Women's Heart Advisor October 2007 Issue

Small Dietary Changes Yield Big Blood Pressure Benefits

Limit sodium, eat more veggies, and add modest amounts of soy nuts and dark chocolate to improve your heart health.

We all know that you can lower your cholesterol by avoiding foods that are high in saturated fats and trans fats. But did you know that eating certain foods can lower your blood pressure? High blood pressure, or hypertension, makes your heart work harder, which can lead to heart failure. High blood pressure is also a serious risk factor for stroke, heart attack, and kidney failure.

The National Heart, Lung and Blood Institute recommends that you maintain a blood pressure reading of 120/80 mmHg or less. Higher pressures are classified as mild, moderate or severe hypertension. While many people require antihypertensive medications, others find that simple changes in their diet can drop their blood pressure into a lower category.

"The most important dietary treatment for high blood pressure is reducing sodium intake," says Cleveland Clinic dietitian Melissa Ohlson, MS, RD, LD. "However, you also need to eat a heart-healthy diet that includes more fruit, vegetables, and whole grains and fewer convenience foods."

Heart-friendly foods

Recent studies have shown that snacking on soy nuts and dark chocolate have a beneficial effect on blood pressure. In one study, postmenopausal women with hypertension who ate 25 grams of unsalted soy nuts per day while following a low-fat, low-cholesterol diet lowered their systolic blood pressure 9.9 percent and diastolic blood pressure 6.8 percent. In participants with normal blood pressure, systolic and diastolic readings dropped 5.5 percent and 2.7 percent respectively. Additionally, undesirable LDL cholesterol and apolipoprotein B dropped 11 percent in hypertensive women and 8 percent in the other participants.

Dark chocolate (70 percent cocoa) is equally beneficial. In a study of men and women with mild hypertension, those who ate 30 calories worth of dark chocolate daily for two weeks dropped their

blood pressure an average of five over two points. Those who ate milk chocolate or white chocolate had no benefit (July 4, 2007

Journal of the American Medical Association).

No one knows for sure why these foods have the effect they do.

"Could it be the phytonutrients in plant-based foods? The isoflavones in soy? The polyphenols in chocolate? We really donít know," says Ohlson.

Eat more vegetables

One thing is for sure: increasing the amount of vegetable protein you consume can reduce your blood pressure, even if animal protein remains in your diet.

"You donít have to eliminate meat, but there are ways you can cut down on excess animal protein while retaining meat flavor. Try mixing meatless meat protein [found in the frozen foods department] with ground turkey or beef in your recipes," Ohlson suggests. "Cut your steak in half, keeping the other portion for tomorrow, and double your veggies."

To ensure you get the amount of veggies your heart needs, use your hands.

"A womanís closed fist is about the size of a cup. You need three to five cups of fruits or vegetables a day. Your plate should be half-filled with veggiesóthatís about two fists," says Ohlson.

Filling your plate with meatless meals is an even better bet. Skip the meat and add beans or veggies to your pasta sauce. Choose black bean burritos, veggie burgers or meatless chili. Grill a Portobello mushroom instead of a hamburger patty and serve it on a bun.

Use salt sparingly

People with elevated blood pressure should consume no more than 1,500 mg of sodium per day. Thatís not much: the average person consumes three times that amount in a day, mostly through careless shopping or reaching for the salt shaker.

A primary problem is convenience foods, which tend to be high in sodium. "If it comes in a can or a box, read the label, compare products, and choose the one lowest in sodium," says Ohlson. "If you are cooking fresh, try not to add salt, but use garlic, onions, lemon or herbs to add flavor," she suggests.

The DASH (Dietary Approaches to Stop Hypertension) diet is the gold standard for people with high blood pressure. The diet is low in sodium and rich in calcium, potassium, and magnesiumóminerals linked to a reduction in blood pressure. Interestingly, dietary supplements donít have the same effect and may even be dangerous.

"Because minerals and electrolytes play roles in the pumping of the heart at the intracellular level, too much of one and not enough of another can throw off a healthy balance. Thatís why we take a whole foods approach and donít recommend supplements," Ohlson explains.

Itís not necessary to follow DASH to the "T," says Ohlson, but you should follow its philosophy, which is similar to that of the Mediterranean diet. Easy, tasty recipes can be found in the

DASH Diet Action Plan book and the Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook, which are available online and in most bookstores.

"There is a great deal of evidence that increasing your fruits and vegetables to five or more servings a day and eating nuts, low-fat dairy products, and whole grains can significantly decrease blood pressure. Soy and dark chocolate merely add to the benefit," says Ohlson.