Foods Which Lower Blood Pressure

by Diane, M.P.H, M.S.

Plant-based diets and diets rich in whole fruits and vegetables are strongly associated with lower blood pressure, so much, that the National Institutes of Health (NIH) officially recommends adopting healthy eating practices as one of the best ways to prevent or lower high blood pressure and hypertension.’ A healthful diet can also reduce your risk of future cardiovascular problems. 

Follow a heart-healthy diet:

  • Keep a food diary: Write down what you eat, how much, when & why, even for just a week, to monitor your true eating habits.
  • Increase your dietary intake of potassium: Potassium can counter the effects of sodium on blood pressure. The best source of potassium is natural, unprocessed food such as fruits and vegetables, rather than supplements.
  • Make a shopping list before going to the supermarket to avoid buying junk food. Read food labels whenever you shop and follow a healthy-eating plan when dining out, too.
  • Eat more poultry (skinless chicken breasts, turkey), fish, nuts, and legumes (beans), tofu and less red meat.
  • Avoid frozen and breaded products, pre-marinated meats and poultry, processed chicken, bacon, sausage, deli meats which tend to be high in sodium and fat.
  • Choose low-fat or nonfat milk and other dairy products instead of full-fat versions.
  • Eat vegetables and fruits instead of sugary or salty snacks and desserts.
  • Select breads, pasta, cereals, and other carbohydrate-rich foods made from whole grains, instead of highly refined white flour.
  • Eat fruit instead of drinking fruit juice.
  • Use unsaturated fats like olive, canola, soybean, peanut, corn, or safflower oils, instead of butter, coconut oil, partially hydrogenated oil, or palm-kernel oil.
  • Choose fresh or frozen foods instead of canned and processed foods.
  • Choose low-sodium foods when possible; use herbs, spices, vinegar, and other low-sodium flavorings instead of salt.
  • Don’t skip meals; try to eat 1/3 of your calories at breakfast.

Reduce the amount of sodium you consume:

  • Estimate and record how much sodium is in what you eat and drink each day.
  • One level teaspoon of salt has 2,300 mg of sodium. Limit sodium to this amount each day or less, to help reduce your blood pressure.
  • A lower sodium level, 1,500 mg a day or less, is recommended for people 51 years of age or older, and individuals of any age who are African-American or have high blood pressure, diabetes or chronic kidney disease.
  • Read food labels: Choose low-sodium or salt-free alternatives of foods and beverages you normally buy.
  • Avoid foods high in sodium, such as canned foods, instant rice and pasta mixes, snacks like chips and crackers, foods that have been preserved or pickled, frozen entrees and fast foods.
  • Eat fewer processed foods; Potato chips, crackers, frozen dinners, bacon, processed deli meats and cheeses are all high in sodium.
  • Use herbs, spices and citrus juices, rather than salt, to add more flavor to your food.
  • If you have difficulty eliminating sodium from your diet, cut back gradually: Your palate will adjust over time.
  • Buy fresh, plain frozen, or canned no-salt-added beans and vegetables.
  • Use fresh fish, poultry and lean meat, rather than canned or processed foods.
  • Use herbs, spices, citrus juice, and salt-free seasonings in cooking and at the table.
  • Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes which usually have added salt.
  • Choose “convenience” foods that are lower in sodium.
  • Reduce your consumption of frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings.
  • Rinse canned foods, such as beans, salmon or tuna, to remove some of the sodium.
  • When available, buy low- or reduced-sodium, or no-salt-added versions of foods.
  • Choose breakfast cereals without or lower in sodium.
  • The National Heart Lung Blood Institute (NHLBI) suggests eating at least 3,500 mg of potassium a day, from foods such as yogurt, cantaloupe, spinach, and bananas. Potassium may help rid the body of too much sodium by acting as a diuretic.
  • Drink plenty of water to help flush excess sodium from your body.

Avoid tobacco products and secondhand smoke:

  • Nicotine in tobacco products can raise blood pressure by 10 mm Hg or more for up to an hour after you smoke.
  • Smoking throughout the day may keep your blood pressure constantly high.
  • Inhaling smoke from others puts you at risk of various health problems, including high blood pressure and heart disease.

Reduce your intake of alcohol:

  • While alcohol in small amounts may lower blood pressure slightly, too much alcohol (more than 1 drink/day for women and men older than age 65, or more than 2/day for men age 65 and younger) will raise blood pressure.
  • If you normally avoid alcohol, don’t start drinking as a way to lower your blood pressure: There’s more potential harm than benefit to drinking alcohol.
  • Drinking more than moderate amounts of alcohol can raise blood pressure by several points, as well as, reduce the effectiveness of high blood pressure medications.
  • Keep an alcohol diary to track your true drinking patterns. One drink equals 12 ounces (355 milliliters, or mL) of beer, 5 ounces of wine (148 mL) or 1.5 ounces of 80-proof liquor (45 mL). If you’re drinking more than these amounts, cut back.
  • Reduce your intake slowly: If you are a heavy drinker, suddenly eliminating all alcohol can actually trigger severe high blood pressure for several days. Therefore, reduce your alcohol intake with the supervision of your doctor, or taper off slowly over one to two weeks.
  • Avoid binge drinking: Having 4 or more drinks in a row can cause sudden, large increases in blood pressure, in addition to other health problems.

Reduce your intake of caffeine:

  • Drinking caffeinated beverages can temporarily cause a spike in blood pressure, but whether the effect is temporary or long lasting is unclear.
  • To see if caffeine raises your blood pressure, check it within 30 minutes of drinking a cup of coffee or another caffeinated beverage you regularly drink. If your blood pressure increases by 5-10 points, reduce your intake.

Foods which can help lower your blood pressure or reduce your need for medication. Consume these as part of a comprehensive approach, including increased exercise and other lifestyle changes:

  • Fresh fruits and vegetables (5 cups a day): Rich in antioxidants, fiber, magnesium, potassium, vitamins, minerals, and other nutrients, these will help you to lower your cholesterol, lose weight, and improve your heart health. Choose these first whenever you need something to eat!
    • Apples
    • Asparagus
    • Avocados in moderation, due to their high fat, high caloric content
    • Berries: Blackberries, blueberries, raspberries and strawberries contain natural anthocyanins, compounds that protect against hypertension.
    • Whole beets and beet juice
    • Bell peppers
    • Broccoli
    • Cabbage
    • Carrots
    • Cauliflower
    • Celery or celery root
    • Dark leafy greens like bok choy, dandelion and mustard greens, kale, spinach, Swiss chard, turnips)
    • Eggplant
    • Green beans
    • Grapes
    • Guava
    • Kiwis
    • Melons: Cantaloupe, honeydew, watermelon, etc.
    • Onions
    • Oranges
    • Papaya
    • Peaches
    • Organic fresh or frozen peas
    • Pears
    • Plums
    • Squash
    • Sweet potatoes
    • Tomatoes
    • Zucchini
  •  Low-fat or nonfat dairy products naturally high in calcium (Avoid cream)
    • Buttermilk, low-fat or nonfat
    • Cheese, nonfat or reduced-fat
    • Cottage cheese or ricotta cheese, nonfat, 1%, unsalted if available
    • Cream cheese, nonfat or light
    • Skim or low-fat milk
    • Non-fat or low-fat yogurt
    • Non-fat or low-fat frozen yogurt
  • Almond milk, soy milk, and other non-dairy products: These can be options, especially if fortified with calcium, Vitamins A and D, and other nutrients, but buy unsweetened versions to avoid added sugar.
  • Fish, poultry, lean meats, and meat substitutes: The American Heart Association suggests 2 servings of fish a week. Eat more heart-healthy tofu and other soy protein and limit fatty cuts of meat, cold cuts, sausage, and other processed meats.
    • Beef, lean cuts and lean ground round or sirloin
    • Chicken or turkey breasts and tenders, skinless, boneless
    • Chicken or turkey, ground
    • Fish, high in omega-3s: Arctic char, herring, mackerel, wild Alaskan salmon, wild Pacific cod, sardines, tilapia, trout, tuna
    • Pork tenderloin, trimmed of fat
    • Seitan
    • Tempeh
    • Tofu
  • Frozen Foods: When your favorite fruits and vegetables are out of season, choose frozen ones for nutritious desserts, side dishes, and snacks.
    • Fruits without added sugar, such as frozen blueberries, raspberries, and strawberries
    • Soybeans (edamame)
    • Vegetables and vegetable mixtures without added sauce, gravy, or sodium
  • Beans, grains, soups, and sauces: Beans and whole grains like bran flakes, oatmeal, oat squares, shredded wheat, brown rice, buckwheat, quinoa , and wheat berries offer fiber to help lower your cholesterol.
    • Beans and lentils, canned (select unsalted or reduced-sodium)
    • Beans and lentils, dried
    • Broth, reduced-sodium vegetable, chicken, or beef
    • Whole-grain cereals with 5 or more grams of dietary fiber and less than 8 grams of sugar per serving
    • Flaxseed, ground or whole
    • Whole wheat flour
    • Whole grains such as barley, brown rice, buckwheat, bulgar, oat bran and rolled, steel-cut, or Irish oats, wheat berries, couscous, polenta, millet, and quinoa
    • Pasta sauce, low-fat or fat-free
    • Pasta, whole wheat, spelt, or kamut (Note: These whole-grain pastas come in bowtie, fettuccini, lasagna, spaghetti, fusilli, spiral, elbow macaroni, and ravioli varieties.)
    • Rice: brown, wild, and brown basmati
    • Soups, low-sodium, and 98% fat-free cream of mushroom
    • Soy flour
    • Tomato paste
    • Tomatoes, whole or diced, reduced-sodium
    • Vegetarian or nonfat refried beans
  • Condiments: Watch out for high amounts of salt in condiments and sauces.
    • Barbecue sauce, low-sodium
    • Ketchup, reduced-sodium
    • Mayonnaise, reduced-fat or nonfat
    • Mustards: whole grain, honey, Dijon, yellow
    • Soy sauce, reduced-sodium
    • Vinegars such as rice, red wine, balsamic, apple cider, raspberry make delicious salad dressings.
  • Use healthy oils, like olive and canola, instead of butter and margarine:
    • Nonfat cooking sprays
    • Olive oil and canola oil
    • Use applesauce, fruit puree, or yogurt as a substitute for fat (butter, shortening) or sour cream when baking
    • Salad dressings, reduced-fat or nonfat
  • Stock your pantry with nuts, dried fruit, and whole grain products for snacks and meals:
    • Unsalted nuts and seeds (almonds, walnuts, pecans, pumpkin seeds, sesame seeds, sunflower seeds)
    • Dried fruits like unsweetened figs, raisins, prunes, dates
    • Popcorn cakes or brown rice cakes
    • Plain, unsalted popcorn
    • Whole grain breads, tortillas, pitas
    • Whole-grain, trans-fat-free, low sodium crackers
    • Whole grain pretzels
    • Baked, trans-fat-free tortilla chips
  • Use the following spices and herbs to flavor your food instead of salt: 
    • Allspice
    • Basil
    • Bay leaves
    • Black pepper
    • Caraway seeds
    • Cayenne
    • Chili powder
    • Chinese five-spice
    • Cinnamon
    • Cloves
    • Coriander
    • Cumin
    • Curry powder
    • Dill
    • Garlic powder
    • Ginger
    • Italian seasoning
    • Marjoram
    • Mint
    • Nutmeg
    • Onion powder
    • Oregano
    • Paprika
    • Parsley
    • Red pepper flakes
    • Rosemary
    • Thyme
    • Sodium-free seasonings
  • Sweeteners: Reduce your intake of sugar, artificial sweeteners, and brown rice syrup which has been found to be high in arsenic. These provide non-nutritive (empty) calories and will only increase your appetite. Instead, use honey or maple syrup in moderation when a sweetener is needed.

In addition to regular physical activity, follow a plant-based diet rich in fruits, vegetables, beans, lentils, nuts and seeds, whole grains, with low-fat dairy products and less saturated fat, cholesterol, salt and sugar, in order to lower your blood pressure naturally!

References:

  1. American Dietetic Association: “Fresh, Canned, or Frozen?”
  2. American Heart Association: “Eating Low-Fat Dairy Foods May Reduce Your Risk of Stroke.” 04/19/12.
  3. American Heart Association: “Eating Fish for Heart Health.” 05/15/15.
  4. American Heart Association: “Fats and Oils.” 10/15/14.
  5. American Heart Association: “Shaking the Salt Habit.” 05/18/15.
  6. American Heart Association: “Sugars, Added Sugars, and Sweeteners.” 06/29/15.
  7. “Cholesterol and Triglycerides Health Center: Your Heart-Healthy Grocery Shopping List.” WebMD, LLC. Reviewed by Arefa Cassoobhoy, MD, MPH: 07/02/14. (Source: http://www.webmd.com/cholesterol-management/heart-healthy-kitchen?page=2)
  8. “Health Risks of Energy Drinks.” Dianesays.com. 10/24/12.
  9. “Blood Pressure Health Tips” category. Dianesays.com:
    • “Foods Which Raise Blood Pressure.”08/17/15.
    • “Lifestyle Changes Which Can Help Lower Your Blood Pressure.” 07/22/15.
    • “Medications and Supplements That Can Raise Blood Pressure.” 07/20/15.
    • “What is Blood Pressure?” 07/20/15.
    • “How to Maintain a Healthy Blood Pressure.” 10/17/12.

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Some daily lifestyle changes can help reduce your high blood pressure to within safe limits:

  • Avoid smoking, or smoke less and try to quit.
  • Get regular physical activity, walk for at least 30 minutes each day, take stairs instead of elevators, dance, garden, engage in a healthy hobby and spend less time sitting.
  • Drink more water (at least 50% of your body weight in ounces).
  • Take a walk after meals whenever possible.
  • Try to get more natural Vitamin D from the sun.
  • If you are overweight, try to lose some weight.
  • Eat a healthier diet naturally rich in antioxidants, magnesium, potassium, calcium, vitamins C and D:
    • Eat more fresh fruits, vegetables, low- or non-fat dairy products, plain unsalted nuts and seeds, lean sources of protein (beans, lentils, fish, lean meats)
    • Eat less animal fat, saturated fat, cholesterol (butter, cakes, cheese, cookies, crackers, meats, cold cuts), sugar and salt.
    • Avoid trans fats of any kind (partially hydrogenated oils, tropical oils)
    • Avoid heavily salted food.
    • Reduce your intake of cold cuts, processed, prepared and restaurant foods.
    • Cook and eat foods with no or little salt added, by using natural herbs, spices, and citrus juice instead to enhance flavor.
    • Reduce your intake of alcohol, caffeinated beverages, energy drinks, sodas, fruit punches.
    • Avoid products containing the preservative sodium benzoate, an unhealthy source of sodium.
  • Spend more time outdoors doing safe activities that you enjoy, hiking and appreciating nature, visiting family and friends, and less time indoors with your TV, computer, and other electronic or wireless devices.
  • Try to get at least 8 hours of sleep each night.
  • Practice meditation, tai chi, yoga and/or express gratitude for the good things in your life. Slow breathing and meditation decrease stress hormones which elevate renin, a kidney enzyme that raises blood pressure. Try 5 minutes in the morning and at night. Inhale deeply and expand your belly. Exhale and release your tension.
  • Take steps to reduce stress in your life.
  • Seek support from your family and friends when you need help in accomplishing tasks or dealing with problems. Otherwise, try to join a support group to talk with people who can help you cope with your situation or give you physical, emotional or spiritual help.

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Some prescription and over-the-counter (OTC) medications, supplements and other substances can raise your blood pressure. They may also interfere with medications intended to lower your blood pressure. If you are taking any of the following medications or supplements and are concerned about their effect on your blood pressure, talk with your doctor:

Acetaminophen:

  • People who take acetaminophen (Tylenol, other versions) daily are more likely to develop high blood pressure than people who don’t take acetaminophen. However, taking acetaminophen occasionally is not known to cause a long-term increase in blood pressure.
  • Tell your doctor if you take acetaminophen regularly. Your doctor may recommend alternating between acetaminophen and other pain relievers. Because pain relievers affect blood pressure in different ways, alternating between them may give your body a break.
  • Try other ways to control pain, such as an anti-inflammatory diet, warm or cold compresses, stretching, exercise or massage.

Antidepressants:

  • These change your body’s response to brain chemicals that affect your mood, such as serotonin, norepinephrine and dopamine, and may also raise your blood pressure:
    • Venlafaxine (Effexor, Effexor XR)
    • Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL)
    • Desipramine (Norpramin)
    • Phenelzine (Nardil)
  • If you take antidepressants, have your blood pressure checked regularly. If your blood pressure increases or isn’t well controlled, ask your doctor about alternatives to these medications.
  • Lifestyle changes (eliminating salt, cold cuts, condiments, processed and prepared foods from your diet, exercising more often, learning better ways to manage stress, engaging in a favorite hobby, etc.) or different medications may improve both your blood pressure and depression.

Birth control pills and other hormonal birth control devices:

  • These contain hormones that may increase your blood pressure by narrowing smaller blood vessels. Almost all birth control pills, patches and vaginal rings warn that high blood pressure can be a side effect.
  • Not all women will have increased blood pressure from using hormonal birth control. If you’re worried, have your blood pressure checked at least every 6-12 months. If you already have high blood pressure, consider using a different form of birth control.
  • While nearly all birth control pills can raise blood pressure, your blood pressure may be less likely to increase if you use a birth control pill or device that contains a lower dose of estrogen.

Caffeine:

  • Can temporarily raise blood pressure by blocking a hormone that keeps blood vessels widened, allowing blood to easily flow through them. Caffeine may also stimulate cortisol and adrenaline production, which makes your blood flow faster, thus increasing your blood pressure.
  • Caffeine-containing medications and products include:
    • Caffeine pills (Vivarin, others)
    • Caffeine in coffee, energy drinks, tea and other beverages
  • Although caffeine has not been shown to raise blood pressure long term, try to limit your daily amount of caffeine to no more than 200 milligrams (about the amount in two 12-ounce [355-milliliter] cups of coffee).

Corticosteroids:

  • All corticosteroid drugs, including prednisone, can cause sodium retention, resulting in dose-related fluid retention.
  • Those with strong mineralocorticoid effects (e.g., fludrocortisone, hydrocortisone) cause the greatest degree of fluid retention.
  • Those with weaker mineralocorticoid activity (e.g., dexamethasone, triamcinolone, betamethasone) may produce minor fluid retention.
  • Corticosteroid-induced fluid retention can cause hypertension; Patients with preexisting hypertension may develop elevated blood pressure when taking such drugs.

Cough and cold medicines (decongestants):

  • Many cough and cold medications contain non steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and/or decongestants. Both of these drugs can narrow your blood vessels, making it harder for blood to flow through them, and thus increase your blood pressure.
  • Decongestants can worsen blood pressure by:
    • Raising your blood pressure and heart rate.
    • Preventing your blood pressure medication from working properly.
    • Pseudoephedrine (Sudafed) is a specific decongestant that can increase blood pressure.
  • Some decongestants which can increase blood pressure include:
    • Pseudoephedrine (Sudafed)
    • Phenylephrine (Sudafed PE)
    • Oxymetazoline (Afrin, others)
  • Always check the label of any allergy, cough and cold medication to see if it contains a decongestant or NSAID. If you have high blood pressure, avoid using such drugs, especially pseudoephedrine. Ask your doctor or pharmacist about safer ways to ease congestion symptoms such as antihistamines or nasal sprays which should minimize cardiovascular effects.

Herbal supplements:

  • Always tell your doctor about any herbal supplements you take or are thinking about taking, since some supplements can raise blood pressure and/or interact with blood pressure medications.
  • Herbal supplements that can affect blood pressure and/or blood pressure medications include:
    • Arnica (Arnica montana)
    • Bitter orange (Citrus aurantium)
    • Ephedra (Ma-huang)
    • Ginseng (Panax quinquefolias and Panax ginseng)
    • Guarana (Paullinia cupana)
    • Licorice (Glycyrrhiza glabra)
    • St. John’s wort (Hypericum perforatum)
    • Senna (Cassia senna)
  • Herbal supplements aren’t necessarily safe just because they are labeled as “natural.” Check with your doctor before taking any herbal supplements. You may need to avoid those that raise blood pressure or interfere with your blood pressure medications.

Immunosuppressants:

  • Some immunosuppressants can affect your kidneys and raise your blood pressure.
  • Immunosuppressants that can increase blood pressure include:
    • Cyclosporine (Neoral, Sandimmune)
    • Methylprednisolone (Medrol)
    • Tacrolimus (Prograf)
  • Have your blood pressure checked regularly. If your blood pressure increases or isn’t well controlled, ask your doctor about alternatives to these medications. Lifestyle changes or additional medications to control your high blood pressure may help.

Illegal drugs:

  • These can raise blood pressure by narrowing arteries that supply blood to your heart. This increases your heart rate and damages your heart muscle.
  • Illegal drugs that can affect your heart include:
    • Amphetamines, including methamphetamine
    • Anabolic steroids
    • Cocaine
    • Ecstasy
    • Phencyclidine (PCP)
  • If you are using illegal drugs, you must stop. Ask your doctor for information on counseling or drug treatment programs.

Migraine headache medications:

  • Some migraine medications constrict blood vessels in your head to relieve migraine pain. However, they also constrict blood vessels throughout your body. This makes your blood pressure rise, sometimes to dangerous levels.
  • If you have high blood pressure or any other type of heart disease, speak with your doctor before taking a drug for migraines or severe headaches.

Nonsteroidal anti-inflammatory drugs (NSAIDs):

  • NSAIDs include both prescription and over-the-counter medication and are often used to reduce inflammation or pain from conditions such as arthritis. However, they may cause your body to retain fluid, stress and decrease the function of your kidneys, and consequently raise your blood pressure, putting even greater stress on your heart and kidneys!
  • Some NSAIDs that can raise blood pressure include:
    • Ibuprofen (Advil, Motrin, others)
    • Meloxicam (Mobic)
    • Naproxen (Naprosyn)
    • Naproxen sodium (Aleve)
  • Have your blood pressure checked regularly. Talk to your doctor about which pain medication is best for you. If you must continue taking an NSAID that increases your blood pressure, your doctor may recommend lifestyle changes or additional medication to control your blood pressure.
  • NSAIDs are sometimes included in over-the-counter medication for various health problems, such as cold medicines. Therefore, before you buy an over-the-counter drug, always check the label for NSAIDs. Ask your doctor if any NSAID is safe for you to use. Sometimes an alternative, such as acetaminophen, may be better than NSAIDs.

Stimulants:

  • Some, like caffeine and methylphenidate (Ritalin), can cause your heart to beat faster or irregularly, raising your blood pressure.
  • Have your blood pressure checked regularly, if you take a stimulant. If your blood pressure increases or isn’t well controlled, ask your doctor about alternatives to these medications. He/she may recommend lifestyle changes or additional medications to control your high blood pressure.

Weight loss drugs: 

  • Appetite suppressants tend to “rev” up your body. This can increase your blood pressure and stress your heart. Some weight loss drugs are known to worsen heart disease.
  • Before using any weight loss drug, whether prescription or over-the-counter, speak with your doctor. While these medications may be useful for weight loss, they may do more harm than good.

Rebound hypertension occurs when blood pressure rises after you stop taking, or lower the dose of, a drug that influences blood pressure (typically a high blood pressure medication):

  • To avoid medical problems, only take medications that are safe for people with high blood pressure.
  • Give a list of ALL medications you use, both prescription and over-the-counter, to each doctor you visit.
  • Read medication labels before buying over-the-counter products.
  • Make sure the medicine does not contain ingredients that could worsen your high blood pressure, such as NSAIDs or decongestants.
  • Talk to your doctor and pharmacist before using any over-the-counter medication, herbal preparation, vitamins, or other nutritional supplements.
  • Ask for alternatives to potentially harmful medicines.

References:

  1. “Medications and supplements that can raise your blood pressure: From acetaminophen to stimulants, know which drugs and supplements can affect your blood pressure.” Mayo Clinic staff. 2015. (Source: http://www.mayoclinic.com/health/blood-pressure/MY00256)
  2. “The Harvard Medical School Family Heath Guide: Don’t Let Decongestants Squeeze Your Heart.” © 2010 WebMD, LLC. All rights reserved. WebMD Medical Reference. Reviewed by Brunilda Nazario, MD on 10/19/11.
  3. “Hypertension/High Blood Pressure Health Center: Medications That Cause High Blood Pressure.” (Source: http://www.webmd.com/hypertension-high-blood-pressure/guide/medications-cause)

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Drug-Induced Hypertension

by Diane, M.P.H, M.S.

Drug-induced hypertension: 

High blood pressure caused by using a chemical substance, drug, or medication

Drugs that can cause hypertension include:

  • Acetaminophen
  • Alcohol, amphetamines, ecstasy (MDMA and derivatives), and cocaine
  • Antidepressants (including venlafaxine, bupropion, and desipramine)
  • Caffeine (including the caffeine in coffee and energy drinks)
  • Corticosteroids
  • Cyclosporine
  • Erythropoietin
  • Estrogens (including birth control pills) and other hormones
  • Many over-the-counter medications such as cough/cold and asthma medications — particularly when the cough/cold medicine is taken with certain antidepressants like tranylcypromine or tricyclics
  • Migraine medications
  • Nasal decongestants
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

Alcohol’s effect on blood pressure is often taken for granted:

  • Drinking too much alcohol can increase your blood pressure.
  • The American Heart Association’s Guidelines state that if you drink alcohol, limit the amount to no more than 2 drinks a day for men, or 1 a day for women. They define a drink as one 12-ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits.
  • If you are taking medication, note that alcohol magnifies the potency and risk of side effects from your dose of medication. Your liver and kidneys must work harder in the presence of alcohol, to metabolize and excrete various components of these drugs.

Rebound hypertension: This occurs when blood pressure rises after you stop taking, or lower the dose of, a drug (typically a high blood pressure medication).

To avoid medical problems, only take medications that are safe for people with high blood pressure:

  • Give a list of ALL medications you use, both prescription and over-the-counter, to each doctor you visit.
  • Read medication labels before buying over-the-counter products.
  • Make sure the medicine does not contain ingredients that could worsen your high blood pressure, such as NSAIDs or decongestants.
  • Talk to your doctor before using any over-the-counter medication, herbal preparation, vitamins, or other nutritional supplements.
  • Ask for alternatives to potentially harmful medicines.

References:

  1. “Medications and supplements that can raise your blood pressure: From acetaminophen to stimulants, know which drugs and supplements can affect your blood pressure.” Mayo Clinic staff. 2015. (Source: http://www.mayoclinic.com/health/blood-pressure/MY00256)
  2. “The Harvard Medical School Family Heath Guide: Don’t Let Decongestants Squeeze Your Heart.” © 2010 WebMD, LLC. All rights reserved. WebMD Medical Reference. Reviewed by Brunilda Nazario, MD on 10/19/11.
  3. “Hypertension/High Blood Pressure Health Center: Medications That Cause High Blood Pressure.” (Source: http://www.webmd.com/hypertension-high-blood-pressure/guide/medications-cause)

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What is Blood Pressure?

by Diane, M.P.H, M.S.

What is blood pressure?

  • Blood pressure is a measure of the force of blood pushing outwards on your arterial walls.
  • It is written as 2 numbers, such as 120/80 mm Hg.
  • Optimal blood pressure is less than 120 mm Hg systolic and 80 mm Hg diastolic.

Blood pressure is typically recorded with two numbers, written as a ratio:

  • Systolic: The top number, which is also the higher of the two numbers, measures pressure in the arteries when the heart beats (when the heart muscle contracts).
  • Diastolic: The bottom number, which is also the lower of the two numbers, measures pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).

Blood pressure is determined by the:

  • Amount of blood the heart pumps
  • Condition of the heart valves
  • Pulse rate
  • Pumping power of the heart
  • Size and condition of the arteries

Other factors which also affect blood pressure:

  • Condition of kidneys, nervous system, and/or blood vessels
  • Genetics
  • Foods eaten, weight, and other body-related variables
  • Levels of various hormones in the body
  • Volume of water in the body

The cardiovascular system regulates blood pressure in various ways:

  • Specific hormones and autonomic nerve signals from the brain affect the rate and strength of heart contractions. Greater contractile force and heart rate lead to an increase in blood pressure.
  • Blood vessels can affect blood pressure:
    • Vasoconstriction decreases an artery’s diameter by contracting smooth muscle in the arterial wall. The sympathetic (fight or flight) division of the autonomic nervous system causes vasoconstriction, which leads to increases in blood pressure and decreases in blood flow in the constricted region.
    • Vasodilation is the expansion of an artery as smooth muscle in the arterial wall relaxes after a fight-or-flight response wears off or under the effect of certain hormones or chemicals in the blood.
  • Blood volume in the body affects blood pressure: A higher volume of blood in the body raises blood pressure by increasing the amount of blood pumped by each heartbeat.
  • Thicker, more viscous blood from clotting disorders can raise blood pressure.

High blood pressure: This occurs when pressure in your arteries is elevated

Types of high blood pressure: 

  • Essential hypertension has no obvious cause.
  • Secondary hypertension occurs due to another disorder.
  • Drug-induced hypertension is a form of secondary hypertension caused by a response to a medication, supplement, or other chemical substance.

 Blood pressure categories:

                                      Systolic        Diastolic

  • Normal (optimal)     <120                  <80
  • Prehypertension       120-139             80-89
  • Hypertension             >139                  >89

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Crustless Greek Spinach Pie

This delicious, nutritious, no-carb version of Greek spanakopita (without flour) is high in protein, calcium, folate, vitamin C, magnesium and potassium, and can be served hot or cold, as a side or meatless main dish:

Servings: 8-10 servings

Time: 1 hour 45 minutes

Ingredients:

  • 2 pounds raw greens such as fresh organic baby spinach, Swiss chard, collard, kale (or their frozen chopped versions, thawed and well drained)
  • 4 large onions, sliced or chopped
  • 1 bunch chopped scallions
  • 1/4 cup olive oil
  • 1 bunch chopped Italian parsley
  • 1 bunch chopped dill**
  • 4 or 5 eggs
  • 1/2 pound rinsed feta cheese, cut into small cubes or crumbled
  • 1/2 pound cottage cheese (I use organic, unsalted, low-fat cottage cheese, when available) or Farmer’s cheese or 5 ounces (about 2 cups) finely grated Parmesan cheese
  • Ground pepper to taste (salt is optional)***
  • Greek seasoning: Dried dill, mint, oregano, parsley, onion

Directions:

  1. Preheat oven to 375 degrees.
  2. Wash greens well, drain, and shake or blot dry with towel.
  3. Heat oil in a large heavy skillet over medium-high heat. Add onions and scallions and saute until softened, about 10 minutes.
  4. Add greens in batches, stirring until they become wilted.
  5. Squeeze and drain liquid from skillet and allow to cool.
  6. Stir in parsley, dill and pepper.
  7. In a large bowl, beat eggs until foamy. Combine beaten eggs, feta, and cottage cheese. Add to the greens/onion/herb mixture and stir to combine.
  8. Grease one shallow 3-quart baking dish or two 2-quart baking dishes with butter or olive oil.
  9. Pour in the spinach mixture, spreading evenly. Bake in 375 degree oven for about 60 minutes, until top begins to brown and spanakopita is bubbling all around.
  10. Allow to cool slightly before cutting into squares.
  11. Spanakopita is also delicious when served cold.

*Kefalotyri, or kefalotiri, is a very hard, salty, yellow cheese made from sheep milk and/or goat milk in Greece and Cyprus. It vaguely resembles Gruyere in taste, except it is harder and saltier. A popular, well-known cheese, Kefalotyri is widely believed to be the ancestor of hard cheeses in Greece with a history that dates back to the Byzantine era. Kefalotyri is used along with feta in many recipes for Spanakopita, where the recipe says to substitute romano or parmesan, if kefalotyri cannot be obtained. A similar cheese, Kefalograviera (also made from sheep and/or goat milk), is sometimes sold outside Greece and Cyprus as Kefalotyri. Young kefalotiri is aged for at least 2 months and has a milder flavor than aged cheese. The longer kefalotyri is aged, the stronger its flavor becomes. Substitutes for kefalotiri cheese are hard cheeses such as Romano or Parmesan, both of which have a similar sharp flavor and dry texture.

**Fresh herbs: Dill, fennel, parsley, mint, whatever you have or prefer; Italian parsley and dill are more traditional, but I’ve used various combinations, chopped finely, & all have worked.

***Cottage cheese, feta cheese, Kefalotiri, ricotta cheese, and Parmesan cheese all contain salt. Feta retains much salt, even after being rinsed!

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No Crust Greek Spinach & Feta Pie Recipe

Spanakopita (Modern Greek: σπανακόπιτα, from σπανάκι, spanáki, spinach, and πίτα, píta, pie), or spinach pie, is traditionally a Greek savory pie pastry baked with phyllo (filo) and a delicious filling of chopped spinach, leeks, chard, or sorrel, onions and/or scallions, feta cheese and eggs. In rural Greece, smaller amounts of spinach are used, with the missing part substituted with leeks, chard, and sorrel. Various white, fresh, preferably salted cheeses (ex. Kefalotiri*, cottage cheese, Farmer’s cheese, Parmesan cheese, Ricotta cheese) may be mixed with, or substituted for, the feta cheese. The filling is usually wrapped or layered in phyllo pastry with butter and/or olive oil, either in a large pan from which individual servings are cut, or rolled into individual triangular servings.

While the phyllo-dough recipe is most common, many recipes from the Greek islands call for a crust made of flour and water to form a crunchier, calzone-like exterior in place of the flaky phyllo dough. The pastry, enhanced by butter and egg yolk, becomes golden in color as it bakes.

Spanakopita is mostly eaten as a snack in Greece, and can be an alternative to tyropita (cheese pie). It can also be served as a side or main dish, straight from the oven or at room temperature. A “fasting”, or vegan, version of spanakopita, is often prepared during Great Lent and other religious fasts, composed of spinach, onions or green onions, other green herbs like dill, parsley, celery, olive oil and a little wheat flour, but without eggs or dairy products; the mixture is oven-baked until crisp. Non-traditional vegan versions are available that typically use tofu instead of cheese.

Servings: 14-18 servings

Time: 1 hour 45 minutes

Ingredients:

  • 3-4 pounds raw greens such as fresh organic baby spinach, Swiss chard, collard, kale (or their frozen versions)
  • 6-8 large onions, sliced or chopped
  • 2 bunches chopped scallions
  • 1/3 cup olive oil
  • 1 bunch chopped Italian parsley
  • 1 bunch dill**
  • 8-10 eggs
  • 1 pound rinsed feta cheese, cut into small cubes or crumbled
  • 1 pound cottage cheese (I use organic, unsalted, low-fat, cottage cheese, when available) or Farmer’s cheese or 5 ounces (about 2 cups) finely grated Parmesan cheese
  • Ground pepper to taste (salt is optional)***
  • Greek seasoning: Dried dill, mint, oregano, parsley, onion

Directions:

  1. Preheat oven to 375 degrees.
  2. Wash greens well, drain, and shake or blot dry with towel.
  3. Heat oil in a large heavy skillet over medium-high heat. Add onions and scallions and saute until softened, about 10 minutes.
  4. Add greens in batches, stirring until they become wilted.
  5. Squeeze and drain liquid from skillet and allow to cool.
  6. Stir in parsley, dill, and pepper.
  7. In a large bowl, beat eggs until foamy. Combine beaten eggs, feta, and cottage cheese. Add to the greens/onion/herb mixture and stir to combine.
  8. Grease one shallow 4-quart baking dish or two 3-quart baking dishes with butter or olive oil. (I use one 4-quart Pyrex casserole, but sometimes liquid leaks over the side. It’s best to use two 3-quart baking dishes.)
  9. Pour in the spinach mixture, spreading evenly. Bake in 375 degree oven for about 60 minutes, until top begins to brown and spanakopita is bubbling all around.
  10. Allow to cool slightly before cutting into squares.
  11. Spanakopita is also delicious when served cold.

*Kefalotyri, or kefalotiri, is a very hard, salty, yellow cheese made from sheep milk and/or goat milk in Greece and Cyprus. It vaguely resembles Gruyere in taste, except it is harder and saltier. A popular, well-known cheese, Kefalotyri is widely believed to be the ancestor of hard cheeses in Greece with a history that dates back to the Byzantine era. Kefalotyri is used along with feta in many recipes for Spanakopita, where the recipe says to substitute romano or parmesan, if kefalotyri cannot be obtained. A similar cheese, Kefalograviera (also made from sheep and/or goat milk), is sometimes sold outside Greece and Cyprus as Kefalotyri. Young kefalotiri is aged for at least 2 months and has a milder flavor than aged cheese. The longer kefalotyri is aged, the stronger its flavor becomes. Substitutes for kefalotiri cheese are hard cheeses such as Romano or Parmesan, both of which have a similar sharp flavor and dry texture.

**Fresh herbs: Dill, fennel, parsley, mint, whatever you have or prefer; Italian parsley and dill are more traditional, but I’ve used various combinations, chopped finely, & all have worked.

***Cottage cheese, feta cheese, Kefalotiri, ricotta cheese, and Parmesan cheese all contain salt. Feta retains much salt, even after being rinsed!

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Stacked Towels

How many times can you use a towel before having to wash it?

  • Consumer and environmental health agencies recommend that towels be washed after 3 or 4 uses, in order to reduce the risk of bacteria, mold, and viruses.
  • Towels used more often can actually breed bacteria and mold.
  • Hang towels and washcloths properly after each use by spreading them out on your towel rack, so they dry thoroughly.
  • Before taking a shower, open the bathroom door as much as possible for ventilation, unless it must stay closed for privacy.
  • If you have a bathroom fan, turn it on while bathing or showering, so the air is less humid.

Why should you wash towels frequently?

  • Every time you use a towel to dry yourself, dead skin cells are scraped off which can accumulate in the fibers of your towel. If you use the same towel for 10 days, 10 days’ worth of exfoliated cells will collect on that towel.
  • Also, your towel got wet when it dried off your body. Whenever fibers get wet, the opportunity to harbor bacteria and other germs is greatly increased.
  • Air drying makes a towel an unfriendly environment for bacteria, but only for so long.
  • If you use the same towel in the morning and night, the number of bacteria will increase exponentially each day! While we are relatively clean when we use a towel after showering, the combination of dead skin cells and moisture (i.e., a food source and water source) create the right conditions for bacteria and mold to grow.

How often should you wash your bathroom rug:

  • If your bathroom rug has a non-skid rubber backing, it will not tolerate being washed frequently: It is best to wash a bathroom rug on warm/hot. However, the rubber backing will deteriorate quickly, if it is washed on hot too many times. To maintain a bathroom rug with rubber backing, wash it only once every 3-4 weeks.
  • If your bathroom is used frequently, rugs should be washed weekly: If several showers are taken in the same bathroom on a daily basis, the rug gets damp multiple times. Since the rug is against a floor that doesn’t breathe well, if at all, it takes a long time to dry. Because of this poor drying between uses, mold and mildew grow easily.
  • In a bathroom where water is routinely splashed on the floor, the rug needs to be washed weekly as well: Again, the rug doesn’t have time to dry out well between uses and can harbor all kinds of fungi and mold. In a damp, warm bathroom, the fungi and mold will multiply.

Guide for washing bathroom rugs:

  • All bathroom rugs should be washed on at least a warm water setting. Hot water is best though, since it cleans items better than warm water.
  • If your rug has a non-skid rubber backing, it is best to let it hang dry over your shower or towel rod, a portable clothesline, or real clothesline if you have one. The rubber backing will stay intact much longer if not exposed to dryer heat.
  • If a bathroom rug does not have rubber backing, place it in the dryer.

Bedding:

  • Since bed sheets are typically in a dry environment, wash them each week or at least every other week.
  • If you sweat at night, wash your bed sheets weekly.
  • Pillows and comforters can be washed 2-3 times a year. An easy reminder: Wash them when the seasons change.
  • After someone has been sick, throw all their bed linens in the washer.

Kitchen towels:

  • Since these tend to be used more often than bath towels, try to change them every day, especially if they become damp.
  • Due to the presence of moisture, the handling of various foods, and bacteria in the average kitchen, the risk of cross-contamination is high.

Clothing:

  • Not everything you wear gets dirty after being worn once. Jackets, dresses, and jeans can be worn several times before they need a cleaning.
  • When denim jeans begin to lose their stretch, it’s time to wash them.
  • Toss your pajamas in the wash after sleeping in them for a few nights.

Reference:

Peterson, Dr. Keri. “How Many Times Can You Use a Bath Towel Before It Needs to be Washed?” Women’s Health. 05/31/15. (Keri Petersen, M.D., internal medicine, Lenox Hill Hospital, New York City).

 

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Delicious Ginger Cardamon Tea (Chai)

by Diane, M.P.H, M.S.

“If you are cold, tea will warm you.

If you are heated, it will cool you.

If you are depressed, it will cheer you.

If you are excited, it will calm you.”

William Ewart Gladstone: (1809-1898) Prominent nineteenth century British politician.

Chai is a delightful blend of tea, herbs, and spices which has been prepared for centuries in India to promote health and peace of mind, enhance digestion and immunity, as well as, reduce inflammation. This beverage has antioxidant properties and may also provide antibacterial and anti-cancer benefits, according to some studies. Chai is made in different ways, depending on the region where it is being consumed, but there are a number of standard ingredients: black tea, ginger, cardamom, cinnamon, fennel, clove and black pepper. When analyzing chai’s health benefits, it’s important to examine each ingredient in turn. Though they act synergistically to increase each other’s benefits, the separate botanical components have powerful health benefits on their own:

  • Black Tea: Black, green, white, oolong, and pu-erh teas are all derived from the Camellia sinensis plant, a shrub native to China and India. These teas are virtually calorie-free and contain many micronutrients, including vitamins and minerals (folate, trace amounts of choline, potassium, magnesium, and manganese), as well as, unique antioxidants called flavonoids and substances linked to a lower risk for heart disease, cancer, and diabetes. Research has shown that black tea may help reduce the risk of cardiovascular disease and stroke, protect lungs from damage due to exposure to cigarette smoke, and have anti-viral and anti-cancer properties. Black tea has the highest caffeine content and forms the basis for flavored teas like chai, along with some instant teas.
  • Ginger: An important root used in Eastern medicine, ginger aids digestion, reduces nausea, improves circulation and immunity, and reduces inflammation which can be especially helpful for people suffering from arthritis. Some research has shown that ginger offers antioxidant and anti-cancer properties.
  • Cardamom: A perennial plant native to the evergreen forests of southern India, cardamon is one of the oldest known spices and popular as a medicinal plant in Sri Lanka, India and the Near East. This peppery, citrusy spice is commonly used in Indian cuisine but has also been used in Ayurvedic medicine as a treatment for mouth ulcers, digestive problems, and even depression. Text of this ancient healing tradition (Ayurveda) indicate that cardamom tea has been used after meals to enhance digestion for about 5,000 years! Found in virtually every Tibetan medicine formula, cardamom aids digestion and immunity, helps detoxify the body, improves circulation, and may also fight respiratory allergies. The medicinally active components are found in the seeds, which can be dried and steeped in hot water to make cardamom tea.
  • Cinnamon: Provides fiber, manganese, and calcium, as well as, antibacterial, anti-inflammatory, and antioxidant support, and aids digestion. Cassia cinnamon may lower blood sugar in people with diabetes. Cinnaldehyde (also called cinnamic aldehyde) in cinnamon helps prevent unwanted clumping of blood platelets.
  • Clove: Offers antibacterial, anti-inflammatory, antioxidant support, aids digestion, and has analgesic (pain relieving) properties which may help alleviate ulcer pain.
  • Fennel: Provides antioxidants, Vitamin C, potassium and fiber, and has demonstrated some anti-cancer properties.
  • Black Pepper: Offers antibacterial and antioxidant support, promotes digestive health, and helps prevent formation of intestinal gas.

What Are the Benefits of Cardamom Tea?

Cardamom Photo Credit YelenaYemchuk/iStock/Getty Images

The following recipe is quite simple to prepare at home:

Servings: 2

Ingredients:

  • Milk – 1 cup
  • Water – 1 cup
  • Ginger – 1 teaspoon grated (or pounded with mortar and pestle) or 1/4 teaspoon ginger powder
  • Cardamom – 2 whole pods, pounded, or 1/2 teaspoon cardamom powder
  • Sugar, honey, or agave syrup – to taste
  • Tea – 2 teaspoons loose tea leaves or 2 tea bags

Directions:

  1. In a small pot, add water and grated ginger. Bring this to a boil.
  2. Add milk and allow it to come to a boil, stirring in between to prevent any sticking or burning.
  3. Stir in tea leaves and bring to a rolling boil.
  4. Turn off stove, add cardamom powder, cover pot with lid and allow tea to steep for 3-4 minutes.
  5. Add sugar to taste.
  6. If using loose tea, pour the tea through a strainer directly into the serving cups.
  7. Serve the hot chai or adrak chai with Indian snacks like pakoras, samosas, biscuits, or cookies.

Variations:

  1. You can vary the ratio of milk to water according to your preference.
  2. If you prefer a stronger tea, allow it to boil a little longer.
  3. For those of you who must limit your tea intake, note that this recipe is still healthful and delicious when prepared without tea.

Ginger Tea

 

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This bountiful dish is eaten for lunch every day by the world’s longest-lived family, the Melises. Traditionally, it is made with whatever is growing in the garden, but it always includes beans and fregula, a toasted pebble-size semolina pasta that is popular in Sardinia. Fregula can be purchased at Italian markets or online. If you can’t find fregula, any tiny pasta, such as Israeli couscous or acini di pepe, will do.

Cooking minestrone takes some time. A longer cooking time blends the flavors and enhances the bioavail­ability of various nutrients (lycopene in tomatoes, carotenoids in carrots, antioxidants, etc.) A shorter cooking time will create a tasty dish as well, but nutritionally inferior. Traditionally, the soup is served with slices of pane carasau, or Sardinian flat bread.

Servings: 4

Ingredients:

  • 1/2 cup dried peeled fava beans
  • 1/2 cup dried cranberry beans
  • 1⁄3 cup dried chickpeas
  • 7 tablespoons extra-virgin olive oil
  • 1 medium yellow or white onion, chopped (about 1 cup)
  • 2 medium carrots, peeled and chopped (about 2⁄3 cup)
  • 2 medium celery stalks, chopped (about 1/2 cup)
  • 2 teaspoons minced garlic
  • 1 (28-ounce) can crushed tomatoes (about 3½ cups)
  • 3 medium yellow potatoes, peeled and diced (about 1½ cups)
  • 1½ cups chopped fennel
  • 1/4 cup loosely packed fresh Italian flat-leaf parsley leaves, chopped
  • 2 tablespoons chopped fresh basil leaves
  • 2⁄3 cup of Sardinian fregula, Israeli couscous, or acini di pepe pasta
  • 1/2 teaspoon salt
  • 1/2 teaspoon freshly ground black pepper
  • 1/4 cup finely grated pecorino Romano (about 2 ounces)

Directions:

  1. Soak fava beans, cranberry beans, and chickpeas in a large bowl of water for at least 8 hours or up to 16 hours (that is, overnight). Drain in a colander set in the sink. Rinse well.
  2. Warm 3 tablespoons of olive oil in a large soup pot or Dutch oven set over medium-high heat. Add onion, carrots, and celery; cook, stirring often, until soft but not browned, about 5 minutes. Add garlic and cook until fragrant, about 20 seconds.
  3. Stir in tomatoes, potatoes, fennel, parsley, and basil, as well as drained beans and chickpeas. Add enough water (6 to 8 cups) so that everything is submerged by 1 inch.
  4. Raise heat to high and bring to a full boil. Reduce heat to low and simmer slowly, uncovered, until the beans are tender, adding more water as necessary if the mixture gets too thick, about 1½ hours.
  5.  Stir in pasta, salt, and pepper. Add up to 2 cups water if the soup seems too dry. Continue simmering, uncovered, until the pasta is tender, about 10 minutes.
  6. Pour 1 tablespoon of olive oil into each of four serving bowls. Divide the soup among them and top each with 1 tablespoon of the grated cheese.

Tips:

  • Vary the beans in the minestrone: pinto beans make a good substitute for cranberry beans; great northern or cannellini beans, for the favas.
  •  Use the stalks and fronds that come off a fennel bulb for the most intense flavor. No feathery fronds on the bulb? Add a teaspoon of fennel seeds to the aromatic vegetables you sauté to begin the dish.
  • Add other fresh vegetables from the garden or market, such as zucchini, cabbage, green beans, and cauliflower or broccoli florets.
  • For a stronger tomato taste, stir in a tablespoon or two of tomato paste.

Akentannos!

A Sardinian phrase meaning “until 100 years.”

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