Category: Fighting Dharma

This post mainly discusses shopping for instant yeast in 2024.

In 2000, in Beth Hensperger in her Bread Lovers’ Bread Machine Cookbook, suggested that bread machine recipes should be different if the bread machine baker used Lesaffre’s SAF Red Instant Yeast, as opposed to other bread Machine yeast. In my 2018 post Dry Yeast, I suggested that yeasts sold as Quick Rising or Bread Machine yeasts were equivalent to, or were instant yeasts with confusing names. I used SAF Red Instant Yeast but I experimented with the amount of yeast and salt. I have tried to reduce salt in the bread I eat, and spend time reconciling recipes to the bread machines I used.

Over the last few years, I was able to buy SAF Red Instant in 450 g bags from King Arthur online either directly from King Arthur’s e-commerce “sales” pages or in the Amazon market twice since 2018. I stored it in a freezer – a bag lasted for a couple of years, and hundreds of medium bread machine loaves.

There was a shortage of yeast in 2020 during the Covid-19 pandemic. Active dry yeast is now available. There is no discussion in the media of a shortage of instant yeast products. Indeed, there are instant yeasts available in the USA and Canada.

Red Barn stores, a local grocery chain was sold vacuum bags of instant yeast, branded as Red Barn, a few years ago. I bought and used a bag.

I was not able to purchase SAF Instant Red in July 2024. King Arthur still sells it but its web store the site refuses to process and order that is to be shipped to a buyer outside the USA. It was possible to buy active dry yeast in grocery stores in Victoria, BC, Canada but product called instant yeast had disappeared. Walmart.ca showed 3 instant yeasts in their e-commerce but not in stock in local (Victoria) stores or available online:

• SAF Instant Red,
• Bob’s Red Mill Instant Yeast (Bob’s Red Mill no longer offers that an Instant Yeast in it e-commerce pages),
• Lallemand Instaferm.

Lallemand Instaferm was available on some Canadian e-commerce sites and at Costco, but shipping charges and Costco membership fees added to the price. Searches of the Walmart stores and markets returned active dry yeasts, including Fleischmann’s, and Bob’s Red Mill Active Dry Yeast to searches for instant yeast.

Fleischmann’s markets instant yeast as “Quick-Rise” in 139 g. glass jars sold at about $5 a jar (Walmart). Fleischmann’s also sells instant yeast as Bread Machine yeast. The Real Canadian Superstore’s Wholesale Club warehouse store listed 139 g. jars of both kinds of the instant yeast online at about $6 a jar.

I found a 450 g. foil vacuum bag of Fleischmann’s IDY (instant dry yeast) in the Real Canadian Superstore’s Wholesale Club warehouse store in Esquimalt for $6. It performed as well as SAF Instant Red in my bread machine

It would appear that the yeast manufacturers have been making yeast but perhaps deceasing the total amounts sold to for retail sale, and playing with regional supply and distribution. The search engines for many retail stores are not useful at finding things,

My browsing led me to a hit about pizza dough. In 2003 Peter Reinhart had published recipes for pizza dough in his book American Pie made with instant yeast. Daniel DiMuzio had a recipe for pizza dough made with a preferment made with instant yeast in Bread Baking: An Artisans Perspective (2010). The baking yeast companies market “pizza crust” yeast, which is not sold, as far as I can see, in Canadian retail stores. Pizza crust yeast:

… is a type of instant yeast … does not require proofing … . In addition to this, pizza crust yeast are also fortified with dough relaxers to prevent snapping back of dough when rolled, and these relaxers can cause the dough to rise quickly in the oven.

… differs from instant yeast … contains L-Cysteine which is an amino acid that serves as a reducing agent for breaking down the proteins in gluten. L-Cysteine helps to soften gluten and therefore relax dough. This is what makes dough not to shrink or spring back when you roll it.

Through this conditioning, a softer, better textured and high volume end result is achieved. Also, it becomes possible to mix, roll and bake pizzas without any proofing needed.

Another difference you’ll notice when comparing the instant dry yeast with the pizza crust yeast is that doughs made with the latter will have a much lower temperature, better consistency and will be easier to handle, even though the difference is by a small degree.

Davis Brown, November 28, 2022, Is Pizza Yeast the Same as Instant Yeast, at Thewhitemeal.com.

Table of Contents

• Fluid Milk
  • Milk
  • Buttermilk
  • Available in Victoria BC.
• Dry Milk
  • Dehydration
  • Buttermilk Powder
  • Substitution for buttermilk powder

Fluid Milk

Milk

Milk, discussed in a Wikipedia entry, is the milk of dairy cows, processed. Fluid milk used in baking, by commercial bakers and home bakers, in Europe and America is mainly cows’ milk. Milk must be taken to a dairy plant to be processed within hours after being harvested in a dairy farm, and only lasts a few days, even with the benefit of refrigeration. Milk sold in retail outlets in North America has been pasteurized – as required by public heath law.

At one point in history, milk was obtained by human by milking cows by hand. Milk is still obtained from cows, but in modern times, the cows are cared for on dairy farms and milked with machines. Milk naturally separate into cream and milk. The high butterfat cream was, historically, churned manually to make butter. The leftover fluid, if the milk had not soured, was sweet traditional buttermilk. If the cream was churned from sour milk, the buttermilk was sour. Milk became sour due to bacteria in the milk, which started fermenting the milk.

A writer for Slate suggested in 2012:

“As long as people have made butter there’s been buttermilk,” says Anne Mendelson, a culinary historian and the author of Milk: The Surprising Story of Milk Through the Ages. Careful: Here, she’s talking about a byproduct of churning whole milk or cream—the thin, white liquid that [Laura Ingals] Wilder wrote about.

So how did that buttermilk, the original buttermilk, turn into the thick, sour, yogurty beverage I sampled … ? The confusion surrounding this drink dates back to the 18th century or before. Until the age of refrigeration, milk soured quickly in the kitchen, and most butter ended up being made from the slightly spoiled stuff. As a result, some historical sources use the word buttermilk … to describe the byproduct of butter-making; others use it to describe butter-making’s standard ingredient at the time—milk that had gone sour from sitting around too long. To make matters more confusing, the butter-byproduct kind of buttermilk could be either “sour,” if you started out with the off milk that was itself sometimes called buttermilk, or “sweet,” if you started out with fresh cream (like Laura’s mom did). So, prior to the 20th century, buttermilk could refer to at least three different categories of beverage: regular old milk that had gone sour; the sour byproduct of churning sour milk or cream into butter; and the “sweet” byproduct of churning fresh milk or cream into butter.

L.V. Anderson, Slate, May 12, 2012, All Churned Around

In industrial dairies, milk is refined by removing butterfat from whole milk with a centrifuge. The process is discussed in web pages other than Wikipedia. Some internet material on industrial dairy methods and science:

• explanatory posts
  • by a dairy equipment dealer titled: “How does a milk separator work“;
  • by an ecommerce entity titled “How is buttermilk made“
• search results at ScienceDirect:
  • overview of material including articles, books and entries in The Encyclopedia of Dairy Sciences, 2nd ed., 2017;
  • article “A 100-Year Review: Yogurt and other cultured dairy products” in the Journal of Dairy Science, Volume 100 (2017).

Dairies began to manufacture cultured buttermilk:

… the stuff known as cultured buttermilk at your local supermarket—i.e. milk that has been deliberately soured—is a 20th-century invention, and the product of a health-food diet craze dating back to the flapper era.

….

In Western Europe and America, the only people who bothered to drink buttermilk of any kind were the poor farmers and slaves who needed all the calories and nutrition they could get. Everyone else fed sour milk and butter-byproduct to their farm animals.

….

While farmers’ wives and other home cooks were using sour milk in their baked goods, America saw an influx of immigrants from parts of the world where sour milk was considered a refreshing everyday beverage. Ashkenazi Jews from Eastern Europe, who have a tendency toward lactose intolerance, may have been especially inclined to drink it, since the bacteria make it more digestible. The nonimmigrant American public was generally mistrustful of sour milk as a beverage until 1907, when [a] Russian biologist … concluded that the relative longevity enjoyed by people living in the Balkans was a direct result of their consumption of sour milk. Health-conscious Americans started going crazy for sour milk, thinking it would prevent aging. At his sanitarium in Battle Creek, Mich., holistic doctor and breakfast-cereal enthusiast John Harvey Kellogg began serving an ultra-tart, deliberately soured version with the catchy name “Bulgarian buttermilk.”

Naturally-occurring sour milk had in the mean time become increasingly rare, thanks to modern refrigeration. So commercial dairies, spotting an unfilled niche, began to culture it themselves, and sold the new product widely as buttermilk starting in the 1920s. This was much like the buttermilk we find in grocery stores today: Made from low-fat milk and lactic acid bacteria that grow best under moderate heat conditions. Dairies used low-fat milk because it was cheaper than whole milk, but still took on a thick, creamy body when cultured.

L.V. Anderson, in Slate, cited above

The milk solids remaining after milk is centrifuged include the cell membranes of the fat cells, casein (a protein) and lactose (a sugar). The casein reacts to acid to curdle milk.

Full butterfat milk – often marketed as Homogenized milk (all milk processed for retail has been homogenized) – is about 3.5 % butterfat. It depends on the cows, the fodder, and the dairy. Fluid milk processed for retail sale is sold as reduced butterfat milk by the percentage of butterfact -ie. 2%, 1%, or as skim milk, which as butterfat content at a fraction over 0%.

Buttermilk

Buttermilk, since the industrialization of dairies, has been a dairy product produced by processing fluid milk. Some fluid buttermilk is produced by fermenting partially skimmed milk. Dairies also produce acidified buttermilk – milk treated by mixing milk with an acid. A dairy may use fermentation or acidification or a combination of both. The production methods are not discussed on product labels or in an ordinary dairy’s promotional materials. Nor do bakers say how the buttermilk used to mix dough was made.

The home baker’s hack to make acidified buttermilk, comparable to store-bought dairy buttermilk is to add an acid, in the amounts noted here to one cup of milk:

• 1 Tablespoon lemon juice;
• 1 Tablespoon vinegar; or
• 1 teaspoon cream of tartar.

Available in Victoria BC.

Most retail grocers in Victoria sell pasteurized milk processed by the Island Farms dairy, which distributes a fermented and/or acidified buttermilk said to be about 1.5% butterfat. The weight of a “1 cup (250 ml.)”¹A US cup is 236.59 ml. Most cookware manufacturers label 250 ml measuring cups as 1 cup. The people who write recipes mainly say “1 cup or 250 ml.” It usually does not make a difference. serving is not stated. Conventionally, a cup of buttermilk weighs 245 grams (compare a US cup of water at 237 g.).

Dry Milk

Dehydration

Dry milk (aka milk powder) is made by dehydrating milk – removing water. Dry milk can be made with whole milk, or reduced butterfat milk. It is reconstituted by adding water. Dry milk can be added to baking recipe or formula as a dry ingredient. Adding water (or milk) to dry ingredients and mixing the ingredients to make dough is a normal process in baking bread. Manufacturers can dehydrate whole milk, skim milk and buttermilk.

Buttermilk Powder

Buttermilk powder is dehydrated dairy cultured buttermilk, made from reduced butterfat milk. It is possible to substitute buttermilk powder and water or plain milk in a recipe (e.g. for pancakes, cakes or bread) for fluid buttermilk. One way is to mix the powder with water and use the reconstituted fluid as buttermilk. Another is to add the amount of powder that would make buttermilk with the water in the bread recipe.

Buttemilk powder can be purchased online from King Arthur Flour and other suppliers. The King Arthur Flour blog, discussing and promoting King Arthur Dried Buttermilk:

Use dried buttermilk as a substitute for the liquid buttermilk called for in your recipe. It’s simple as (buttermilk) pie: For every cup of liquid buttermilk, substitute 1/4 cup (30g) dried buttermilk plus 1 cup (227g) water (or milk).  Don’t worry about reconstituting the powder by stirring it together with liquid: Simply mix dried buttermilk into your recipe at the same time you add the flour, and add the liquid when the recipe says to add the buttermilk.

….

Dried buttermilk yields results nearly identical to liquid, with just two small differences: Baked goods made with dried buttermilk are slightly lighter in color than those made with liquid cultured buttermilk, and their flavor is a bit richer — more creamy-buttery than tangy. 

…. 

Another discovery: When replacing fresh buttermilk with dried, using milk in place of the water typically called for in this substitution gives baked goods even better texture and flavor, thanks to the additional milk solids, fats, and sugars. 

P.J. Hamel, September 14, 2022, King Arthur blog, Why you should be keeping dried buttermilk in your pantry

As of 2024, retail grocers in Victoria BC have skim milk powder for sale. I have not seen whole milk powder or buttermilk powder on the grocery store shelves for years. I have been able to get buttermilk powder in a local outlet of the bulk foods chain Bulk Barn (which also sells full fat milk powder and skim milk powder). Bulk Barn uses a serving size of 100 g. of buttermilk powder for the Food Facts label. 100 mg. contains 517 mg. of sodium. Bulk Barn suggests 25 g. to make 1 cup of buttermilk. This can be scaled to 28 g. of powder in 1 ⅛ cups of water. These are normal liquid quantities in recipes for medium loaves, in bread machine terms.

Fluid dairy buttermilk, reconstituted buttermilk and buttermilk powder added as a bread ingredient before mixing all produce similiar loaves.

A “1 cup” serving of Island Farms buttermilk contains 270 mg of sodium. “1 cup” of buttermilk made with 25 g. of Bulk Barn Buttermilk powder (and 1 “cup”) of water contains just under 260 mg. of sodium.

Substitution for buttermilk powder

Some internet resources suggest that mixing cream of tartar with skim milk powder, produces a powder that can be substituted for buttermilk powder. I am skepical in the absence of a scientific explanation and test/experimental evidence:

• Would adding cream of tartar (or one of the other acids) to a cup of reconstituted skim milk work – skim milk is very low in butterfat – make buttermilk that compares to dairy buttermilk; and
• Doesn’t the cream of tartar, added as a powder to the dry dough ingredients (and not to the fluid milk) act like vinegar or other acids that relax dough – affecting the gluten and producing soft crumb.

Table of Contents

• Resources
  • Wikipedia
  • Governments
    • USA
    • Canada Department of Heath (Health Canada):
  • Advocacy, Charities
• Blood Pressure
  • Blood Vessels
    • Circulation
    • Measuring Pressure
  • Home Devices
    • Home Use
    • Manufacturer Training
  • Readings
  • Treatment of Hypertension
    • Drugs vs Lifestyle
    • Diet
    • Alcohol
    • Caffeine
• Sodium
  • Salt
  • Chemistry, Biology
  • Salt Free Foods
    • Salt Substitutes
    • Salt Free Prepared Foods
  • Salt Sensitivity
  • Baking
    • Baking Soda
    • Baking Powder
• Sodium in Food Table

Resources

Wikipedia

Wikipidia entries provide information on the science and Medical professions professional views of subjects relevant to hypertension:

• Standard Atmosphere; Atmospheric Pressure;
• Pressure Measurement (Manometers); mmHg – Millimeters of Mercury;
• Blood pressure;
• Stethoscope; Sphygmomanometer (devices used by medical professinals to measure blood pressure);
• Blood Pressure Measurement; Ambulatory blood pressure monitoring;
• Hypertension; Labile Hypertension; Hypertension and the brain.

Salt and sodium:

• Salt; Sodium Chloride – chemistry of salt, more history and other uses;
• Health effects of salt; Sodium in biology.

Governments

USA

• US Food and Drug Administation (FDA) Guidance on salt.
• US Department of Agriculture (USDA) 2020-2025 Dietary Guidelines.

The US Department of Agriculture Agricultural Research Service’s FoodData Central (“USDA FDC”) can search 5 data sets. It may be necessary to search in each set. The American government collects or tests samples for the FNDDS Survey Foods data set, but not the others. The government requires tests from accredited services at a manufacturer or distributor’s expense in most instances.

Other countries, including Canada, have data sets on products offered for sale in those countries. The data comes from manufacturers or hired services. Government or independent testing is limited.

The USDA FDC data sets are:

• Foundation Foods,
• Standard Reference Legacy Foods,
• Human Research Center Food and Nutrient database for Dietary Studies (“FNDDS Survey Foods”),
• Branded Foods,
• Experimental Foods.

Canada Department of Heath (Health Canada):

• Canada Food Guide,
• Dietary Guidelines,
• Guidance on sodium,
• Sodium detector, and
• information on sodium content of common processed foods.

Advocacy, Charities

The American Heart Association (AHA),

• Get the Scoop on Sodium and Salt – web page;
• Understanding Blood Pressure Readings – web page;
• published medical scientific journal Hypertension.
• diet guides and cookbooks. The AHA sells a Low-Salt Cookbook, first published in 1990. The 2011 4th edition is the most modern, and is currently for sale on the internet at the AHA website;

Hypertension Canada

• 2020-22 Guidelines Highlights;
• Diagnosis & Assessment Guidelines.

Blood Pressure

Blood Vessels

Circulation

The noises of the heartbeat, the flow of blood through blood vessels, and the detectable pulse in blood vessels have been known for a very long time. Medical science, in the 19th and 20th centuries, credited the idea that blood circulated through the body by vessels from and to the heart to William Harvey, in 1628. This theory was accepted as a better idea than the idea of “humours” postulated by classical and medieval Greek, Roman, Arabic, and middle Eastern writers.

Measuring Pressure

The measurement of blood pressure was identified by medical and scientific persons as posssible and desireable in the 18th century. The theory was that all human beings had an ideal objective “normal” blood pressure. By the early decades of the 20th century, measurement of blood pressure was a standard diagnostic procedure. It is still understood that way. The Wikipedia entry for Blood Pressure notes, as of late 2023 “Blood pressure is one of the vital signs … that healthcare professionals use in evaluating a patient’s health.”

The health care professions describe ausculatory and oscillomatric measurement of blood pressure as “non-invasive”, because blood vessels are not pierced or penetrated.

Both methods, as of the late 20th century, have monitored the air pressure in an airtight bladder contained in a cuff. The cuffs are held in a fixed position against the body by the fabric shell of the cuff, which is closed with a fastener. The adhesive hook and loop fastener system, known as Velcro is used in devices built in and after the late 20th century. The airtight inflatable cuff is the inner layer of a cuff assembly. Its outer layer has a fastener sewed the outside.

Ausculatory blood pressure measurement started in the 19th century. The stethoscope and the sphygnomanometer were invented and came into use. The ausculatory method involved (and still involves, when used):

1. listening to the the artery – ususally the brachial artery, a major artery in the upper arm – with a stethoscope applied to the inside of the limb above the elbow, to detect when blood is flowing,
2. restricting the flow until the sound was not detected, then releasing it, and
3. using a sphygnomanometer to measure the pressure in cuff used to restrict the flow in the artery.

The Ausculatory method was administered by trained professionals in medical facilities. Medical doctors and nursed used the method to gather data about “normal”.

Since the early 20th century, for the ausculatory method, the flow in the artery has been been restricted with an inflatable cuff device – at one time a manually inflated pneumatic device. It was wide enough to apply pressure without bruising or injury to the limb, and applied above the elbow. The pressure in the cuff was a measure of the blood pressure.

Systolic pressure is the maximum pressure during one heartbeat. Diastolic pressure is the minimum pressure between two heartbeats. The units of measurement are millimeters of mercury (abbreviated mmHg), derived from the original mercury column sphygnomanometer. In the 20th century medical offices, clinics and hospitals were equipped with aneroid sphygnomanometers. The devices are or were regularly calibrated to the ambient air pressure for proper use.

Oscillations in the circulatory system were noted in medical literature as early as 1876. The oscillometic method was dependent on the development of transducers and monitors by the electronic industry. The idea of using compressed air in hose to trigger a switch had been used commercially to design devices that could monitor traffic in the 20th century. Automobile service stations used devices made up of a hose, a pressure switch and a bell to alert staff that vehicle had entered the lot and was in a position to purchase gasoline. Such devices are still on the market in the early 21st century to monitor entry to some properties.

The first commercial oscillometer blood pressure monitor was patented in the USA in 1976. With an electronic sensor, this kind of monitor could detect oscillations in the cuff. The oscillations could used to measure blood pressure with the oscillometric method. A sensor could detect the pressure applied by the cuff when the oscillations of the artery in the limb to which the cuff was applied had stopped.

Automated oscillometric blood pressure cuffs and meters do not detect the sounds in the artery or correlate sounds to pressure. These devices inflate the cuff, detect when blood flow through the limb has paused, take readings, release the cuff, record and display blood pressure and pulse. They appears to work like a health care worker using a stethocope and an aneroid sphygnomanometer:

• shut down at a pressure slightly higher than the pressure when the ocillations stopped,
• release pressure gradually,
• record the systolic and diastolic pressure, and
• release pressure.

The oscillometric method is very accurate. It can be administered without a stethoscope and by automated devices. Its accuracy is subject to the hardware and to electronic and software settings. It has changed the idea of a normal measurement.The standards of normal pressure and unhealthy hypertension are being redefined according to statistical analysis of sample groups of readings among patients with different characteristics.

The oscillometric method is used to measure blood pressure in automated devices used in

1. most medical care facilities and some diagnostic settings, and
2. for home use for patients to monitor and report blood pressure.

Automated monitor methods are less expensive and time consuming for health care providers. Automated devices are built to standards. A device is regarded as accurate if the design and the manufacturing process meet standards. In theory, automated device are self-calibrating, and deliver acceptably accurate readings every time they are used, if:

• the device is working as the manufacturer says,
• the cuff is applied properly,
• the patient
  • is properly seated,
  • has been inactive, and is warm and comfortable, and
  • is not stressed by anything.

Automated meters are also used in ambulatory measurement.

Home Devices

Home Use

A patient must install the cuff, take the reading and record the result. Many home devices use a flexible internal plastic shell between the inner cuff and the outlayer. The shell curves around the limb where the cuff is applied. This makes the cuff easier to fit on an arm, and easier to fasten. It is possible. perhaps easy, to install the cuff incorrectly, leading to incorrect readings.

The Canadian advocacy entity Hypertension Canada allows manufacturers to use its Gold and Silver marks on product packages based on its review of how the manufacturers have met certain standards¹“Those with a Gold rating meet the highest and most current international standards, and those with the Silver ratings meet the highest international standards available prior to their most recent updates. (Both Gold and Silver levels are accepted as accurate)”. The rating makes the devices more marketable. The rating process is not transparent. It does not appear that Hypertension Canada tests devices to verify accuracy. It appears that Hypertension Canada requires manufacturers seeking approval to say that they have processes that meet standards.

The basic home device would has:

1. a cuff connected by a hose to a
2. device containing g the pump, the sensor and an LCD display.

An automated home device, sold in 2020-23 might have Bluetooth to upload data to another device, or other data collection and transmission functions.

Manufacturer Training

The manufacturers of home devices do not train home uses directly. They provide detailed instructions to users on attaching the cuff, posture during readings, and the operation of devices. A manual will suggest the cuff be applied to upper part of the left arm at a distance above the elbow, usually with the inflation tube aligned to the inside of the limb. It may suggest a different place and alignment on the right arm.

A manual will advise aking readings in a quiet place, at the same time, keeping warm, avoiding stresss and not taking readins for at least 30 minutes after bathing, consuming alcohol or caffeine, smoking ot excercising. Similiar advice can also be found in resources like the Canadian advocacy entity Hypertension Canada’s pamphlet for professionals. These instructions are actually important to get an accurate reading.

The display area has an area that flashes the systolic pressure as the cuff inflates, and as the cuff deflates. This area gives the systolic reading when the device stops. A separate heartbeat symbol flashes when oscillations are detected as the cuff is inflated, and as the cuff is deflated and the reading is taken. Some devices will display icons for “movement error” and irregular heartbeat”. Irregular heart beat icon can be triggered by movment errors, which may occur when the cuff is not attached properly, as well as when the user moves the limb with the cuff, or coughs or sneezes.

Readings

The normal blood pressure, according to older medical literature and most blood pressure monitor manufacturers, of a healthy adult is 120 mmHg systolic and 80 mmHg diastolic. This is written as 120/80 (spoken as “120 over 80”). “Normal” is more complicated than 120/80:

“… the average blood pressure, age standardized, since 1975 to the present, at approx. 127/79 in men and 122/77 in women, although these average data mask significantly diverging regional trends.”

… in many older people, systolic blood pressure often exceeds the normal adult range”.

….

Blood pressure fluctuates from minute to minute and normally shows a circadian rhythm over a 24-hour period, with highest readings in the early morning and evenings and lowest readings at night. Loss of the normal fall in blood pressure at night is associated with a greater future risk of cardiovascular disease and there is evidence that night-time blood pressure is a stronger predictor of cardiovascular events than day-time blood pressure. Blood pressure varies over longer time periods (months to years) and this variability predicts adverse outcomes. Blood pressure also changes in response to temperature, noise, emotional stress, consumption of food or liquid, dietary factors, physical activity, changes in posture (such as standing-up), drugs, and disease. The variability in blood pressure and the better predictive value of ambulatory blood pressure measurements has led some authorities, such as the National Institute for Health and Care Excellence (NICE) in the UK, to advocate for the use of ambulatory blood pressure as the preferred method for diagnosis of hypertension

Wikipedia, September 2022, Blood Pressure

Blood pressure is stable for periods of time. Measurement is complicated by environmental and psychological factors. Health care professionals recognize white coat hypertension which is studied in reference to the effect of being monitored in a clinical setting and labile hypertension.

Some people may have labile hypertension. Labile means changeable and connotes unstable.

Health care professionals generally trust the devices to provide an accurate measurement of blood pressure at a point in time. Readings play a major role in the diagnosis and treatment of hypertension. The AHA’s online pamphlet Understanding Blood Pressure Readings classifies of 5 bands of BP readings. Hypertension can be described(by the AHA stage 2, above) as a medical condition in which the blood pressure in the arteries is persistently elevated – systolic blood pressure is elevated (>140 mmHg) with a normal diastolic blood pressure. Isolated systolic hypertension may present a health concern. This is called elevated or prehypertension in some material. Where elevated readings (>140/>90) appear twice, a medical doctor can diagnose hypertension.

Hypertension … is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide.

High blood pressure is classified as primary (essential) hypertension or secondary hypertension. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.

Blood pressure is classified by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. For most adults, normal blood pressure at rest is within the range of 100–130 millimeters mercury (mmHg) systolic and 60–80 mmHg diastolic. For most adults, high blood pressure is present if the resting blood pressure is persistently at or above 130/80 or 140/90 mmHg. … Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office-based blood pressure measurement.

Wikipedia, September 2022, Hypertension

Treatment of Hypertension

Drugs vs Lifestyle

Physicians in most places diagnose hypertension on the basis of blood pressure readings, and treat it by prescribing anti-hypertensive medication and testing patients periodically. A few countries cover the cost of prescribed medications under health insurance or drug cost insurance.

Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. If lifestyle changes are not sufficient, then blood pressure medications are used. Up to three medications taken concurrently can control blood pressure in 90% of people. The treatment of moderately high arterial blood pressure (defined as >160/100 mmHg) with medications is associated with an improved life expectancy. The effect of treatment of blood pressure between 130/80 mmHg and 160/100 mmHg is less clear …

….

The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Though these have all been recommended in scientific advisories, a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension.The review did find a decrease in body weight and blood pressure.Their potential effectiveness is similar to and at times exceeds a single medication. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication.

Dietary changes shown to reduce blood pressure include diets with low sodium, the DASH diet (Dietary Approaches to Stop Hypertension), and plant-based diets. … There is evidence from randomized, double-blind, placebo-controlled clinical trials that Hibiscus tea consumption significantly reduces systolic blood pressure (-4.71 mmHg, 95% CI [-7.87, -1.55]) and diastolic blood pressure (-4.08 mmHg, 95% CI [-6.48, -1.67]). Beetroot juice consumption also significantly lowers the blood pressure of people with high blood pressure

Increasing dietary potassium has a potential benefit for lowering the risk of hypertension. The 2015 Dietary Guidelines Advisory Committee (DGAC) stated that potassium is one of the shortfall nutrients which is under-consumed in the United States. However, people who take certain antihypertensive medications (such as ACE-inhibitors or ARBs) should not take potassium supplements or potassium-enriched salts due to the risk of high levels of potassium.

Wikipedia, September 2022, Hypertension

Doctors often prescribe medications to reduce blood pressure to levels under 140/90. Medical care is often dedicated to managing medications and adverse side-effects. The medications have adverse side-effects. ACE inhibitors (e.g.), can cause persistent dry coughing, among other things. Calcium channel blockers (e.g. Amlodypine) often cause peripheral edema.

Diet

Some governments and advocacy groups (e.g. the AHA) have promoted the Dietary Approaches to Stop Hypertension (“DASH”), eating plan.

Alcohol

In the short run, drinking alcohol increases blood pressure for a short period after consumption. One drink will raise blood pressure for about two hours. Long term regular drinking contributes to hypertension, The causation is still under discussion. A 2014 paper says:

… the mechanism through which alcohol raises blood pressure remains elusive. Several possible mechanisms have been proposed such as an imbalance of the central nervous system, impairment of the baroreceptors, enhanced sympathetic activity, stimulation of the renin-angiotensin-aldosterone system, increased cortisol levels, increased vascular reactivity due to increase in intracellular calcium levels, stimulation of the endothelium to release vasoconstrictors and loss of relaxation due to inflammation and oxidative injury of the endothelium leading to inhibition of endothelium-dependent nitric oxide production. Loss of relaxation due to inflammation and oxidative injury of the endothelium by angiotensin II leading to inhibition of endothelium-dependent nitric oxide production is the major contributors of the alcohol-induced hypertension. For the prevention of alcohol-induced hypertension is to reduce the amount of alcohol intake. Physical conditioning/exercise training is one of the most important strategies to prevent/treat chronic alcohol-induced hypertension on physiological basis. The efficacious pharmacologic treatment includes the angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARBs) which have antioxidant activity and calcium channel blockers.

Abstract, Husain, Ansari, Ferder; Alcohol-induced hypertension: Mechanism and prevention 6 World J. Cardiol. 245 (2014)

Abstention by long term regular drinkers can reduce blood pressure readings during the period of absention. Studies:

• Alcohol consumption and hypertension, (1987)
• Alcohol consumption and hypertension, (1993)
• Lifestyle modifications to prevent and control hypertension. 3. Recommendations on alcohol consumption. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada (1999)
• The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis (2017)

The American Heart Association says that limiting alcohol consumption to less than two drinks a day is advised.

Caffeine

Caffeine can elevate blood pressure temporarily, which will affect blood pressure readings. It is not discussed as a significant lifestyle or dietary factor causing hypertension.

Sodium

Salt

Salt is found as a crystaline solid, or in solution in water. Salt can be mined from mineral deposits, or extracted from seawater by evaporation. Salt was used to preserve, store and prepare food for centuries.

Most salt for cooking is processed to standard sized crystals sold as table salt. It is the standard presentation of the salt sold in grocery stores for household use in cooking and baking. The crystals are small enough to fit the holes in a salt shaker, and dissolve in water including in the amounts used to mix bread dough in industrial bakeries. Table salt is treated with anti-caking agents. Depending on manufacturer and brand, it may be treated with or without iodine and other chemicals.

Kosher salt is a table salt with slightly larger crystals, and normally not treated with chemicals other than anti-caking ingredients. Sea salt may have crystals of varying sizes, some of which may not dissolve and distribute uniformly during cooking and baking.

Humans became habituated to salt. During the industrialization of food processing, the food industry used salt to mask the changes to the taste of food that was processed in canneries, and began to use salt as flavour enhancer to increase the sales of processed foods.

It was not believed to be harmful until medical research was conducted in the 20th century.

Chemistry, Biology

Salt, at the atomic/molecular level has one atom of sodium (symbol Na) bonded to and one atom of chlorine (symbol Cl), and is chemically described as (NaCL) sodium chloride. Salt crystals dissolve in water. NaCl can be separated by electrolysis. Salt molecules consumed by living organisms are used in metabolism in extracellular fluid and interstitial fluid.

Sodium is an element, an alkaline earth metal in Group 1, in the periodic table. In living organisms, salt is separated into sodium cations (positively charged ions) and chlorine anions. Before industrial food processing manufactured other products made with sodium, humans consumed animals and plants, or salt, to acquire sodium. Most plants consume little salt, but animals, including humans, require sodium. Sodium is a vital nutrient:

Sodium ions play a diverse and important role in many physiological processes, acting to regulate blood volume, blood pressure, osmotic equilibrium and pH.

Wikipedia, Sodium in Biology, September 2022

Sodium is the primary cation in extracellular fluids in animals and humans. Sodium ions pass into cellular fluid by the enzyme in the cell walls known as the sodium-potassium pump. I have not found an explanation for whether or how the sodium ions are separated from the chlorine or other anions/atoms. Humans (and other animals) have taste receptors that detect sodium ions or salt. These receptors also detect the ions of other alkali metals as salty.

The sense of taste for salt is not calibrated. Humans can detect that a mouthful of food contains salt but cannot tell how much sodium they consume.

The adequate intake for sodium is 1,200 to 1,500 milligrams per day. On average, people in the United States consume 3,400 milligrams per day, an amount that promotes hypertension. Salt contains about 39.3% sodium by mass; the safe upper limit for sodium is under 1 teaspoon per day. 1 tsp of table salt weighs 5.7 grams, and contains 2,240 mg. of sodium.

The food industry resists reducing the use of sodium in the preparation of packaged foods and restaurant meals. It markets some salty items as traditional foods. Its lobbyists and lawyers disputes the harms of salt. The food industry argues that

• consumers make informed decisions (the same argument tobacco companies and drug companies used to defend their profit from the sale of addictive products), and
• manufacturers have the right to use salt to sell products profitably.

Manufacturers are required to disclose facts to the USDA in the USA, and to disclose facts to persons purchasing packaged foods with a label on the package headed “Nutrition Facts”. Sodium is listed in the Food/Nutrition facts labels in milligrams; (.001 or 1/1000 of a gram). Sodium is also stated in the Food/Nutrition facts labelsas a % of the national recommended daily allowance (usually the USDA RDA) in a stated amount called a serving, as defined by the manufacturer. It is usually given as a volume and often also as a weight measured in grams.

There are regulations in the USA requiring chain restaurants to disclose sodium content on menus and in some instances tag the content with health risk logo that may alert consumers. These regulations are resisted by restaurants and manufacturers, by lobbying, occasional litigation, obscurity, equivocation and evasion. The Canadian CBC Network covered sodium in restaurant food in Canada in its television/streaming program Marketplace‘s episode “Putting takeout to the test: the shocking amount of sodium in some restaurant meals” (Season 50, Episode aired January 6, 2023) – Text for internet article, with link to YouTube video.

I have put sodium content of several food items in a table at the end of this post.

Salt Free Foods

Salt Substitutes

Salt is essential to the preparation of some foods.

Some mineral compounds interact with the salt sensors in the human mouth. Potassium Choride is one such compound. The food manufacturer French’s began to manufacture and distribute a product called NoSalt, now packaged as the Original Sodium Free Salt Subsitute salt. In 2017 the French’s brands were acquired by McCormick & Company. NoSalt is sold by some retail grocery chains and by some specialized internet vendors. By 2024, I was able to find a potassium chloride product called SaltFree marketed by Windsor Salt in Canadian retail. There are other salt substitute products.

Salt Free Prepared Foods

Some manufacturers have produced salt free foods and brought them to market. Some have been abandoned for unknown reasons. Some salt free processed food products are on the market.

In British Columbia, Canada, the Thrifty’s grocery stores (now part of the retail group that manages the Sobeys stores) sold a store brand of no sodium whole wheat bread. It wasn’t good, but it appeared to sell. The store stopped offering it in about 2020.

Becel (an Upfield brand) packaged a low sodium margerine spread for retail distribution and sale in Canada for several years. It disappeared from retail grocery stores on Vancouver Island in British Columbia, Canada and everywhere Upfield did busness, as far as I can tell, in 2019. Becel’s other margerine spreads generally have about 70 mg. of sodium per 2 tsp. of margerine spread. Becel/Upfield does not post Nutrition Facts on the Web (it complies with the law and has Nutition Facts labels on its product tubs and wrappers. Becel/Upfield promotes Becel margerine spreads as healthy plant based oil products. Becel still manufactures a salt free margerine, sold in blocks. It is not spreadable.

Some zero salt products available before 2020 fell victim to supply chain problems or disappeared for retail stores during the pandemic

Salt Sensitivity

The journal Hypertension published Salt Sensitivity of Blood Pressure; A Scientific Statement From the American Heart Association in Volume 68, No. 3 in September 2016 which argued for the existence of a physiological trait by which the blood pressure of some members of the population exhibits changes parallel to changes in salt intake. Physicians in most places do not diagnose salt sensitivity.

Baking

Salt used in baking yeasted or yeast-leaving bread to flavour bread and to affect the formation of gluten. It is a normal ingredient in recipes and formulas for yeasted bread, as I discuss in my post Sodium in Bread.

Baking Soda

Baking soda, also known as sodium bicarbonate is used in baking as a chemical leaving agent. It is also used as an ingredient in manufacturing baking powder. It is not uncommon for baking recipes to use both baking powder and baking soda. Baking soda has some other uses in cooking, and several other uses.

There is a sodium free baking soda substitute called Ener-G Baking Soda Substitute, manufactured by Ener-G Foods Inc., and available online.

Baking Powder

Baking powder is a chemical leavening agent used in baking, made with baking soda. There is a sodium free baking powder substitute called Featherweight, manufactured by Hain Pure Foods, and available online.

Sodium in Food Table

The table below surveys Food Facts data on product labels for several foods that I encounter in local grocery stores. I have a separate table of food products used in baking, including salt, in my post for baking ingredients.

The column headings for the sodium content table lists the items, in groups. The column headings identify the food product, and

• the Food/Nutrition Facts “serving” size, normally set by the manufacturer and details as stated by the mfr., in the Food Facts label:
  • the weight or mass (in grams) of the Unit and/or
  • the volume (American Tablespoons (“T”) and teaspoons (“t”) , and/or metric in milliters (“ml”)), ;
• for some items, a realistic amount (“RA”) used in a recipe;
• the sodium (“Na”) in the RA, by weight, in milligrams. If no RA is given, the Na is per serving.

In the house sauce group, I have chosen the pepper sauces with low sodium, which use 1 teaspoon as a serving size. I have not used the heavily marketed hot sauces (e.g. Frank’s Red Hot) which may use a large serving size.

Food	Serving	RA	Na (mg.)
Condiments & Spreads
Mayonnaise Hellman’s Regular	1 T		98
Mustard (Dijon) Maille	1 t 5 ml		120
Peanut Butter Island Nut Roastery (Sidney BC)	15 g. 1 T		0
Hot Sauce McIlhenny Tabasco	1 t. 5 ml.		35
Hot Sauce Hot Ones Classic	1 t. 5 ml.		20
Salsa (Black Bean & Corn) Fox Valley	28 g. 2 T		35
Salsa (Medium) FrogRanch	32 g. 2 T		40
Salsa (Hot) FrogRanch	32 g. 2 T		40
Salsa Desert Pepper (not available 2024)	2 T 30 ml	4 T	160
Salsa (Medium) Que Pasa	60 g. ¼ cup (4 T)		210
Salsa (hot) Everland Organic	2 T 30 ml	4 T	260
Olives, Spanish Queen (Martini) Mezzeta	2		340
(cucumber) Pickles Bicks Garlic Dill Pickles “50% of the salt …”	60 g. 1 pickle		270
(cucumber) Pickles Bicks Sandwick Slices “tangy dill” slices “50% of the salt …”	30 g. 2 slices		135
“Low Sodium” Tomato Ketchup French’s	1 T. 15 ml.		40
Dry Beans
Cannellini (White Kidney) Everland Organic	28 g.	1 cup 160 g.	14.4
White Kidney Walmart “Great Value”	35 g. ⅕ cup	1 cup 175 g.	0 ?
Romano Walmart “Great Value”	35 g. ⅕ cup	1 cup 175 g.	0 ?
Produce (raw/fresh)
Cabbage, green USDA FoodData Central	100 g.		18
Tomato USDA FoodData Central	123 g. 1 medium		6.2
Tomato, diced USDA FoodData Central	180 g. 1 cup		9
Fruit & Veg, Processed
Tomatoes, Sun-dried Turkish, ready to Eat San Remo	15 g. 3 pieces		314
Tomatoes, Sun-dried in oil Unico	30 g. 5 pieces		300
Tomatoes, canned, diced; no salt added Western Family “Only Goodness”	125 ml 1/2 cup		10
Tomatoes, canned diced, no salt added Unico	125 ml 1/2 cup		5
Soup & Broth
Vegetable Broth No salt added Campbell	250 ml 1 cup		15
Cheese
Velveeta Process Cheez Kraft	30 g. Cube		450
Gouda (Dutch, sold in wedges or wheels) Several brand names	30 g. Cube		320
Emmental (Swiss or French, sold in blocks) Several brand & retailer names	30 g. Cube		varies 30 to 60
Swiss, sliced Castello brand	18 g. 1 slice		60
Swiss, sliced Cracker Barrel brand (a Lactanis brand)	20 g. 1 slice		45
Beverages
Beer 0.0% Heineken lager	355 ml 1 can		10
Beer 0.0% Grolsch lager	500 ml 1 can		20
Beer 0.5% Molson Exel ale	355 ml 1 can		10