Health diet

Diet is very important in management of high blood pressure and patients’ health state. Very few diseases are there where diet is as important as in high blood pressure. Some of the diseases where diet plays a major role in management (treatment) are diabetes, gout, cardiovascular diseases etc. But the role of diet in these diseases is not as important as that of hypertension except diabetes, where diet plays a major role in its management. A proper diet with low sodium content is essential in management of high blood pressure. Most of the cases of high blood pressure the cause of the high blood pressure are not known, and it is called “essential hypertension”. There are very less percentage of hypertension patients where the cause can be defined.

Patients of “essential hypertension” require a proper diet plan as part of treatment of hypertension. In fact many of the mild to moderate high blood pressure cases can be managed with proper planning of diet alone, without the need of medication.

The major aim and objective of a diet plan in hypertension is to provide adequate nutrition for optimal health state and also to keep high blood pressure under control (within normal limit) and not to allow blood pressure to go up further.

A proper diet plan for patients of high blood pressure is like this:

Early morning:

Early morning should be only tea, preferably black tea without sugar. If sugar is added to tea it should be minimal for taste.

Breakfast:

The breakfast should consist of tea/coffee (black tea or coffee), milk, porridge etc. Liberal amount of fruits like apples, pears, water melon, papaya etc. can be taken.

Lunch:

The lunch should be taken according to the customs, traditions and liking of the individual. But it should be remembered that lunch should not be very heavy and preferably it should have good amount of vegetables and whole cereals.

Evening tea:

It should be with tea or coffee with non salted biscuits.

Dinner:

It should be started with soup (tomato or other vegetable soup). Not much of salt should be added (as salt content is more in soups). One serving of whole cereals (like rice, bread made of whole grain etc.), salad and fresh vegetable preparation. Fruit custard can be taken at dinner time.

It is important to know which type of diets or what diet to be avoided if you are suffering from high blood pressure for maintenance of health state in good condition for the hypertensive patient. The food to be avoided in high blood pressure generally depends on the degree of sodium restriction, which in turn depends on the severity of blood pressure. The higher the blood pressure, the greater is the degree of salt (sodium) restriction.

Experts on treatment or management of high blood pressure suggest four levels of dietary sodium restriction, which are as follows:

1. Mild sodium restriction, which is to limit intake of sodium to 2 to 3 grams per day.
2. Moderate sodium restriction, which is limiting sodium restriction to 1 gram per day.
3. Strict sodium restriction, which is restricting sodium intake to 500 mg or 0.5 gram per day.
4. Severe sodium restriction, which is 200 mg or 0.2 gram per day, this practically means almost not taking any sodium.

The intake of sodium varies according to the habit of individuals and it varies generally from 3-4 grams to as high as 10-12 grams per day. The main source of sodium is common salt (sodium chloride) and other sources of sodium are baking soda or baking powder, sodium bi-carbonate and food preservatives. Mono sodium gluconate also contribute to some extent, especially Chinese people use mono sodium gluconate for preparing food more commonly. Seafood is another good source of sodium, but vegetables and other animal foods contains lesser sodium.

The following diets should be avoided for restricting sodium intake by a patient of high blood pressure:

Table salt should be strictly restricted for optimum patients’ health. Use less salt in cooking and also avoid salted or smoked meat (ham, bacon, sausages, etc), salted or smoked fish etc. Highly salted foods such as crackers, chips, salted nuts, salted popcorns, salted snacks etc. should be avoided. Avoid foods which are preserved in salt like tomato ketchup, chilli sauce, Soya sauce, garlic sauce, meat pickles etc. and also salted butter.

Canned vegetables and canned vegetable juices should be avoided. Fresh vegetables to be avoided are beetroots, carrots, beet greens, mustard greens, spinach, lotus stem and white turnip, as they contain higher amount of sodium (this is only for moderate to severe salt restricted patients and not for patients with mild sodium restriction).

In deciding the diet as part of management of high blood pressure for better patients’ health, it is important to know what food items to be taken as well as what food items to be avoided. To decide what diet to take and what diet to avoid, the knowledge about nutrition and diet is essential. But the basic principle of hypertensive diet is restriction of sodium and fat (mainly unsaturated fatty acids, which are found in fats of animal origin) intake and to consume adequate amount of vitamins, minerals, dietary fibers, antioxidants (all these can be found in fresh fruits and vegetables) etc.

The main aim of hypertensive diet is to provide adequate nutrition for maintenance of good patients’ health (if possible optimal health) and to help in controlling blood pressure to within normal limit.

Preferred foods in high blood pressure:

The foods which are preferred in high blood pressure generally have low sodium content and have high potassium content. Common foods with low sodium contents and high potassium content are potatoes, bananas, apricots, legumes etc. and should be included in routine diet of hypertensive patients. Diet of hypertension patient should include high fiber diets like leafy vegetables, fresh fruits and other vegetables.

Diet for hypertension should be more or less normal. Food should be made in a way that it is palatable even with lesser amount of salt, which can be done by using variety of condiments which are low in sodium and flavoring agents such as lemon, vinegar, onion, garlic and many other spices. Use of these condiments and spices will make the food to more palatable with very little sodium salt or even without salt. The condiments may vary from country to country, but the basic idea is to improve acceptability of food according to the local customs and traditions and also to reduce or restrict salt intake.

Replacement of sodium salt (sodium chloride) with that of potassium salt is another alternative and it is a very practical and good alternative. It does not change the taste of food, but retain the original taste. Potassium salts can be purchased from any nearby medical store.

Two factors play very important role in causation of high blood pressure. They are diet and genetics. Unfortunately we do not have any control on genetics, but diet is within our control and a healthy diet is essential for healthy life. Diet is a major player in hypertension is clear from the fact that certain in certain communities’ high blood pressure are not common. The dietary role of hypertension is also clear from the fact that the prevalence of hypertension more common the Japanese settled in USA for last few generations than the Japanese who live in Japan.

The objectives of preparing diet for hypertension:

1. To maintain adequate nutrition.

2. To reduce intake of sodium chloride (common salt) and also fat intake (depending on lipid profile).

3. To achieve gradual weight loss, if overweight and to maintain ideal body weight (BMI of 18.5 to 23) or as near to the ideal body weight as possible.

Dietary Modifications in hypertension:

Proteins: Protein intake should be like for normal people and excess intake of protein should ideally be restricted (this is mainly for the presence of high saturated fat and sodium in the food sources of high protein).

Carbohydrates: Take carbohydrates which are complex like starch and dietary fibers, rather than simple carbohydrates like sugar.

Fats: The total amount of fat intake should be reduced and low energy diets should be taken (low energy diets contain low fat content). Fats should be of plant origin and not animal origin. Fats of animal origin are rich in saturated fatty acids and plant origins are rich in unsaturated fatty acids. Fats of plant origin are soya oil, groundnut oil, sunflower oil, mustard oil and corn oil. Fats from animal origin such as ghee, butter etc. and these should be restricted.

Other minerals: Two other minerals (other than sodium), potassium and calcium, are important in relation to hypertension. An adequate potassium intake is an essential part of treatment which can be done by including sufficient amounts of potassium rich foods like milk, fruits and vegetables (if needed potassium supplementation can be done). Adequate amount of calcium may be beneficial in treating high blood pressure. Some of the calcium rich foods are milk and diary products, leafy vegetables etc.

Energy: The total calorie intake should be reduced, especially for obese persons. Sometimes hypertension can be controlled by simply reducing body weight to normal and maintaining it. Even normal weight individuals can benefit from slight weight reduction. Reduction in energy intake should be combined with regular exercise.

Sodium restriction is an essential part of management of hypertension. Ideally the total sodium intake should be not more than 3 grams per day.

Hypertension or high blood pressure is a common problem in this modern time. The causes of high blood pressure are multifactorial. Common causes of high blood pressure are excess intake of refined foods (fats especially saturated fatty acids, fried food, high cholesterol diet etc.), excess intake of common salt (sodium chloride), tension in modern lifestyle, lack of exercise etc. Diet plays an important role in causation of hypertension. These days’ fast foods are very popular and fast foods are high in fat as well as refined food. A good diet helps to maintain hypertensive patients’ health for long time.

Intake of salt is one of the most important factors in causation of high blood pressure, which is proved by many clinical studies on some of the African tribes who do not consume any salt. The incidence of high blood pressure is almost nil among the tribes where salt is not consumed. This simple observation proves that salt plays an important role in causation of high blood pressure. Low dietary intakes of calcium and potassium may also contribute to the risk of hypertension.

One of the important factors in hypertension is obesity and obesity is mainly due to excess eating, although genetics and environment plays an important role in causation of obesity. In on study it was found that more than 60% hypertensive people are more than 20% overweight.

What is blood pressure?

Blood pressure is “the lateral pressure that is exerted by the blood volume on the blood vessel wall”.

Problems of hypertension:

Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke and renal failure. If hypertension is associated with diabetes, obesity and other chronic problems the risk is multiplied several times in compare to normal individuals.

Epidemiology of hypertension:

Worldwide high blood pressure accounts for approximately 6% of total deaths. Environmental and genetic factors contribute to regional and racial variations of blood pressure and hypertension prevalence in a society. In the United States, based the National Health and Nutrition Examination Survey (NHANES) results, 28.7% of U.S. adults (which means more than 58.4 million individuals), have hypertension ( as per following definition of hypertension: systolic blood pressure of more than 140 mmHg; diastolic blood pressure 90 mmHg; taking antihypertensive medications). Hypertension increases with age and its prevalence is more than 65% among people aged more than 60 years.

Diet is very important if you are suffering from hepatitis. Hepatitis is inflammation (commonly due to infection by hepatitis viruses like hepatitis A, B, C, D etc.) of liver and if liver is inflamed it has to be treated promptly and diet plays an important role in the management of hepatitis. Hepatitis A is common in developing countries, where nutrition status may not be up to the standard in many people and maintaining nutrition by healthy and balanced diet is very important in hepatitis, especially in third world countries.

Aim of diet plan in hepatitis:

The main aim of a diet plan in hepatitis is maintaining patients’ health by adequate nutrition, so that the liver cells can regenerate quickly and liver can start functioning properly as early as possible. The diet plan also helps in preventing further damage to the liver.

Breakfast:

Breakfast should consist of bread with jam (depending on the local custom and tradition it may vary in different countries and locations) and milk. Fruits such as papaya (good for digestion), apple and many others can be taken.

Mid morning:

It should consist of thick soup and light snacks.

Lunch:

Lunch should consist of cereals (depending on the habit it may be rice, wheat, maize etc.), vegetables (preferably mixed vegetables), egg, fish, white meat (poultry), salad, curd etc. Lunch should not be very heavy.

Mid afternoon:

Fruit juice, fruit yoghurt and some fruits like banana (high energy fruit), apple, berries.

Evening tea:

Orange juice, sandwich etc. is preferred in the evening. Soup can also be taken in the evening.

Dinner:

Dinner should consist of soup (vegetable or chicken soup) rice with vegetables (or maize, wheat etc.), bread, boiled eggs, fish/meat, salad, custard etc.

Bedtime:

A glass of milk with sugar should be taken before sleep.

Important points to remember in hepatitis:

1. Hepatitis cause loss of appetite and patient should be encouraged to eat.

2. Food should suit taste buds of the patient and well cooked.

3. Diet should be blend and soft for easy digestion.

4. Do not take large meals; instead take small meals more frequently.

5. Avoid alcohol and also restrict at least for a year after hepatitis.

6. Foods to be included in the diet are sugar, honey, glucose, cereals, pulses, milk and milk products, eggs, fruits, and vegetables.

7. Keep the likes and dislikes of the patient in mind while preparing food.

Foods to be avoided during hepatitis:

Fried and fatty foods, fats, oils, nuts and oilseeds, strongly flavored vegetables etc. should be avoided during hepatitis.