The silent killer

The silent killer... High blood pressure shows next to no symptoms and many don't even know they have it.  In fact, one in four adults suffer from it.

High blood pressure can lead to; damage to your arteries in the form of artery damage and narrowing, and aneurysm.  Damage to your heart in the form of coronary artery disease, enlarged left heart and heart failure.  It can also damage your brain leading to transient ischemic attacks (TIAs), stroke, dementia and mild cognitive impairment.  High blood pressure can also damage your kidneys leading to kidney failure, scarring of the kidneys and kidney artery aneurysm.

The causes of high blood pressure are many; smoking, being overweight or obese, too much salt in the diet, lack of physical activity, more than 1 or 2 alcoholic drinks per day, stress, age, genetics, family history of high blood pressure, chronic kidney disease, adrenal and thyroid disorders and sleep apnea.

Many of these causes, although not all, are due to lifestyle, so change your lifestyle and you will most probably reverse your high blood pressure.

There are several things you can do on a nutritional level to help lower your blood pressure, there are certain foods that you SHOULD eat and others that you should AVOID.

What you should AVOID:

Obviously you should lower your salt intake as this is one of the things that raises blood pressure.  However, it isn't that easy.  Yes, you can certainly lower the amount you put in your home cooked food, but salt or sodium chloride has been used as a flavor enhancer and preservative for centuries.

Adults need between 1.2 and 2.4g of salt per day, however most adults are consuming far more than that.  A review of studies involving 3,230 participants showed that reducing salt intake by 4.4g per day reduced systolic blood pressure by 4.2mmHg and diastolic blood pressure by 2.1 mmHg.  Among the participants who had high blood pressure there were even bigger reductions of 5.4 mmHg (systolic) and 2.8 mmHg (diastolic).

Stay clear of processed foods and watch your added salt intake.

As already said above, more than one or two alcoholic drinks per day is associated with a systolic blood pressure reading of about 2.7 mmHg, and a diastolic reading of 1.4 mmHg - this is higher than in non-drinkers.

When you consume alcohol your blood pressure actually goes down first, only to rise later on and this rise is more likely to happen while you are awake than when you are asleep.  However, the more you drink means the greater your risk of having high blood pressure especially in men, but to a lesser extent in women too.

High intakes of caffeine increase blood pressure in the short term.  Caffeine is most commonly consumed in coffee and tea, but also in cola and in huge amounts in energy drinks such as Red Bull.

In a review of 5 clinical trials, the participants were given one or two cups of strong coffee, their systolic blood pressure increased to 8.1 mmHg and 5.7 mmHg diastolic blood pressure, up to three hours after drinking the coffee.  However response to caffeine is very different in each person, some people don't have a problem with it whereas others are very sensitive to it.  So analyze its effect on you as an individual.

Liquorice has an active ingredient called glycyrrhizic acid (GZA) but most liquorice sweets sold nowadays have very little real liquorice root in it and therefore very little GZA.  GZA causes sodium retention and loss of potassium, which contributes to high blood pressure, so you need to check the labels and be careful if it contains liquorice root.

What you SHOULD eat:

Vitamin C also known as ascorbic acid, is found in lots of fresh fruits and vegetables where an average serving contains between 10-40mg of vitamin C.

Vitamin C has been shown to improve blood pressure in a review of 29 short-term studies where participants were given 500mg of vitamin C per day over a period of eight weeks.  Their blood pressure improved significantly, with an average reduction in systolic blood pressure of 3.84 mmHg and 1.48 mmHg for diastolic blood pressure.

However, people who are susceptible to kidney stones should be careful with vitamin C consumption as it can contribute to the formation of kidney stones as the excess vitamin C is excreted via the kidneys.

Another advantage of increasing your vitamin C intake from fruits and vegetables is that you also increase your potassium intake which helps counter the effects of sodium.

You should all know by now that fiber is extremely important for good health.  Investigators found rolled oats or 25g of oat bran per day had systolic blood pressure at 2.7 mmHg lower and diastolic blood pressure was 1.5 mmHg lower than those who didn't include this amount of fiber in their diets.
that people who ate about 60g of

For on extra gram of total daily fiber, there was an extra 0.11 mmHg reduction in diastolic blood pressure.  The recommended minimum daily intake for fiber in adults is 30g for men and 25g for women.  Just make sure it is good quality fiber.

Inorganic nitrate is a compound found in beetroot.  During digestion, this compound is converted into nitric oxide, which in turn, causes arteries to dilate directly lowering the pressure within.

Beetroot juice has been shown to reduce systolic and diastolic blood pressure in adult men who already had high blood pressure.  They were randomly assigned to drink 250ml of beetroot juice per day for four weeks or given a non-active placebo.

Those drinking the beetroot juice reduced their blood pressure over 24 hours, with systolic blood pressure 7.7 mmHg lower and diastolic blood pressure 5.2 mmHg lower.  

Be careful with beetroot though as it is also very high in sugar.

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

Cold Season is coming!

Unfortunately, it's that time of year again... autumn arrives and with it colder weather, rain, and colds and flu and there is still winter to come!

Last week researchers revealed that taking ibuprofen doesn't help at all and it might just make you worse.  The British Medical Journal reported on a study where researchers from the University of Southampton in the UK, carried out a trial with 889 primary care patients from the age of 3 and over with acute respiratory tract infections (colds, sore throats).  The patients were randomly advised to take ibuprofen, paracetamol or ibuprofen and paracetamol.  The researchers then assessed symptom severity on days 2-4 plus temperature and antibiotic use and it was noted if the patients sought further consultations with their doctor for further complications or lingering symptoms.

The results showed that compared with paracetamol, ibuprofen or ibuprofen and paracetamol combined offered no advantage on the whole to patients with colds or sore throats.  The study found that patients advised to take ibuprofen or ibuprofen and paracetamol were more likely to return within a month with unresolved symptoms or new complications, compared with patients advised to take only paracetamol.  Between 50-70% more of the participants who took ibuprofen or ibuprofen with paracetamol came back.

This may be because ibuprofen reduces inflammation - and an inflammatory response is part of the body's immune response to the infection.

There are several popular remedies for treating these winter ailments, which one do you swear by?

Chicken Soup:

For centuries chicken soup has been thought to help relieve symptoms of cold and flu.  A study in the journal Chest in 2000 speculated that it helped prevent the movement of neutrophils (a form of immune cell) which cause some of the symptoms of a cold by stimulating the release of mucus.

A recent study in the American Journal of Therapeutics suggests that the protein in chicken soup provides carnosine a substance that increases the production of nitric oxide.

Catherine Collins, principal dietitian at St. George's Hospital, London, says:

"Protein is needed for the production of immune cells, but some chicken soups may have little protein in them.  You may as well have a glass of milk.  A bowl of good chicken soup might provide some nutritional benefit - as well as protein, the chicken will give you zinc, also good for the immune function - and just the fluid itself can be helpful.  But to say it will help you recover from a cold or flu is a step too far."

Probiotics:

These are used for preventing and treating norovirus, colds and flu.  Probiotics, also known as good bacteria, and prebiotics - which encourage good bacteria to grow in the gut - are thought to have a preventive effect, as well as treating illness.  A review of 63 studies by the Cochrane Library found that probiotics could reduce the length of time people had a stomach bug, such as norovirus by a day.  Also, a US study published in Paediatrics in 2009 found that giving children probiotic products twice a day reduced their incidence of colds and coughs.

Professor Glenn Gibson, a microbiologist at Reading University says:

"Probiotics help improve the immune response.  The majority of our immune defense is found in the gut wall and probiotics appear to boost the response from immune cells such as T cells and natural killer cells, which are part of the immune system.

"I think the evidence is most compelling for gut infections, but some studies found that taking probiotics speeds up the recovery from a cold by around a day."

You can find probiotics as supplements or in foods such as yogurts or prebiotics also en supplement form or in food such as cereal - personally I'd go for the supplements as far as prebiotics are concerned.  You will need to take them for a few days for them to work.

Honey and Lemon:

This is an ancient remedy for treating a cough and a sore throat.  Israeli investigators tested various honeys as a way to ease a cough in children, giving them either 10g of honey or date extract half an hour before bed.

The honey reduced the severity and frequency of the cough and improved the child's sleep better than the date extract, they wrote last year in the Journal Paediatrics.  Also a U.S Study found honey was better at reducing children's night-time cough than popular suppressant dextromethorphan.

Adam Frosh, a consultant ENT surgeon from the Lister Hospital, Stevenage says:

"The sugar in honey can give a pep up if you haven't been eating, but why honey should reduce a cough is not understood.  Manuka honey is thought to be antibacterial, but there has been no robust research into its use for fighting infections such as a sore throat."

As far as a hot lemon and honey drink are concerned:

"Hot drinks provide steam and warmth, which can soothe inflammation in the throat around the vocal cords.  The taste of citrus can give a strong feeling of wellbeing.  However, any hot drink would do really - but the effects will be temporary." 

Echinacea:

This is a common herbal remedy for speeding up the recovery from a cold.  A review of 14 studies published in The Lancet Infectious Diseases said it seemed to reduce the duration of a cold by 1.4 days.  But, a review from the Cochrane Library said evidence for its ability to help treat colds was "not fully consistent".

Another popular herbal treatment is Koloba (pelargonium).  In 2008 the Cochrane Library reviewed several studies on this medicinal plant and concluded that it may be effective in alleviating symptoms of bronchitis and colds in adults and children, but "doubt exists".

Professor Mike Gleeson, an expert in exercise and physiology at Loughborough University Says:

"There is no evidence that echinacea reduces the incidence of colds but it may reduce their duration by a bit.

"Koloba won't prevent a cold, but it has been shown to reduce the symptoms and duration of a respiratory infection.  Both remedies are thought to help improve white cell function - part of the immune response to bacteria and viruses."

Vitamin D:

Also known as the sunshine vitamin, it is important for bone health, but has also been recently linked to the immune system. The journal PLoS One published a review of 11 studies which says; that taking daily vitamin D pills has "a protective effect against colds and other respiratory infections".

Dr. Adrian Martinueau, a leader in respiratory infection and immunity at Barts and London Medical School, says that vitamin D can help reduce respiratory infections by making certain immune cells in the blood and lungs stronger:

"But it doesn't work for everyone.  For example, a study giving vitamin D to Mongolian children who were profoundly deficient found it had a dramatic effect on preventing colds, but a trial with adults in NEw Zealand who all had good levels found it had no effect."

How you take it also seems to be relevant:

"Some studies have involved giving one big dose a month but this does not seem to be as helpful as giving a smaller does of 10-50 micrograms daily."

The NHS recommends anyone over 65 or who has little sun exposure to take 10 micrograms daily.

Steam Inhalation: 

Putting your head over a bowl of steaming (not boiling) water is an age old treatment for colds especially the mucus build-up in the sinuses.  However,  a study published this month in the British Medical Journal found that using this technique for five minutes, three times a day had no benefit when tried on a group of 200 people with respiratory tract infections.

Adam Frosh, consultant ENT from the Lister Hospital says:

"The warm steam can soothe an inflamed voice box and help the cough associated with laryngitis.  It can also penetrate the sinuses and give a comforting feeling, although won't actually unblock them.

"Adding menthol may temporarily make you feel as if the nose is less congested - actually it isn't, menthol just makes receptors in the nose more sensitive to airflow but does not physically improve the air flow.  Use it for around five minutes, three times a day.

"It can be useful to do before going to bed if you are suffering from a night time cough."

Vitamin C:

Who hasn't heard of the need for Vitamin C to prevent and cure colds?  It became popular as a way to improve immunity back in the Seventies.  A recent review by the Cochrane Library of 29 studies involving more than 11,000 people found that regularly taking Vitamin C (the dose varied) did not affect the number of colds people developed unless they were a serious athlete, when it halved their risk of colds.

Professor Paul Little, Primary Care Researcher at Southampton University says:

"There is no evidence vitamin C will prevent a cold, and little that it will help when you have one."

So what do I do?

Well, one of the most effective things I have found is to take Zinc supplements the minute you start feeling the onset of a cold.  For me it helps considerably.  Obviously drink lots of water and hot drinks too.  Tell me what works for you... I'd be really interested to hear your remedies.

Social Nutrition:

You can make an appointment to improve your health with Social Nutrition either in person (Madrid) or online (Skype).  Just send an email to lucycarr@socialnutrition.com