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The role that diet plays in managing hypertension

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Step 1: Understanding the relationship between hypertension and food

Your blood pressure is too high. But what does it have to do with food and eating?

A number of risk factors for hypertension have been identified, and four of these factors are directly related to eating habits.

  • Family history of hypertension
  • Increased age
  • Black ethnicity
  • Sensitivity to sodium (salt) intake
  • Excessive alcohol consumption
  • Low intake of potassium, magnesium and calcium
  • Obesity
  • Physical inactivity

Step 2: Adopting new healthy habits

Lower you blood pressure:

You can do something to help control your hypertension better. And four of the six steps you can take, are related to your eating habits.

  • Lose weight - The most effective non-drug method of lowering blood pressure.
  • Exercise - Even 30 to 45 minutes of mild to moderate aerobic exercise (brisk walking or cycling four times a week) can nudge your blood pressure down a few points.
  • Limit your alcohol intake to one to two drinks per day.
  • Eat a low-fat, high-fruit and -vegetable diet.
  • Limit your salt intake to no more than 2.4g per day – about 1 teaspoon of salt.
  • Don't smoke.

Step 3: Understanding the basic principles of the Dash diet

Developed in the USA, Dash is the acronym for Dietary Approaches to Stop Hypertension, and has proved so healthy that it’s been recommended for everybody, not just those with hypertension.

As with the Mediterranean diet (good for heart health), the Dash diet concentrates on replacing high protein, saturated and animal fats, and refined sugars with more simple fare.

The do's:

The bulk of the diet consists of:

  • Lentils and a variety of beans
  • Fresh vegetables
  • Fresh fruit

The don'ts:

Small portions of:

  • Low-fat dairy products
  • Meat, poultry, fish
  • Nuts

The reasons for the do's and don'ts:

  • Vegetables and fruit contain significant amounts of potassium. Potassium appears to replace and eliminate excess sodium from the body's tissues, enabling dilation of the blood vessels and lowering of the blood pressure. Some studies indicate that higher levels of potassium in the blood may inhibit the formation of free radicals and the formation of blood clots, both of which play a role in the development of atherosclerosis.
  • A maximum of two portions of meat, poultry or fish, and three portions of low-fat or fat-free dairy food per week to lower fat consumption (to counteract obesity and elevated blood fat levels) and protein consumption (and thereby hidden fats, as well as preventing possible kidney failure due to high protein intake).

Step 4: Your basic daily guide to eating correctly to treat your hypertension
The following table outlines the major food groups, and the number and sizes of servings you need.

Food group

Daily servings

Serving sizes

Examples/Notes

Significance of each Food group to the DASH Diet pattern

Grains and cereals

7-8

1 slice bread
1/2 cup dry cereal
1/2 cup cooked rice, pasta or cereal

whole wheat bread, or low-GI bread, pita bread, cereals, maize meal, samp, oat porridge, ProVitas, RyeVitas

Major sources of energy and fibre

Vegetables

4-5

1 cup raw leafy vegetable
1/2 cup cooked vegetable
170ml vegetable juice

tomatoes potatoes, carrots, peas, squash, broccoli, turnip, greens collards, kale, spinach, artichokes, sweet potatoes, green beans

Rich sources of potassium, magnesium and fibre

Fruits

4-5

170ml fruit juice
1 medium fruit
1/4 cup dried fruit
1/2 cup fresh, frozen, or canned fruit

apricots, bananas, dates, oranges, orange juice, grapefruit, grapefruit juice, mangoes, melons, peaches, pineapples, prunes, raisins, strawberries, naartjies

Important sources of potassium, magnesium, and fibre

Low fat or fat-free dairy foods

2-3

200ml milk
1 cup yoghurt
30 gram cheese

skim or low-fat or 2% milk, skim or low-fat buttermilk or maas, low-fat yoghurt, low-fat mozarella cheese, fat-free cottage cheese

Major sources of calcium and protein

Meals, poultry and fish

2 or less

60 gram cooked meats, poultry or fish

select only lean; trim away visible fat; grill, roast or boil, instead of frying; remove skin from poultry

Rich sources of protein and magnesium

Nuts, seeds, and legumes

4-5 per week

30 gram or 1/3 cup nuts
2 Tbsp seeds
1/2 cup cooked legumes

Almonds, macadamias, mixed nuts, peanuts, walnuts, sunflower seeds, pumpkin seeds, kidney beans, cooked or canned dry beans, pease or lentils

Rich sources of energy, magnesium, potassium, protein, and fibre

(Information from the National Institutes of Health)

If you need help to apply the Dash diet consult your nearest dietician who will guide you through the initial phases until you are used to the diet. Visit the Association for Dietetics SA website to find a dietician in your area.

Read more:

Menu plan for Dash diet
Using the Dash diet in South Africa

Visit our Hypertension Centre for comprehensive information on hypertension.

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