The importance of a sodium-restricted diet in hypertension

“THE association between sodium and hypertension has been firmly established,” states Dr. Virginia Claudio, a registered nutritionist-dietician and co-author of the Basic Diet Therapy for Filipinos.

According to Dr. Anne Harley, chapter contributor of Pathophysiology: Reviews and Rationales for Nursing: “Hypertension is a [condition of] sustained blood pressure (BP) that is greater than normal, usually greater than 140 mmHg systolic and 90 mmHg diastolic.”

She writer further that “Hypertension is a silent killer because many clients do not have symptoms.”

For health experts, a high sodium dietary intake may predispose one to hypertension.

In 1998, the Hypertension Detection and Follow-up Program of the US recommended that among the measures to institute for all diagnosed hypertensive patients is to restrict sodium consumption to no more than 70 mEq per day or 1.6 grams.

Dr. Claudio says “About 50 to 60 percent of hypertensive patients experience a reduction in BP when dietary sodium is restricted.”

Unfortunately, sodium is almost present in all food, processed or unprocessed and whether seasoned with salt or not.

According to the 1998 Camara-Besa report on the sodium content of Philippine food, an average Filipino diet without added salt contains 1.0 to 5.8 grams of sodium.

“Salt is added during processing and it may come in forms such as preservatives, flavour enhancer, glazing, thickener and texturizer and all of these are in the form of sodium salts” explains Dr. Claudio.

“When ‘patis’, ‘toyo’ [soy sauce], ‘vetsin’ [mono sodium glutamate] and other salty condiments are added to food to make it more palatable, an increase in sodium content as high as seven to 15 grams per day is noted,” she adds.

Meanwhile, the Managing Chronic Disorder maintains that table salt is about 40 percent sodium and that one teaspoon of salt is equivalent to two grams of sodium.

Treatment of hypertension, states The Lippincott Manual of Nursing Practice, involves drug therapy and lifestyle modification that includes dietary sodium intake restriction.

In terms of dietary sodium restriction, it recommends adhering to the DASH diet (Dietary Approaches to Stop Hypertension) that enumerates such food as fruits, vegetables, low fat dairy products, fiber and low in saturated and total fat.

More particularly, the DASH diet recommends daily consumption of the following food groups: 1) seven to eight servings of grains and grain products such as whole wheat bread, muffin, bagel, oatmeal, cereals; 2) four to five servings of vegetables like tomatoes, potatoes, carrots, peas, squash, broccoli, beans, sweet potatoes; 3) four to five servings of fruits such as bananas, grapes, oranges, melons, pineapples; 4) two to three servings of low fat or non fat dairy- skim milk, non-fat or low-fat yogurt, non-fat cheese; and 5) two or less serving of meat, fish and poultry.

On the other hand, the Managing Chronic Disorders recommends the following sodium-reduction measures: 1) read labels on medications and food; 2) buy only fresh fruits, meats and vegetables instead of processed and canned foods; 3) you may substitute spices and lemons for salt; 4) watch out for hidden sodium like in carbonated beverages, non dairy creamers, cookies and cakes; and avoid salty food like bacon, sausage, potato chips, pickles and some cheeses.

Lastly, it emphasizes other things worthy to consider in avoiding sodium in the diet that includes: 1) condiments such as ketchup contain high amounts of sodium; 2) not all food high in sodium tastes salty; 3) other not-so-known food that are high in sodium content are baking powder, baking soda, barbecue sauce, chilli sauce, cooking wine and softened water; and 4) medications and other non food items contain sodium such as ‘Alkaliners’ for indigestion, laxatives, aspirin, certain cough medications, mouthwashes and toothpastes.

According to the data of the Department of Health, hypertension ranks fifth among the top 10 leading causes of morbidity in the country.

We can actually choose to resist being part of the statistics in the future by adhering to the low dietary salt intake at present.

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