Blood pressure is the force of the blood pushing against the walls of the arteries. Sounds simple enough but when that pressure gets high it can put you at risk for heart disease and stroke. Nearly half of adults in the U.S. (that is about 108 million) have high blood pressure (also called hypertension) yet only 24% or about 1 in 4 have it under control.
High blood pressure doesn’t make you feel bad so you might not know that you have it until it is too late. What can you do to control it? The good news is that medications can control it, but did you know that dietary changes can be just as effective as some drugs? And, the bonus is that a healthful diet also provides other disease-management benefits such as lowering cholesterol and blood sugar. I sat down with colleague and friend, Rosanne Rust, a registered dietitian and author, to talk about her latest cookbook, DASH Diet for Two.
Question: Give us the big picture of the DASH diet…. what is it and how do we know it works to lower blood pressure?
DASH is an acronym for Dietary Approaches to Stop Hypertension (high blood pressure). It’s based on a 1997 landmark clinical trial (it was a randomized, controlled study, often called the “gold standard” for research) and has been repeated with other studies. The original study compared 3 groups, each given a dietary plan to follow over an 8-week period. Those on the DASH diet saw a drop in blood pressure in just 2 weeks, which translates to a 15% drop in heart attack risk and as much as a 27% reduction in stroke risk. The study included 459 people, half women, half men, and all had high blood pressure. Since high blood pressure is prevalent in the African American community, the researchers made sure to include them; 60% of study participants were Black.
DASH is a meal plan that emphasizes plant foods (especially fruits, vegetables, and whole grains), limits salt, sugars and saturated fat, and includes healthy plant fats and oils. It focuses on balanced meals with small portions of lean meats and fish twice a week to round out the plate. Low-fat dairy foods are also an important part of the DASH plan.
Question: When people hear about diet and high blood pressure, they usually think about a low sodium diet, a tasteless low sodium diet at that. What other nutrients are important in regulating blood pressure?
The DASH diet is rich in minerals that help to manage blood pressure: potassium, calcium, magnesium. The DASH trials showed that sodium is not the main player in lowering blood pressure. Including fruits, veggies and dairy foods (all rich in potassium, calcium, and magnesium) helps lower blood pressure even on a diet that includes 3000 milligrams of sodium a day.
Fruits, veggies, and whole grains are also rich in antioxidants. While antioxidants don’t directly impact blood pressure, they are important to help keep cells healthy.
Question: Sodium is still important in blood pressure control, so I want to talk a bit about choosing foods in the grocery store and when dining out. Any tips?
I love restaurants and dining out. But you’ll end up consuming much more sodium when eating out than when you cook at home. Right now, we are all eating out less and cooking more at home but when you begin to eat out again try to balance the “eating out” days with days of eating less sodium while cooking at home.
Sodium doesn’t just come from the saltshaker. Most of the sodium in our meals comes from packaged foods that contain sodium in a variety of forms, including as a preservative. Reading labels is important because even within a category, there can be huge differences in the sodium content. Many brands have reformulated and call out reduced sodium on the label so that is a good place to start when trying to lower sodium.
Other tips to reduce sodium include:
- Rinsing canned veggies. Did you know that by draining and rinsing canned beans (a nutrition superstar) you can cut sodium by 40%?
- Cut salt in your cooking and use herbs and spices for flavor.
- Compare bread and grains products; bread, while not tasting salty, can contribute to sodium intake, so choose breads with less sodium.
Question: I can hear people saying, “I’m on blood pressure meds so I don’t have to worry about what I eat.” What would you say to that?
That is my pet peeve! Just because medication is lowering your blood pressure doesn’t mean you don’t have high blood pressure. You still have the diagnosis of high blood pressure and you will be healthier by eating better. For those who have been told they have “pre-hypertension,” the DASH diet can help lower blood pressure so you will never need medication. And, if you are currently taking a blood pressure medicine, following a healthy eating plan, like the DASH diet can often allow you to reduce the dosage thereby saving money and reducing side effects from the drug.
Question: I am one of seven kids and when we were all out of the house my mother complained she didn’t’ know how to cook without a crowd around her. Recipes for two sounds genius! Why did you write this cookbook and why are the recipes for two?
I have a strong family history of heart disease on both sides of my family, so I’ve been interested in studying prevention since the 1990s. There is a genetic component to high blood pressure, so despite my best efforts, I ended up being diagnosed with hypertension at age 52. I already ate well and have always included physical activity in my weekly routine, so I asked to be placed on the lowest possible dose of medication, and amped up my efforts to follow a DASH eating plan. It worked.
Having written two other DASH books, and now having HTN, I’m organically married to this lifestyle!
As for the reason for recipes for “two,” I’m now an empty nester as my three sons are out of the house so recipes for two sounded like a perfect fit for me. So far, the reception has been great. I intentionally included traditional recipes that I “made-over,” along with comfort foods and dishes that people might think would be off limits for a blood pressure lowering, heart healthy diet. The Buffalo Chicken Mac N Cheese is a favorite! (Click here for the recipe.)
Question: How did your family react to the recipes…I’m assuming your sons don’t have high blood pressure so did they turn their noses up at the idea of eating recipes developed for those with high blood pressure?
I was amazed when my 22-year old said, “It’s pretty good,” as he proceeded to eat a large portion of the Vegged Up Beef Enchiladas. Other recipes are dishes that we’ve eaten for years, so they’re simply used to eating this way. The men in my household do like meat though, so if it was up to them, they’d have big portions of meat more often. But I keep working on them and I have my husband convinced that a meatless meal occasionally is a good thing. He loves the 50-50 burgers: 50% lean ground beef and 50% finely chopped mushrooms make for a juicy burger with less fat, less sodium, and an extra serving of veggies.
I hope you enjoyed hearing about how to lower blood pressure with your food choices. Please share this post with anyone you know who has high blood pressure and is curious about lowering it and being healthier at the same time.
Dr. Christine Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.
Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved