WELLNESS

Maintaining Healthy Blood Pressure

27th August, 2021

The cardiovascular system, also commonly known as the circulatory system, consists of the heart, veins, arteries, capillaries and blood. These structures work together in circulating blood throughout the body while transporting oxygen, nutrients, hormones and waste products. The circulatory system has the vital role of maintaining blood homeostasis and the mechanisms which regulate this process are closely related to blood pressure.

Blood pressure is determined by two factors: 1) the amount of blood your heart pumps, and 2) the amount of resistance to blood flow in the arteries. This results with a blood pressure reading of two numbers: the systolic and diastolic, in a measurement of millimetres of mercury (mmHg). The systolic (top) number shows the pressure in the arteries during heart beats while pumping out blood; and the diastolic (bottom) number shows the pressure in arteries during the rests in-between heart beats. Healthy blood pressure is less than 120/80 mmHg.

Blood pressure naturally rises and falls throughout the day, however a consistently high force of blood flowing against arteries, causing circulatory resistance can result in high blood pressure. Prolonged high blood pressure may lead to a clinical diagnosis of hypertension, a common circulatory system condition and leading risk factor of cardiovascular disease.

The National Health Survey of 2017-2018 indicated that 4.3 million people had high blood pressure and 2.6 million adults reported hypertension. Hypertension and high blood pressure are often termed ‘silent conditions’, as they can be present for many years without any signs or symptoms. When uncontrolled, further complications may arise and for this reason, it is important to regularly monitor blood pressure.

There are five categories of hypertension: healthy, elevated, stage 1, stage 2 and hypertensive crisis. The progression of this condition can be caused by primary or secondary factors. Primary or essential hypertension is the most common type which develops gradually over many years with no direct cause, however it can be influenced by genetics, environmental factors, diet and lifestyle. Secondary hypertension has a rapid onset and tends to be more severe, occurring as a result of underlying health conditions.

Risk factors of hypertension include age, gender, ethnicity, family history and pregnancy. The proportion of Australians with high blood pressure and hypertension shows a trend which increases with age. The prevalence also varies with gender, with 25% of men and 20% of women reporting high blood pressure. Additional contributing factors in the development of hypertension include: insufficient physical activity, being overweight, poor sleep quality, stress, smoking, excessive alcohol consumption and an unhealthy diet.

So what are some ways to support healthy blood pressure?

Diet

The DASH diet, short for ‘Dietary Approaches to Stop Hypertension’ is a nutritional program which aims to support healthy blood pressure. The DASH diet recommends a reduction of sodium, saturated fats, sugars and alcohol, while encouraging more vegetables, fruits, nuts, beans, wholegrains, poultry, fish and low-fat dairy products.

According to the Australian Institute of Health and Welfare, in 2015, 5.8% of Australia’s total burden of disease was attributed to high blood pressure and of this, 21% was due to diets high in sodium. Sodium can directly increase the risk of hypertension and based on national guidelines, it is recommended to restrict daily intake to 1,500mg – 2,300mg.

Potassium has dual actions in hypertension, it helps to reduce the effects of sodium and also supports blood vessel health. The recommended intake of potassium is 2,800mg – 3,800mg daily and can be found in foods including: apricots, avocados, bananas, beans, raisins, prunes, spinach, mushrooms and potato.

Calcium is a mineral required for healthy functioning of the cardiovascular system and heart. The recommended intake of calcium is 1,000mg – 1,300mg daily and food sources include low-fat dairy, seafood, collard greens, legumes, white beans, tofu and dried fruit.

Magnesium supports cardiovascular system health and functions. The recommended daily intake is 255mg – 420mg and dietary sources include: pumpkin seeds, almond, spinach, cashew, and black beans.

Other heart healthy foods: antioxidants and flavonoids i.e. berries; polyphenols i.e. dark cocoa chocolate; nitrates i.e. beetroot juice; fibre i.e. oatmeal; and omega-3 i.e. salmon.

Other foods to avoid: sugars and fructose, refined carbohydrates, red meats, caffeine and processed foods. An unhealthy diet has been associated with high blood pressure and reports indicate Australians don’t consume enough from the five food groups.

Lifestyle

Statistics show that four in five Australian adults do not meet the national guidelines for physical activity and that 67% of adults are classified as overweight or obese. Being overweight places extra stress on the cardiovascular system, with studies linking excessive body fat to increased risk of high blood pressure. A healthy weight range as indicated by the Body Mass Index (BMI) scale, supports a healthy blood pressure. Weekly recommendations include 150 minutes of moderate physical activity.

Stress is a contributing factor to elevated blood pressure, particularly when faced by a stressful situation. The release of hormones activates the body’s “fight or flight” response, causing blood vessels to constrict and the heart rate to increase. Stress management techniques such as mediation, deep breathing or yoga can help to manage stress and shield against the short-term onset of high blood pressure.

Sleep regulates various function in the body, including blood pressure. During sleep, blood pressure usually decreases and having deprived or disturbed sleeping patterns may negatively impact the cardiovascular system health and increase the risk of high blood pressure. It is recommended to sleep 7-9 hours per night and to promote good sleep quality, bedtime routines are encouraged.

A clean lifestyle can help to maintain healthy blood pressure and also general wellbeing. Studies show that excessive alcohol consumption and smoking can have a damaging effect on the cardiovascular system and increase the risk of hypertension. Reports from 2019 indicate that of Australians aged 14 and over, 11% are daily smokers and 5.4% are daily consumers of alcohol. Reducing to a moderate intake, or ideally cessation of smoking and alcohol consumption habits can help to support healthy blood pressure.

To maintain a healthy blood pressure level, consider these modifiable risk factors of diet and lifestyle for a proactive approach towards supporting overall cardiovascular system health.

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Traditional Ayurvedic and Chinese Medicine healers have been using turmeric as a natural remedy for centuries. Today, Turmeric is now one of the most researched herbs in the world and thousands of studies have demonstrated its therapeutic benefits for a wide range of health conditions. Is turmeric a herb or is it a spice? It’s both. Turmeric is a perennial herbaceous plant from the same family as ginger. The underground stems, called rhizomes, are harvested, dried and ground into a powder, which is the golden spice used for medicinal and culinary purposes. What gives turmeric its health benefits? There’s a lot of confusion out there about how turmeric works. Turmeric isn’t just a homogenous powder. Like many natural remedies, it’s made up of a number of biologically active substances. Of these, there is a group of three compounds, called curcuminoids, which make up about 2% -5% of turmeric. They are curcumin, demethoxycurcumin and bisdemethoxycurcumin. Curcumin is the star of the trio. It’s the curcuminoid primarily responsible for turmeric’s anti-inflammatory and antioxidant properties. Curcumin is a natural anti-inflammatory Inflammation can be triggered as the body’s way of defending and healing. In the process of inflammation, the release of cytokines sets off a pro-inflammatory cascade which lead to the production of inflammatory molecules such as thromboxane and prostaglandis. Tissue damage, as in arthritis, causes the release of cytokines and sets off pro-inflammatory processes which lead to the production of inflammatory molecules such as thromboxane and prostaglandins. These inflammatory molecules are produced by enzymes such as phospholipase, lipoxygenase, 5-LOX and COX-2. Curcumin works by inhibiting some of these inflammatory processes and enzymes, and also by down-regulating the activity of some inflammatory molecules. Curcumin also helps to support joint health. Curcumin also helps to protect cells from damage by free radicals Free radicals are highly reactive molecules that roam around the body and can damage cells through a process called oxidative stress. Oxidative stress has been linked to many health conditions, including poor joint health and function, so antioxidants are important to keep our bodies healthy. Learn more about the benefits of Turmeric for joint health, here. Curcumin works by directly scavenging free radicals as well as by inhibiting some of the processes that generate free radicals, so it helps to reduce the damage they can cause to body cells. Can you just eat turmeric powder to get the benefits of curcumin? Not really. Firstly, like we mentioned earlier, curcumin and turmeric are not the same thing. Curcuminoids make up only around 2-5% of turmeric rhizome powder, and of that 2-5%, curcumin makes up about 75%. So that means an average teaspoon of turmeric powder may contain less than 1% of the all-important curcumin. And that’s not the only reason that turmeric powder alone can’t really deliver much in the way of health benefits. To have a therapeutic effect in your body curcumin needs to get into your blood plasma. Once there it can circulate around the body and exert its anti-inflammatory and antioxidant effects. But turmeric, and the curcumin in it, is very poorly absorbed by your body. It is naturally insoluble in water (just check out that yellow gunk at the bottom of your turmeric latte or tea!) Very little remains intact after it gets into the highly acidic stomach environment What does remain isn’t absorbed very well by your digestive system And what is absorbed gets broken down and excreted by your liver really quickly. So consuming turmeric, or even straight curcumin powder, isn’t a very effective way of getting enough bioactive curcumin into your bloodstream. A better way to get the health benefits of curcumin The best way to get the health benefits of curcumin is by taking a high strength supplement which has been formulated for higher bioavailability.

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What is inflammation? The word inflammation is derived from the latin word, “inflammatio”, which translates to ‘ignite’ or to ‘set fire’. During the 1st century AD, the Roman scholar and medical encyclopaedist Aulus Cornelius Celsus described the clinical symptoms of inflammation, as: calor (heat), dolor (pain), rubor (redness) and tumour (swelling). With thousands of years in medical advances, the understanding of inflammation’s pathogenesis has subsequently expanded into a sophisticatedly coordinated cascade of events. The 5 cardinal symptoms are: heat, pain, redness, swelling and a limited range of motion. Inflammation is a defence mechanism and essential component in the healing process where the body attempts to maintain homeostasis by repairing affected structures and restoring function, in order to return the site of damage back to its pre-injury state. Inflammation is produced by the body when it interprets trauma or potentially harmful agents and in response stimulates a series of immune reactions, however depending on the cause of inflammation, the process may slightly differ and involve condition specific immune reactions. For example, inflammation from physical injuries, skin irritation and sinus allergies will have unique immune responses such as the chemicals stimulated and pathways allowed, although the common phases of the inflammation cascade are as followed: Understanding the inflammation process The process of inflammation is initiated by a varying degree of trauma or damage, which can occur either internally or externally. The initial trauma which triggers inflammation can be due to virtually anything that causes damage to our body cells, tissues, organs or other structures. Common causes could include injuries, infections, allergens, certain medications, chronic stress and exposure to harmful pathogens, irritants, toxins or chemicals. There is a diverse range of inflammation causes, examples may range from a paper cut, pollen, certain foods, topical sensitives, sprained ankle, broken bone or underlying health conditions i.e. arthritis. Inflammation is a multi-factorial however the progression has various influences, such as: genetic predisposition, medical history, lifestyle and dietary factors, age, weight, immune function, sensitivities and allergies and current health status. The first response is the immediate recognition of trauma to the cells which is detected by sentinel cells, such as mast cells or macrophages. These immune sentinel cells are often referred to as the body's first line of defence as their duty is to recognise damage or harmful microbes and signal for a recruitment of inflammatory factors to regulate and remove the damage, thereby commencing the immune-inflammation cascade. In this acute phase, there is a stimulation of chemicals and hormones such as histamine which assists in the breakdown of our blood barriers at a microcirculatory level. The release of histamine increases local blood flow and a process of vasodilation takes place where blood vessels dilate and enlarge, resulting in an increased capillary permeability. The vasodilation facilitates the transportation of inflammatory factors including plasma and White Blood Cells (WBC) at the site of injury. This activation causes the presentation of heat and redness and can generally last 2-5 days. In the sub-acute phase, the focus is removing acquired threats and repairing damaged structures. The immune WBC’s migrate towards the affected area where they stimulate the release of inflammatory mediators such as antibodies, immunoglobulins (IgE), cytokines (IL, TNF) and prostaglandins (PGE2). Inflammatory mediators are essentially ‘messengers’ that promote stimulation of immune responses. This stimulation causes an accumulation of various active hormones, chemicals and plasma proteins which then actively work together in removing the damaged cells. The localised concentration of substances is what causes swelling. An additional process in this phase is the production of Nitric Oxide (NO), which is a ‘pain producing’ substance. The local release of NO signals the nervous system for the generation of the pain sensation, which interestingly is a protective mechanism the body makes! If the structure that is inflamed is experiencing pain, we are more likely to protect the area. A fifth symptom is also observed here, a limited range of motion which is another protective method. The repair and removal of cellular waste can have a duration lasting up to approximately 6-8 weeks. Throughout this sub-acute phase, the main pathway involved is the cyclooxygenase (COX) pathway. The final stage is known as the chronic phase, where remodelling and maturation of the original injury or trauma takes place. Once the inflammation inducer has been removed, the process of wound healing and/or tissue repair occurs, where damaged tissue is regenerated or they may be replaced with collagen strands and fibroblasts to begin the remodelling process. When collagen has been generated, the strands are progressively replaced by other materials and they adapt to the original tissue. If the inflammation continues, or the structures further destruct, scar tissue or fibrosis follows. This chronic phase can last months to years, depending on the type of injury and the inflammation. What is the difference between acute and chronic inflammation? Inflammation may present as acute or chronic and the main influence of this is the type and intensity of trauma. In acute inflammation, the onset is rapid with short-term symptoms which may be severe, whereas chronic inflammation has a long-term presentation with a prolonged duration that may last years. In some cases, chronic stressors causing inflammation can have a suppressive effect on the immune system in contrast to the acute stressors which enhance immediate adaptive immunity. In this scenario, sustained stressors may actually over-activate the immune system causing an imbalance of pro-inflammatory and anti-inflammatory mediators in the body, causing chronic inflammation. Chronic inflammation has a negative impact on overall health including our cells, tissues and organs which in-turn can increase the risk of developing disease and poor health states. Tips to help better manage inflammation Just as there are various factors contributing to the progression of inflammation, there are also multiple strategies for the management of symptoms, including pharmaceutical, physical therapies, dietary or lifestyle alterations and other complimentary or alternative medicine modalities. Some natural remedy suggestions may include herbal or nutritional sources with anti-inflammatory actions. The term ‘anti-inflammatory’ relates to a substance which has direct actions in reduces inflammation. Dietary food sources with anti-inflammatory actions can inhibit pathways such as the COX and therefore the inflammatory mediators such as prostaglandins, TNF, IL etc. described earlier also provide benefits to inflammatory conditions. Overall, an anti-inflammatory diet would ideally include higher intakes of antioxidant and fibre rich foods plus ensuring an adequate balance between healthy fats, proteins and carbohydrates. Try to avoid In inflammatory conditions, it is advised to limit the intake of refined carbohydrates i.e. white pasta, trans fats i.e. margarine, processed meats i.e. deli meats and sugars. It is best to avoid these food groups as they aggravate inflammation and contribute to inflammation by producing Advanced Glycation End (AGE’s) and may raise blood glucose levels, with cell damaging effects. Lifestyle suggestions to support the anti-inflammatory diet may include moderate physical activity to maintain a healthy weight range, reducing stress levels, allowing enough sleep for cell repair and recovery and managing any associated pre-existing conditions. It is also recommended to reduce alcohol intake and smoking as they can create inflammation driving toxins in the body. Fun Fact: Conditions ending in ‘-itis’ indicate inflammation of a specific organ, tissue or structure. For example: derma (skin) + itis (inflammation) = dermatitis

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One day your jeans zip up without a problem… the next day you’re undoing the top button or browsing for clothes with elasticated waistbands. Belly bloat, food baby, abdominal bloating, abdominal distension…whatever it’s called it’s uncomfortable! What causes bloating? A bloated stomach is that feeling of pressure or fullness in your belly. It may or may not be accompanied by distension, which is a noticeable difference in the size of your abdomen. A build-up of gas in the stomach and intestines is one of the most common causes of bloating. Intestinal gas can be caused by eating certain foods, particularly beans and cruciferous vegetables such as cauliflower, broccoli, and cabbage. Some foods are high in a type of sugar called FODMAPS. In people sensitive to FODMAP-rich foods, the small intestine doesn't always fully absorb these carbohydrates, and instead passes them to the colon, where they are fermented by bacteria and produce gas. FODMAPs don’t affect everyone equally, so while certain FODMAPs may make you feel bloated, you may be able to process others just fine. Eating too quickly, drinking through a straw, or drinking lots of fizzy drinks can cause you to swallow lots of air and make you feel full. Constipation can cause a build-up of faecal matter in the intestine leading to abdominal distension and bloating. Bloating can also be caused by medically diagnosed conditions such as food intolerances and intestinal disorders such as IBS (irritable bowel syndrome), IBD (inflammatory bowel disease, including Crohn’s disease and ulcerative colitis), and SIBO (small intestinal bacterial overgrowth). Is bloating the same thing as fluid retention? Yes and no. Fluid (water) retention, also known as oedema, is related to the kidneys, while bloating is usually related to the gastrointestinal tract. Fluid retention can make you feel bloated, but it doesn’t usually affect your abdomen as much as bloating caused by intestinal gas. Fluid retention occurs when excess fluid builds up in your body's circulatory system and generally causes swelling in your extremities, such as your feet, ankles, legs and hands. A common sign of fluid retention is when your rings feel tight on your fingers, or your ankles are swollen after sitting down for a long time. A diet high in carbohydrates, sugar and salt can cause your body to retain water, leading to that feeling of puffiness and heaviness. Fluid retention can also be caused by hot weather and hormonal changes. What can I do about bloating? Bloating that comes and goes is usually digestive-related and tends to disappear after a couple of days. It will often help if you cut down on salty foods, carbohydrates and fizzy drinks. If you have a food intolerance, or suspect that FODMAPS might be the issue, try eating less of the problem foods for a while. Keep a food diary for a couple of weeks, noting everything that you eat and drink and when bloating troubles you most. If you find you have a regular problem with certain foods though, you should consult a doctor or dietitian before making any permanent dietary changes. Adopting a few simple lifestyle changes may also help. Avoid chewing gum Eat slowly Avoid drinking from a straw Drink plenty of water If you suffer from constipation, try eating more high-fibre foods, increasing the amount of water that you drink, and exercising regularly. It might also be helpful to try taking probiotics. These can support a healthy gut bacteria population and help your digestive system moderate the effects of a bloated stomach. If bloating or fluid retention persists for more than a couple of days, or is accompanied by pain or diarrhoea, then you should speak to a doctor.

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Maintaining Healthy Blood Pressure

27th August, 2021

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