Healthy Eating Tweaks for Lower Blood Pressure
These three strategies can take a whole lot of pressure off
Among people with high blood pressure, only about half have their blood pressure under good control. Whether you have high blood pressure or hope to delay or avoid development of high blood pressure, the good news is that changes in your eating habits can help.
Even better news: If you’re not up for a major overhaul of your diet, research has identified ways in which we can “tweak” eating habits with relatively small changes that can add up to make a difference for a healthier blood pressure and improve overall health at the same time.
Let’s consider three ways you might tweak your current eating habits for healthy blood pressure.
Tweak #1: Cut sodium with smart swaps
You’ve probably heard the to-and-fro controversy about how much sodium in the diet is best. A big part of this confusion: Different types of studies address the question, and each poses problems as researchers work at interpreting what they really show.
Years of controlled trials in which food is provided for people — meaning they don’t have to figure out how to choose and prepare food to keep sodium at a particular level — show reducing sodium consumption leads to lower blood pressure in most people.
One review of a wide range of studies led a panel of expert researchers to conclude evidence is strong in adults 30 to 80 years of age, with or without hypertension, that reducing sodium intake by about 1150 milligrams (mg) per day reduces blood pressure by 3 to 4/1 to 2mm Hg. The panel concluded that evidence is more limited regarding specific health outcomes, but that reducing sodium intake by about 1000 mg a day reduces cardiovascular disease events by about 30 percent. Even if recommended sodium levels are not reached, reducing sodium by about 1000 mg a day reduces blood pressure.
Since latest figures place U.S. adults’ average sodium consumption at 3592 a day, setting an initial goal of reducing current daily totals by 1000 mg a day makes sense. The current recommendation is no more than 2300 mg/day for the general adult population. An even lower intake (1500 mg) is recommended for some people according to certain guidelines.
For most people, looking only at the salt shaker is looking in the wrong place. It’s estimated that for most Americans, 75 to 80 percent of our sodium comes from the foods we eat, rather than the salt we add to it at the table.
More than 40 percent of the sodium we eat comes from 10 basic food types: breads and rolls, cold cuts and cured meats (like bacon, ham and sausage), pizza, poultry (from types that are injected with salt water solution, as well as all the processed versions of poultry we choose), soups, sandwiches, cheese, pasta dishes, meat dishes and snacks.
That makes these foods a great place to focus. Find four swaps that each cut 250 mg of sodium, and you’ll achieve that target of cutting sodium by 1000 mg a day. Here are a few to start your thinking:
- Swap highly processed foods with added salt and sodium-based additives for less processed forms.
Rice, couscous or other cooked grains: Instead of “flavored” mixes, skip the salty flavor packet — or save money by choosing the unflavored version — and add your own herbs, spices, garlic or other flavorings. Sodium drops from 500 to 1000 mg per cup (cooked) to essentially 0 mg.
- Switch the proportion of foods in your overall eating habits: more low-sodium options, smaller amounts of foods higher in sodium.
Burgers on the menu? Stick to one burger (and thus one bun, which has more than double the sodium of the burger), adding some extra raw vegetables to your plate. The change drops at least 250 mg of sodium.
- Change out specific products for other brands or lower-sodium versions.
Legumes like garbanzo beans and black beans offer so much nutritionally. Switch from 1/2 cup regular canned (390 mg sodium) to 1/2 cup canned with no added salt (10 mg sodium). Or at least drain and rinse the regular beans, and you’ll cut sodium by 156 mg.
Tweak #2: “DASH-ify” your eating habits
The DASH diet was developed to test steps beyond limiting sodium that could reduce blood pressure. Even when sodium consumption was about 3000 to 3300 mg, the DASH diet reduced blood pressure in study participants by about 6/3 mm Hg. Among those with hypertension, the effect was even more powerful, reducing blood pressure by about 11/6 mm Hg.
Combining DASH with cuts in sodium, brings the biggest blood pressure drop. The good news is that DASH helps people who need it most: Blood pressure falls more in people with hypertension, and more in those who aren’t reaching recommended sodium targets, than in those who get sodium down to 1500 mg a day.
So how do you DASH-ify your eating habits?Some people have focused on DASH to boost potassium, which seems to counter sodium’s blood pressure-raising effects. However, when researchers added supplements of potassium — even with magnesium, which is also increased in a DASH-style diet compared to typical U.S. eating habits — although elevated blood pressure improved, it did not drop to the extent seen with the same amount of potassium and magnesium delivered as part of whole foods in a healthy eating pattern.
DASH-style eating habits mean eating more whole grains, legumes (dried beans and peas), nuts and seeds. Together, all these plant foods boost consumption of potassium and magnesium, and provide heart-healthy nitrates (from dark leafy greens and beets), dietary fiber and natural plant compounds like polyphenols. Not only do these foods together seem to improve blood pressure more than potassium alone — research shows other heart-health benefits, and the potential to reduce cancer risk, too.
Related: Diet Rx for Stronger Bones
DASH-style eating habits don’t only boost these healthful foods. To avoid excess calories and weight gain from all the foods added, limit sweets and sugar-sweetened drinks — ideally to just a few small servings a week. It’s not yet clear, but some evidence suggests that high intake of added sugars might affect blood pressure and heart health directly, in addition to its effects on weight gain.
- Include at least 1 to 1 1/2 cups of vegetables and/or fruits at each meal. To do that without adding excess calories, keep portions of meat or poultry and grains or other starchy foods proportionately smaller.
- Swap grain product choices so that at least half are whole-grain options instead of refined grains, which are lower in nutrients and protective plant compounds.
- Including 2 to 3 servings of low-fat dairy products has been part of the DASH diets as tested to reduce blood pressure. The total DASH diet reduced blood pressure more than a diet only increased in vegetables and fruits. Since this may reflect effects of calcium, if you don’t use dairy products, non-dairy alternatives that are rich in calcium (like calcium-fortified soymilk) are good choices. Blood pressure-specific effects of either of these options aren’t clear.
- Behavior is most effectively changed when you focus on what you will do, rather than what you won’t. If you drink sugar-sweetened ice tea, soda or coffee beverages often, focus on drinking more water instead.
Related: Can Soda Shorten Your Life?
Tweak #3: Consider cutting some calories
Even when DASH-style eating habits are combined with reduced sodium, for people who have excess unhealthy body fat, adding a calorie cut (and boosting physical activity) to allow some weight loss slashes blood pressure more effectively than DASH plus lower sodium alone. An expert panel concluded that strong evidence shows a 5 percent weight loss (9 pounds for someone who weighs 180) generally reduces blood pressure by about 3/2 mm Hg. This loss is enough to reduce need for blood pressure control medications, and even smaller losses can have some effect on blood pressure.
Don’t count on “eating healthy” to produce weight loss. Healthy choices help, but weight loss is not automatic.
- When lots of food is available, many people find they eat more whether or not they’re truly hungry. Set yourself up to allow the DASH-style boost in vegetables to fill you up on fewer calories.
- Just as you can accumulate several lower-sodium choices that add up to a total drop in sodium consumption that makes a difference, you can also make choices that add up to cut 500 calories a day, a recommended target for losing weight. A few small swaps that each reduce calories by 100 calories or so are all it takes.
- If non-hunger eating — eating in response to stress or boredom, for example — is driving your eating, address those habits. You can develop new ways to respond to those situations. You can also address the balance of Drainers vs. Fillers in your life to reduce how often you’re in the position of using food to deal with stress.
You can gradually tweak your eating habits, making swaps and adjustments that multi-task in reducing sodium and excess calories, while helping you include more of the foods linked with lower blood pressure.
You can read a complete version of this blog on Karen’s website.
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