Archive for Monday, April 30, 2007

Monday Medical: Shaking out sodium, potassium

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Imagine for a minute a two-sided balance scale, much like the mythical scales held by blindfolded Lady Justice. Do you have that image? Now, on one side of the scale, place all the high-sodium, prepared foods you eat on a regular basis: a can of chicken soup, chips, crackers, a frozen dinner. Also add to that side of the balance every meal you eat from a restaurant.

On the other side of the scale, place all potassium-rich fruits and vegetables you eat regularly: bananas, apricots, oranges, spinach, acorn squash, cantaloupe. Whole-grain breads and cereals also belong on this side.

At this point, if you're at all typical, your scales are heavily weighted in favor of sodium. To even things out a bit, you can add potatoes to the potassium side. Unfortunately, fast-food fries come with so much salt that they belong on the other side of the scale.

Sodium and potassium are out of balance in the American diet. As a result, one of every three adults has high blood pressure, a major risk factor for stroke, heart attack and heart failure. One look at the imaginary scales will give you a very simple solution: you need to eat more fresh fruits and vegetables and fewer processed convenience foods.

Sodium and potassium are minerals that the body needs, and they basically work in opposition to each other to maintain a proper fluid balance in cells and control blood pressure.

Dietary guidelines today recommend a potassium/sodium ratio of 2:1 to 3:1; yet the typical American diet actually has those ratios reversed.

The kidneys correct the imbalance, but at a price. Fluid retention, an increase in blood pressure, calcium loss and a risk of heart disease, osteoporosis and other chronic diseases can result.

Sodium restriction is an important part of the treatment and prevention of high blood pressure. It should be a priority for all of us. The recommended level for healthy adults is 1,500 to 2,300 milligrams a day. Most people consume much more than this amount.

As a preservative and flavor-enhancer, salt is used generously in canned and processed foods. Supermarket shopping requires vigilant label reading. When you're eating out, inquire about how food is prepared.

Eat as many meals at home as possible, preparing food from scratch and using herbs, spices, pepper, lemon and garlic for seasoning. In addition to the added sodium, food processing tends to destroy whatever potassium was in the food originally. Potassium levels are highest in fresh foods.

The effectiveness of the DASH (Dietary Approaches to Stop Hypertension) diet can be attributed in part to its high potassium content. This diet calls for five servings a day of both fruits and vegetables, and generous portions of whole grains, nuts and legumes. The diet also recommends liberal quantities of low-fat dairy products, such as non-fat yogurt.

Studies have found the DASH diet more effective than sodium restriction alone in lowering blood pressure. A combination of the DASH diet and sodium restriction is even better. In addition, several large population-based studies have found that persons eating a potassium-rich diet had a substantially reduced risk of stroke.

Getting enough potassium should not be difficult because the mineral is prevalent in many foods. Too much cooking and too much processing tend to destroy it, however. And too much sodium tends to deplete the body's supply of potassium.

The answer is simple: to keep the nutrition scales in a healthy balance, choose foods that are fresh, whole and natural.

Lisa A. Bankard coordinates wellness and community education at Yampa Valley Medical Center.

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