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How Can Different Diets Combined With Salt Restriction Alleviate High Blood Pressure And Hypertension?
A recent Clinical Nutrition study conducted a clinical trial to compare the popular diets, namely, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet (MedDiet), in combination with a salt-restricting strategy for reducing high blood pressure (BP) and hypertension.
Study: DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial. Image Credit: Sea Wave/Shutterstock.Com Background Ineffective BP control strategies are a prominent risk factor for premature mortality and morbidity worldwide. An uncontrolled BP increases the risk of complications suh as cardiovascular events and chronic kidney disease.
People with grade 1 hypertension and low-moderate cardiovascular disease are recommended to intake less salt and adopt non-pharmaceutical interventions to manage hypertension. Recent meta-analyses of randomized controlled trials (RCTs) have correlated salt intake with BP level. Low salt intake can improve BP levels.
Besides salt intake, both DASH and MedDiet are associated with effective BP reduction in adults with or without hypertension. Both the diet types recommended a high intake of plant-based foods and a low intake of red and processed meat.
Compared to the DASH diet, the MedDiet is high in total fat due to the inclusion of olive oil. Therefore, for patients with high BP, the DASH diet has proved to be more effective than the MedDiet.
Although the American College of Cardiology/American Heart Association (ACC/AHA) recommended the DASH diet as a heart-healthy diet in 2017, it was contradicted by the European Society of Cardiology/European Society of Hypertension (ESC/ESH) in 2018. The ESC/ESH recommended the MedDiet to be a healthy diet that can be easily practiced for a prolonged period.
The DASH diet with salt restriction exhibited a higher BP reduction. However, it must be noted that this combining strategy is not commonly practiced. To date, no studies have indicated the effectiveness of MedDiet with salt restriction. Furthermore, there is a need for a comparative study to assess the effectiveness of the DASH diet and MedDiet in lowering BP.
About the studyThe current randomized, single-center, controlled, single-blinded study compared the effectiveness of the DASH diet and the MedDiet based on a three-month intervention period. A total of four parallel groups, i.E., control group (CG), salt restriction group (SRG), DASH diet combined with salt restriction group (DDG), and MedDiet combined with salt restriction group (MDG), were formed with a 1:1:1:1 allocation.
Participants (18 to 65 years of age) who visited the Hypertension Unit of the Hippokration General Hospital of Athens for the first time were selected for this study.
All participants had a high normal BP (systolic BP 130-139 mmHg and/or diastolic BP 85-89 mmHg), grade 1 hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg), or low-moderate cardiovascular disease risk.
However, none of them were under antihypertensive drug treatment or had a history of major medical conditions. At baseline, BP was measured, fasting blood samples were collected, and ambulatory blood pressure monitoring (ABPM) was performed.
Study findingsA total of 240 participants were randomly assigned to one of the four trial groups. The four study groups did not differ in terms of demographic and clinical characteristics at baseline.
Furthermore, at baseline, ~48% of the study cohort had high normal BP, and ~51% had grade 1 hypertension. The mean baseline BP (systolic/diastolic) was 137/88 mmHg, and the baseline 24-hour ambulatory BP (systolic/diastolic) was 133/83.
The primary assessment after three months of intervention revealed that, except for CG, all other intervention groups exhibited improvement in systolic and diastolic pressure. Compared to SRG, both the DDG and the MDG exhibited a greater reduction in systolic BP.
Furthermore, compared to the DDG, the MDG revealed a greater reduction of systolic BP values. All intervention groups exhibited a significant reduction in diastolic BP. Both the DDG and the MDG intervention exhibited similar 24-hour ambulatory systolic and diastolic BP values.
In comparison to CG, all other intervention groups indicated marginal odds of hypertension. Among interventions, the DDG and MDG exhibited lower odds of hypertension, with 65% and 84% odds, respectively, compared to the SRG.
In relation to the baseline levels, the greatest reduction in office systolic BP was found in MDG and diastolic was found in the DDG.
ConclusionsIn sum, the MedDiet was found to be more effective in reducing office systolic BP compared to the DASH diet, while the DASH diet exhibited equal effectiveness for the reduction in office diastolic BP.
After three months of intervention, the DASH and the MedDiet exhibited similar 24-hour ambulatory systolic and diastolic BP values. Notably, dietary patterns combined with salt restriction exhibited the most effective result in BP improvement.
In the future, more studies are required to investigate the cardiovascular disease risk and other outcomes linked to MedDiet and the DASH diet combined with salt restriction. A longer clinical trial must be conducted to understand the effectiveness of each intervention better.
Orange Food That 'ticks Many Of The Boxes' For Lowering Blood Pressure
Dr Chris Steele shares diet tips on reducing blood pressureHypertension, or having high blood pressure, is a common condition that is thought to affect around one in three adults.
It refers to the pressure of the blood in your arteries - the vessels that carry blood around the body.
A certain amount of pressure is needed to keep the blood moving, however, if it is consistently high this is cause for concern.
This is because prolonged high blood pressure places extra pressure on the heart and other organs.
It is a major risk factor in a number of medical emergencies such as heart attacks and strokes.
Some people will be more likely to develop high blood pressure than others due to things that are beyond their control, such as being aged over 65 and having a family history of the condition.
However, there are certain lifestyle factors that can also lead to high blood pressure.
These include:
Diet is one of the main contributing factors to high blood pressure, with eating too much salt the main culprit.
Sodium, which is found in salt, makes the body hold on to water, which raises blood pressure.
While cutting back on salt will help this problem, there are also certain foods that can actively help counteract the impact of salt.
Potassium is a mineral known to do this. It helps the body remove salt through urine.
It also relaxes blood vessel walls, furthering its blood pressure-lowering effects.
One food rich in potassium is sweet potato. According to the US Department of Agriculture, 100 grams of sweet potato contains around 337mg of potassium.
Sian Porter, consultant dietitian to the North Carolina Sweet Potato Commission, spoke with Express.Co.Uk to explain more.
She said: "Amongst other nutritional benefits, sweet potatoes are a source of potassium.
"Potassium is an essential mineral that contributes to the maintenance of normal blood pressure as part of a varied, balanced diet and healthy lifestyle.
"The DASH (dietary approaches to stop hypertension) diet based on robust research studies has been shown to effectively lower blood pressure.
"Blood pressure control with the DASH diet involves a low salt diet, rich in fruits, vegetables, low-fat or non-fat dairy and whole grains. This combination provides a diet rich in potassium, magnesium, calcium, and fibre.
"Sweet potatoes, in addition to being a source of potassium, count as one portion of your five-a-day, as well as being high in fibre and very low salt so tick many of the dietary boxes for managing high blood pressure."
She added: "By including foods that are a source of potassium and high in fibre as well as providing a portion of vegetables, such as sweet potatoes, you can help maintain normal blood pressure as part of a varied, balanced diet and healthy lifestyle."
Other foods high in potassium include:
Four Gut-friendly Foods Could Pose A Risk For Your Blood Pressure, Expert Warns
Dr Chris Steele shares diet tips on reducing blood pressureCharacterised by tart flavours and plentiful gut bacteria, fermented foods have been around for centuries.
However, the recent decade has seen a rise in popularity in the likes of kombucha and sauerkraut.
While fermented foods can boost your gut health and even dampen down inflammation, they might not be so generous to your blood pressure, according to Alison Cullen, Nutritional Practitioner and Education Manager at A.Vogel.
The expert said: "Miso, sauerkraut, kimchi, sourdough bread all contain varying amounts of salt, which may affect blood pressure if taken in immoderate amounts, or on top of a diet that already contains large quantities of salty foods or added table salt."
Blood Pressure UK explains that eating too much salt is the "single biggest" cause of high blood pressure.
Worryingly, the more of the common seasoning you eat, the higher your blood pressure can be.
Salt makes your body hold onto water, which puts extra water in your blood, applying extra pressure on your blood vessel walls.
This process is a recipe for high blood pressure levels, according to the charity.
What's worse, if you already have a high reading, salt can raise your blood pressure even further.
The good news is that cutting down on the popular ingredient is one of the simplest ways to lower your blood pressure.
What's more, keeping your salt intake in check will start to make a difference "very quickly", Blood Pressure UK explains.
Therefore, the charity recommends cutting down on high-salt foods.
They recommend checking the labels as salt contents can vary greatly between products.
"Check the labels of foods before you buy them and compare with other products – you'll often find lower salt low-salt options," Blood Pressure UK advises.
The following guidelines can help you understand how to choose less salty foods:
While some fermented foods can add extra salt to your diet, Cullen explained you shouldn't ditch them altogether.
The expert said: "It's all about the dosage, as with so many things! Even water can be bad for you if you take too much.
"Adding one tablespoon of an average sauerkraut to your daily menu will give you a gut boost without adding more than around 0.08g of salt to your daily intake."
"However, it's important to keep an eye on your overall salt intake, with the daily limit set by the NHS being no more than six grams of salt per day.
"This includes the salt that's already in our food and the salt added during and after cooking," the health body adds.
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