How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

Original Link

How to Treat High Blood Pressure with Diet

How to Treat High Blood Pressure with Diet.jpeg

High blood pressure ranks as the number-one risk factor for death and disability in the world. In my video, How to Prevent High Blood Pressure with Diet, I showed how a plant-based diet may prevent high blood pressure. But what do we do if we already have it? That's the topic of How to Treat High Blood Pressure with Diet.

The American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention recommend lifestyle modification as the first-line treatment. If that doesn't work, patients may be prescribed a thiazide diuretic (commonly known as a water pill) before getting even more meds until their blood pressure is forced down. Commonly, people will end up on three drugs, though researchers are experimenting with four at a time. Some patients even end up on five different meds.

What's wrong with skipping the lifestyle modification step and jumping straight to the drugs? Because drugs don't treat the underlying cause of high blood pressure yet can cause side effects. Less than half of patients stick with even the first-line drugs, perhaps due to such adverse effects as erectile dysfunction, fatigue, and muscle cramps.

What are the recommended lifestyle changes? The AHA, ACC, and CDC recommend controlling one's weight, salt, and alcohol intake, engaging in regular exercise, and adopting a DASH eating plan.

The DASH diet has been described as a lactovegetarian diet, but it's not. It emphasizes fruits, vegetables, and low-fat dairy, but only a reduction in meat consumption. Why not vegetarian? We've known for decades that animal products are significantly associated with blood pressure. In fact, if we take vegetarians and give them meat (and pay them enough to eat it!), we can watch their blood pressures go right up.

I've talked about the benefits to getting blood pressure down as low as 110 over 70. But who can get that low? Populations centering their diets around whole plant foods. Rural Chinese have been recorded with blood pressures averaging around 110 over 70 their whole lives. In rural Africa, the elderly have perfect blood pressure as opposed to hypertension. What both diets share in common is that they're plant-based day-to-day, with meat only eaten on special occasion.

How do we know it's the plant-based nature of their diets that was so protective? Because in the Western world, as the American Heart Association has pointed out, the only folks getting down that low were those eating strictly plant-based diets, coming out about 110 over 65.

So were the creators of the DASH diet just not aware of this landmark research done by Harvard's Frank Sacks? No, they were aware. The Chair of the Design Committee that came up with the DASH diet was Dr. Sacks himself. In fact, the DASH diet was explicitly designed with the number-one goal of capturing the blood pressure-lowering benefits of a vegetarian diet, yet including enough animal products to make it "palatable" to the general public.

You can see what they were thinking. Just like drugs never work--unless you actually take them. Diet never work--unless you actually eat them. So what's the point of telling people to eat strictly plant-based if few people will do it? So by soft-peddling the truth and coming up with a compromise diet you can imagine how they were thinking that on a population clae they might be doing more good. Ok, but tell that to the thousand U.S. families a day that lose a loved one to high blood pressure. Maybe it's time to start telling the American public the truth.

Sacks himself found that the more dairy the lactovegetarians ate, the higher their blood pressures. But they had to make the diet acceptable. Research has since shown that it's the added plant foods--not the changes in oil, sweets, or dairy--that appears to the critical component of the DASH diet. So why not eat a diet composed entirely of plant foods?

A recent meta-analysis showed vegetarian diets are good, but strictly plant-based diets may be better. In general, vegetarian diets provide protection against cardiovascular diseases, some cancers, and even death. But completely plant-based diets seem to offer additional protection against obesity, hypertension, type-2 diabetes, and heart disease mortality. Based on a study of more than 89,000 people, those eating meat-free diets appear to cut their risk of high blood pressure in half. But those eating meat-free, egg-free, and dairy-free may have 75% lower risk.

What if we're already eating a whole food, plant-based diet, no processed foods, no table salt, yet still not hitting 110 over 70? Here are some foods recently found to offer additional protection: Just a few tablespoons of ground flaxseeds a day was 2 to 3 times more potent than instituting an aerobic endurance exercise program and induced one of the most powerful, antihypertensive effects ever achieved by a diet-related intervention. Watermelon also appears to be extraordinary, but you'd have to eat around 2 pounds a day. Sounds like my kind of medicine, but it's hard to get year-round (at least in my neck of the woods). Red wine may help, but only if the alcohol has been taken out. Raw vegetables or cooked? The answer is both, though raw may work better. Beans, split peas, chickpeas, and lentils may also help a bit.

Kiwifruits don't seem to work at all, even though the study was funded by a kiwifruit company. Maybe they should have taken direction from the California Raisin Marketing Board, which came out with a study showing raisins can reduce blood pressure, but only, apparently, compared to fudge cookies, Cheez-Its, and Chips Ahoy.

The DASH diet is one of the best studied, and it consistently ranks as US News & World Report's #1 diet. It's one of the few diets that medical students are taught about in medical school. I was so fascinated to learn of its origins as a compromise between practicality and efficacy.

I've talked about the patronizing attitude many doctors have that patients can't handle the truth in:

What would hearing the truth from your physician sound like? See Fully Consensual Heart Disease Treatment and The Actual Benefit of Diet vs. Drugs.

For more on what plants can do for high blood pressure, see:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank. This image has been modified.

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Are Raisins a Good Snack Choice?

NF-Oct13 Are Raisins Good Snacks for Kids.jpeg

Raisins, like all fruits, have a variety of health benefits, but dried fruit is higher in calories per serving than fresh, so might they contribute to weight gain? A study done by the University of Connecticut helped set people's minds at ease. Men and women were assigned to consume a cup of raisins a day for six weeks and were able to successfully offset the consumption of other foods in their diets such that they experienced no significant change in weight or waist circumference. What about in kids? I explore that in the video, Are Raisins Good Snacks for Kids?.

Leave it to the California Raisin Marketing Board to dream up a study titled, "An after-school snack of raisins lowers cumulative food intake in young children." Sounds good, right? They compared raisins to potato chips and chocolate chip cookies. They gave kids raisins, grapes, chips or cookies and said they could eat as much as they wanted and surprise surprise kids ate less fruit and more junk, but I guess naming the paper "Kids Prefer Cookies" would not have garnered the same kind of sponsor approval.

This reminds me of another study they did showing that regular consumption of raisins may reduce blood sugar levels... compared to fudge cookies and Oreos. Another study showed raisins caused less of a blood sugar spike than Coca-cola and candy bars. Though you can tell it was not funded by Big Raisin by their conclusion, "whether the general public should be advised to snack on fruit rather than on candy bars requires further debate and investigation."

Comparing raisins to chips and cookies was similarly unhelpful. Luckily, a less biased study was published by researchers at the University of Toronto. Nine to eleven year old boys and girls were told to eat all the grapes or raisins they wanted 30 minutes before a meal in which they could eat all the pizza they wanted. If you just gave them the meal, no snack, they ate 837 calories worth of pizza. If you gave them all-you-can-eat grapes before the meal, they ate 128 calories of grapes, but that seemed to fill them up a bit, so they ended up eating less pizza. But because they ate the snack and the meal they ended up getting more calories over all. Still, grape calories are better than pizza calories, but when given raisins instead, they ate even more snack calories, but the raisins were evidently so satiating that they ate so much less pizza that they ate fewer calories over all.

Now I know as parents there's a concern that if our kids eat snacks it might spoil their dinner, but when the snacks are fruit and the meal is a pepperoni and three cheese pizza, the more we can ruin their appetite, the better.

Raisin marketers aren't the only one's trying game the scientific method. Check out:

How to help get our kids to eat their fruits and veggies:

More dried fruit studies (my fave is dried mango):

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations--2013: Uprooting the Leading Causes of Death, More Than an Apple a Day, 2014: From Table to Able: Combating Disabling Diseases with Food, 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet, and my latest, 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers.

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Eating Garlic and Raisins May Help Prevent Preterm Birth

NF-Apr7 Garlic and Raisins to Prevent Premature Birth.jpeg

The United States has one of the worst premature birth rates in the world, now ranking 131st worldwide. Even worse, over the last few decades, the rate of preterm birth in the U.S. has been going up.

We've known that preterm delivery is associated with significant problems during infancy, and almost three quarters of all infant deaths. Unfortunately even preemies who survive past infancy may carry a legacy of health issues, such as behavioral problems, moderate to severe neurodevelopmental disabilities and psychiatric disorders in half of those born extremely preterm by the time they reach school-age. There's even evidence now that adults born very prematurely are at increased risk for things like heart disease and diabetes. And babies don't even have to be born that premature to suffer long-term effects. Even so-called near-term births at 36 or 37 weeks are now thought to be related to subtle developmental problems. So what can pregnant women do to decrease this risk?

66,000 pregnant women were studied to examine whether an association exists between maternal dietary patterns and risk of preterm delivery. Researchers compared a so-called "prudent," which was more plant-based versus a Western or traditional Scandinavian diet (vegetables, fruits, oils, water as beverage, whole grain cereals, fiber rich bread) versus the "Western" (salty and sweet snacks, white bread, desserts, processed meat products), and found that the "prudent" pattern was associated with significantly reduced risk of preterm delivery.

Inflammation is thought to play a role in triggering delivery, so a diet characterized by high intakes of vegetables, fruit and berries can reduce both systemic and local inflammation, and the lower saturated fat levels would also be associated with reduced inflammation. Any foods in particular?

A significant percentage of preterm deliveries are thought to be related to infections and inflammatory conditions in the genital tract. Garlic is well-known for its antimicrobial properties, and also has probiotic dietary fibers that feed our good bacteria. Dried fruit is also packed with fiber and has antimicrobial activities against some of the bacteria suspected to play a role in preterm delivery.

Researchers (highlighted in my video, Garlic and Raisins to Prevent Premature Birth) studied the garlic, onion and dried fruit intake of nearly 19,000 pregnant women, and indeed, they observed a reduced risk of spontaneous preterm delivery related to groups of garlic and onion family vegetables and dried fruits. In particular, garlic stood out for the vegetables and raisins stood out for the dried fruit. Both were associated with a reduced risk of both preterm delivery and preterm pre-labor rupture of membranes, which means your water breaking prematurely (before 37 weeks). And it didn't seem to take much. The so-called "high" garlic intake associated with the lowest risk was just about one clove a week or more, and "high" raisin intake was defined as just one of those mini snack boxes of raisins a month.

Here's the video on aspartame (NutraSweet) and diet soda during pregnancy: Diet Soda and Preterm Birth.

Some other popular pregnancy videos include:

More on garlic in #1 Anti-Cancer Vegetable and Cancer, Interrupted: Garlic and Flavenoids.

Videos on dried fruit include:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Isabel Eyre / Flickr

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Apple Crisp

This apple crisp is a perfect “anytime” dessert. I like to use Granny Smith apples because they soften nicely but still retain their shape. However, others may be used as well, such as a Gala, Fuji, or Pink Lady. Using a mix of apples is also fun. Print Apple Crisp Prep time:  30 mins Cook time:  30 mins...

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Granola

Finding a granola that doesn’t contain oil is nearly impossible. This is another food that can be perfectly delicious (and still crunchy) without added oil. Making your own homemade granola is very easy, and you don’t even need a food dehydrator. Print Granola Prep time:  15 mins Cook time:  60 mins Total time:  1 hour...

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Foods for Computer Eye Strain

NF-Jan8 How to Combat Computer Eye Strain.jpg

What happens to our eyesight when we sit in front of a computer all day?

As researchers from the SUNY College of Optometry note, the rise in computer screens "has led to an increase in ocular and visual problems, including eye discomfort, blurring of distant objects, eye strain, and asthenopia (visual fatigue)." This has caused so-called "nearwork-induced transient myopia." That's when after staring at a computer screen for a while we look out the window and things start out all blurry. Our vision becomes blurred because our poor little ciliary muscles pulling at our lens are locked in this constant state of contraction to keep that near focus. Over time, this may have long-term adverse consequences.

How to Combat Computer Eye Strain

Experts in the field recommend taking 4-12 minute breaks staring out the window every hour.

We can also aid our vision with our diet. A double-blind placebo-controlled crossover study, for example, found a significant improvement in refractive values and eyestrain symptoms when subjects ate black currants compared to a placebo.

However, what passes for currants in the U.S. are usually champagne grape raisins, not actual black currants, which were banned in the U.S. a century ago at the behest of the lumber industry. The lumber industry feared that they might spread a plant disease that affects white pine (which we hardly even harvest any more). Black currants are, however, currently making a comeback (and the ban has been lifted in some states), though any anthocyanin-rich berry might have similar benefits (such as bilberries, blueberries, cranberries, black raspberries and red raspberries).

Foods vs. Supplements

Why bother with whole bilberries or black currants when we could just take powder capsules? Because, as we've seen over and over again, when we test supplements, we're lucky if they actually contain what is listed on the label. Furthermore, even for products containing bilberries, one study found that labeling was often uninformative, misleading, or both, something or which the herbal supplement market is infamous. The largest study to date found that it appears most herbal supplement labels lie.

A Brief History of Bilberries

Bilberries gained notoriety during World War II when it was said that pilots in the British Royal Air Force "were eating bilberry jam to improve their night vision." It turns out this may have been a story concocted to fool the Germans. The real reason the Brits were able to suddenly target Nazi bombers in the middle of the night before the bombers even made it to the English channel was likely not because of bilberries, but because of a top secret new invention the British needed to keep quiet: radar.

For best results when it comes to computer eye strain, stick to whole berries with blue and red pigments, and don't forget to give your eyes a break each hour.

For other videos on protecting our vision, check out Greens vs. Glaucoma, where I listed the best foods to help prevent glaucoma; in Dietary Prevention of Age-Related Macular Degeneration I did the same for age-related macular degeneration. I've also addressed the Dietary Treatment of Glaucoma.

By using a standing or treadmill desk, we can avoid some of the other adverse health effects of sitting at a computer all day. See my video Standing Up for Your Health. I'm now up to 17 miles a day!

-Michael Greger, M.D

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: GBloniarz / Flickr

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Baked Oatmeal with Apples & Raisins

Baked Oatmeal is delicious for breakfast or as a snack bar (when cooled). Baking the oatmeal results in a spongy texture much like bread pudding. It’s easy to make and customize with your favorite non-dairy milk, fresh or dried fruits, and spices. Traditional baked oatmeal, an Amish creation, usually calls for eggs, butter, cow’s milk, […]

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Curried Sweet Potato Salad

If traditional Potato Salad was in a midlife crisis and its therapist asked, “What would you be if you could be anything in the world,” it might say “Curried Sweet Potato Salad!” It’s distinctive, daring, and delectable, not to mention, attractive! Ingredients Dressing: 1/2 cup raw, unsalted cashews (2 ounces) 1/2 cup water 1/4 cup […]

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Raisins vs. Energy Gels for Athletic Performance

 

 

 

 

 

 

 

 

 

After about an hour of strenuous exercise, long-distance athletes can really start to deplete their glycogen stores, the body’s source of quick energy. Studies dating back to the ’30s found that by hooking athletes on a treadmill up to an IV drip of sugar water, you could delay fatigue, and that drinking sugar water could help as well.  So the sports supplement industry has come up with an array of energy shots, gels, bars, and chews—even sports jelly beans, used (what a coincidence) by the Jelly Belly Cycling Team. In fact the Jelly Belly Candy Company paid for a study that found that said jellybeans could shave 4 or 5 seconds off of a 10km cycling trial compared to sports drinks or gels. But what about compared to a natural, nutrient-rich source of energy such as raisins?

As I explain in my 3-min video Raisins vs. Jelly Beans for Athletic Performance, athletes are so heavily marketed to that they may be left with the impression that specially designed supplements are essential for optimal performance. Yet cheaper, healthier alternatives may be overlooked. A research team at Louisiana State University tested low-cost, natural food products rich in carbs such as sun-dried raisins to see if they had the potential to improve performance to a similar degree. Raisins are described as a nutritious, convenient, palatable, cost-effective source of concentrated carbohydrates. But do they work as well?

The researchers found they work just as well. Trained cyclists and triathletes put raisins to the test against sports jelly beans and arrived at the same competitive times and achieved the same power output. San Diego State University researchers stacked raisins up against commercial sports gels and arrived at the same conclusion: same respiratory exchange, carb and fat oxidation, and energy expenditure. In fact the only significant difference was in “hedonic scores.” In scoring the pleasantness of the contenders, raisins beat out the jelly beans. Compared to jelly beans with flavors like “extreme watermelon” there was a greater preference for just plain raisin-flavored raisins.

Beans, Beans, Good for Your Heart—but only the non-jelly variety! Other sports supplements may be worse than just a waste of money. See, for example my videos Heterocyclic Amines in Eggs, Cheese, and Creatine? and Heavy Metals in Protein Powder Supplements.

Compare the antioxidant content of raisins to other dried fruits in my videos Dried Apples Versus Cholesterol and Better Than Goji Berries.

For more on the latest science surrounding on dried fruit, check out:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Soerfm via Wikimedia Commons

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