YOUR DIETITIAN: Eating your way to lower blood pressure

May is National high blood pressure awareness month. High blood pressure can creep up on you unnoticed. Most of the time high blood pressure doesn't have any symptoms until it becomes a health crisis such as a stroke, aneurysm, heart attack or vascular dementia. Experts estimate that 46 percent of adults with high blood pressure don't realize they have it. That is why the National Institute of Health recommends everyone should have their blood pressure checked once a year. Lowering blood pressure naturally Exercising, quitting smoking, and losing excess pounds can help to lower blood pressure. In addition, daily eating foods rich in three minerals has been proven to lower blood pressure. The three minerals are potassium, magnesium and calcium. Eating foods high in these minerals along with eliminating foods high in sodium can significantly lower blood pressure — without medication. This style of eating is called the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension. (Hypertension is the medical term for high blood pressure.) Limit sodium (salt) Salt is sodium chloride. High intakes of sodium cause the body to retain water — resulting in higher blood pressure. Over time, a high sodium intake also damages the heart. It drastically thickens and stiffens the walls of the left ventricle of the heart (the heart's main pumping chamber). This makes it harder for the heart to effectively pump blood. Unfortunately, most people get way too much sodium (salt) — especially when they eat out or eat prepared packaged foods. Most sodium (salt) is hidden, not added at the table. Restaurant foods, including pizza, are notoriously high in salt — providing an entire day's worth of sodium in just one meal. At home, sodium is hidden in processed meats (luncheon meats, hot dogs, sausages), TV dinners, prepared foods, rice and pasta mixes, processed cheeses and condiments such as pickles and olives. Foods lowest in sodium include fresh meats and poultry; eggs; unseasoned fresh fish; frozen seafood; fresh sweet and white potatoes and other fresh vegetables; frozen or low-sodium canned veggies; fresh, frozen, canned and dried fruits; unseasoned rice and pasta; quinoa, barley and farro; oats; milk; natural aged cheeses (not processed cheeses); yogurt, ice cream, pudding and custard; unsalted or low-sodium nuts. Increase potassium-rich foods The most important mineral that helps to lower blood pressure is potassium. Most Americans get twice the recommended intake for sodium and only half the recommended amount of potassium. This is exactly the opposite of what the body needs to maintain normal blood pressure. Research has shown that getting twice as much potassium as sodium can significantly lower blood pressure. To get this ratio of potassium to sodium intake, simply choose foods lower in sodium and add foods rich in potassium to meals and snacks. Eating plenty of foods high in potassium causes the kidneys to excrete more sodium and water. This lowers blood pressure. The top potassium-rich foods include avocados, baked* potatoes (white and sweet), winter squashes (acorn, butternut), lima beans, leafy greens, dried beans and lentils, cantaloupe, bananas, tomatoes and kiwifruit. *Baked potatoes contain twice the potassium as boiled, mashed or fried. Half the potassium in potatoes is lost when potatoes are cooked in water or soaked in water before frying. Eat magnesium-rich foods Adequate magnesium intake is vital for over 300 different functions in the body — including regulating blood pressure. "The combination of a high magnesium intake (500 to 1,000 milligrams per day) and potassium coupled with a reduced sodium intake is more effective in reducing blood pressure than single mineral intake and is often as effective as (taking) one antihypertensive (blood pressure) drug in treating hypertension (high blood pressure)" per a study in The Journal of Clinical Hypertension. In addition, the study states: "Oral magnesium acts as a natural calcium blocker, increases nitric oxide, improves endothelial dysfunction and induces direct and indirect vasodilation." In other words, a high intake of magnesium works like the high blood pressure medications called calcium channel blockers to lower blood pressure. It increases nitric oxide, a compound which relaxes the smooth muscles surrounding blood vessels. This improves the ability of blood vessel walls to relax and expand — which lowers blood pressure. The top sources of magnesium are: nuts (especially almonds/almond butter, cashews, hazelnuts and peanuts), spinach, whole grains, pumpkin seeds, and dried beans (such as black beans, navy beans, great northern beans), and milk. Add calcium-rich foods Interestingly, people who get adequate calcium from their diets tend to have lower blood pressure. Calcium helps to regulate blood pressure in two ways. "It helps blood vessels to tighten and relax (expand) when they need to," according to Harvard Medical School. Plus, calcium promotes the excretion of excess sodium via the kidneys. The recommended intake of calcium for adults is 1,200 mg (milligrams) per day. Milk is the richest source of calcium. One cup of cow's milk or kefir contains 300 mg and one cup of fortified Silk almond milk contains 470 mg calcium. Unfortunately, many adults don't drink milk, or only have milk with cereal. Foods made with milk are alternative ways to get calcium. These include cream soups, puddings, custard and cheese. When making lasagna, instead of using cottage cheese, try using ricotta cheese. Among cheeses, ricotta cheese tops the list with 295 mg calcium per half-cup (versus 100 mg in cottage cheese). Parmesan comes in next with 300 mg per ounce, followed by mozzarella and cheddar with about 200 mg per ounce. Greek yogurt contains twice the protein as regular yogurt, but about one-third less calcium. A small (5.3-ounce) of plain Greek yogurt delivers about 130 mg calcium. Firm tofu is a great source of calcium if it has been processed with calcium sulfate. Read the label on tofu to find the amount of calcium. Although spinach is high in calcium, it is also high in oxalates, a compound which binds to calcium. So, only 5 percent of its calcium is available for absorption, per Harvard Medical School. Kale, which is low in oxalates, is a better choice — with 90 mg of calcium per cup. Other low-oxalate greens with calcium include collard greens, turnip greens and mustard greens. So, when planning your meals, try including more foods rich in potassium, magnesium and calcium. With so many delicious foods high in these minerals, lowering your blood pressure never tasted so good. For more recipes and information on the DASH diet, go to the National Heart, Lung and Blood Institute website: nhlbi.nih.gov/education/dash-eating-plan. Phyllis J. Molnar is a registered and licensed dietitian who writes about food and health for The Chronicle-Telegram and The Gazette. Email her at pjmolnar56@gmail.com. Chicken Ratatouille 1 tablespoon extra-virgin olive oil 12 ounces boneless, skinless chicken breast cut into thin strips 2 small zucchinis, unpeeled, ends trimmed and thinly sliced 1 small eggplant, unpeeled, ends trimmed and cut into 1-inch cubes 1 medium onion, peeled and thinly sliced 1 medium green bell pepper, cored and cut into 1-inch pieces ½ pound fresh mushrooms, scrubbed well and sliced 1 can (14½ ounces), diced tomatoes, undrained 1½ teaspoons minced garlic 1½ teaspoons dried basil, crushed 1 tablespoon fresh parsley, washed, dried and minced (or 1 teaspoon dried parsley) 1/8 teaspoon black pepper 1. Heat oil in a large nonstick skillet. Add chicken and sauté for about 3 minutes or until lightly browned. Add zucchini, eggplant, onion, green pepper and mushrooms. Cook, stirring constantly for about 15 minutes. Add remaining ingredients. Stir. Cook for 5 minutes. 2. Serve warm over whole wheat pasta. Nutrition information per serving: 266 calories, 8 grams fat, 2 grams saturated fat, 66 mg cholesterol, 253 mg sodium, 6 grams fiber, 30 grams protein, 21 grams carbohydrate, 1,148 mg potassium Makes: 4 servings SOURCE: National Heart, Lung and Blood Institute (NHLBI) Italian Strawberry Ricotta Parfait 1 cup whole milk ricotta cheese (about half of a 15-ounce carton) 2 tablespoons honey ½ teaspoon almond extract Fresh strawberries, washed, hulled and sliced About ½ cup sliced almonds, toasted* 1. To toast almonds: Place almond slices in a dry skillet. Cook on medium-low heat just until fragrant and lightly browned, stirring constantly with a wooden spoon, for about 4 minutes. Set aside to cool. 2. Place ricotta cheese, honey and almond extract into a food processor bowl. Blend until very smooth, about 2 minutes. Refrigerate one hour before serving. 3. To assemble parfait, layer ricotta cheese mixture and strawberries in pretty parfait glasses (or wine goblet). Top with toasted almonds. Nutrition note: Ricotta cheese is high in calcium. Almonds are rich in magnesium. Makes: 4 servings SOURCE: Drusilla Cagnoni's comment on recipe for Vanilla Ricotta Dessert at healthyrecipesblog.com Variation: Vanilla Ricotta Dessert (original recipe) Use vanilla extract in place of almond extract. Omit strawberries and almonds. Serve vanilla ricotta in pretty dessert glasses (or wine glasses). This is similar to Italian cannoli filling. If desired, top with fresh berries and/or a drizzle of melted dark chocolate and chopped nuts. Asparagus Frittata for two 1 tablespoon oil (or butter) ¼ cup finely sliced shallots ½ pound thin spear asparagus, tough ends snapped off, cut diagonally into 1-inch pieces 3-4 large eggs 3 ounces (a rounded ⅓ cup) Ricotta cheese ¼ teaspoon salt (if using salted butter, omit salt) 1½ teaspoons minced fresh chives (or ¾ teaspoon dried chives) 1/8 teaspoon dried tarragon ½ cup shredded Swiss cheese (I use 2 slices, very thinly sliced) 1. Trim ends off washed asparagus and cut into 1-inch pieces. Set aside. 2. Heat oil (or butter) in a medium ovenproof skillet over medium heat. (If you don't have an ovenproof skillet, simply skip the broiling step.) 3. Add the shallots to the pan. 4. Cook, stirring occasionally, until they soften and turn translucent, about 1 minute. 5. Add the asparagus and cook for an additional 3 minutes. 6. Beat the eggs, ricotta cheese and salt together. Stir in the chives and tarragon. 7. Pour egg mixture into the skillet. Cover and cook over medium-low heat until almost set. 8. Sprinkle Swiss cheese on top. 9. If the skillet is ovenproof, broil until the cheese is melted and slightly brown, about 4 minutes. If the skillet is not ovenproof, cover the skillet and cook for another minute or two, until the cheese is melted. It will not brown. Nutrition note: Swiss cheese is the lowest in sodium compared with other cheeses. Ricotta cheese and Swiss cheese are high in calcium. Makes: 2 servings SOURCE: Elise Bauer at www.simplyrecipes.com