By Lauren Bock, ADVANCE CONTRIBUTOR
I met Kaye and Dave a few years ago when Dave begrudgingly joined one of my group Lifestyle Medicine classes. Kaye is a retired middle school art teacher and mother of two children, one of whom lives in a far off land with the couple’s grandkids. She’s also a breast cancer survivor, honest, passionate, charismatic, a strong advocate for herself and those that she loves—especially Dave, a retired Marine.
They dutifully attended together, Kaye nodding along while Dave sat quietly through six weeks of classes, skeptically soaking up bits of knowledge with distant hopes of shortening his medication list, just like a handful of others with similar stories:
High blood pressure and high cholesterol.
Statin-weary and medication-averse.
Some joined after their first, second, or even third heart attack. Others came hoping to prevent what they feared was inevitable given their alarming family histories and high-risk comorbidities. Each person questioned if they could learn enough to make a meaningful difference in their own health trajectory.
Within weeks, changes begin to take place in most of the attendees with the support of a community-is-medicine mindset. A mere swap of Dave’s daily Jimmy Dean breakfast sandwich for Kaye’s favorite oatmeal was easy enough for him to implement—a seemingly small change that yielded quantifiable results.
Unfortunately, Dave also became dizzy and hypotensive due to his suddenly low blood pressure, which we soon learned had been caused by his sodium sensitivity. Simply put, he cut his sodium intake too quickly, and his body hadn’t had time to adjust to the radical decrease in salt from his diet.
This shouldn’t have been too surprising when you consider that Jimmy Dean’s sausage/egg/cheese breakfast biscuit contains 850mg of sodium, 42 percent of the total recommended daily value—not to mention the fat, cholesterol, and refined carbohydrates in that savory breakfast.
On the other hand, a standard serving of plain steel cut oatmeal—Dave’s new daily breakfast—contains 0mg of sodium, 0g of cholesterol, 3g of fat and 5g of fiber: a breakfast superstar. Which meant that after cutting out his Jimmy Deans, Dave was—ironically—sodium-deficient.
As a general rule, for those with hypertension—like Dave and others in that group class—I recommend reducing total daily sodium intake by half, which means 1,000mg daily for the average adult. A single breakfast sandwich contained 84 percent of Dave’s recommended total daily sodium. Take that away and you can see why things swung so far the other direction.
The numbers are unfortunately worse when you leave the comfort of your own kitchen. A classic Chick-Fil-A chicken sandwich will send your sodium soaring into orbit before you even dip the first delectable waffle fry into their signature, creamy Chick-Fil-A sauce. The sandwich alone clocks in at 1,470mg.
Cambridge University researchers have found simply eating home-cooked meals reduces the risk of chronic health diseases. Ten-year survival increases by 47 percent when we choose home cooking instead of eating out most days of the week. If you were to eat out of the garden for most of your meals, the sodium conversation would be obsolete. Even the high-sodium vegetables like celery, spinach, beetroot, and Swiss chard pale in comparison to processed foods.
The health benefits of eating at home extend beyond the food itself. When we cook at home, we engage in NEAT: Non-energy activity thermogenesis. NEAT movement accounts for about 15-30 percent of our daily caloric burn, and includes the non-exercise activities throughout our day: standing, pacing, cleaning, fidgeting, cooking and, my favorite, gardening. The mere act of cooking engages NEAT.
While we may not always enjoy doing the dishes, standing at the sink for 20 minutes after a meal is infinitely better for one’s health than post-meal sitting, driving home and retiring to the couch after an engorging meal at your local dive. Ideally, leave the dishes on the table, head out for a 15-minute post-meal stroll, then come home to wash the dishes with the music on and the lights a little dim as we start preparing for the evening wind-down. Can’t stand to leave dishes on the table? Swap the routine: clear the table, then go for a walk. Don’t overthink this.
After a few tweaks and adjustments to Dave’s medications, and increasing his water intake, the hypotension cleared up and he felt like himself again. Correction, Dave was beginning to feel better than he had when we first met. I noticed a little more pep in his step as his changes began to take shape and the chronic skeptic seemed a little more willing to lean into changes that could give him a few more years to visit his grandchildren or co-pilot yardwork with Kaye.
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Lauren Bock is a certified Physician Assistant. From 2021 until 2025, she led a Preventative Cardiology program with Virginia Cardiology Consultants and Oracle Heart and Vascular. She was the first provider in the Fredericksburg area to be board-certified in Lifestyle Medicine. You can contact her at her Lifestyle Medicine practice Be Well.
