By: Adebowale Bello, Freelance Health Writer with editorial contribution by The Datelinehealth Africa Team.
Introduction
Hypertension has long been regarded as a silent killer and rightly so, statistics from the World Health Organization have shown that 345.6 million Africans live with hypertension. (1)
Hypertension is a medical condition in which your blood pressure levels rise due to high force of blood pumped by the heart against the walls of arteries in the body.
It is also known by its common name as High blood pressure.
While factors like genetics, stress and anxiety could increase your risk of high blood pressure, your dietary choice plays a vital role in the increase, control and management of hypertension.
In this article, you would learn about the best types of diet that are heart healthy and help in the control of hypertension.
Fig. 1 Healthy African Food Pyramid. Click on image to enlarge.
What you eat is important because a poor diet may lead to hypertension while a healthy diet can help to manage it.
According to the US Center for Disease Control, a poor diet is a diet that lacks the necessary nutrients in the right proportion needed for healthy living (2). Such a diet could contain an unhealthy amount of sodium, potassium and added sugars while being low in proteins, vitamins and minerals.
Studies have shown that 5 in 10 adults consume at least one sugary drink everyday while less than 1 out of 10 eats enough fruits and vegetables daily (2). Some examples of unhealthy foods include highly processed foods like white bread, breakfast cereals, canned soups, soft drinks, fruit juices and candies.(3)
On the other hand, a healthy diet contains all nutrients required for optimal health. It usually contains a variety of foods, especially those that undergo minimal pre-processing.
A healthy diet for hypertension focuses on reduced sodium (salt) intake while promoting the intake of potassium rich foods like legumes. The addition of fruits, vegetables and whole grains complete a heart healthy diet for those living with hypertension (see fig. 1).
The abundant variety of food in Africa has made it necessary for general dietary guidelines aimed at promoting the consumption of healthy meals.
Food-based dietary guidelines are purposefully developed by countries as a matter of public health policy to encourage their citizens to eat healthy while identifying those that aid healthy eating and those that should be limited or totally avoided.(4)
At the moment, only 8 out of 47 African countries have dietary guidelines (4) which shows that there's still much work needed to enlighten the public on their dietary habits.
There are several ways to control hypertension and diet control is one of such effective ways.
Kelsey Costa, a registered dietitian and founder of Nutrition Insights discusses the major areas through which a healthy diet helps to control hypertension and they include:
Your body can function properly with little sodium intake and the recommended sodium intake by the World Health Organization is < 2g per day yet a review of studies on sodium intake showed that many African countries exceed this limit conveniently reaching as high as 5g per day.(5)
If you regularly eat highly processed foods like burgers, pizza, cheese and macaroni, your sodium levels would increase because these foods are abundant in sodium which increases your blood pressure.
Costa recommends against the extra addition of salt to dishes at mealtime as it could increase your blood pressure levels, instead try to consume several low-sodium foods like vegetables, fruits, potatoes, fish, egg, milk and meat.
Potassium is an important mineral which has been proven to lower blood pressure levels, it does this by nullifying the effects of sodium in your body and relaxing your blood vessels.
According to the American Heart Association, many people fall short of the recommended potassium intake which ranges between 2600 and 3400 milligrams. (6)
You can increase your potassium intake by consuming foods like potatoes, oranges, mushrooms, grapefruits and dates (see figure 2)
Figure 2: Examples of potassium rich foods. Click on image to enlarge
Consumption of a balanced diet which contains the right nutrients in the right proportion is important in controlling blood pressure levels.
Combine that with physical activity and your overall mortality risk decreases by 18% (7). A healthy diet also helps to prevent obesity which is a major risk factor for hypertension.
Fat is an important nutrient which you need for proper bodily development and they are present majorly in food groups like milk, meat and oils. Though a major source of energy, fat contains the most calories of any nutrients we consume and if your body does not use up the excess fat, it gets stored as fat tissue.
Some fats are considered as healthy fats such as monounsaturated, polyunsaturated and Omega-3 fats while others like saturated and trans fats are considered unhealthy. (12)
Saturated fat is gotten from animals and dairy products while trans fat is liquid oil that has turned into solid fat and examples of processed foods which contain these unhealthy fats include high fat meat, high-fat cheese, butter, cookies, potato chips and crackers.(13)
According to the Centre for Disease Control, food items like fish, soybean, vegetable oil and nuts (almonds, peanuts, walnuts) contain healthy fats and should be consumed regularly.
There are many diet options available to you with each having its own benefits and limitations. This is why it's important to understand these diets and how they help in controlling hypertension.
Let's have a brief overview of three of the most popular diets for people who live with hypertension.
This diet is based on the eating habits of the 21 countries which border the Mediterranean Sea such as Spain, France and Portugal. As expected, there is variety in this diet because of the different eating patterns of these countries.
The Mediterranean diet includes fruits, legumes, whole grains, nuts and vegetables while the consumption of poultry, fish and eggs are also encouraged. (8)
A review of studies on the Mediterranean diet (9) has revealed the diet's potential role in reducing the risk of chronic diseases, encouraging weight loss and improving overall well-being.
It also encourages the consumption of healthy fats especially in the form of olive oil which has potent antioxidant properties and may reduce inflammation.
You can practice the Mediterranean diet by eating lots of the following:
The DASH diet was created to promote heart health and reduce blood pressure levels through consumption of nutrient packed foods.
Because of individual taste and preferences, the DASH diet can be flexible and offers a wide range of options to enable you to get the best nutrients possible. It limits foods which are high in sodium and saturated fats while containing foods that are high in potassium and calcium.
If you intend to follow the DASH diet, then you should pick foods that meet up with the criteria above.
Some examples of such foods include:
This diet is a combination of the Mediterranean and DASH diet with a specific aim of improving brain health. It combines foods from both diets that have been proven to contain beneficial nutrients for brain health while limiting foods that increase the risk of brain diseases.
Some of the foods contained in the MIND diet include:
Whole grains also contain fiber which have been proven to improve digestive health and movement. Some of the whole grains include brown rice, wheat, oats and cereals.
It is a healthier option compared to red meat and is associated with better cognitive function.
Note that excessive alcohol consumption can have negative effects on your brain health, so moderation is key.
Another diet which is effective in the control of hypertension is the Nordic Diet and our expert dietitian, Kelsey Costa comments on the Nordic diet, saying:
‘’The Nordic diet which is popular in Nordic countries such as Sweden, Finland and Norway is an excellent way to manage hypertension. This diet is based on traditional, locally sourced cuisine emphasizing whole grains, legumes, lean proteins (such as fish), seasonal fruits, vegetables and healthy plant fats.
The diet also includes small amounts of dairy products, eggs and game meats, with the occasional red meat and animal fats. Sugars, sugary drinks, processed meats and additives are avoided completely and studies have shown that following this diet can lead to better blood pressure control and a lower risk of hypertension.’’
At the moment, there is no African centric diet that has been created with the aim of hypertension control. But the African Heritage Diet provides a helpful guide for incorporating the bountiful healthy and delicious foods and dishes available to Africans.
As Costa explains further, this diet prioritizes consumption of vegetables, fruits, legumes, nuts, seeds, rice, flatbreads and other whole grains (see fig 1 for a representation of a healthy African food pyramid).
The African Heritage Diet naturally has low levels of processed sugar, unhealthy fats, meat, and sodium as they can lead to hypertension when overconsumed.
In some cases, diet alone might be enough to control hypertension, but it is just one out of several other factors that work together to control hypertension effectively.
Costa gives some other tips which can help control hypertension such as increasing physical activity, limiting alcohol consumption, managing stress levels and maintaining a healthy weight.
Regular exercise has been proven to be a key factor in controlling hypertension. Exercise helps to strengthen your heart muscles while reducing your stress levels.
Spending just 30 minutes a day swimming, brisk walking, dancing or playing football would help you control hypertension.
Research has shown that sleeping for less than optimum hours for an adult increases your risk of hypertension (11).
You should aim to sleep 7-9 hours per night according to the American Academy of Sleep Medicine and you can achieve this by having a fixed bedtime and a conducive sleep environment.
If you're overweight, your chances of hypertension are higher because your heart has to work harder to pump blood and this increases blood pressure levels.
You can lose weight by exercising regularly, eating a balanced diet, practicing portion control and managing stress.
Smoking decreases the amount of oxygen getting to the heart due to its narrowing effect on blood vessels and the heart has to work harder to overcome this smoking induced resistance.
It also increases your risk for stroke and heart attack. Talk with your doctor for help in how to quit smoking.
Excessive consumption of alcohol may increase blood pressure levels because alcohol relaxes the blood vessels which increases blood flow.
Alcohol also stimulates the production of stress hormones majorly adrenaline and cortisol and the continuous presence of these hormones in the blood could be disastrous.
Though it's not bad for you to consume alcohol. The goal is to consume it moderately. This tallies to no more than 1 or 2 eight to twelve ounces volume size daily depending on your gender and the alcohol content of the beverage.
Diet is an effective way to control hypertension and consuming foods that are low in sodium and high in potassium such as fruits, vegetables and whole grains are keys.
Your diet may not be enough to control hypertension, but could be more effective when combined with regular exercise, weight loss and abstinence from smoking.
It's also wise to always consult with your doctor and or dietician in order to make informed decisions about your diet and health.
Related: Hypertension in Nigerian adults. Essential things to know.
Published: May 9, 2023
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