Tuesday, April 23, 2013

Dr Visit and the FAT Issue

I went to the doctor today to get some feedback on my blood pressure. My doctor was awesome. He was very thorough and after the nurse had taken my blood pressure twice (and came back in the 124/76 range), we chatted for a bit and then the doctor took my blood pressure himself, once in each arm. He got a slightly higher reading, and I told him about the readings I am getting at home with my Omron. After a lengthy, detailed discussion of my weight, foot pain, activity level, diet, and supplements, here is what he said.

1) the meloxicam I was taking can elevate blood pressure.
2) becoming sedentary as I have can elevate blood pressure.
3) eating a low fat diet (under 30%) can lower blood pressure.

This is what he wants me to do for the next 6 weeks:

1) don't take the meloxicam unless absolutely necessary.
2) get on the bike for as long as I can without hurting my feet, every day if possible, and get my heart rate up. He advised me not to do any strength training with weights at this point, as it can spike blood pressure.
3) keep my fat intake under 30%.
4) continue to lower my sodium intake, not just by avoiding the salt shaker but by reading the labels on what I eat (I do eat some higher sodium foods like turkey sausage, cheese, jarred tomato sauces).
5) stay off the caffeine.

He told me that when I take my blood pressure, I need to sit in a quiet room with my feet flat on the floor, relaxed, for at least 5 minutes. Then take the reading. I am to write them down and bring a list of readings back to him at my next appointment.

He wants me back in 6 weeks, and if I have followed all of these instructions and still have high readings, he will order an EKG and start me on blood pressure medication.

Now about that fat. Someone left me a comment the other day saying my fat intake was too high and referring me to the Medifast vegetarian guide. At the bottom, it says that on the 5&1 Plan, daily fat intake should be "at least 10 grams but less than 30 grams." Well, this surprised me. The documents I have, and the nutritionists on Medifast, have always said "10 to 34 grams of fat per day." So is the maximum 29? Or 34? I sent an email off to my dietitian who explained:

"The overall goal is to have less than 30% of total calories be from fat for the 5 & 1 Plan. For 800 calories this would be an upper limit of  about 27 grams and for 1,000 calories this would be about 34 grams. In other words, 34 grams is the specific ‘maximum’ amount. To make things easier, whole numbers are often used; therefore the guidelines on the meatless options stating 10-30 grams was developed. Both guidelines meet the intended goal of less than 30% of total calories from fat."

So there you have it. Basically I need to stay under 30% of calories from fat, just like my doctor recommended. That's a clear guideline, and I can do that.

My problem has been in using fats as condiments and fatty nuts as snacks on Medifast. This is what has put me over 30% for most of the time I've been on Medifast. Yes, nuts are allowed as snacks. Yes, some fats can be used as condiments on Medifast. If I use fats as my 3 condiments and nuts as my snack, that adds 10-12 grams of fat to my day. So I have to keep a better eye on that. Also, the healthy fats on Medifast are supposed to be consumed with the Lean & Green meal for gall bladder health. I didn't know that for a long time, and got in the habit of using my fats throughout the day like many folks do on Medifast: half & half in my coffee, cream cheese on my Medifast muffin. I am going to stick to having my fats only with my main meal from now on, too. ETA: here's an interesting study on the effect of dietary fat on blood pressure.

I am hopeful that with more exercise, less salt and fat, and following all of my doctor's other advice, my blood pressure (and my weight) will start going down.

I see the specialist next week and will get his input as well.


Terri Lin said...

I have never posted a comment on your site but wanted to share with you my experience with plantar fasciitis, since you said you have it now. I had it several years ago and read an article that said that if you wear a night splint boot made for plantar fasciitis every night for 12 weeks it can be cured. This was my second time suffering from plantar fasciitis so I decided to give it a try. It worked and I haven't had any problems since. I found my night splint boot on Amazon. I just wanted to share this with you in case it might be of some help. Good luck with it. I enjoy reading your blog, it gives me inspiration.

Lyn said...

Terri Lin~

Thank you so much! You reminded me of something my doctor said to me today about those night boots. I have a pair but they keep me awake so I rarely use them. He told me to try and sleep with ONE of them on each night and see if I can get at least one foot better. Then I could switch to the other foot. Oh, and he also told me that in order to get relief without as much risk to my "degrading fat pads" on my heels, I could do a smaller dose of cortisone in a shot. I didn't know that was an option either (lower dose). So I will try the boot and then if need be, the lower dose shots.

MargieAnne said...

Lyn I am kind of shocked that your BP reading at the Dr's office is considered high. To me that is normal, maybe on the high side of normal but nothing to be concerned about. I am seriously concerned that the medical people seem to keep reducing what they term as normal. Of course it suits the pharm industry because more meds are likely to be prescribed. You seem to have a wise Dr. and I hope following his prescription brings you to a level considered acceptable.

If you looked at the link I mentioned yesterday you will see that there is a clear link between magnesium, potassium and sodium and blood pressure levels and well-being. This, to my way of thinking, is far more important that reducing sodium unless you are certain you are exceeding common sense.

Sometimes when I feel low a sachet of electolytes in a glass of water makes an enormous difference to energy and general well-being.

I know you have chosen a low to moderate fat diet but don't forget that the good things fat does within our bodies and good fats, (not seed oils, hydrogenated fats etc), are the one thing our bodies need us to eat. Without fat we have no way of getting the benefits of vitamins D and A

Glad your Dr visit worked out well for you and look forward to the difference as you follow instructions.


Lyn said...


I just looked back and I wasn't really clear in this post about my blood pressure readings, but at home I have been getting 140's over high 80's. He got 130's over 88 when he checked it. I think the first readings by the nurse would be considered normal though. I agree about the pharm industry :)

I think you are right about the mag/potassoim/sodium thing, too. I started taking a magnesium supplement recently (Natural Calm) and am paying attention to the potassium in my foods (mainly spinach and chard from that list you linked to). The salt I was using is Himalayan crystal salt which is healthy, but I think the sodium in the processed foods is the main culprit if anything.

Agreed on the fat... and I really look forward to getting back to eating more avocado etc when I am in maintenance!

Thank you MargieAnne :)

Chanelle Felder said...

I find it so funny/ironic that another commenter of yours mentioned how she *believes* there is a strong link between sodium/magnesium/potassium when (as a person with no adrenal glands), I can tell you with absolute certainty that there IS a link between the two. A powerful link in fact! I deal with the exact opposite issues as you, Lyn (low BP, never enough salt in my diet, trying to gain weight healthfully, etc.), and the way my body works, I am constantly salting my food in order to retain water and help my body deal with the excess potassium that my body stores (whereas, "normal" people are told to watch their salt and eat more potassium). Of course, you do need salt and fat in your diet, which of course you know, but I would really see if increasing your potassium-rich foods could help you adjust how your body is dealing with the salt and thus, get your blood pressure in line.

Just a thought from your exact opposite (health wise!)


Lyn said...


that is really interesting. I am sorry you are dealing with that! I am going to try and find more potassium-rich foods that are also low enough in carbs for me to eat on my current plan. Will be doing more research on this sodium/potassium/magnesium thing. Thanks!

timothy said...

sounds like thr doc gave you some good input and try the boots definatelY! also garlic can lower blood pressure

Anonymous said...

The tips your doctor has given you seem spot on to me. I'm no expert but I have had a similar issue in the past, if you get your fat % lower and increase your exercise your blood pressure will go right down. It worked for me :)


Caroline said...

Don't be afraid of fat! Check out the Fat Head documentary (I saw it on Netflix) - it changed my life and it will change yours - for the better of course! It led me to an even bigger life changer: Good Calories Bad Calories by Gary Taubes, which totally blew my mind (I found it at my local library - it's a pretty big book, but he has a shorter less sciency version as well if you're not up for all the technical details). Fat is your friend! Well, not fake fats, but the ones we've all been told to be scared of are. I'm not afraid of salt anymore either, but I am fighting sugar, because sugar is the real problem. Most doctors aren't paying attention and are still telling us to watch fat and salt intake, and that's a real shame. We all owe it to ourselves to understand what's really going on in our bodies. Please please check out the documentary and/or the book! It will probably lead you on a wild chase for more information, as it has for me (though I admit I'm also extremely into research and I studied to be a librarian). Btw, these days I find most of my inspiration to give up sugar on www.marksdailyapple.com. I'm totally determined to win!