Have questions or comments? Call Wegmans Consumer Affairs Monday - Friday 8am-5pm (585) 464-4760 or toll free at 1-800-WEGMANS ext. 4760. visit us at wegmans.com

More Resources: Your Guide to Lowering High Blood Pressure from the National Heart, Lung and Blood Institute www.nhlbi.nih.gov/hbp/ Learn About Strokes from the American Heart Association www.strokeassociation.org Estimating Your 10-Year Risk of Having a Heart Attack hp2010.nhlbihin.net/atpiii/calculator.asp

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For Lower Blood Pressure

Contents Look for these color bars along the edges of this brochure to quickly find the section you’re interested in. Orange: Blood Pressure Basics Green: Eat Well, Live Well. Blue: Salt & Sodium Purple: How Wegmans Can Help Thanks to several health professionals, as well as employees at our Taft Road and Canandaigua stores, who reviewed this booklet and shared their valuable insight.

pressure fact: BP blood Along the way, you’ll see helpful “did you know” blood pressure facts.

A smart approach to blood pressure Has your blood pressure been creeping up? You’re not alone. But unless something changes you’re likely to develop the full blown medical condition of high blood pressure, also called “hypertension.” A healthy lifestyle is the first critical step in preventing or treating elevated blood pressure. For those in the earliest stage, called “pre-hypertension,” it could be all that’s needed! For others with higher blood pressure already, a healthy lifestyle could mean better control with fewer medications. This booklet can help you get started. Many things can help you enjoy a healthier better life, but one is absolutely key: a desire to make things better. Yet, advice on blood pressure can come from so many different directions that you’re not sure which way to turn. Wegmans nutrition-pharmacy team has based this booklet on the National Heart, Lung, and Blood Institute clinical guidelines and research studies. Our goal is not to be a substitute for your physician. Rather, it’s to share helpful information and be there to offer support. The rest is up to you! Wegmans Nutrition-Pharmacy Team Jane Andrews, MS, RD; Jennifer Felice RD; Theresa Jackson, RD; Trish Kazacos, RD; Brian Pompo, RPh and Krystal Register, MS, RD

BP blood pressure fact:

Small elevations in blood pressure, combined with other slight increases in blood sugar, waist size or cholesterol can multiply your heart disease risk.

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High blood pressure: “The silent killer” Even though it’s also called “hypertension” don’t confuse it with being HYPER-TENSE from the pressures of life. You simply can’t judge blood pressure by your levels of stress or nervous tension. In fact, high blood pressure is called “The Silent Killer” since there are usually no symptoms … that is, until the first heart attack or stroke.

Ignorance is not bliss! One third of people with high blood pressure don’t even know they have it. Left alone, high blood pressure can cause great harm: heart attacks, strokes, kidney damage, eye damage and even dementia. More people suffer and die from heart disease than any other ailment. Stroke is also common, especially as we age. High blood pressure is only one of several risk factors shared by both heart disease and stroke. The more risk factors that pile on, the more likely you are to have a heart attack or stroke in the next 5 years.

pressure fact: BP blood Every 20 point increase in the top blood pressure number doubles your risk of dying from a stroke or heart attack.

The risk factors for heart disease and stroke that we can control:

Blood pressure defined Put simply, blood pressure measures the force that the heart uses to pump blood through your blood vessels. It tells whether your heart is over-worked. Think about water gushing through a hose. If the hose is clean and flexible, the water flows through easily. But if the hose becomes clogged with gunk (as arteries can with cholesterol) or becomes stiff from being left outside all winter (as arteries can do with age) it becomes more difficult for the water to get through. The more you turn up the hydrant, the more the pressure builds. And that can further damage the hose with buildups, bulges and leaks. In your arteries, such pressure could knock loose a blood clot, which could lodge in a smaller artery and stop blood flow—actually starving parts of a vital organ like your heart, brain, kidney or eye.

pressure fact: BP blood About 25% of Americans have pre-hypertension. Another 30% have high blood pressure, rising to over 50% for those over 65 years of age.

Measuring your progress . . . How Wegmans Pharmacy can help Along with routine blood pressure checks at your doctor’s office, you can stop by our pharmacy and get your reading from one of the nearby blood pressure machines. Our pharmacists are ready to help you use the machine, as well as explain what the numbers mean and how to record them. Ironically, there can be a “White Coat Syndrome,” where blood pressure can sometimes rise due to the natural anxiety of going to the doctor’s office.

What’s your pressure? High Blood Pressure

Smoking

Diabetes

The top number represents the pressure in your blood vessels during a heartbeat. The bottom number is your vessel pressure between beats. Healthy

Below 120/80

Pre-hypertension

120/80 to 139/89

High blood pressure

Blood Cholesterol High LDL “Lousy” Low HDL “ Healthy”

3

Inactivity

Stage 1 hypertension

140/90 to 159/99

Stage 2 hypertension

160/100 or greater

Overweight— Waist Over 35" in Women; 40" in Men

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BP blood pressure fact:

Regardless of how you choose to measure and record your blood pressure, the most important thing is that you measure your blood pressure on a regular basis.

For more reliable blood pressure readings… Blood pressure can bounce around during the day. To get a more reliable reading, it’s good to be aware of things that might temporarily raise blood pressure. Time of Day—Typically, blood pressure will be lower when asleep and rise when more active and awake. Try to measure blood pressure at the same time each day for better accuracy. Physical Activity—Blood pressure will rise during and immediately after exercise and tends to be lower after you have rested quietly for a few minutes. A good workout (at least 30 minutes) could help lower blood pressure readings – even through the next day. Coffee & Tea—Caffeine may raise blood pressure temporarily so it’s better to avoid it for 30 minutes before having your blood pressure measured. However, routine use of coffee and tea seems to improve health, so there’s no need to abstain unless your doctor tells you to. Emotional Stress—If you’ve just had an argument or you’re worried about a job interview, it’s better to wait and take your blood pressure later. Tobacco—A single cigarette raises blood pressure temporarily, but not enough to cause high blood pressure. Tobacco DOES increase the risk of heart and blood vessel diseases by damaging blood vessel walls and speeding up the process of hardening of the arteries. So even though it does not cause high blood pressure, smoking is bad for anyone, especially those with high blood pressure. If you smoke, quit. If you don’t smoke, don’t start. Once you quit, your risk of having a heart attack is reduced after the first year. So you have a lot to gain by quitting. Sleep—People who get the recommended 7–9 hours a night tend to carry less weight, have slimmer waistlines and lower blood pressure. For Women Only—Birth control pills and hormone therapy can spike up blood pressure in some women. High blood pressure during pregnancy needs to be carefully monitored.

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Better than any single medication! The Eat Well, Live Well principles are everyday tips to stay healthy, including lowering blood pressure. Eat Well, Live Well is Wegmans way of describing a lifestyle that promotes wellness while reducing health hassles (along with health care costs). You’ll see our principles, programs and tips throughout the store and in Wegmans Menu magazine. We even have an Eat Well, Live Well blood pressure section on wegmans.com! Think of these four principles, along with moderate sodium and alcohol use, as the basic habits that can lower blood pressure over the long haul. These same strategies can improve your health in several other ways. What else can do that?

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BP blood pressure fact:

An 8 oz glass of OJ every day is an easy way to get blood pressure friendly nutrition with almost no sodium. Count one cup toward your Strive for 5 cup goal!

BP blood pressure fact:

Some blood pressure medications may change how quickly you can rev up with physical activity. You can still get a good workout, but first check with your doctor or pharmacist.

Fruits, veggies and beans help lower blood pressure because of the nutrients they contain (plant protein, vitamins and minerals, like potassium). They are naturally low in calories, saturated fat and sodium.

It’s all about taking in fewer calories than you burn. Finding ways to trick yourself into eating less could be as simple as using a 10-inch plate or slimmer glassware.

You can cut your risk of high blood pressure by 20–50%. Aim for at least 10,000 steps per day or 30 minutes per day of moderate physical activity beyond your usual daily routine. It’s fine to break the 30 minutes into smaller chunks through the day.

If you don’t know what your blood pressure is, how can you know where you stand? If elevated, regularly re-check as a reminder to stay on track.

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What makes the most difference? Action Lose weight

BP point reduction off top number 5–20

Make it easier for the heart to pump blood to the rest of your body.

Make your calories count

8–14

4–5 cups veggies, 3 low fat dairy, 3 whole grains, lean protein— Nutritious foods have minerals (potassium, calcium, and magnesium) and other nutrients that help pull sodium out of your body.

Get moving

4–9

Work your heart to make it stronger and it will pump with less effort. The force on the arteries will decrease and lower blood pressure.

Cut back on sodium (less than 2300 mg)

Weight loss has fabulous health benefits, but getting the pounds to stay off can be a struggle. Instead of fixating on the scale, focus on one small goal that has staying power, then gradually add other simple goals. Accomplishing these small changes builds confidence. One way to get started is with Half-Plate Healthy. This tip helps blood pressure in two ways: fewer calories and more veggies!

2–8

Less sodium (in salt) can make your blood vessels retain less fluid. A lower total volume of blood will lead to lower blood pressure.

Limit alcohol

Half-Plate Healthy

2–4

No more than 2 drinks for men, and 1 drink a day for women.

These are the lifestyle changes that matter most—with the most important at the top. If you’ve ever watched “The Biggest Loser,” you know that taking those pounds off helps many people get off blood pressure medications. For every 20 pounds lost, the top number can drop 5–20 points. Having a smaller body makes it easier for your heart. But don’t think this is only about losing weight. Making those calories count with nutritious food choices—even if you don’t lose a pound—will lower your blood pressure up to 14 points.

Fill half your plate with veggies, fruit & salad, and half with anything else.

This more nutritious way of eating is known by researchers as DASH which stands for Dietary Approaches to Stop Hypertension. We’ve put it together in a visual format, the Daily Meal Template, on pages 1112. The basic advice has been part of Eat Well, Live Well for years: strive for 5 cups of fruits and veggies; 3 cups of low fat dairy; 3 servings of whole grains and plenty of lean protein foods. Here’s how it works: these foods are so rich in nutrients, particularly potassium, calcium and magnesium, they can pull sodium out of your body. Get moving, cutting back on sodium and limiting alcohol are smart habits that will help lower blood pressure as well. The good news is that these changes can really add up when you do several of them at once. But the real surprise: cutting salt is part of the picture, just not the most important part. See the blue section of this brochure for more information on salt and sodium.

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Make your calories count with our Daily Meal Template

How many calories do I need each day? If you naturally maintain a healthy weight there’s no real need to consider calories. But most of us are overweight and understanding calories gives perspective on how much to eat. A reasonable target for overweight women is 1500 calories a day; for men it is 2000 calories a day. Visit mypyramid.gov to get personalized goals for calories and daily food groups based on age, weight and activity level.

How to fill your plate Whole Grains

Breakfast

Dairy or Protein (1 oz.)

Goal: 300 calories

Fruit

Snack Goal:

100–200 calories

Lunch

Goal: 400–500 calories

Whole Grain

Fruit & Vegetable Protein (2–3 oz.)

Snack Goal:

100–200 calories

Dairy

Dinner Goal: 500–600 calories

Three whole grain servings a day ( try for one serving at every meal).

Water throughout the day

Now you know that a healthy body weight makes a huge difference in blood pressure. You’ve also learned that getting enough veggies, fruits, low fat dairy, whole grains and lean protein foods can help further lower the top blood pressure number by 8-14 points. The Daily Meal Template paints a picture of how this could all come together. It goes beyond our “half-plate healthy” tip to show how all the important food groups can be included while controlling overall calories.



Whole Grain

Whole Grain Protein

Fruit & Vegetable

(3–4 oz.)

Fruits & Vegetables Strive for five cups a day. Go for a rainbow of colors.

Dairy Three cups daily—including yogurt.

Snack Goal:

100–200 calories

Protein Lean meats, poultry, fish and beans. Include fish twice a week.

Oil Include nuts, fish, and vegetable oils.

Snacks Use snacks to help balance your day. Choose grains, fruits, vegetables, dairy, and protein.

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more at wegmans.com BP learn • Daily meal template details • Suggested menus • Detailed Eat Well, Live Well guides

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The 500+ Club Here are just a few foods that typically have more than 500 milligrams sodium per serving. You could combine them with low sodium foods, for example, adding an extra cup of frozen veggies to a prepared soup to lower the overall sodium level per serving. Or you could use them less often or specifically look for lower sodium options, such as with a “lite” soy sauce.

Making sense of sodium and salt Most of us use the terms sodium and salt as if they mean the same thing, but there is a key difference. When we say “salt”, we are usually talking about table salt, which is made up of 40% sodium and 60% chloride. In other words, every 1000 milligrams (mg) of salt contains 400 mg sodium. Our bodies need only a small amount, less than 1000mg of sodium a day to function properly.

BP blood pressure fact:

Overall, 26 percent of Americans with normal blood pressure and 58 percent of those with hypertension are salt sensitive, that is, their blood pressure rises when they use more salt. According to the Mayo Clinic, salt sensitivity is especially common among older people, African-Americans, and people with hypertension, kidney disease or diabetes.

On average, Americans consume over 4,000 milligrams (mg) of sodium a day. That’s a lot more than the recommended limit of 2300 mg a day for those who have normal blood pressure, and it’s really off the charts for people who have high blood pressure and should have no more than 1500 mg a day. But a few shopping and cooking tips can easily help you lower your intake.

Soup, 1 cup

up to 1000 mg

Soy Sauce, 1 tsp

up to 900 mg

Taco, 1 small

800 mg

Sauerkraut, 1/2 cup

780 mg

Vegetable Juice, 1 cup 650 mg Ham, 2 oz

600 mg

Pasta Sauce, /2 cup

up to 900 mg

Hot Dog

500 mg

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Power foods for potassium Potassium-rich foods can help lower blood pressure. The more processed a food, the less potassium it has. Examples: all-purpose flour has less than whole wheat flour; Velveeta® has less than cheddar cheese. Potassium is lost in the cooking water, so techniques such as grilling, roasting, stir-frying and steaming help protect potassium. Food

Serving Size

Potassium (mg)

Bananas, raw

1 cup

594

Cantaloupe

1 cup

494

Milk, fat free or skim

1 cup

407

Orange juice

1 cup

496

1 potato

1,081

/2 cup

545

Spinach, cooked

1 cup

839

Winter squash

1 cup

896

Yogurt, plain

1 cup

579

Potatoes, baked with skin Raisins

1

BP blood pressure fact:

The Nutrition Facts Sodium tally includes sodium naturally in food as well as that added from salt or other sodium-containing additives like MSG.

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BP blood pressure fact:

If blood pressure medications are prescribed, it’s important to take them, even if you feel fine. 14

Shake the salt habit: fresh cooking tips Drastically cutting back on salt could leave food seeming tasteless. This calls for fresh thinking. Look for new ways to add flavor so that the fresh ingredients are the star of the dish instead of salt being front and center. Below are a few tips to help you get started: • Your best bet is to begin with fresh, unprocessed foods that are naturally low in sodium like fruits, vegetables, plain meats, seafood, tofu, etc. • Fresh squeezed citrus juice or zest can brighten the flavor of most dishes.

• Rinse salted canned vegetables about 2 minutes under running water to reduce sodium by up to 40%. • Choose lower sodium foods when available. For example, lower sodium versions are readily found among frozen vegetables, canned soups and tomato products. • When using sauce or ingredients that contribute a lot of salt, use less of them.

BP blood pressure fact:

Research has found that the preference for heavy use of salt is learned, which is great news because you can unlearn that preference. Trim your salt intake slowly, over a few weeks, to give taste buds time to adjust.

• Season without salt by using fresh or dried herbs and spices. This is also a great way to get additional healthy plant compounds found in spices like ground turmeric, ginger, cumin, cinnamon, curry powder, oregano, and paprika.

Caution on salt substitutes; Kosher, sea, seasoning salts

• Experiment with a little aged balsamic, fig, or other vinegar for a nice tang. • Try a drizzle of flavored basting, lemon, pumpkin seed or truffle oils for an extra pop of flavor. • If you like an extra kick, add a few drops of hot pepper sauce to spice things up. • Fresh garlic is a delicious way to add lots of flavor with no added salt. • Instead of pasta or tomato sauces with loads of salt, start with unsalted tomatoes and add your own herbs (search wegmans.com for recipes).

Wondering if salt substitutes are a good option? Maybe, but maybe not. Many salt substitutes contain potassium chloride. The extra potassium can be helpful for many people with high blood pressure but harmful for folks with kidney disease or who are on certain blood pressure medications. It’s always best to check with your doctor first.

Sea salt and kosher salt are coarsely ground and therefore weigh less per teaspoon. That means a few less milligrams of sodium with each shake of salt.

Type

Origin

Table Salt

Underground Salt Mines

Sea Salt

Evaporated Sea Water Kosher Salt Evaporated Sea Water or Underground Salt Mines

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Preservatives/ Sodium Additives per tsp. Iodine, 2300mg Sometimes Anti-clumping Agents None

1920mg

None

1920mg

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How Wegmans helps: In the store & online Gain support from our people!

Wegmans makes great meals easy All of our meals contain at least 1 cup of fruits or vegetables. Wegmans Menu magazine recipes all feature Wellness Keys and complete nutrition information.

Our in-store Vegetable Coaches and Nature’s Marketplace Team Leaders are happy to share product ideas and cooking tips. And of course, our pharmacists will answer your medication questions and offer on-going support.

Barbecue Salmon with Asparagus, Jicama, Red Pepper & Corn Salad

More help  is at wegmans.com From the home page: • Click on Eat Well, Live Well in the banner,

Wellness Keys— health and wellness at a glance Find these easy-to-recognize “dots” on our Wegmans products and recipes.

then Special Diets, then Blood Pressure to see how the principles help. • Click on the video graphic/icon to see our series of short videos on blood pressure. • Click on Meal Ideas for blood-pressure friendly combinations from the current issue of Wegmans Menu magazine. • Click on Recipes in the banner, then on Find recipe to do a recipe search based on Wellness Keys or other nutrition preferences.

Two Slices Provide:

SERVING

17

Toward your goal of 3 per day

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