Fifteen years ago today, the U.S Food and Drug Administration (FDA) published its final rule authorizing the use of the health claim linking soluble fiber from whole oats and reduced risk of coronary heart disease.¹ In essence, the FDA agreed with The Quaker Oats Company that consumption of soluble fiber from whole oats, as part of a diet low in saturated fat and cholesterol, lowered blood cholesterol levels.  This was a seminal event because prior to this ruling, the FDA had  prohibited food manufacturers from using any language on product labels that linked specific foods to specific health conditions.² However, upon reviewing the totality of  evidence presented by Quaker and the rigor of the underlying scientific research, the federal regulators concluded that the health claim was justified, making  Quaker the first company to gain FDA health claim approval for a specific food and later serve as the model for other manufacturers seeking health claims.³

Quaker made history as one of the first companies to cooperate with regulators for an authorized health claim; previously regulators and industry had engaged in a tug-of-war over nutritional messaging. Ironically, a health fad centering on oat bran during the late 1980s proliferated misleading health information on packaging. This type of abuse was a primary motivator for the Nutrition Labeling and Education Act (NLEA) of 1990, which gave the FDA broad authority to control nutrition information on food packages. Quaker was one of the most vocal supporters of regulation; the company viewed the oat bran fad as a detriment to its hard-earned reputation for science based claims, responsible labeling and appropriate use of nutrition information. Following the passage of the NLEA, Quaker was well positioned to make the case for the heart health benefits of oats, with over a dozen independent nutrition studies; but what type of claim could Quaker make on its Quaker Oats packages?

Label claims have existed in three types since the 1990 legislation. Quaker was one of the first to garner a claim with the highest level of regulatory approval  (a “Health Claim Meeting Significant Scientific Agreement (SSA)” which links a food to a reduction of disease risk).  The other types of claims, such as nutrient content claims (e.g. “contains 500mg of calcium”), structure-function claims (e.g. “calcium helps maintain bone density”), and qualified health claims⁶ (e.g. “Supportive but not conclusive research shows that eating 1.5 ounces per day of walnuts, as part of a low saturated fat and low cholesterol diet and not resulting in increased caloric intake, may reduce the risk of coronary heart disease”) have increased steadily to encompass about one-third of product labels, albeit with significantly greater FDA oversight than in the pre-NLEA period.⁴ Quaker’s oat claim joined government-initiated heart health claims for fruits, vegetables, and low-fat foods. The claim served as a trendsetter for a class of manufacturer-petitioned claims related to heart health. Barley and psyllium grains were added  to the oat claim in later years, and whole grains, plant esters and soy protein are other food substances with claims linked to the reduction of heart disease risk that have resulted from manufacturer entreaties.  Altogether, the FDA now recognizes 16 claims in total, with several from manufacturer requests and a majority from government recommendations.⁵

Quaker’s ground-breaking heart health claim cemented the company’s reputation as a maker of nutritious, heart-healthy foods, and has served as a consistently valuable promotional tool. Quaker’s commitment to heart health in particular, and health and wellness in general, has continued following the company’s 2001 acquisition by PepsiCo, where the brand now serves as a beacon of nutrition grounded in the wholesome goodness of oats.

Most importantly, as part of PepsiCo’s multibillion dollar portfolio, and sitting side by side in Chicago with PepsiCo’s Global Nutrition Group (recently created to deliver breakthrough innovation in the areas of fruits and vegetables, grains, dairy, and functional nutrition⁷), Quaker has the unique opportunity to leverage multiple platforms and brands to scale up its business – and mission – of nourishing people around the globe.  In fact, the scientific and technological advances in research and development, such as those that that led to the first food-specific health claim 15 years ago, continue today and serve as the innovation engine for consumer-centered solutions demonstrating that what is good for the consumers’ health can also be good for business. Best wishes for a happy and special 15^th anniversary celebration to Quaker!

Selected References

1. Food and Drug Administration. Food Labeling: Health Claims; Oats and Coronary Heart Disease; Final Rule. Fed Regist 1997 January 23;62(15):3583-601.
2. United States Congress. Pure Food and Drug Act of 1906. United States Statutes at Large (59th Cong , Sess I, Chp 3915, p 768-772; cited as 34 U S Stats 768) 1906;Available at: URL: http://www.ncbi.nlm.nih.gov/books/NBK22116/pdf/purefood.pdf
3. Fitzsimmons R. Oh, What Those Oats Can Do. Quaker Oats, the Food and Drug Administration, and the Market Value of Scientific Evidence 1984 to 2010. Compr Rev Food Sci Food Safety 2012; 11:59-99.
4. Food and Drugs Administration.  Claims That Can Be Made for Conventional Foods and Dietary Supplements.  http://www.fda.gov/food/labelingnutrition/labelclaims/ucm111447.htm
5. Food and Drugs Administration.  Guidance for Industry: A Food Labeling Guide http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/FoodLabelingGuide/ucm064919.htm
6. Food and Drugs Administration Qualified Health Claims http://www.fda.gov/Food/LabelingNutrition/LabelClaims/QualifiedHealthClaims/ucm072756.htm
7. Khan M.  PepsiCo’s new Global Nutrition Group. http://foodfrontiers.pepsicoblogs.com/2010/10/pepsico%E2%80%99s-new-global-nutrition-group/

Eating a healthy breakfast is a fundamental step in building a nutritious, total diet that meets the updated Dietary Guidelines for Americans. A growing body of research supports eating breakfast regularly for heart health, lower body weight and improved overall diet quality. Breakfast consumers tend to have higher micronutrient intakes, partly because of the fortification of breakfast cereals, and have a better macronutrient profile than “breakfast skippers” (1). Studies in children suggest that breakfast eaters are more likely to meet daily nutrient intake guidelines compared with children who eat breakfast infrequently or skip breakfast (2).

Evidence suggests that regular breakfast consumers also have healthier body weights than those who skip breakfast (3). It has been suggested that skipping breakfast may lead to overall greater levels of hunger later in the day, which in turn may lead to overeating, particularly foods that are higher in energy density (4-6). Similarly, children who regularly eat breakfast tend to have a lower BMI and are less likely to be overweight than those who eat breakfast less frequently (7-10). Evidence in children also suggests that breakfast consumption may have generally positive effects on cognitive performance in comparison with breakfast omission (11).

Consequently, having a nutritious breakfast daily can benefit your overall health in numerous ways; besides fueling your body after the overnight fast, the perfect breakfast not only helps the body get the micro and macronutrients required for the day, it can also help reduce the mid-morning loss of energy, and may support your goals to manage cholesterol, blood sugar and blood pressure. Oatmeal is a good example – many studies conducted with Quaker Oats led the FDA to conclude that 3g of soluble fiber daily from oatmeal, in a diet low in saturated fat and cholesterol may reduce the risk of heart disease.

Despite the evidence showing the important role breakfast can play in helping adults and children meet nutrition recommendations, only half consume breakfast daily.  Quaker aims to be a part of the public-health solution by helping alleviate America’s breakfast deficit and hopes to advance the scientific understanding and definition of a healthy breakfast as requested by the Dietary Guidelines Advisory Committee’s June 2010 report.

We are looking forward to collaborating with the scientific community in this area through research to address some key questions: What are the reasons people skip breakfast? Time can be a factor for many in our busy lives; do we design a breakfast with convenience in mind, or focus on behavioral strategies to help individuals return to the habit of a daily breakfast? There is also a perception that skipping breakfast can contribute to weight management despite all the evidence to the contrary. How do we change that perception to ensure breakfast becomes part of a weight management strategy? Are there technological breakthroughs and unlocks that would be game-changing for children and adults to enjoy breakfast?

1. Timlin MT, Pereira MA. Breakfast frequency and quality in the etiology of adult obesity and chronic diseases. Nutr Rev 2007;65:268–81.
2. Deshmukh-Taskar PR, Nicklas TA, O’Neil CE, Keast DR, Radcliffe JD, Cho S. The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999 2006. J Am Diet Assoc. 2010 Jun;110(6):869-78.
3. Smith KJ, Gall SL, McNaughton SA, Blizzard L, Dwyer T, Venn AJ. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr. 2010 Dec;92(6):1316-25. Epub 2010 Oct 6
4. Nicklas TA, Bao W, Webber LS, Berenson GS. Breakfast consumptionaffects  adequacy of total daily intake in children. J Am Diet Assoc 1993; 93:886–91.
5. Sampson AE, Dixit S, Meyers AF, Houser R Jr. The nutritional impact of breakfast consumption on the diets of inner-city African-American elementary school children. J Natl Med Assoc 1995;87:195–202.
6. Sjoberg A, Hallberg L, Hoglund D, Hulthen L. Meal pattern, food choice, nutrient intake and lifestyle factors in The Goteborg Adolescence Study. Eur J Clin Nutr 2003;57:1569–78.
7. Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD (2005). Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 105, 743–760; quiz 761-742.
8. Utter J, Scragg R, Mhurchu CN, Schaaf D (2007). At-home breakfast consumption among New Zealand children: associations with body mass index and related nutrition behaviors. J Am Diet Assoc 107, 570–576.
9. Croezen S, Visscher TL, Ter Bogt NC, Veling ML, Haveman-Nies A (2009). Skipping breakfast, alcohol consumption and physical inactivity as risk factors for overweight and obesity in adolescents: results of the E-MOVO project. Eur J Clin Nutr 63, 405–412.
10. Timlin MT, Pereira MA, Story M, Neumark-Sztainer D (2008). Breakfast eating and weight change in a 5-year prospective analysis of adolescents: Project EAT (Eating Among Teens). Pediatrics 121, e638–e645.
11. Hoyland A, Dye L, Lawton CL. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev. 2009 Dec; 22(2):220-43. Epub.Review

Recent data supporting genuine concern about heart health are well-documented in the 2011 update of the Heart Disease and Stroke Statistics published by the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies. There was also three recent publications of note in the Lancet on cholesterol, blood pressure, and obesity.

Its clear more work still needs to be done but we also want to share the good news! For example, over the most recent decade for which complete data are available (1997 – 2007), the annual death rate due to heart attacks declined 26.3%, and the actual number of deaths declined 12.9%.  In fact, death rates from heart attacks have fallen dramatically from their peak in 1963 (when the American Heart Month observance was established) to the level today. To put this in perspective, for every 100,000 Americans, there were 429 deaths from heart attack in 1963 compared to 126 deaths in 2007.

We know that about half of these dramatic declines are attributable to improvements in treatments such as heart bypass surgery, angioplasty, stents, and the use of safe and powerful drugs after heart attack, chest pain, and heart failure. The major concern is that the skyrocketing trend in the cost of care for heart disease is unlikely to be sustainable much longer. The cost of care for heart disease will triple from $273 billion to $818 billion by 2030, according to a recent report by the AHA.

Now, here is the really good news. We also know that the other half of the dramatic declines in heart attack deaths can be attributed to lower blood pressure, lower blood cholesterol, lower burden of cigarette smoking, and increased physical activity – all of which contributed about 44% to the dramatic decline in heart attack deaths from 1980 – 2000. The good news is that the impressive reductions in mean blood pressure and cholesterol have continued, not just in the U.S. but in many regions of the world as shown in the recent publications in the Lancet on cholesterol and blood pressure. In fact, had we been able to also decrease the burden of obesity and diabetes, there would have been an additional 18% decrease in number of heart attack deaths in the U.S. based on the data for 1980-2000. Clearly, the continuing burden of obesity and diabetes remains the major cause for concern.

At PepsiCo, we firmly believe that our major human sustainability commitments to reduce salt, added sugar and saturated fat; and increase the amount of whole grains, fruits, vegetables, nuts, seeds, and low-fat dairy in our global portfolio provide consumers more options to positively impact major risk factors and to achieve further reductions in heart attack and heart disease risk. In addition to optimizing basic nutrition, we have the opportunity to explore specific functional nutrients which may contribute to further reductions in heart disease risk factors.

The strong commitments we have made in the marketplace and community may also contribute to consumers’ understanding of what it takes to prevent and control obesity, diabetes, and the other risk factors for heart disease. These commitments include our front-of-package calorie labeling; restrictions in advertising to children under age 12; further restrictions in the direct sale of full-sugar soft drinks in primary and secondary schools; increasing the availability of foods and beverages that offer solutions for managing calories; and expanding both PepsiCo Corporate and PepsiCo Foundation initiatives to promote healthier communities, including enhancing diet and physical activity programs.

As we observe another American Heart Month, we reaffirm our support for programs such as the First Lady Michelle Obama’s Let’s Move! Initiative, and the Healthy Weight Commitment Foundation both of which are committed to reducing obesity – especially childhood obesity. We also express our thanks to the many researchers, health professionals, and heart health visionaries whose efforts have led to the dramatic declines in heart disease death rates we see in Americans today. We look forward to continued engagement with you and especially to your input and guidance as to how best we contribute to continuing progress in improving heart health in the U.S. and abroad.

Sunday, September 26^th, marked the 10^th anniversary of the observance of World Heart Day (WHD), a time each year to teach people around the globe about heart disease and stroke. Together as cardiovascular diseases, heart disease and stroke are the world’s leading cause of death, claiming 17.1 million lives each year. World Heart Day is also a time to assess the progress made and the challenges that persist in the prevention and control of heart disease and stroke.

This year’s theme for World Heart Day is “workplace wellness” – an issue PepsiCo agrees is important. Worksite health promotion programs with trained experts can go a long way in supporting employees in their attempts to achieve the best personal outcome for their health. In PepsiCo locations around the world including Brazil, Argentina, Thailand, Mexico, Germany and the Philippines, we sponsor events that raise awareness about cardiovascular disease via onsite lectures, and blood pressure and cholesterol checks.

At PepsiCo, we also know we can make a difference in reducing heart disease in populations around the world. In June, we participated in the World Congress of Cardiology, where we held a series of meetings with leading scientists and public health experts to discuss the latest scientific research into cardiovascular disease, the role the food industry can play in promoting heart health, and how to utilize multi-sector partnerships to achieve change within the food industry, governments and populations. The World Congress of Cardiology was hosted in China, where cardiovascular disease is the leading cause of death, and death rates have surpassed those in the developed world.

India is another country of concern when it comes to cardiovascular disease burden. Did you know that over the next 15 years, more than half of the heart disease cases in the world will come from India?

Quaker Oats, a PepsiCo company, championed a social program in India to improve heart health. The program, Good Morning Heart, launched in 2009, has included events to educate people on the role of healthy diet, including the consumption of oats, in preventing cardiovascular disease.

Earlier this month, the program entered into a partnership with the Chennai police to help empower the police personnel to make informed choices on good nutrition and active lifestyle through nutrition assessments and group or one-on-one counseling.

PepsiCo understands that heart disease is the number one cause of death in the world. World Heart Day gives us the chance to talk about the risks of heart disease and demonstrate our interest in actively working with global and local partners to help contribute to reducing the risk.

In the most recent report from the World Health Organization on mortality and burden of disease attributable to major risks (Global Health Risks), nearly 1.7 million deaths were attributed to low intake of fruits and vegetables globally in 2004 (Table A3 WHO report 2009). In that report, insufficient intake of fruits and vegetables was estimated to have caused 14% of stomach cancer deaths, 11% of ischemic heart disease deaths and about 9% of stroke deaths world wide. The primary health benefit identified as relating to fruit and vegetables intake is its impact on reducing cardiovascular disease but also on the reduction of risk of specific cancers.

Despite the well-known understanding that fruits and vegetables should be included in a healthy diet, Americans are still falling far short of the recommended intake.  A recent report in the CDC Morbidity and Mortality Weekly Report (MMWR) released Sept 10, 2010 shows that not a single state in the U.S. met the national Healthy People 2010 targets for fruit & vegetable consumption. The CDC report estimates that in 2009, about a third (32.5%) of adults in the U.S. consumed fruit two or more times a day, and just over a quarter (26.3%) consumed vegetables three or more times a day – both far less than national targets. These data were developed from the analysis of the CDC Behavioral Risk Factor Surveillance System and underscore the need for more drastic national, state, and community action to increase fruit and vegetable intake.

It is clear that more needs to be done to improve access, availability and affordability of fruits and vegetables. Some of the challenges the public health community faces are:

• How do we increase the fruit and vegetable food supply (our supply chain) with the limited and shrinking availability of agricultural land?
• How do we overcome the barriers such as accessibility, affordability, taste and convenience to consuming fruit and vegetables?
• How can we deliver the goodness of fruit and vegetables in minimally processed forms that deliver the positive health impact of whole fruits and vegetables?
• How can we educate people, starting at a young age about the benefits of fruits and vegetables and encourage children to make eating fruits and vegetables a lifetime habit?

At PepsiCo we are taking a new look at these complicated issues and subsequent blogs will address the challenges listed above. Are there any other issues that you, our readers, would like us to consider?

Each year, we sponsor a summer internship program for young scientists in the nutrition field. The program provides students an opportunity to see the important role the food industry can play in meeting global nutrition challenges, and it provides us the opportunity to learn from the intern’s fresh perspectives. As the summer draws to a close, we want to take this opportunity to highlight some of the great work the PepsiCo R&D interns did in nutrition science and food policy.

Our 21 interns all had impressive backgrounds in science and nutrition. They hailed from the Friedman School of Nutrition Science & Policy, the Frances Stern Nutrition Center at Tufts Medical Center, the School of Human Ecology at Cornell University, Department of Food Science & Technology at the University of Georgia, the College of Arts and Sciences at the University of Pennsylvania, and the Center for Human Nutrition at the Johns Hopkins Bloomberg School of Public Health, just to name a few.

Our PepsiCo 2010 summer interns undertook a variety of projects, including:

• Creating a calorie education program for our New York-based employees that provided valuable information about the importance of conscious calorie intake.
• Conducting a critical evaluation of the science behind the health benefits associated with the consumption of fruits and vegetables.
• Assessing the USDA’s national school meals program in order to explore opportunities for guiding product development.
• Developing an internal quarterly nutrition newsletter for PepsiCo team members.
• Exploring programs to strengthen the nutritional impact of PepsiCo’s contribution to Feeding America, the nation’s largest hunger charity.
• Reviewing 3 major reports from the Institute of Medicine and the White House White House Task Force on Childhood Obesity in order to assess the practical implications for the food industry.
• Conducting a scientific literature review on the use of low-calorie sweeteners for aiding weight loss and weight maintenance programs.

We are proud to have interns who have undertaken such significant work as part of our team because they represent the future of the nutrition science and food policy world.

To the scientists out there reading Food Frontiers, we hope you’ll share some of the valuable experiences you had early in your careers that might be helpful for PepsiCo R&D to know as we continue building our internship program.  What are some of the nutrition and health science areas you suggest we explore with our interns next summer? What innovative and successful models for nurturing trainees and young professionals are you familiar with, and how best can we learn from them?  We look forward to hearing from you.  In the interim, please join us in congratulating our PepsiCo R&D summer interns and wishing them the very best in their careers!

A recent report from the U.S. Centers for Disease Control and Prevention (CDC) shows that 9 out of 10 Americans exceed the limit recommended for daily sodium intake. In fact, for the group of Americans whom a lower dietary intake of sodium is important, the amount of sodium consumed was more than double the recommended limit.

The CDC report also showed that only 9.6% of U.S. adults were below the recommended dietary limit of 2,300 mg per day for sodium; and only 5.5% among the group recommended to limit sodium intake to less than 1,500 mg per day achieved that target.  Overall, the average sodium consumption for U.S. adults was 3,466 mg per day, far in excess of the 2,300 mg per day recommended.  In the group of adults recommended to limit sodium intake to less than 1,500 mg per day, the actual intake averaged 3,366 mg per day. Excess dietary intake of sodium is not just an American issue but a genuine global health concern as emphasized by the World Action on Salt and Health and the World Health Organization.

Why is an excess intake of sodium a concern?  The scientific evidence is compelling that excess dietary sodium is associated with major adverse health outcomes, and that reducing this excess can be a cost-effective action that leads to a lower rate of new heart attack and stroke, as well as a lower death rate in all Americans, especially black men and women.

It has been estimated that 77% of dietary sodium intake in the U.S. comes from processed foods while another 11 percent comes from salt added at the table or during cooking. In the CDC report, most of the daily sodium consumed came from grain products such as yeast breads (36.9%) and meats, poultry, fish, and mixtures (27.9%), followed by vegetable products (12.4%).  The USDA has produced a list of the top products that contribute the most to daily sodium intake.

For any large scale sodium reduction strategy to be effective, it must engage all members of the entire food system including ingredient manufacturers, retailers, restaurants and especially the food industry.  PepsiCo has set a global goal and has made a commitment to reduce the average amount of sodium per serving in key global food brands, in key countries, by 25 percent by 2015, with a 2006 baseline. Given the capability we have today and substantial investments planned over the next 5 years, we believe we can achieve this goal.

For PepsiCo to achieve sodium reductions of 50% and greater, significant scientific and technological breakthroughs will be required and engagement of the broader scientific community is crucially needed. However, discussions of dietary sodium reductions today have typically been limited to public health officials, policy makers, health care providers and food industry scientists.  Conversations need to be broadened to include more than just these professionals. ‪

Input of scientists with expertise in taste perception; neurosensory receptor activation and signal transduction mechanisms; molecular and biophysical structure; and physiological properties of sodium salts is required to drive innovation.  We also need to engage scientists with expertise in socio-ecological determinants of lifestyle choices, behavioral economics, and choice architecture who can help nudge the public towards requesting and choosing foods and snacks with a reduced sodium content.‪

In the interim, we at PepsiCo are taking action today to increase the use of fruits, vegetables, whole grains, seeds, legumes, and nuts for which scientific evidence of health benefits exist.  In addition to our attention to sodium, we continue to invest in research and development and explore other opportunities (such as reducing added sugars, the saturated fat content, and calorie-density) to expand our product offerings.  We look forward to continuing the conversation on sodium and receiving input that may lead to even greater sodium reduction in foods without compromising taste, quality, and food safety.

References

1. CDC. Sodium Intake Among Adults — United States, 2005−2006. Morbidity and Mortality Weekly Report; June 25, 2010; 59(24);746-749. URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5924a4.htm.
2. World Action on Salt and Health (WASH). Salt & Health. URL: http://www.worldactiononsalt.com/health/salt_health.htm.
3. World Health Organization. Sodium intakes around the world. Background document prepared for the Forum and Technical meeting on Reducing Salt Intake in Populations (Paris 5-7th October 2006). URL: http://www.who.int/dietphysicalactivity/Elliot-brown-2007.pdf.
4. Bibbins-Domingo K, et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. The New England Journal of Medicine February 18, 2010; 362(7):590-599. URL: http://content.nejm.org/cgi/content/abstract/362/7/590
5. PepsiCo. 2009 Annual Report. Performance with Purpose – The Promise of PepsiCo. URL: http://www.pepsico.com/annual09/human_sustainability.html.
6. USDA.  National Nutrient Database for Standard Reference, Release 18; URL: http://www.nal.usda.gov/fnic/foodcomp/Data/SR18/nutrlist/sr18w307.pdf.
7. Mattes RD, Donnelly D.  Relative contributions of dietary sodium sources. Journal of the American College of Nutrition 1991;10(4):383-393.  URL: http://www.jacn.org/cgi/content/abstract/10/4/383?ijkey=7496e0ca4e5e9caa2531f3ceebdcad5cb082678c&keytype2=tf_ipsecsha
8. USDA. Could Behavioral Economics Help Improve Diet Quality for Nutrition Assistance Program Participants? DR Just, L Mancino, B Wansink (eds); Economic Research Report no. 43, June 2007. URL: http://www.ers.usda.gov/publications/err43/err43.pdf.

Note: The views expressed here represent the personal views of the authors and not necessarily the views of PepsiCo, Inc.

See the link below for more details, and if you have any questions for George please post them in the comments section:

Atlanta Journal Constitution: Whatever happened to… George Mensah?

When your blood pressure is measured you will be given two numbers (for example, 120/80).

• If your first number is always less than 120 and the second is always less than 80, you have ideal blood pressure, or your blood pressure is in the “ideal zone”.
• If your first number is 140 or higher or the second is 90 or higher, you must talk with your healthcare provider because these numbers suggest that you may have HBP.
• If your first number is between 120 & 140 and the second number is between 80 & 90, you are considered to have prehypertension.  This means you are very likely to develop HBP and a visit with your healthcare provider is recommended.

Knowing your blood pressure is important but it is not enough. You must also take steps to keep your blood pressure in the ideal zone. This year, the theme of World Hypertension Day is “Healthy Weight – Healthy Blood Pressure” and the four specific actions recommended are: Check Your Waist; Eat Green; Exercise; and Cut Salt.  In addition to these, it is important that you measure your blood pressure regularly. If your blood pressure numbers are not in the ideal zone, see your health care provider to get an assessment. If you have HBP or are currently taking medications for hypertension, be sure to take your medications regularly, and consult your healthcare provider about maintaining ideal weight.

At PepsiCo, we believe that the scientific evidence is very strong for both the global importance of HBP and the use of lifestyle changes as part of a strategy to control HBP or maintain ideal blood pressure. In particular, a diet rich in whole grains, fruits and vegetables, nuts and seeds, and low in sodium, saturated fats, and added sugars is recommended along with moderate levels of physical activity on a regular basis.  Our Human Sustainability efforts and the eleven global goals and commitments we have made directly support these actions. Our partnerships with groups such as the Healthy Weight Commitment Foundation also support these healthy lifestyle habits.

PepsiCo has recently partnered with the American Society of Hypertension and provided support for publication and dissemination of a brochure to be used in its community outreach program.  This brochure is currently available in English, ”Blood Pressure and Your Health” and Spanish “La presión arterial y su salud.” The World Hypertension League has also produced a resource on high blood pressure, for World Hypertension Day, ”Healthy Weight, Healthy Blood Pressure.”

As many of you know, heart disease is the leading cause of death for both men and women in the United States. It is also a major cause of disability, reduced quality of life, and rising health care costs.

It is now well-recognized that poor nutrition and physical inactivity are some of the most important factors that contribute to poor health. At PepsiCo, we are on a journey to transform our portfolio of products to support our consumers in their effort to reduce their risk of heart disease and promote overall well-being. We recognize that specific changes in food industry practices can favorably impact diet and nutrition, and may therefore contribute to reducing the risk of heart disease.

At PepsiCo, we want to be part of the solution. As a result, below are seven key actions that PepsiCo is currently taking to help reduce the risk of heart disease around the globe:

• Increasing the use of healthy oils
• Reducing saturated fats, transfats, added sugar, and sodium
• Enhancing healthy ingredients such as fiber, omega-3 fatty acids, fruits and vegetables
• Investing in novel crops that also contribute to enhanced nutrient-density
• Reducing calorie density and providing options for portion size
• Raising public awareness and promoting physical activity
• Adopting advertising practices that promote balanced nutrition, particularly in children

No single sector has been successful in addressing the enormity of the heart disease problem by itself. PepsiCo’s goal is to be a leader in the food industry by fostering partnerships to address heart health.  We believe that the industry’s global reach, experience, and expertise in food production, processing, and distribution, and its invaluable consumer insights provide unique opportunities to make a positive impact on heart health.

In addition to supporting PepsiCo’s actions, we can all help promote heart health by participating in workplace wellness programs, being active, eating healthily, and seeking regular preventive screening as recommended by our health care providers.