[JM 3]Dietary management to control hypertension

Dietary Approaches to Stop Hypertension (DASH) is a highly effective aspect of the non-pharmacologic management of hypertension. Based on a research sponsored by the US-based National Heart, Lung and Blood Institute, it targets hypertensive as well as normotensive individuals at risk for hypertension.

According to Dr. Nelson Abelardo, professor with the University of the Philippines, College of Medicine, DASH involves eating a balanced diet of low-salt, nutrient-rich, low-cholesterol, low-saturated-fat food.  It calls for a number of daily servings of different food items, such as four to five servings of fruits and six to eight servings of grains, among others.

DASH can be adjusted to suit the daily caloric intake ranging from 1600 to 3100 calories. For a 2,100-calorie daily diet, it recommends obtaining 27 percent of the daily calories from fat (of which 6 percent of the total daily allowance is from saturated fat), 15 percent from proteins and 55 percent from carbohydrates.

The recommended daily cholesterol is 150mg; fiber 30g; potassium 4,700mg, calcium 1,250mg, and magnesium 500mg. The daily allowance for sodium is 2,300mg but 1,500mg was tested to be even more effective. The 2014 Canadian Recommendation for Hypertension suggests 1500mg for ages 50 and younger; 1,300mg for ages 51 to 70, and 1,200mg  for ages older than 70.

Abelardo cited several studies demonstrating the impact of diet and other lifestyle changes on hypertension. The Exercise and Nutritional Interventions for Cardiovascular Health study showed that DASH, together with exercise and weight loss, resulted in large improvements in blood pressure (BP) and cardiovascular functions [Arch Intern Med 2010 25;170(2):126-35].

In another study, supplementation with polyunsaturated fatty acids was linked with reduced BP, pulse pressure and basal heart rate [Clin Exp Hypertens 2010;32(2):137-44]. Meanwhile, the European Prospective Investigation into Cancer and Nutrition study showed that many aspects of the Mediterranean diet have beneficial effects on cardiovascular diseases [Am J Clin Nutr 2004;80:1012-18].  In still another study, gazpacho, a tomato-based cold soup, was inversely associated with BP and hypertension prevalence. [Nutr Metab Cardiovasc Dis 2013;23(10):944-52].

Abelardo concluded that based on these studies, consumption of food rich in antioxidants, healthy fat and minerals (ie, potassium, magnesium and calcium) – vegetables, fruits, olive oil and seafood – can reduce cardiovascular risk. On the other hand, he said, “factors that are positively correlated with BP include high intake of ethanol, cereals, and meat and meat products.”