BLOOD PRESSURE - DIETARY CHANGES

Fortunately, a blood-pressure-friendly diet also supports necessary weight loss, along with healthy levels of blood sugar, lipids, and cholesterol. When you make smart dietary changes, you're creating a climate in which your body can find overall balance and well-being.

"Dietary Approaches to Stop Hypertension" known as the "DASH" Diet is widely recommended for hypertensive patients. The DASH diet restricts salt and saturated fat and emphasizes fruits, vegetables, and low fat dairy products. The Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure recommends the DASH diet for all hypertensive patients.

Specific recommendations of the DASH diet are as follows:

    Only 30 percent of total caloric intake from fats.
    Eight to 10 servings of fruits and vegetables daily.
    Seven or eight servings of whole grains daily.
    No more than five servings of seeds and nuts each week.

The evidence supporting the blood pressure benefits of DASH is clear, but compliance appears to be poor. Phillip B. Mellen, MD, MS, of the Hattiesburg Clinic in Hattiesburg, Miss., and colleagues, investigated some of the data from the 1988-1994 and 1999-2004 NHANES study. Only 7.3 percent of individuals diagnosed with hypertension were following the DASH diet. The rate of dietary compliance was lowest among young people, the obese, and African-Americans.

Effect of Diet on Weight

If you're overweight and you start eating a healthy diet, you will lose weight. That may have the biggest impact on blood pressure. The University of Pavia's Robert Fogari, MD, and colleagues challenged 220 overweight but not obese hypertensive adults to lose five percent of their body weight within six months. These men and women had been diagnosed with stage 1 hypertension, which refers to blood pressure between 140/90 to 159/99.

After six months, 59 percent of the women and 53 percent of the men had met this goal. A little more than half of that group brought their blood pressure down to a healthy range, below 120/80.The results of this study were presented at the American Heart Association's 61st Annual Fall Conference of the Council for High Blood Pressure Research, in Tucson, Ariz., in 2007. The moral of the story? Even modest weight loss as little as 10 pounds can normalize blood pressure readings. And we can achieve weight loss through a diet high in fruits, vegetables, whole grains, and low-fat dairy foods, and low in fat, sodium, and refined sugar and flour

Role of Dietary Fat

Early humans were hard-wired to crave high-fat foods because they are dense in calories and helped ensure the survival of the species. In modern societies, famine is unlikely, but we still have that primitive craving. Furthermore, since most of the flavors in foods are fat soluble, fattier foods taste better. Paradoxically, the craving that once ensured our survival now appears to be threatening it.

To protect our blood pressure and overall health, we need to cut down on saturated fat and trans-fatty acids (also known as hydrogenated fat). Sources of saturated fat include meat, poultry, butter, cheese, whole milk, and coconut oil. Trans fat, a kind of artificial fat, is found in many margarines, baked goods, cookies, and crackers. In 2006, the Food and Drug Administration began requiring mandatory trans-fat labeling.

First, cutting down on saturated fats and trans fatty acids can help you reduce or control your weight. Second, saturated fat appears to contribute to insulin resistance, which is implicated in high blood pressure. Third, trans fatty acids are believed to raise LDL ("bad") cholesterol and lower HDL ("good") cholesterol. When cholesterol builds up along the artery walls, it causes the arteries to get harder and more clogged up. As a result, blood pressure rises.

However, not all fats are harmful. Fish oil, rich in omega-3 fatty acids, appears to reverse insulin resistance. A 60-day trial among overweight people in Surrey, England, showed an increase in insulin sensitivity, as well as a significant decrease in diastolic blood pressure, with the use of fish oil supplements.

Caffeine

The role of caffeine in blood pressure is still up for debate. Moderate coffee consumption is defined as three 8-ounce cups a day. But in our hurryup modern age, many people are just warming up with that third cup of coffee. They may also discount the caffeine they're getting through soft drinks, tea, chocolate, and other sources. Caffeine triggers the release of cortisol, which contributes to high blood pressure and metabolic disorder. Excess coffee acts on the body like extra stress. It may also interfere with the quality of our sleep, which is discussed in more detail on page 27.

In addition, coffee appears to stimulate the excretion of B vitamins through the urine. A recent study in Norway measured B-vitamin levels in 10,601 healthy, middle-aged men and women. Researchers found a greater loss of B vitamins in the urine of coffee drinkers who already had higher plasma levels of B vitamins. Deficiencies in folate and vitamins B6 and B12 lead to high homocysteine levels, a cardiovascular risk factor

Refined Sugar

We love refined sugar and the products made from it: soft drinks, cookies, candy, cake, and ice cream are as American as apple pie (which is also high in sugar). However, we indulge ourselves excessively, eating an average of 150 pounds of refined sugar every year. We could also add to this an extra 200 pounds of refined flour and cereal products. We are less physically active, yet we are consuming far more carbohydrates than did our great grandparents. And we pay for this excess with expanding waistlines, insulin resistance and hypertension.

In a review published in the American Journal of Nutrition, the authors speculate that a high intake of sugar has contributed to metabolic disorder, Hypertension, and kidney disease. Over the past 40 years, we've seen a dramatic increase in the use of refined table sugar and high-fructose corn syrup, which is found in soft drinks, fruit punches, pastries, and processed foods. The authors cite a 1939 study, which found hypertension in only 12 to 13 percent of men between ages 50 to 55. Today, that percentage is up to 31 percent.

Interestingly, according to a report in the American Journal of Clinical Nutrition, hypertension, diabetes, and obesity were first documented in England, France, and Germany nations where refined sugar first became available.

Laboratory research supports the link between refined sugar and these health problems. Researchers in Mexico added commercially refined sugar to rats' drinking water for 12 to 17 weeks. Compared to a control group, the sugar-fed rats had more contracted arteries, higher triglyceride levels, and higher blood pressure.

Emphasize Whole, Unprocessed Foods

When we have too many responsibilities and too little time, we often opt for convenience: fast food, frozen dinners, or canned soup. These readymade meals are fast, easy, and relatively cheap.

But they do cost us. Processed foods are typically high in sodium, low in nutrients, and they come with artificial preservatives that have no business in the human body. These quick meals also tend to supplant real food: fruits, vegetables, and legumes.

The average Western diet provides alarmingly low levels of potassium, calcium, and magnesium nutrients that are vital for healthy blood pressure. In sharp contrast, the Mediterranean diet is rich in plant foods and omega-3 fatty acids. This diet has also been favorably compared to drug treatments in The American Journal of Medicine for reducing hypertension and high triglyceride levels.

Deeply colored foods, such as oranges, peppers, beets, and broccoli, are also the most nutrient-rich. The adage "eat for color" is excellent advice. The phytochemicals that create those rich colors are the same ones that protect our health.

Value of Organic Foods

Yes, organic foods are more expensive but they may be one of the most important long-term investments you'll ever make. Organic foods lack the pesticides, herbicides and heavy metals we consume with other foods; they also provide higher levels of antioxidants. Antioxidants neutralize free radicals, unstable molecules that have been implicated in health problems including heart disease, diabetes, inflammatory disorders, Alzheimer's, and Parkinson's disease.

Let's consider the research. For more than four years, scientists from Britain's Newcastle University raised cattle and grew fruits and vegetables, using either organic or conventional approaches. The results have been startling: The organic fruits and vegetables provide up to 40 percent higher levels of antioxidants than conventionally grown produce. Organic milk was found to be 90 percent more antioxidant-rich than conventional milk. An earlier survey from Swiss researchers also showed much higher levels of health-promoting omega-3 fatty acids in organic milk.

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