Dr. Kevin Most: Thanksgiving and some new blood pressure news

Dr. Kevin Most

Well it is Thanksgiving week, the week we all look forward to. Family, Friends, Fun and feast, who wouldn’t like it? I thought we would take a few minutes to discuss how we can have Family, Friends, Fun and a feast but make it a bit healthier. Some recent changes in the definition of High Blood Pressure make this even more important. I want to make sure that you understand, I am not saying one meal impacts your health in a terribly negative way but what if you could still enjoy the day but do it in a healthy way without impacting the fun or feast.

Before we touch on the meal, lets discuss the important change that was noted last week. Believe it or not overnight last week, 40 million people became diagnosed with hypertension, or high blood pressure and it had nothing to do with preparing for Thanksgiving. Last week the American heart Association and the American College of Cardiology redefined which individuals in the United States are now consider to have high blood pressure. Before last week the blood pressure of 140/90 was considered to be too high for individuals with any heart risk, now that reading is 130/80. So overnight we increased the number of patients with high blood pressure. The impact is substantial, prior to the change 32% of the adult population were considered to have high blood pressure that has changed to 46%.

This is the first change in BP recommendations in 14 years. The changes are based on a large federal study called “SPRINT” this study looked to see what the impact was on keeping blood pressure markedly lower in seniors. The study looked at over 9,300 individuals. The study showed a dramatic decrease in heart attacks, heart failure and strokes in those patients with the lower blood pressure when compared to the previous standards. The other key finding was it allowed seniors to maintain their independence. Many estimate that this will also lower the cost of care. Some may say why would this lower the cost of care as many more patients will be placed on medications. The main reason is, delay or avoidance of a stroke or heart attack will decrease the high costs associated with the hospital care, rehab and loss of work income. Couple that with the fact that many great medications for high blood pressure are now generic and cost pennies a day.

Now I am not saying that 40 million people will be placed on medication this week, in fact most doctors will use this time to promote lifestyle changes. Lifestyle changes with diet, exercise and weight loss will allow many of these patients to not require any medication at all. For example, losing 5 lbs. of excess weight can often drop your blood pressure by 5 points. So that individual who is close to the level of high blood pressure may work on losing weight instead of needing blood pressure medication.

So this announcement has some really bad timing as we enter Thanksgiving Week. I just told you 40 Million people are now moved into a classification of high blood pressure and that losing weight is a great way to lower your blood pressure, and we are entering the week of Thanksgiving and the holiday season where we often see individuals put on 10 pounds not lose 5 pounds. By the way we have president Lincoln to blame for this as he made Thanksgiving a national holiday in 1864

First some basics the average adult needs 1800 – 2400 calories in a day, depending on sex and activity level. Many individuals track calories and most restaurants and fast food facilities share the caloric intake on their menus so we can have an idea of what we ingest. Smart eaters are looking at menu’s differently these days and restaurants are actually starting to look at portion control as a selling point. Well, I hate to share this with you but let’s discuss the Thanksgiving meal that we all love and look forward to. Any guesses on how many calories Thanksgiving dinner will bring each of us? Would you believe it ranges from 3500 to 6000 calories depending on if you go back for seconds. Worse yet the meal will also deliver up to 250 grams of fat, that is 3 times the amount of fat that we should be taking in each day.

Well not to be a bummer but let’s discuss a few things about the feast.

Watch out for the appetizers- although it is not considered part of the meal, appetizers are often loaded with fat grams and thus can easily add 1500 calories. Consider healthy appetizers

Let’s go over the meal

Turkey with gravy- 8 oz. with skin on- 440 calories 18 grams of fat
Stuffing- 1 cup 400 calories 18 grams of fat
Green bean casserole- 1 cup 350 calories 17 grams of fat
Mashed potatoes with gravy- 1 cup 443 calories 25 grams of fat
Sweet potatoes with marshmallows 1 big scoop 610 calories 9 grams of fat
Cranberry sauce 1/2 cup 200 calories but no fat !!
Biscuit with butter 200 calories 15 grams of fat
Pecan pie- Pumpkin Pie 400 calories 30 grams of fat

This total is 3100 calories, but we have not added in appetizers, or any drinks. So with basic appetizers and a few drinks and you are north of 4500 calories just for the Thanksgiving meal alone!!

So what can we do to make sure we still enjoy the Thanksgiving meal and we don’t upset any relatives by avoiding the portion of the meal they brought. The main thing one can do is portion control. Your plate does not need to be overflowing, cutting back on serving sizes allows you to still enjoy each portion while limiting calories. Minimize appetizers that are not healthy, cream based dips and cheese balls have lots of calories that you would rather save for the main meal. Removing or not eating the skin of the turkey eliminates a lot of calories as well as fat grams. When having dessert ask for the slice to be cut in half, and take the other half home to enjoy the next day.

For those of you preparing dishes consider a healthier preparation of some of the favorites. For example sweet potatoes are very healthy, lots of Vitamin A and C, calcium and iron with a low calorie count. The calories add up quickly however when we add butter, sugar and marshmallows. There are healthy recipes where spices add flavor without adding calories.

Green bean casserole is a classic Thanksgiving vegetable, but in all honesty we should not consider it a vegetable at all. First we often will used canned beans as they are easier to find and less expensive. Unfortunately they are loaded with sodium, (think of blood pressure issue from above), then we add a cream based soup that is loaded with sodium and fat, and then we top it with fried onions, loaded with sodium and fat. It is no surprise that this side is consider a “heart attack waiting to happen” Green beans are a great vegetable and can be cooked in a very healthy way and use spices in place of sodium to get a true vegetable on your plate while lowering fat, calories and sodium.

I don’t want to be a bummer before Thanksgiving, but going into the holiday with some information and strategies will help your health. So if you are preparing, think about healthy prep and recipes, if you are consuming consider portion control. I like to think of it in this way, why have one huge meal on Thanksgiving, why not stretch it out to 3-4 good meals over the weekend. If you are the host have plenty of zip lock bags available so leftovers can be distributed to guests at the end of the day, this also lowers your temptation to have another big meal over the next few days as we hate to waste food. We all look forward to the left over Thanksgiving meals on Friday and Saturday so left overs are appreciated. Balance your caloric intake the few days following and try to get out for some exercise.

The goal going into December should be looking at a stable weight pattern, a new focus on blood pressure as we prepare for the New Year.

I hope you all have a wonderful Thanksgiving surrounded by families and friends, make sure you share with them that you are thankful for their friendship, it is a key part to keeping us all healthy.