Beyond the salt shaker: A new look at diet and blood pressure

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For years health professionals have echoed the same blood-pressure-lowering mantra: cut back on sodium and alcohol and lose weight. That may change, however, given the results of a new study that took place at 6 major medical centers around the country.

Researchers from the centers put more than 450 people on 1 of 3 diets, none of which involved rigid sodium or alcohol restriction or even weight loss. One group followed an eating plan that included nearly 10 servings of fruits and vegetables a day plus low-fat dairy foods. The plan was also low in saturated and total fat. Fat comprised 26 percent of total calories--well below the 30-percent benchmark health experts recommend.

A second group ate a diet that was also heavy on produce, with 8-plus servings a day on average. But this was a high-fat plan, containing 36 percent of calories as fat. The third group followed a typical American diet: fewer than 4 servings of fruits and vegetables daily and 36 percent of calories as fat.

After 8 weeks, people who followed the higher-fat, fruit-and-vegetable-rich diet experienced reductions in blood pressure. But those on the low-fat, high-produce plan checked in with blood pressure readings that had fallen the most. Specifically, systolic pressure (the first number in a reading) had dropped 5.5 millimeters more than in the group following the typical American diet. Diastolic pressure (the second number) had come down by 3 millimeters more. Those on that plan who started out with hypertension generally ended up with particularly significant reductions in blood pressure--reductions similar in magnitude to those often seen in patients who begin drug therapy.

The findings have created a buzz among medical experts for a number of reasons. For one, all 3 groups took in at least 2,800 milligrams of sodium daily--17 percent more than the 2,400-milligram limit recommended by the National Academy of Sciences. Furthermore, none of the participants was told to abstain from alcohol or follow a reduced-calorie plan for weight loss. Thus, the new eating plan, dubbed the DASH diet for Dietary Approaches to Stop Hypertension, allows far more flexibility and therefore is the kind of healthful diet a person can live with for the long haul (although experts speculate that combining established interventions with the low-fat, high-produce eating plan might promote even greater drops in blood pressure).

THE DASH DIET
Scientists don't know what it is about the high-fruit-and-vegetable, low-fat DASH diet that may help lower blood pressure. Some point to the fact that the eating plan is richer than the typical American diet in minerals such as potassium, magnesium, and calcium, which preliminary research suggests may be involved in keeping blood pressure down.

One thing is for sure. The eating plan is a particularly produce-rich version of the kind of healthful eating pattern experts urge all Americans to adopt to lower the risk of chronic diseases like heart disease and cancer.

The plan here shows how many servings of various foods a person on a 2,000-calorie diet would have to eat to adhere to a DASH regimen.

For sample menus, an excellent overview on the roles of sodium, alcohol, and weight in blood pressure, and other information related to hypertension, people with Internet access can visit the DASH Diet Web site at http://dash.bwh.harvard.edu. Or, to learn more about blood pressure, call the National Heart, Lung, and Blood Institute at 1-800-575-9355.

Daily
Number of
Food Group Servings 1 Serving

Grains & 7-8 1 slice bread
grain products 1/2 cup dry cereal
1/2 cup cooked rice,
pasta, or cereal

Vegetables 4-5 1 cup raw leafy vegetable
1/2 cup cooked vegetable
6 oz. vegetable juice

Fruits 4-5 1 medium fruit
1/2 cup fresh, frozen,
or canned fruit
1/4 cup dried fruit
6 oz. fruit juice

Low-fat or non-fat 2-3 8 oz. milk
dairy foods 1 cup yogurt
1.5 oz. cheese

Lean meats, 2 or less 3 oz. cooked meats,
poultry, or fish skinless poultry, or fish

Nuts and other 1/2 1.5 oz. or 1/3 cup nuts
alternatives 2 Tbsp. seeds
to meat 1/2 cup cooked legumes

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