in protein, and very low in added sugars, saturated fat, and cholesterol.  Food Sources of Magnesium and Potassium The large number of servings of fruits, vegetables, nuts, seeds, and legumes might seem like a lot, but to ensure an adequate intake of fiber, potassium, and magnesium, it is necessary. If you find that your MyNetDiary reports reveal a low intake of these minerals, check to see if there is missing data for those nutrients in the foods that you have logged. Food labels are required to list calcium, but not magnesium or potassium. I find that the USDA generic food items for basic unprocessed foods (e.g. nuts, seeds, legumes, veggies, dairy, and fruit) typically contain more nutrients than brand items. If you find that the brand you use has complete information but is not displayed, then you can edit the food item to include those nutrients if the item is “user contributed.” If it is a system-entered item, then you can take a photo of the food label and request an update if you have the iPhone app.  Or, you can simply copy and edit a system-entered food to include the full nutrient content. You can check nutrient levels in your daily log, but here is a sample list of foods particularly high in potassium and magnesium (values from MyNetDiary).Magnesium:  1 oz pumpkin seeds (173 mg), 1 oz sesame seeds (102 mg), ¼ cup wheat bran (90 mg), 1 oz almonds (80 mg), ½ cup cooked Swiss chard or spinach (77 mg), 1 oz dark chocolate (65 mg), ½ cup cooked black beans (61 mg).Potassium:  medium baked white potato (940 mg), medium baked sweet potato (564 mg), 1 cup yogurt (470 mg), ½ cup cooked spinach (423 mg), medium banana (423 mg), ¼ cup dried apricots (376 mg), 1 cup milk (376 mg). Consider upgrading your subscription if you are unable to track magnesium or potassium (calcium is included in all subscriptions). You can customize your nutrient goals for those three nutrients using the DASH guidelines (magnesium 500 mg, potassium 4700 mg, and calcium 1250 mg).Sodium:  2300 mg vs. 1500 mg The researchers who developed the DASH Eating Plan found that an intake of 2300 mg sodium along with a diet rich in magnesium, potassium, and calcium was effective at lowering blood pressure.  This is very helpful information for those of us still struggling to lower our sodium intake.  Once you reach an average intake of 2300 mg sodium, consider reducing your goal to 1500 mg if you belong to a higher risk group:  have high blood pressure and/or are middle-aged (or older) or African American. Have questions or comments about this post?  Please feel free to comment on MyNetDiary’s Forum or Facebook page.  I would love to hear from you! Best,Kathy Isacks, MPS, RD Consulting Dietitian for MyNetDiaryMore Resources: Harvard Health Publications. Beating High Blood Pressure with Food. Office of Dietary Supplements, National Institutes of Health.  Magnesium. Calcium. Contains useful information about food sources of these nutrients, not just supplement information.Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

Dietary Control of Blood Pressure – It’s Not Just About Sodium

Controlling blood pressure can be accomplished by exercise, losing weight if overweight, diet, and/or medication. Although most messages we hear about dietary control of hypertension focus on salt or sodium reduction, it is only one of four important minerals that affect blood pressure control. Ideally, our eating plan will limit sodium but it will, just as importantly, contain a good supply of three minerals important in controlling blood pressure: magnesium, potassium, and calcium. This recommendation is based upon extensive research behind the National Heart Lung and Blood Institute’s “Dietary Approaches to Stop Hypertension” or DASH Eating Plan.  

DASH Eating Plan

You might recall seeing the DASH Eating Plan as U.S. News & World Report’s winner of both the “Best Diets Overall” and “Best Diets for Healthy Eating” categories in their annual survey. This survey uses health experts to rank eating plans by various categories, including the two listed above as well as “Best Weight-Loss Diet,” “Best Diabetes Diet,” “Best Heart Healthy Diets,” “Best Commercial Diet Plans,” and “Easiest Diets to Follow.” In all categories except for the one that was not applicable (“Best Commercial Diet Plan”), DASH placed in the top ten for all rankings.  

So, what is the DASH Eating Plan? The food groups that get star billing are nuts, seeds, legumes, fruits, vegetables, whole grains, low-fat dairy and lean proteins. Foods high in added sugars are the most severely restricted of all. Following this plan results in a nutrient intake that is high in magnesium, calcium, potassium, and fiber, generous in protein, and very low in added sugars, saturated fat, and cholesterol.  

Food Sources of Magnesium and Potassium

The large number of servings of fruits, vegetables, nuts, seeds, and legumes might seem like a lot, but to ensure an adequate intake of fiber, potassium, and magnesium, it is necessary. If you find that your MyNetDiary reports reveal a low intake of these minerals, check to see if there is missing data for those nutrients in the foods that you have logged. Food labels are required to list calcium, but not magnesium or potassium. I find that the USDA generic food items for basic unprocessed foods (e.g. nuts, seeds, legumes, veggies, dairy, and fruit) typically contain more nutrients than brand items. If you find that the brand you use has complete information but is not displayed, then you can edit the food item to include those nutrients if the item is “user contributed.” If it is a system-entered item, then you can take a photo of the food label and request an update if you have the iPhone app.  Or, you can simply copy and edit a system-entered food to include the full nutrient content.

You can check nutrient levels in your daily log, but here is a sample list of foods particularly high in potassium and magnesium (values from MyNetDiary).

Magnesium:  1 oz pumpkin seeds (173 mg), 1 oz sesame seeds (102 mg), ¼ cup wheat bran (90 mg), 1 oz almonds (80 mg), ½ cup cooked Swiss chard or spinach (77 mg), 1 oz dark chocolate (65 mg), ½ cup cooked black beans (61 mg).

Potassium:  medium baked white potato (940 mg), medium baked sweet potato (564 mg), 1 cup yogurt (470 mg), ½ cup cooked spinach (423 mg), medium banana (423 mg), ¼ cup dried apricots (376 mg), 1 cup milk (376 mg).

Consider upgrading your subscription if you are unable to track magnesium or potassium (calcium is included in all subscriptions). You can customize your nutrient goals for those three nutrients using the DASH guidelines (magnesium 500 mg, potassium 4700 mg, and calcium 1250 mg).

Sodium:  2300 mg vs. 1500 mg

The researchers who developed the DASH Eating Plan found that an intake of 2300 mg sodium along with a diet rich in magnesium, potassium, and calcium was effective at lowering blood pressure.  This is very helpful information for those of us still struggling to lower our sodium intake.  Once you reach an average intake of 2300 mg sodium, consider reducing your goal to 1500 mg if you belong to a higher risk group:  have high blood pressure and/or are middle-aged (or older) or African American.

Have questions or comments about this post?  Please feel free to comment on MyNetDiary’s Forum or Facebook page.  I would love to hear from you!

Best,
Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

More Resources:

Harvard Health Publications. Beating High Blood Pressure with Food.

Office of Dietary Supplements, National Institutes of Health.  Magnesium. Calcium. Contains useful information about food sources of these nutrients, not just supplement information.

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

10 May 11
Fat, Carbs, and Protein: Which Macronutrient Percentage is Best for You?I often get asked what proportion of calories from fat, carbs, and protein is best for weight loss. There is no one right answer to this question. As long as your total calories intake is less than your total calories expended, you will lose weight. As long as the plan is nutritionally sound, allows you to eat foods that you enjoy, provides satiety, reduces risk of chronic disease and allows you to lose weight – it works!Having said that, there is a growing body of current research that supports using lower carb intakes to help curb appetite and lose weight. Last Friday, I had the pleasure of hearing Christopher Gardner, Ph.D. talk about his study on diet types (“The A to Z Weight Loss Study”).  This study compared weight loss, blood pressure and blood cholesterol levels in women assigned to one of four diets: Atkins, Zone, LEARN and Ornish. Here is a description of these four diets: Atkins: The New Diet Revolution (20 g carbs during Induction Phase and then up to 50 g carbs (about 15% calories from carbs, and fat and protein as desired) Enter the Zone (40% carbs, 30% fat, 30% protein) The LEARN Manual for Weight Management (55-60% carbs, <10% saturated fat: this diet is closest to the dietary guidelines) Eat More, Weight Less by Dean Ornish (<10% total fat – this is a very low fat diet) Interestingly, by six months and again at 1 year, study participants were not eating the macronutrients in the amounts recommended by their assigned diet books. At one year, the folks following the Zone and LEARN diets were averaging similar macronutrient percentages (46-48% carbs, 33-34% fat, 19-20% protein); whereas Ornish (very low fat) dieters were eating 52% carbs, 29% fat, and 19% protein. Atkins dieters were eating an average of 32% carbs, 46% fat, and 22% protein. It is striking that all four groups eventually drifted to nearly the same protein percentage – somewhere between 19-22% calories from protein. Note that this study had participants follow the diets without keeping records or using diet tracking tools. Food intake was collected by using multiple 24-hour recalls conducted by trained study personnel. In case you are wondering, the dieters assigned to the “Atkins group” lost the most amount of weight at both the 6-month and 1-year time points. They also had the best retention rate (88% vs. 76-78% for the other groups), and they experienced the most improvement with blood pressure and blood cholesterol levels (which is likely related to their weight loss). The Zone, LEARN, and Ornish groups did not differ significantly in terms of weight loss, but they all lost weight.    If you want to try low carb, do you have to do Atkins? Not necessarily. After all, the study participants assigned to the Atkins Diet didn’t even follow it – they drifted up to 32% calories from carbs and still lost weight and improved their blood cholesterol levels. The American Dietetic Association defines low carb as anything below 35% total calories.  Tracking is helpful since you have your data at your fingertips. You can figure out which macronutrient distribution works best for you. Start with whatever eating plan appeals to you first, then tweak it as you go. To check for nutrient adequacy, review your average intake at MyNetDiary online, under the Reports tab.  Remember, the bottom line for weight loss is calories. No matter what diet type or eating plan you follow to lose weight, you must eat fewer calories than you expend.  Have questions about this topic? Please post them on MyNetDiary’s Forum. I would love to hear from you!Best,Kathy Isacks, MPS, RDConsulting Dietitian for MyNetDiaryMore ResourcesChristopher Gardner. The Battle of the Diets: Is Anyone Winning? YouTube video of a talk he gave at Stanford.Institutes of Medicine, National Academies Press. Dietary Reference Intakes. Chapter 11:  Macronutrients and Healthful Diets.  Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

Fat, Carbs, and Protein: Which Macronutrient Percentage is Best for You?

I often get asked what proportion of calories from fat, carbs, and protein is best for weight loss. There is no one right answer to this question. As long as your total calories intake is less than your total calories expended, you will lose weight. As long as the plan is nutritionally sound, allows you to eat foods that you enjoy, provides satiety, reduces risk of chronic disease and allows you to lose weight – it works!

Having said that, there is a growing body of current research that supports using lower carb intakes to help curb appetite and lose weight. Last Friday, I had the pleasure of hearing Christopher Gardner, Ph.D. talk about his study on diet types (“The A to Z Weight Loss Study”).  This study compared weight loss, blood pressure and blood cholesterol levels in women assigned to one of four diets: Atkins, Zone, LEARN and Ornish. Here is a description of these four diets:

  • Atkins: The New Diet Revolution (20 g carbs during Induction Phase and then up to 50 g carbs (about 15% calories from carbs, and fat and protein as desired)
Interestingly, by six months and again at 1 year, study participants were not eating the macronutrients in the amounts recommended by their assigned diet books. At one year, the folks following the Zone and LEARN diets were averaging similar macronutrient percentages (46-48% carbs, 33-34% fat, 19-20% protein); whereas Ornish (very low fat) dieters were eating 52% carbs, 29% fat, and 19% protein. Atkins dieters were eating an average of 32% carbs, 46% fat, and 22% protein. It is striking that all four groups eventually drifted to nearly the same protein percentage – somewhere between 19-22% calories from protein. Note that this study had participants follow the diets without keeping records or using diet tracking tools. Food intake was collected by using multiple 24-hour recalls conducted by trained study personnel.

In case you are wondering, the dieters assigned to the “Atkins group” lost the most amount of weight at both the 6-month and 1-year time points. They also had the best retention rate (88% vs. 76-78% for the other groups), and they experienced the most improvement with blood pressure and blood cholesterol levels (which is likely related to their weight loss). The Zone, LEARN, and Ornish groups did not differ significantly in terms of weight loss, but they all lost weight.    

If you want to try low carb, do you have to do Atkins? Not necessarily. After all, the study participants assigned to the Atkins Diet didn’t even follow it – they drifted up to 32% calories from carbs and still lost weight and improved their blood cholesterol levels. The American Dietetic Association defines low carb as anything below 35% total calories.  

Tracking is helpful since you have your data at your fingertips. You can figure out which macronutrient distribution works best for you. Start with whatever eating plan appeals to you first, then tweak it as you go. To check for nutrient adequacy, review your average intake at MyNetDiary online, under the Reports tab.  

Remember, the bottom line for weight loss is calories. No matter what diet type or eating plan you follow to lose weight, you must eat fewer calories than you expend.  

Have questions about this topic? Please post them on MyNetDiary’s Forum. I would love to hear from you!

Best,
Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

More Resources

Christopher Gardner. The Battle of the Diets: Is Anyone Winning? YouTube video of a talk he gave at Stanford.

Institutes of Medicine, National Academies Press. Dietary Reference Intakes. Chapter 11:  Macronutrients and Healthful Diets.  

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.
24 February 11
Weight Loss Diets & Heart HealthChances are good that if you are reading this post, you are already in the process of losing weight if you are overweight. Fantastic! Since obesity (BMI ≥ 30) is one of the six major risk factors for heart disease, losing weight is very important for reducing your risk of heart disease.  The other five major risk factors are high blood pressure, high blood cholesterol levels (and low HDL level), smoking, diabetes and lack of exercise.Generally, weight loss from a combination of diet and exercise will result in heart healthy blood cholesterol changes, i.e., lower total cholesterol, LDL, and triglyceride levels and a higher HDL level. However, some diets might shift your blood cholesterol levels in directions that are not conducive to heart health. Ideally, get your blood cholesterol panel measured before and during weight loss so that you and your doctor can monitor the heart healthfulness of your weight loss eating plan.Low Fat, High Carb DietsIn an effort to lower calories while also lowering LDL and total cholesterol levels, many organizations recommend a low fat, calorie-controlled diet to lose weight. This is effective but there are a couple of red flags regarding this diet type. If you lower calories from fat and increase calories from carbs, you might inadvertently drop your HDL level and increase your triglyceride level. If the shift is small and your levels are still within healthy ranges (HDL > 40 mg/dl for men, > 50 mg/dl for women and triglycerides <150 mg/dl), then just keep monitoring your levels. However, if the shift results in levels that are outside of the healthy ranges, then consider increasing calories from the heart healthy fats (monounsaturated and polyunsaturated fats) while lowering calories from carbs (especially from sugars and refined carbs).Low Carb, High Fat DietsIf you prefer the appetite-lowering effects of a low carb diet such as Atkins, then be careful to have your LDL level monitored. Some research shows that the Atkins Diet, a diet where you carefully restrict grams of carbs, but do not restrict fats and proteins, can raise your LDL level. However, research also shows that HDLs can rise and triglycerides can decrease on this diet – which are heart healthy changes. Both low-fat and low-carb diets can promote long-term weight loss. For more information, see Foster et al.’s “Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial.”Monounsaturated and Polyunsaturated FatsRegardless of the type of eating plan you follow to lose weight, most of the fat you consume should be monounsaturated and polyunsaturated if you wish to support heart health. Monounsaturated fats are plant-based, with the richest sources coming from olive, canola, and peanut oils, nuts (especially peanuts, pistachios, almonds, cashews, hazelnuts, macadamias, and pecans), seeds (especially pumpkin and sesame), olives, and avocado. Polyunsaturated fats, including omega-3 fats, come from both plants and fish/seafood. Flax, walnuts, canola oil, and soybeans are especially high in alpha-linolenic acid, the omega-3 fat found in plants. EPA and DHA are the omega-3 fats found in fish and seafood. These fats are considered to have the most potent effects on heart health. Choices that maximize DHA and EPA content while minimizing contaminants (e.g. mercury and PCBs) are wild salmon (fresh, frozen, or canned), Atlantic herring, anchovies, Atlantic mackerel, sardines and trout. If these foods appeal to you, then consider exploring the Mediterranean diet. This is an eating style that can promote weight loss while maximizing heart health. Your intake will be mostly vegetables, fruits, whole grains, fish, a small amount of dairy (cheese or yogurt), meat, and poultry and 1-2 glasses of red wine.Have questions about weight loss, heart health, and fats? Let’s hear from you! Post your questions on MyNetDiary’s Forum.   Best,Kathy Isacks, MPS, RDConsulting Dietitian for MyNetDiaryMore ResourcesAmerican Heart Association. Nutrition Center.Harvard Health Publications. Healthy Eating for a Healthy Heart. 2009. This is a great booklet that summarizes nutrition recommendations based upon current research. Mozaffarian, D and Rimm, EB. Fish Intake, Contaminants, and Human Health: Evaluating the Risks and the Benefits. JAMA, 2006; 296:1885-1899. Access online at:  http://jama.ama-assn.org/content/296/15/1885.full.pdf+htmlWillett, WC and Skerrett, PJ. Eat, Drink, and Be Healthy. 2005. Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

Weight Loss Diets & Heart Health

Chances are good that if you are reading this post, you are already in the process of losing weight if you are overweight. Fantastic! Since obesity (BMI ≥ 30) is one of the six major risk factors for heart disease, losing weight is very important for reducing your risk of heart disease.  The other five major risk factors are high blood pressure, high blood cholesterol levels (and low HDL level), smoking, diabetes and lack of exercise.

Generally, weight loss from a combination of diet and exercise will result in heart healthy blood cholesterol changes, i.e., lower total cholesterol, LDL, and triglyceride levels and a higher HDL level. However, some diets might shift your blood cholesterol levels in directions that are not conducive to heart health. Ideally, get your blood cholesterol panel measured before and during weight loss so that you and your doctor can monitor the heart healthfulness of your weight loss eating plan.

Low Fat, High Carb Diets

In an effort to lower calories while also lowering LDL and total cholesterol levels, many organizations recommend a low fat, calorie-controlled diet to lose weight. This is effective but there are a couple of red flags regarding this diet type.

If you lower calories from fat and increase calories from carbs, you might inadvertently drop your HDL level and increase your triglyceride level. If the shift is small and your levels are still within healthy ranges (HDL > 40 mg/dl for men, > 50 mg/dl for women and triglycerides <150 mg/dl), then just keep monitoring your levels. However, if the shift results in levels that are outside of the healthy ranges, then consider increasing calories from the heart healthy fats (monounsaturated and polyunsaturated fats) while lowering calories from carbs (especially from sugars and refined carbs).

Low Carb, High Fat Diets

If you prefer the appetite-lowering effects of a low carb diet such as Atkins, then be careful to have your LDL level monitored. Some research shows that the Atkins Diet, a diet where you carefully restrict grams of carbs, but do not restrict fats and proteins, can raise your LDL level. However, research also shows that HDLs can rise and triglycerides can decrease on this diet – which are heart healthy changes.

Both low-fat and low-carb diets can promote long-term weight loss. For more information, see Foster et al.’s “Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial.”

Monounsaturated and Polyunsaturated Fats

Regardless of the type of eating plan you follow to lose weight, most of the fat you consume should be monounsaturated and polyunsaturated if you wish to support heart health. Monounsaturated fats are plant-based, with the richest sources coming from olive, canola, and peanut oils, nuts (especially peanuts, pistachios, almonds, cashews, hazelnuts, macadamias, and pecans), seeds (especially pumpkin and sesame), olives, and avocado.

Polyunsaturated fats, including omega-3 fats, come from both plants and fish/seafood. Flax, walnuts, canola oil, and soybeans are especially high in alpha-linolenic acid, the omega-3 fat found in plants. EPA and DHA are the omega-3 fats found in fish and seafood. These fats are considered to have the most potent effects on heart health. Choices that maximize DHA and EPA content while minimizing contaminants (e.g. mercury and PCBs) are wild salmon (fresh, frozen, or canned), Atlantic herring, anchovies, Atlantic mackerel, sardines and trout.

If these foods appeal to you, then consider exploring the Mediterranean diet. This is an eating style that can promote weight loss while maximizing heart health. Your intake will be mostly vegetables, fruits, whole grains, fish, a small amount of dairy (cheese or yogurt), meat, and poultry and 1-2 glasses of red wine.

Have questions about weight loss, heart health, and fats? Let’s hear from you! Post your questions on MyNetDiary’s Forum.   

Best,
Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

More Resources

American Heart Association. Nutrition Center.

Harvard Health Publications. Healthy Eating for a Healthy Heart. 2009. This is a great booklet that summarizes nutrition recommendations based upon current research.

Mozaffarian, D and Rimm, EB. Fish Intake, Contaminants, and Human Health: Evaluating the Risks and the Benefits. JAMA, 2006; 296:1885-1899. Access online at:  http://jama.ama-assn.org/content/296/15/1885.full.pdf+html

Willett, WC and Skerrett, PJ. Eat, Drink, and Be Healthy. 2005.

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

Copyright © 2010, 2011 by MyNetDiary.com
Themed by Hunson. Originally by Josh