Category Archives: Nutrition

Alternative Ways To Lower Blood Pressure

High Blood Pressure, or Hypertension, is one of the leading health problems in our society. There are many different types of excellent medications we have to help lower blood pressure; however, I like to encourage NON-MEDICATION ways of lowering blood pressure as the first step for my patients. [Of course, if your blood pressure is very high, sometimes we have to use medicines first to get you in a safe zone in conjunction with alternative strategies]


Definition Of Hypertension

Definition Of Hypertension

Below are some alternative strategies to help you lower your blood pressure.


Weight Loss = Lower Blood Pressure

Weight Loss = Lower Blood Pressure

Obesity/Overweight and hypertension have a strong relationship. Weight loss significantly helps lower blood pressure. Studies show that losing 8Kg of weight results in blood pressure drops of 8.5 points in your Systolic Blood Pressure (SBP–the TOP number of your blood pressure reading) and 6.5 points in your Diastolic Blood Pressure (DBP–the BOTTOM number of your blood pressure reading).

All forms of excercising including Aerobic (cardiovascular excercise), Dynamic Resistence, and Isometric Handgrips have been shown to help with lowering of blood pressure. Excercising alone can help lower your blood pressure readings by 3.5 points on the SBP and 2.5 points on the DBP.


Sources of Salt. Courtesy UpToDate

Sources of Salt. Courtesy UpToDate

Sodium or Salt can increase your blood pressure. Unfortunately, in general our diet is quite high in salt. There are many different sources of salt that we need to be aware of. Table salt or salt we add to our foods is a definite source, but there are many foods that are inherently high in salt. Foods such as: deli meats, cold cuts, canned foods, and soups are to name a few. Processed and packaged foods are also very high in salt/sodium. As a general rule, any food that has to stay fresh for a prolonged period of time until you are ready to eat it, is high in sodium/salt because salt is a natural preservative. So try to avoid microwave dinners, frozen meals, and canned foods OR look for Low Salt/Sodium versions of these foods. Eating and cooking fresh is the best way to go!

Eating out at restaurants can also open you to getting foods high in sodium. Foods with a lot of spices, marinades, sauces have high sodium. Certain cuisines are inherently high in sodium/salt such as Thai, Chinese, and Indian to name a few.

Aside from increasing your blood pressure, high sodium can lead to fluid retention and cause bloating and swelling especially in your ankles and feet. Avoiding the salt will help keep that fluid weight away and help some weight loss as well!

When we are trying to lower blood pressure through salt/sodium restriction, I recommend my patients to read the food lables of all their food and drinks and have a goal of getting LESS than 1500mg of sodium a day.

You can also check out the DASH diet website as it is a great source of information on foods and recipes to help lower your blood pressure.




Caffeine is a stimulant and all stimulants can lead to high blood pressure. In our fast paced soceity, we rely on outside sources to give us a little boost! Caffeine in the form of coffee, tea, energy drinks, and pills can all negatively affect your blood pressure.




Getting enough sleep is very important to help your mind and body restore itself. There are many important chemical and metabolic reactions that happen during your sleep which are essential to keep your body functioning at its best. Lack of sleep or not getting good quality sleep are risk factors for problems with your blood pressure.

If you snore at night, toss and turn, have difficulty falling asleep, or wake up in the morning and do not feel well rested from your sleep, you should speak to your doctor about getting tested for Sleep Apnea or other sleep disorders.

Easier said than done! But this is so important in managing your blood pressure. Increased stress and anxiety definetely raises your blood pressure.
Below are a few techniques to try to help with stress reduction:
1. Meditation
2. Relaxation and deep breathing–studies have shown that in stressful situations, stopping and taking deep breaths and counting slowly from 1 to 10 in fact helps you through the stress.
3. Biofeedback
4. Yoga
5. Organizing
6. Prioritizing tasks
–yes, everything is important and everything has to get done, but not right now. So reevaluate your tasks and really prioritize them and tackle them one at a time.
7. Delegating–although you are the best at doing it, you really can’t do it all so get help and learn to let go and delegate!

Things To Do To Help Your Memory!

Power Of The MindRecently, I was at a local restaurant and ran into a patient who is 75 and her husband is 81 years old. They inquired about things they can do to help with their memory. This is a common question now that we all are living longer and want to live healthy independent lives!

There have been a lot of studies to see if certain foods and supplements can help prevent memory loss. Although these studies have had mixed results, below is a list of things that have been tested and shown to help.

ANTIOXIDANTS: Studies have shown that Dementia patients, in particular Alzheimer’s, have a lot of “oxidative stress” so Antioxidants have been shown to help.

Vitamin E: The Alzheimer’s Disease Cooperative Study suggested that Vitamin E may be beneficial in slowing the progression of disease in patients who already have Alzheimer’s Dementia. Vitamin E has also been shown to lower risk of developing dementia in some patients.
Note: Vitamin E can think the blood and cause easy bruising and bleeding so if you are already on blood thinners (such as Pradaxa, Xarelto, Warfarin (coumadin), aspirin) then you should discuss with your doctor before taking extra Vitamin E. Also, if you are already on Vitamin E supplements, you should stop it 1 week before any surgeries as it can increase your bleeding risk.

Beta Carotene: supplementation with Beta Carotene helped improve testing scores on memory testing.

Flavonoids: Flavonoids are nutrients found in berries (blueberries, strawberries) and have antioxidant and anti-inflammatory properties both of which have been associated with slowing the rate of memory decline.

Courtesy Natural Remedies

Courtesy Natural Remedies

Folic acid, Vitamin B12, Vitamin B6: low levels of these vitamins can cause memory loss and impaired memory function so taking these may help strengthen your memory. I typically recommend that patients take 400 to 800mcg of folic acid; Vitamin b12 1000mcg, and Vitamin B6 of 25mg to 50mg daily.

Vitamin D: There is some evidence that Vitamin D deficiency may be related to memory and cognitive impairment so taking extra Vitamin D supplementation of 1000 I.U. to 2000 I.U. daily may help.


A diet high in saturated fats, trans-fat, or cholesterol has been shown in some studies to cause cognitive decline.

Omega-3 Fatty Acids: These help both brain and heart! The key thing to look for in “Omega-3 Fatty Acids” is the EPA (Eicosapentaenoic Acid) and DHA (Docosahexaenoic Acid). Fish oil also helps lower cholesterol and helps with cardiovascular health. In the Framingham Study, patients with higher level of DHA showed lower rates of incidence of Dementia at their 9 year follow up and patients with high levels of EPA showed to have lesser amount of hippocampal atrophy (shrinkage). [The Hippocampus is an area of the brain responsible for memory.]

Fruits and Vegetables: A diet high in fresh fruits and vegetables helps with your heart as well as your cognitive function!

Mediterranean Diet: Although a vague term which is at mercy of interpretation…this is typically a diet rich in fruits, vegetables, whole grains, beans, nuts, and seeds and includes olive oil as an imporant source of fat. This diet has very little red mean and low to moderate amounts of fish, poultry and dairy products. Patients who were strict about sticking to this type of “mediterranean diet” had less cognitive decline over time and less incidence of cognitive imparment and Alzheimer’s.


Many different studies have shown that higher levels of mental and physical activities slow the rate of cognitive decline. So get out there and EXCERCISE!
Challenge Your Mind
Mental activities and memory games such as Crossword Puzzles, Reading, Sudoku, Scrabble are all great ways of challenging and keeping your mind engaged. Simple socialization with friends and family also helps keep the mind sharp. Social interaction is very important for elderly patients who may be home bound. Adult daycares, afternoon activities at the local YMCA, social clubs or church events are wonderful ways to stay engaged.


We know that uncontrolled and/or suboptimally controlled hypertension (high blood pressure) causes decrease in blood supply to the brain which over time can lead to decline in memory and cognitive funcitoning. Goal blood pressure is to keep it less than 140/90, ideal blood pressure is around 120/80.

Gingko Biloba and estrogen therapy in menopaual women are no longer recommended to be used for prevention of dementia because studies showed that they did NOT help with memory loss.

What Can I Do To Help My Bones?

If you have Osteopenia (thinning bones; T-score between -1 and -2.5), Osteoporosis (brittle bones; T-score ≤-2.5) or even normal bones, you can always benefit from implementing lifestyle and nutritional changes to help!

Healthy Diet
Make sure you eat enough and avoid malnutrition—eating enough is not a problem for most of us, but eating the right things often is the tricky part! A diet rich in calcium and vitamin D is important. There has been some controversy surrounding Calcium supplementation, so generally Calcium of 1000mg a day is what I recommend now (this is total in a day from supplements and diet). I recommend Vitamin D supplementation of 1000 I.U. to 2000 I.U. daily. If you have Osteopenia or Osteoporosis, then I recommend that you have your blood Vitamin D levels checked and your goal should be in the 40 to 50 range.
Calcium and Vitamin D

Vitamin K: Vitamin K is a useful co-factor in bone metabolism. Most studies for Vitamin K have been done on Japanese women and Vitamin K is widely used in Japan to help prevent bone loss and fractures. Experts do warn caution when deciding to use Vitamin K because most studies were done on the Japanese population and testing on Caucasian population did not show similar reductions in fracture risk or increase in bone density.
Isoflavones: Foods high in isoflavones (a type of ‘phytoestrogens’—plant estrogen) have been shown to help bones. Examples of such foods are: soybeans, chick peas and lentils.


Exercising at least 30 mins three times a week has been shown to reduce risk of hip fractures in older women. Exercise also helps improve your bone density, although this may not be reflective in your actual T-score, but we know that it does help improve the actual mass—we think the effects are likely more by changing architecture of the bone and improving muscle strength as well. Exercising to include walking, jumping, jogging, and resistance training are all excellent to help with your bone health.

Stop Smoking!
I often tell my patients; “there is NOTHING good that comes out of smoking” so might as well just stop and save the money! Here is another reason to quit—help your bones! As quoted from an UpToDate article, “Smoking one pack per day during adult life was associated with a 5 to 10 percent reduction in bone density.”


Certain medicines like steroids, seizure medicines, antacids (especially Proton Pump Inhibitors like Nexium, Protonix, Prevacid, Prilosec) can cause bone loss so you should try to either avoid taking these medicines for a prolonged period of time OR speak with your physicians about alternatives. Of course there are situations where you have to take these medicines (like the seizure medicines) so I often tell my patients to make sure they are good with their Vitamin D supplementation when they are on these medicines. If you have to be on prolonged steroids to treat health problems like Autoimmune Rheumatoid Arthritis, Lupus, or Psoriasis, I would recommend speaking with your doctor about doing a Bone Density Scan (DEXA) after 6 months of being on the medicine to make sure there is no extensive bone loss occurring.

What’s Up With Vitamin D?

Vitamin-DVitamin D is an essential nutrient that plays an important part in our bodies for balance and metabolism of calcium and bone health. The main source of Vitamin D is from sunlight as sunlight is needed to help convert pro-Vitamin D which is in our skin to the active Vitamin D (called cholecalciferol) which the body can use. Other sources of Vitamin D are through diet such as fortified milk (which means that we as a society have added Vitamin D in the milk we purchase, it is not naturally present in animal milk), fatty fish, cod liver oil, and eggs to name a few.
Vitamin D Sources

Vitamin D deficiency is increasingly being diagnosed for multiple reasons. One of the big ones is because we, frankly, are checking for it! Another big reason is because we have become more of an “indoor society” which limits our sun exposure: we are either indoors at home, inside a building for work, or in our cars trying to get to one of those two places! When we are outside, we use sunscreen which blocks the absorption of the rays needed to do the Vitamin D conversion. Sunscreen is important! So don’t stop using it, especially if recommended by your doctor! People with pigmented skin (African Americans, South Asians, Africans etc) have higher incidence of Vitamin D deficiency than their lighter skin counterparts due to the melanin content in their skin. Melanin is the substance in our skin that gives us our color–more melanin a person has the darker their skin color. Melanin also helps prevent skin cancer because it blocks sun rays absorption, but as you can imagine, this is the same reason why darker pigmented people would have higher risk of low Vitamin D.

During winter people tend to have lower Vitamin D levels because there is less sun around due to shorter days thus less sun exposure. Elderly are more prone to Vitamin D deficiency because they tend to stay indoors more. Residents of certain cold countries such as the Netherlands, Greenland etc are low in Vitamin D due to less sun in those regions.

People who avoid dairy due to medical or personal preferance reasons tend to be low in Vitamin D as well due to lack of dietary intake.

Aside from bone health, Vitamin D helps your immune system. It has been shown to help prevent certain cancers including Melanoma, Prostate Cancer, and Colon Cancer. It helps with autoimmune conditions. Multiple studies have shown Vitamin D to help prevent falls; especially in the elderly population (one of the best ways to prevent bone fractures is to prevent falling!). Vitamin D has also been shown to help with decreasing depression. Certain neurological conditions such as Multiple Sclerosis have shown to benefit from Vitamin D supplementation as well. Low levels of Vitamin D have been associated with development of Dementia or decline in memory.

American Journal of Clinical Nutrition published an article where they found that low levels of Vitamin D were “associated with an increase in all-cause mortality [i.e.: death] and mortality from cardiovascular disease, cancer, and respiratory illness.”

Normal levels of Vitamin D are greater than 30. I typically like most of my patients to be around the 40 to 50 range. I recommend my patients with history of Melanoma keep their Vitamin D above 50. If your Vitamin D is low, your doctor will likely give you the prescription dose of Vitamin D of 50,000 I.U. to take once a week for a typical course of 12 weeks to help restore your levels. It is recommended you go back in at the end of the treatment and get your levels rechecked to see if the levels got better.

Many times I have cases where patients tell me “my Vitamin D always comes as low” or “I had my Vitamin D level checked, it was low, I took the prescription medicine so why is it low again?”. The prescription Vitamin D is an excellent way of helping RESTORE OR INCREASE your levels to a NORMAL range; however, you need to do something on a regular basis to help MAINTAIN and KEEP your levels up. Remember, our main reason for low Vitamin D is our LIFESTYLE: a lack of sun exposed lifestyle, which will not change regardless of the prescription Vitamin D. Therefore, after you are done with your Vitamin D prescription, speak with your physician about MAINTAINENCE Vitamin D. I typically ask my patients to take Vitamin D-3 (cholecalciferol) 1000 I.U. to 2000 I.U. daily to help keep their levels up.