High blood pressure or hypertension is a condition in which the force of blood against the walls of the arteries is high. With each heartbeat, blood is pumped through the arteries to the entire body. When blood is pushed harder against the walls of the arteries, then the ‘blood pressure’ rises. Having such a high blood pressure most of the time may lead to serious health issues. In addition, uncontrolled hypertension increases the risk of developing cardiovascular diseases and stroke.
Classification of Blood Pressure
|Category||Systolic blood pressure (mm Hg)||Diastolic blood pressure (mm Hg)|
|Stage 1 HTN||140-159||90-99|
|Stage 2 HTN||≥ 160||≥ 100|
Nutritional management of hypertension
The following points will help you understanding the principles of dietary management for high blood pressure.
The amount of calories a hypertensive should be eating depends on his/her height and present body weight. Being overweight or obese increases the risk of hypertension and several studies have shown a positive relationship between weight loss and blood pressure reduction. Therefore, people who have high blood pressure should first aim at losing some weight in order to treat their hypertension successfully. Research has also shown that modest weight loss can reduce the risk of hypertension by 20% in pre-hypertensive individuals.
Dietary fiber is an indigestible part of plants. Eating a diet high in dietary fiber has shown to reduce both systolic and diastolic blood pressure. Dietary fiber also provides satiety and reduces overall caloric intake. This leads to weight loss, which further helps in reducing blood pressure. Therefore, a diet containing 25 to 30 grams per day should be consumed. Here are some ways to make your diet fiber rich.
- Include more whole grains in your daily diet such as whole wheat, wheat cracks, buckwheat, oats, barley, sorghum and millets.
- Eat more fruits and vegetables. Include at least two servings of fruits and 3 to 4 servings of vegetables in the daily diet. Prefer whole fruits than fruit juices.
- Add wheat bran or oat bran to soups, porridges and breads.
- Add flaxseeds to breads and salads.
Low protein intake is associated with hypertension. Studies have found that consuming a diet rich in protein reduces hypertension and the risk of developing cardiovascular diseases. Protein rich foods include.
- Low-fat milk and milk products
- Soy and soy milk
- Pulses, beans and legumes
Reducing Salt Intake
Hypertension is very common among people with high salt intake. Sodium is a very important mineral required by the body to maintain fluid and electrolyte balance. The main source of sodium intake is through the salt in the food. Excess sodium is then excreted out of the body. Eating excess salt will lead to sodium and water retention, which then increases the overall blood pressure. It will also lead to vasoconstriction, which will further lead to a rise in the blood pressure. Therefore, it is important to cut down intake of high salt foods. Foods with high salt content, which needs to be restricted, are:
- Soy sauce
- Ketchups and other sauces
- Salted nuts
- Ready-to-eat foods- such as gravies and soups
- Savory snacks
- Bread and other bakery products
- Frozen meals
- Ready-to-eat breakfast cereals
- Canned vegetables
- Salted Butter
Reading the food label
Before buying a food product, it is very important for a smart consumer to read the food label in order to know the ingredients present in the food and its overall nutritional content. Reading the sodium content on the food label can help you make a healthier choice. When a food label says:
- Unsalted or no salt added or without added salt: It means no salt is added and it only contains sodium coming from the natural part of the food.
- Sodium free: One serving contains less than 5 milligrams of sodium.
- Very low sodium: One serving contains 35 milligrams or less of sodium.
- Low sodium: One serving contains less than 140 milligrams of sodium.
- Reduced sodium: The level of sodium in that particular food product is reduced by 25%.
A food label may mention about salt or sodium with different names. Therefore, do not just always look for the word ‘salt’. Other names include.
- Sodium bicarbonate
- Sodium benzoate
- Sodium chloride
- Sodium citrate
- Sodium hydroxide
- Sodium ascorbate
- Sodium caseinate
- Sodium sulphite
- Mono sodium glutamate (MSG or ajinomoto)
- Disodium phosphate
Improving palatability of food
As people with hypertension need to cut down their salt intake, so it becomes very important to use other flavoring to improve the palatability of food. Things that can be used instead of salt to improve the palatability of food without having any negative effect on blood pressure include.
- Lemon juice
- Dried mango powder
- Spices and condiments
Increasing Potassium Intake
Many studies have shown benefits of potassium intake on reducing both systolic and diastolic blood pressure in people with hypertension or high blood pressure. Potassium acts as a vasodilator and thus opens up the blood vessels, thus allowing smooth blood flow. It works on the walls of the arteries, helps in muscle relaxation and prevents the walls from narrowing. As a result of this, blood flows easily throughout the arteries. Thus, people with high blood pressure can benefit by including high potassium foods in their diet. Potassium also inhibits sodium reabsorption, which in turn inhibits vasoconstriction. Foods rich in potassium include.
- Roots and tubers
- Coconut water
- Pulses and legumes
Increasing Calcium Intake
Calcium too helps in the relaxation of blood vessels by inhibiting vasoconstriction. It also promotes urinary loss of sodium, which further promotes reduction in the blood pressure. Rich food sources of calcium include.
- Green leafy vegetables
- Calcium fortified fruit juices and soymilk
- Cheese is a good source of calcium but it contains high amount of sodium.
Lifestyle Modification for Hypertension
|Modification||Recommendation||Approximate reduction in systolic blood pressure|
|Dietary sodium reduction||Reduce dietary sodium intake to 2.4 grams of sodium or 6 grams of salt.||2-8 mm Hg.|
|Limit alcohol consumption||Limit consumption of no more than 2 drinks per day for men and one drink per day for women.||2-4 mm Hg.|
|Weight loss||Maintain body weight between normal BMI range, that is, 18.5-24.9.||5-20 mm Hg per 10 Kgs weight loss.|
|Restrict total fat intake||Reduce intake of saturated and trans fat and increase intake of monounsaturated fat and omega-3 fat. Also consume low fat dairy products.|
|Exercise||Engage in regular exercise or physical activity such as brisk walk or jogging for at least 30 minutes per day or 150 minutes per week.||4-9 mm Hg.|
|Increase fruit and vegetable consumption||Consume at least 2 servings of fruits and 3-4 servings of vegetables daily.|
Sample Diet Plan
|Meal timing||Menu||Reason behind|
|Breakfast||1 portion high fiber cereal grain with vegetables +1 glass low fat milk + few almonds/ 2 boiled egg whites.||A high fiber-calcium rich breakfast. Lemon juice can be squeezed to improve the taste.|
|Mid-morning||1 whole fruit.||Fruits are a good source of potassium.|
|Lunch||1 bowl of salad with flaxseeds or pumpkin seeds + 1 portion high fiber cereal grains + 1 portion pulses/legumes/sprouts + 1 bowl yogurt||Do not use salad dressing as they have high sodium content. Also do not add extra salt to the meal.|
|Mid-evening||I cup green tea/green coffee|
|Evening||1 cup low fat yogurt or fruit smoothie|
|Dinner||1 bowl of salad with flaxseeds or pumpkin seeds + 1 portion high fiber cereal grains + 1 portion pulses/legumes/sprouts + 1 bowl yogurt||Do not use salad dressing as they have high sodium content. Also do not add extra salt to the meal.|
|Bedtime||1 cup milk||A good source of calcium which will allow your muscles to relax.|
Quick Tips and important points to keep in mind
- Include at least 6-7 servings of whole grain fiber rich cereals. Avoid refined flour products.
- Include at least 3-4 low fat dairy products.
- Include good source of protein in each meal.
- Include fruits and vegetables as mid-meal fillers and along with meals.
- Consume unsalted nuts.
- Use no more than 3-4 teaspoons of oil daily for cooking.
- Strictly limit intake of bakery products as they do contain high amount of sodium.
- Restrict intake of salad dressing, ketchups, sauces, mayonnaise. They contain sodium in the hidden form.
- Limit alcohol intake.
- Avoid smoking.