COUNSELING AFRICAN AMERICAN IN TREATMENT & CONTROL OF
HYPERTENSION (CAATCH) STUDY
Usual Care
Group Curriculum
Usual Care Flow Diagram
Usual Care Sessions
- Should have no relation or reference to
hypertension and hypertension
management.

No weight loss tips

No stress reduction tips

No cholesterol reduction tips

No mention of diabetes
Usual Care Sessions
I. Vitamins
II. Minerals
III. Macronutrients Part1 (Carbohydrates &
Proteins)
IV. Macronutrients Part 2 (Fats) & Herbs
and Botanicals
Usual Care Sessions
Structure:
I. Vitamins: Video  Module Discussion
II. Minerals: Video  Module Discussion
III. Carbs and Protein: Module
IV. Fats & H&B: Module
Vitamins
• What are vitamins?
Vitamins are nutrients you must get from
food because your body can’t make them
from scratch.
Vitamins
• 1. What are the different vitamins?
• Four vitamins are fat-soluble and tend to
accumulate in the body. These are vitamins A, D,
E, and K.
•
• The others are water-soluble, such as Vitamins C,
and the eight B vitamins (thiamin, riboflavin,
niacin, biotin, pantothenic acid, pyridoxine,
folate, and cobalamin).
What are the sources of these vitamins?
Vit. A
Fortified breakfast cereal, dairy, liver & organ meats, squash, cantaloupe,
cod liver
Vit. D
Fortified cereals, milk & other dairy products, eggs, fish, cod liver oil,
the sun*(!)
Vit. E
Vegetable oils, nuts and seeds, avocados, eggs, whole grain cereals
Vit. K
Green leafy vegetables, liver and animal sources
What are the sources of these vitamins?
Vit. B1 (thiamin)
Whole grain cereals, bread, rice, organ meat, peas, bananas, peanuts
Vit. B2 (riboflavin)
Whole grains, liver, fish, lean meats, milk, yogurt, almonds, sunflower seeds
Vit. B3 (niacin)
Lean meats, beans, fish, chicken, legumes, nuts
Vit. B6 (pyridoxine)
Chicken, fish, liver, eggs, rice, soybeans, oats, whole wheat, nuts, bananas, avocados
Vit. B9 (folate)
Fortified breads and cereals, green leafy vegetables, organ meats, orange juice, beans, legumes
Vit. B12 (cobalamin)
Sunflower seeds, kelp, bananas, nuts
Biotin
Liver, egg yolk, milk, yeast
Pantothenic acid
Liver, yeast, egg yolk, broccoli
Vit. C
Citrus fruits, vegetables
What, exactly, do I need vitamins for?
In most cases, the lack of a vitamin causes severe problems. The
following list shows diseases associated with the lack of different
vitamins:
• Lack of Vitamin A: Night blindness, xerophthalmia
• Lack of Vitamin B1: Beriberi
• Lack of Vitamin B2: Problems with lips, tongue, skin,
• Lack of Vitamin B3: Pellagra
• Lack of Vitamin B12: Pernicious anemia
• Lack of Vitamin C: Scurvy
• Lack of Vitamin D: Rickets
• Lack of Vitamin E: Malabsorption of fats, anemia
• Lack of Vitamin K: Poor blood clotting, internal bleeding
If I eat a healthy diet, should I
take a vitamin pill?
• still best to consult with your doctor.
• some individuals with certain medical
conditions may need nutritional
supplements: a woman who might become
pregnant or is pregnant; for a person who
is a heavy smoker or drinker; for vegans;
and for poor urban dwellers
Can taking large amounts of vitamins cure
or prevent a particular disease?
• The present evidence does not support the idea
that taking a large amount of a certain vitamin
will cure a particular condition (for example,
taking high doses of vitamin C for the flu)
• Vitamin D – an RDA of 400 IU per day is
recommended to reduce the risk of osteoporosis
and fractures.
• Elderly persons – they do not absorb vitamin B12
from the stomach as efficiently as they used to.
What will happen if I take too much
of a vitamin?
• They are not only potentially harmful but
also unnecessary and a waste of money!
– Large doses of vitamin A can damage your
liver
– Excess water-soluble vitamins such as vitamin
C are just removed by the kidney
The bottom line about
vitamins?
• Never a substitute for a healthy diet and
lifestyle.
• There are lots of other nutrients and other
healthful substances in fruits, vegetables,
or whole grains that are not present in a
vitamin pill.
• Ask your doctor whether or not you need
to take vitamin supplements.
Minerals
What are nutrient minerals?
Minerals are inorganic elements (salts), that
are smaller than vitamins, and are essential
for growth and maintenance of the
different systems in the body.
Minerals
What are the functions of minerals?
• They build body tissue
• They regulate body processes and
metabolism
Minerals
• Excess amounts can
be harmful!
and
• They are needed only
in small quantities!
What are the minerals needed
by the body?
• Macrominerals = 100mg/d or more
•
•
•
•
•
•
Calcium
Phosphorus
Sodium
Potassium
Magnesium
Chloride
Sulfur
What are the minerals needed
by the body?
• Microminerals (trace minerals) = needed
in very small amts
• Iron
• Iodine
• Fluoride
• Other: selenium, zinc, manganese, cobalt,
copper, molybdenum, chromium
Why do I need these minerals?
What are their functions?
Here are some of the more common minerals our bodies need:
• Calcium - used by teeth, bones
• Fluorine - strengthens teeth
• Iodine - combines with tryosine to create the hormone thyroxine
• Iron - transports oxygen in red blood cells
• Magnesium - healthy bone formation
• Phosphorus - bone, teeth, and nerve cell formation
• Potassium - important ion in nerve cells
• Sodium - fluid regulation and acid-base balance
• Zinc - proper wound healing, growth, cell and tissue repair, and
sexual development
How can I get my daily amount?
• Calcium- Green leafy vegetables, fortified
orange juice, dairy products, tofu, sardines
• Iron - organ and red meats, beans, peas, dried
apricots, green leafy vegetables
• Potassium - Fruits, vegetables, grains
• Phosphorus - Widely available in plant and
animal foods
• Iodine - Seaweed, swiss chard, turnip greens,
garlic, watercress, seafood and fish liver oils
• Zinc - Wheat bran, pumpkin seeds, sunflower
seeds, brewer’s yeast, onions, oysters, green leafy
vegetables
Food Pyramid Chart (old & new)
Carbohydrates
• What are carbohydrates?
- grains, sugars, fibers and starches
- primary source of fuel for the body
Bad Carbs and Good Carbs
• Glycemic Index (GI)
- higher the glycemic index is, the faster it
raises your blood sugar levels
- more processed the food is, the higher the
glycemic index
Ex. white bread = 70
spaghetti = 42
How do I choose my carbs?

•

•

•

•

•
Fiber content.
Fiber - shields the starchy carbohydrates in food immediate and rapid attack
by digestive enzymes; this slows the release of sugar molecules into the
bloodstream.

Ripeness.
Ripe fruits and vegetables = more sugar than unripe ones; higher glycemic
index.

Type of starch.
Some starches are easier to break into sugar molecules than others. The
starch in potatoes, for example, is digested and absorbed into the
bloodstream relatively quickly.

Fat content and acid content.
The more fat or acid a food contains, the slower its carbohydrates are
converted to sugar and absorbed into the bloodstream.

Physical form.
Finely ground grain is more rapidly digested, and so has a higher glycemic
index, than more coarsely ground grain.
So is it healthy to follow a lowcarbohydrate diet?
• long-term effects of it has not yet been
clarified
• a lot of low-carb diets encourage eating
worrisome amounts of unhealthy fats
• best to get most of your carbs from wholegrains, fruits, and vegetables!
Proteins
• Proteins = amino acid + amino acid + …
• body - able to store carbohydrates and fats,
but it is unable to store amino acids
• needs a daily supply of amino acids in
order to make new protein
Where do I get my protein?
• Meats, fish, nuts,
beans….
All protein created equal?
• Some foods contain all the amino acids
needed to build protein; other sources such
as vegetables and nuts lack one or two
essential amino acids
• Vary protein sources
• Vegans – consult with nutritionist
General Recommendations on Protein:
- Get a good mix of protein
- Pay attention to what comes with the
protein.
stick with the lean cuts
remove any skin and fat
choose skim or low-fat milk
- Balance the carbs and protein
Fats
Fats
• Saturated fats - normally solid at room
temperature; lard and shortening, animal
fat
• Unsaturated fats - liquid at room
temperature; vegetable oils
Fats
• Also a source of energy
• Needed for fat-soluble vitamin absorption
• Essential fatty acids
Good vs. Bad Fats
• Saturated Fats  bad fat!
- animal fats: meat, seafood, whole-milk dairy
products (cheese, milk, and ice cream), poultry
skin, and egg yolks
Trans Fats  another bad fat!
produced by heating liquid vegetable oils in the
presence of hydrogen; commercially prepared
baked goods, margarines, snack foods, and
processed foods
Good vs. Bad Fats
• Unsaturated Fats--Polyunsaturated and
Monounsaturated  good fats
- plant sources, such as vegetable oils, nuts, and
seeds.
-polyunsaturated fats: found in high
concentrations in sunflower, corn, and soybean
oils)
-monounsaturated fats: found in high
concentrations in canola, peanut, and olive oils)
Tips for lowering trans fat intake:

Choose liquid vegetable oils or a soft tub
margarine - little or no trans fats.
 
Reduce intake of commercially prepared baked
goods, snack foods, and processed foods, including fast
foods.
 
When foods containing hydrogenated or partially
hydrogenated oils can't be avoided, choose products that
list the hydrogenated oils near the end of the ingredient
list.
 
To avoid trans fats in restaurants, one strategy is to
avoid deep-fried foods, since many restaurants continue
to use partially hydrogenated oils in their fryers.
Herbs and Botanicals
• Being sold as dietary supplements
• Little or no FDA regulation: “not intended
to treat, diagnose, mitigate, prevent, or cure
disease.”
Tips before buying a dietary
supplement

Remember: Safety First. Some
supplement ingredients, including nutrients and
plant components, can be toxic

Think twice about chasing the latest
headline. Be wary of results claiming a "quick
fix" that depart from scientific research and
established dietary guidance.
Tips before buying a dietary
supplement
 
Learn to Spot False Claims. Remember: "If
something sounds too good to be true, it probably is."
Some examples of false claims on product labels:
q
Quick and effective "cure-all."
q
Can treat or cure disease.
q
"Totally safe," "all natural," and has "definitely no
side effects."
q
Limited availability, "no-risk, money-back
guarantees," or requires advance payment.
Tips before buying a dietary
supplement
•

More may not be better. Some
products can be harmful when consumed in
high amounts, for a long time, or in
combination with certain other substances.
Tips before buying a dietary
supplement
  The term "natural" doesn't always mean
safe.
• - interact with medicines, be dangerous for
people with certain health conditions, or be
harmful in high doses.
Tips before buying a dietary
supplement
•
•
•
- Is the product worth the money? Resist the
pressure to buy a product or treatment "on the
spot."
-Some supplement products may be expensive
or may not provide the benefit you expect.
- For example, excessive amounts of watersoluble vitamins, like vitamin C and B
vitamins, are not used by the body and are
eliminated in the urine.
Ginger
•
•
•
•
•
Analgesic
Sedative
Antipyretic
Antibacterial
GI tract motility effects.
Garlic
• infections (especially chest problems)
• digestive disorders
• fungal infections
Fish Oil
• now recommended for a healthy diet
• American Heart Association recommends
the consumption of 1g of fish oil daily,
preferably by eating fish, for patients with
coronary heart disease
• help protect the brain from cognitive
problems associated with Alzheimer's
disease.
Glucosamine
• synthetic version of a compound the
human body makes to stimulate the growth
of cartilage
• help rebuild cartilage and reduce the
symptoms of arthritis.
The Bottom Line
• Check with your health care providers before taking a
supplement, especially when combining or substituting
them with other foods or medicine.
• Some supplements can help you meet your daily
requirements for certain nutrients, but others may cause
health problems.
• Do not self diagnose any health condition.
• Dietary supplements are not intended to treat, diagnose,
mitigate, prevent, or cure disease, or to replace the variety
of foods important to a healthful diet.