Oct 01, 2001 (Scripps Howard News Service) - It's entirely appropriate that supermarkets provide sit-down machinery to measure a person's blood pressure, and not just because there's an in-house pharmacy.
Controlling the silent killer called hypertension is not just about a pill prescription. It's all about the daily diet and consistent shopping choices at the grocery store. Other traditional approaches include losing weight if overweight, stopping smoking, limiting alcohol and increasing physical activity.
Dietary changes have focused on single nutrients. We've all been told to moderate salt and sodium. Americans take in eight to 10 times more sodium than needed by the body, according to the American Dietetic Association, and the myth persists that high blood pressure results from shaking on the salt. It's not that simple. Some people are sodium-sensitive and some are not. Other nutrients are probably involved, especially a mineral balance of calcium, potassium and magnesium.
Almost 20 years ago, researchers reported that a change in the overall dietary pattern of Americans to include more dairy foods, fruits and vegetables could lower blood pressure. Confirmation of this strategy was provided by a large-scale study called DASH (Dietary Approaches to Stop Hypertension). This government-sponsored study involved 450 adults randomly assigned to one of three dietary regimens for eight weeks. Findings were that a low-fat diet rich in low-fat dairy products, fruits and vegetables (the DASH diet) reduced blood pressure. A diet high in fruits and vegetables worked, too, but less effectively than the DASH combination diet containing dairy foods. Remember that calcium has long been suspected of being a factor in blood pressure control.
Another point: Even slender, active people can suffer from hypertension, so it's important to have blood pressure checked regularly. Dangerously high readings can happen to anybody.
The good news is that the DASH diet, used both for preventing and controlling high blood pressure, is a delicious and colorful daily eating guide. And the same sensible eating style reduces blood levels of homocysteine, an amino acid linked to an increased risk of heart disease, stroke and peripheral vascular disease, according to a study funded by the National Heart, Lung, and Blood Institute.
In other words, DASH is a healthy, balanced diet incorporating all the major food groups of the Food Pyramid and it protects good health in more ways than one. If the right food choices are made within each group, it could serve as a weight-reduction and maintenance plan. DASH has been shown to be twice as effective in African-Americans, who are actually at greater risk for being affected by high blood pressure.
Here are the DASH diet's building blocks:
- Grain products, 7 to 8 daily servings
- Vegetables, 4 to 5 daily servings
- Fruits, 4 to 5 daily servings
- Low-fat/fat-free dairy products, 3 daily servings
- Meats, poultry and fish, 2 or less daily servings
- Nuts, seeds and beans, 4 to 5 per week
- Fats and oils, 2 to 3 daily servings
- Sweets, 5 per week
This DASH plan is based on 2,000 calories a day, which would provide 4,700 mg of potassium, 500 mg of magnesium and 1,240 mg of calcium. In addition, the diet provides less than 10 percent saturated fat, an average of 2,400 mg sodium and less than 300 mg of cholesterol.
Granted, long-term compliance may be tough, but DASH is a goal, if not always a daily-diet destination. Even striving to get there could be a healthy journey.
"The dairy part of the diet has to be low-fat and fat-free milk products, such as 1 percent or fat-free milk, yogurt and reduced-fat cheeses," says Nancy Zwick, nutrition educator for the Dairy Council.
"Three dairy servings are required each day, along with 8 to 10 daily servings of fruits and vegetables. Studies have shown results within two weeks," Zwick says. "The key is they have to follow the DASH diet; they can't get off."
She says a typical American diet is low in calcium, high in sodium, with 30 percent or more calories from fat. "The DASH diet sounds like so much food, but the daily servings are smaller than people might picture," Zwick said. "For example, a large banana is really two servings, not one. Same for a large apple.
"Some people, no matter what they do," she says, "have to be on medication. But the DASH diet may reduce one's risk for developing high blood pressure."
"It is important," Zwick advises, "that milk is taken at mealtimes because the body won't absorb a big dose of calcium, say in pill form, at other times. Calcium is hard to get across the gut."
