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.
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