Reducing blood pressure with diet

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Reducing blood pressure with diet

Postby Zana » Wed Jul 16, 2008 12:26 pm

My blood pressure is slightly higher than it should be and I have been making serious efforts to lower it, so far without a lot of success.

I have been on a low fat vegan diet for about a year now, although not McDougall ,and have eaten small amounts of free oils until 12 days ago when I cut them out completely to see if this would help to lower my bp. At that point I was eating no more than one teaspoon of extra virgin olive oil per day, plus the occasional oat cake with oil in the ingredients. For about 7 days I have also drastically reduced my salt intake. I am eating only home made food so I know that there is no hidden salt in anything I eat.

As I haven't seen any real improvement yet is there anything else you can suggest that I should be doing? I eat lots of vegetables and fruit, pulses and whole grain cereals.

Also I wondered how long it shoul take for my bp to drop after cutting out oil and salt. Perhaps I am being unrealistic in expecting to see any change yet.

My mother was on medication for bp at my age (49). I exercise regularly and I am not overweight (BMI just over 17),
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Re: Reducing blood pressure with diet

Postby JeffN » Thu Jul 17, 2008 8:04 am

Zana wrote:My blood pressure is slightly higher than it should be and I have been making serious efforts to lower it, so far without a lot of success.

I have been on a low fat vegan diet for about a year now, although not McDougall ,and have eaten small amounts of free oils until 12 days ago when I cut them out completely to see if this would help to lower my bp. At that point I was eating no more than one teaspoon of extra virgin olive oil per day, plus the occasional oat cake with oil in the ingredients. For about 7 days I have also drastically reduced my salt intake. I am eating only home made food so I know that there is no hidden salt in anything I eat.

As I haven't seen any real improvement yet is there anything else you can suggest that I should be doing? I eat lots of vegetables and fruit, pulses and whole grain cereals.

Also I wondered how long it shoul take for my bp to drop after cutting out oil and salt. Perhaps I am being unrealistic in expecting to see any change yet.


Hi Zana

Congratulations on your efforts to improve your diet and health. I know that putting in large amounts of effort and not seeing results is frustrating.

I would recommend you continue to do what you do but take a closer look at your sodium intake. The reason is, over 75% of the sodium ingested is very well hidden in foods, including packaged and processed foods and restaurant foods. Only around 10% of the sodium comes from what is added at the table and/or during cooking. Most people are just not aware of how much sodium is really in the food they consume and have no real way to measure this and to know how much would be considered "excess". In addition, they have no effective way to reduce this intake. And, if you are someone who is more "sensitive", that all these issues become that much more important.

The odds are, unless you are consuming anything but fresh fruits and veggies straight from the garden, you are consuming excess sodium.

Here is a simple rule for any packaged and processed food you consume, regardless of whether or not it is vegan. Make sure the amount of sodium (in mgs) per serving, is no more than the amount of calories per serving. So, if a product has 100 calories per serving, the amount of sodium per serving should not exceed 100 mgs.

If you are eating in restaurants, the only thing you can do is ask them not to add any sodium, but be aware, than any one serving of any entree is almost any restaurant, can exceed the amount of sodium recommended for a full day for a healthy young person.

So, my recommendation is to take a closer look and then report back. In some, results can be seen very quickly and in others, it may take some time.

In Health
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Postby Zana » Sat Jul 19, 2008 12:22 am

Jeff

Thank you for your reply. I can only repeat again that I eat almost no processed food now and so my sodium intake must be very low. I have eaten in a cafe on a handful of occasions in the past year. I had only a fruit smoothie that I saw being prepared with fresh fruit, except once when I had some sliced cucumber, tomato and onion with nothing added. I do not usually eat out as I don't trust restaurants.

I do not have my own garden but I buy fresh fruit and vegetables from the local greengrocer and prepare all my own meals. I have cut out all baked products that I used to make (healthy ones with wholegrains) because of baking powder and now eat only home made wholewheat bread without any added salt. I do not eat any canned products. I have cut out all obvious sources of sodium such as soy sauce, yeast extract and other sauces and condiments. I did eat some spaghetti two days ago but it had no added salt. The only significant source of sodium I can think of now would be tap water. I have no way of finding out the content where I live in Europe. I will probably start drinking only spring water with a very low sodium content rather than filtered tap water (using Brita filters).

HealthFreak, Well done on reducing your BP numbers. I suppose I might just have to be more patient to see consistent change. I have read Dr McDougall's articles on blood pressure, but didn't find any ideas to add to what I am already doing. The information was excellent.

Donna, Thank you for your comments. I have never drunk coffee and don't think I consume anything containing caffeine. I drink only water. Also I have never taken decongestants, in fact I stay away from all medication if possible.
As for my BP readings, Dr McDougall and other respected authorities state that if your BP is above 115/75 you have double the risk of heart disease. I don't think it's unrealistic of me to want to keep my readings at or below that figure.

Debbie, Thank you for your reply. I think you may have a point about me being anxious about the BP reading, at least on some occasions. I take my BP at home so the higher readings can't be accounted for by white coat syndrome. I have started to take my BP less often, just in the mornings and evenings. When it has been high I have sometimes taken it again 5 minutes later and found that the systolic has dropped a little - once by 10 points! This morning my BP was fine, 113/74, but last night it was 133/75. I must confess though that I was ill last night and had lost the contents of my lunch and supper before taking my BP.
I was interested to read that your BP is so low. I hope that doesn't give you any problems. I hadn't heard of anyone with such low BP before.
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salt substitutes?

Postby thorny » Mon Jul 21, 2008 4:59 am

has anyone out there tried any of the salt substitutes? I was reading about one called AlsoSalt made from potassium chloride and L-lysine. Does Dr. Moore recomend a product in his book, homemade or otherwise? How much sodium do we need on a daily basis? Am I the only one who is clueless about all this stuff?

After reading this thread I went back and took a harder look at the foods I love. Even my favorite McDougall soup (pad thai) has quite a bit of the dreaded sodium. I guess my new expression is "salt-the new meat!"

Peter
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Re: salt substitutes?

Postby JeffN » Mon Jul 21, 2008 6:05 am

thorny wrote:has anyone out there tried any of the salt substitutes? I was reading about one called AlsoSalt made from potassium chloride and L-lysine. Does Dr. Moore recomend a product in his book, homemade or otherwise? How much sodium do we need on a daily basis? Am I the only one who is clueless about all this stuff?


There are many threads where this is discussed in detail. The human body only requires about 150 mgs of sodium to survive and the minimum RDA is set at 500 mgs which is what you would get from what occurs naturally in food.

http://www.drmcdougall.com/forums/viewtopic.php?t=5916

http://www.drmcdougall.com/forums/viewtopic.php?t=5966

I would not recommend the use of salt substitutes that contain potassium chloride at all as they have their own set of problems. If someone was to follow these recommendations, they would get more then enough potassium and the sodium would be reduced to a "safe" level. That is your best course of action.

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Postby thorny » Mon Jul 21, 2008 7:15 am

Hi Jeff,

Thanks for the feedback and threads about BP. One more question. I've read (heard) that people with BP's above an average of 117/75 are DOUBLE the risk of heart attacks. Is that true? Don't Dr. M and (I'm guessing) go by the British levels which say that hypertension is anything over 140/90? thanks, Peter
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Postby JeffN » Mon Jul 21, 2008 7:24 am

thorny wrote:Hi Jeff,

Thanks for the feedback and threads about BP. One more question. I've read (heard) that people with BP's above an average of 117/75 are DOUBLE the risk of heart attacks. Is that true? Don't Dr. M and (I'm guessing) go by the British levels which say that hypertension is anything over 140/90? thanks, Peter


I think you may be confusing two issues.

There is an increased risk at BPs at rising levels and if your BP is elevated you should do everything you can through "lifestyle" and "diet to reduce your level and so your risk.

While I can not answer for sure, I beleive the British levels you are mentioning are the ones Dr McDougall uses in regard to whether to use medication or not. At lower levels, the risks of the medications outweigh any potential benefit. In addition, there is a J Curve where if BP is lowered too low by Medication (not diet/lifestyle), there is an increase in certain risks.

However, you may want to address your concern to Dr McDougall himself.

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Postby JeffN » Mon Jul 21, 2008 6:01 pm

This is a fairly accurate article

http://en.wikipedia.org/wiki/Pulse_pressure

As is this one

http://www.emedmag.com/html/pre/cov/covers/101500.asp

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Postby JeffN » Mon Jul 21, 2008 6:10 pm

PS it is always best to check the National Library Of Medicine at www.pubmed.com


European Heart Journal 2005 26(20):2120-2126;

Aims To investigate pulse pressure (PP) as an independent predictor of coronary heart disease (CHD) risk.

Methods and results On the basis of a 10-year follow-up of 5389 men aged 35–65 at recruitment into PROCAM, we used a proportional hazards model to calculate the effect of systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP on CHD risk after correcting for age, high-density lipoprotein cholesterol, LDL cholesterol, triglycerides, smoking, diabetes, and family history of premature CHD. Increases of 10 mmHg in DBP, SBP, and PP were associated with an increased CHD hazard ratio (HR) of ~10%. When the group was divided into the age groups <50, 50–59, and >59 years, this relationship was seen in the age group 50–59 years for DBP, SBP, and PP and in men aged ≥60 for PP only (25% increase in HR). Overall, CHD risk in men with PP ≥70 mmHg was more three times that of men with PP <50 mmHg. This increased risk was not apparent at age <50 years, was greatest at age >60 years, and was also present in men who were normotensive at recruitment (SBP ≤160 mmHg, DBP ≤95 mmHg).

Conclusion In older European men, increased PP is an important independent determinant of coronary risk, even among those initially considered normotensive.



J Am Coll Cardiol. 2000 Jul;36(1):130-8.Pulse pressure and risk for myocardial infarction and heart failure in the elderly.

OBJECTIVES: We sought to determine whether pulse pressure (PP), a measure of arterial stiffness, is an independent predictor of the incidence of coronary heart disease (CHD), congestive heart failure (CHF) and overall mortality among community-dwelling elderly. BACKGROUND: Current hypertension guidelines classify cardiovascular risk on the basis of elevated systolic blood pressure (SBP) or diastolic blood pressure (DBP) without considering their combined effects. Recent studies suggest that PP is a strong predictor of cardiovascular end points, but few data are available among community elderly. METHODS: The study sample included 2,152 individuals age > or =65 years, who were participants in the Established Populations for Epidemiologic Study of the Elderly program, free of CHD and CHF at baseline and still alive at one year after enrollment. Blood pressure was measured at baseline. Incidence of CHD, incidence of CHF and total mortality were monitored in the following 10 years. RESULTS: There were 328 incident CHD events, 224 incident CHF events and 1,046 persons who died of any cause. Pulse pressure showed a strong and linear relationship with each end point. After adjusting for demographics, comorbidity and CHD risk factors, a 10-mm Hg increment in PP was associated with a 12% increase in CHD risk (95% confidence interval [CI], 2% to 22%), a 14% increase in CHF risk (95% CI, 5% to 24%), and a 6% increase in overall mortality (95% CI, 0% to 12%). While SBP and mean arterial pressure (MAP) also showed positive associations with the end points, PP yielded the highest likelihood ratio chi-square. When PP was entered in the model in conjunction with other blood pressure parameters (SBP, DBP, MAP or hypertension stage, respectively), the association remained positive for PP but became negative for the other blood pressure variables. The effect of PP persisted after adjusting for current medication use and was present in normotensive individuals and individuals with isolated systolic hypertension but not in individuals with diastolic hypertension. CONCLUSIONS: Elevated PP is a powerful independent predictor of cardiovascular end points in the elderly.

PMID: 10898424



Circulation. 1999 Jul 27;100(4):354-60. Is pulse pressure useful in predicting risk for coronary heart Disease? The Framingham heart study.


BACKGROUND: Current definitions of hypertension are based on levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP), but not on pulse pressure (PP). We examined whether PP adds useful information for predicting coronary heart disease (CHD) in the population-based Framingham Heart Study. METHODS AND RESULTS: We studied 1924 men and women between 50 and 79 years of age at baseline with no clinical evidence of CHD and not taking antihypertensive drug therapy. Cox regression, adjusted for age, sex, and other risk factors, was used to assess the relations between blood pressure components and CHD risk over a 20-year follow-up. The association with CHD risk was positive for SBP, DBP, and PP, considering each pressure individually; of the 3, PP yielded the largest chi(2) statistic. When SBP and DBP were jointly entered into the multivariable model, the association with CHD risk was positive for SBP (HR, 1.22; 95% CI, 1.15 to 1.30) and negative for DBP (HR, 0. 86; 95% CI, 0.75 to 0.98). Four subgroups were defined according to SBP levels (<120, 120 to 139, 140 to 159, and >/=160 mm Hg). Within each subgroup, the association with CHD risk was negative for DBP and positive for PP. A cross-classification of SBP-DBP levels confirmed these results. CONCLUSIONS: In the middle-aged and elderly, CHD risk increased with lower DBP at any level of SBP>/=120 mm Hg, suggesting that higher PP was an important component of risk. Neither SBP nor DBP was superior to PP in predicting CHD risk.

PMID: 10421594
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Postby JeffN » Tue Jul 22, 2008 9:02 am

These threads discuss the sodium guidelines/recommendations for humans and for labels and which is the best.

viewtopic.php?t=5916

viewtopic.php?t=5966

These discuss fat recommendations

viewtopic.php?t=6129

viewtopic.php?t=5868

viewtopic.php?t=6183

You will notice, these discussions are based on published peer reviewed data, the national recommendations and long lived populations. And, when you step back, and see the big picture of all of these together, it all makes sense.

There is a great free CPE article on Hypertension here that I recommend everyone concerned with this issue read. It is well researched and document and written by a friend and colleague.

http://www.foodandhealth.com/cpecourses/SaltCPE.doc

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Postby Zana » Tue Jul 22, 2008 11:51 pm

Jeff

Thank you for the CPE article. It's quite long so I've only read a few pages but it's very interesting. I saved it to my computer so I can read it later.

Alias Thank you also for the information about taking BP readings.
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Postby Zana » Wed Jul 23, 2008 9:10 am

I just wanted to say that I have now read the CPE article on hypertension and found it very instructive. The main thing I would like to repeat from it is that studies have shown that it can take at least a month and sometimes several months to see a reduction in BP after commencing a low salt diet. Improvements were sometimes seen up to 5 - 7 years after the diet was started. So if anyone else is trying to reduce their BP with diet, they should not be discouraged if there is no or little immediate change. I am now going to try to be patient and look forward to further improvement.
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BP readings update

Postby Zana » Thu Aug 14, 2008 3:00 am

I'd like to thank everyone for their encouragement and advice. I am finally seeing good results with a low sodium diet. I stopped taking my BP every day and reduced this to twice a week. I was concerned at first that my diastolic was rising as my systolic was falling, but now my diastolic has gone down again. My systolic has not gone over 123 in the last two weeks and is much lower in the mornings. My diastolic is back down in the 60's again.

I would encourage anyone with BP problems to try a low sodium diet, but not to expect instant results. I would also emphasise that I have been radical in cutting out sodium and salt, making my own bread without salt and eating almost no processed food at all.
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Re: BP readings update

Postby JeffN » Thu Aug 14, 2008 3:48 am

Zana wrote:I'd like to thank everyone for their encouragement and advice. I am finally seeing good results with a low sodium diet. I stopped taking my BP every day and reduced this to twice a week. I was concerned at first that my diastolic was rising as my systolic was falling, but now my diastolic has gone down again. My systolic has not gone over 123 in the last two weeks and is much lower in the mornings. My diastolic is back down in the 60's again.

I would encourage anyone with BP problems to try a low sodium diet, but not to expect instant results. I would also emphasise that I have been radical in cutting out sodium and salt, making my own bread without salt and eating almost no processed food at all.


Hi Zana

Glad to hear of your success with your BP.

For some, results are often so fast, it seems almost miraculous. For others, it takes a little more time, but they well get the results if they stick with it.

As you have demonstrated, adherence and time are the two key issues.

Congrats!

In Health
Jeff

PS, the Food For Life Ezekiel 4:9 Low Sodium bread is commercially available and truly salt free.

PSS on the new Blood Pressure Guidelines
viewtopic.php?f=22&t=57369
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Postby Zana » Thu Aug 14, 2008 9:09 am

Thank you Jeff.

I would look for this bread but I live in Europe and can't get it here.
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