Ask most people how they should eat to bring blood pressure or cholesterol numbers down and they'll talk about reducing salt and saturated fat. Yet the key to improving both is more about adding foods to the diet rather than cutting them out says Sydney-based dietitian Courtney Thornton from Sydney's Nutrition and Wellbeing Clinic.
GPs often refer people with cholesterol or blood pressure problems to Thornton, who says many hope to avoid or minimize the use of medication by changing the way they eat.
The cholesterol busters
Thornton's approach involves adding four kinds of foods, all with different cholesterol-lowering properties, including nuts; soy foods; foods containing viscous fibres such as oats, barley and legumes; and plant sterols (cholesterol-lowering compounds found in plants). Known as the Portfolio Diet, it was developed in 2003 by Canadian researcher Dr David Jenkins of the University of Toronto who wanted to see what happened when you took a number of foods – all credited individually with lowering "bad" LDL cholesterol – and put them together in one diet. In a 2011 study comparing Jenkins' diet to a diet low in saturated fat, the Portfolio Diet lowered "bad" LDL cholesterol by 13 per cent compared to 3 per cent on the diet that reduced saturated fat.
"Each of these foods targets cholesterol in a different way," Thornton says. "For instance, the fibre in oats and legumes works by flushing bile acids out of the system – bile acids are the building blocks of cholesterol. But in combination these foods have a powerful effect."
How easy is it to get all of these food groups into your diet daily? Nuts and viscous fibres are easy – unsalted nuts are perfect snack foods, breakfast muesli takes care of oats, and legumes like chickpeas and lentils are easily added to soups, salads, curries and pasta sauces. Psyllium husks, another type of viscous fibre available in the health food aisle, can be added to smoothies. With soy foods, Thornton suggests switching to soy milk and adding tofu to stir fries or tossing flavoured tofu or soybeans through a lunchtime salad. And plant sterols?
"They're available in foods like spreads, milk and yoghurt fortified with plant sterols but a daily supplement of plant sterols is another option," she says.
Dietitian Sue Radd runs regular cooking workshops at the clinic to show how eating the right food can help avoid the need for pills to reduce levels of cholesterol, blood pressure and blood glucose. "The more ways you know of using cholesterol-lowering foods, the easier it is for this way of eating to be sustainable," she says. Her tips include using barley as your rice, using extra-virgin olive oil generously to flavour and thicken dishes, adding lots of herbs and spices, and using the "cook once eat twice" trick – in other words make double and freeze a portion for later.
Foods for better blood pressure
Going vegetarian is one way of improving blood pressure – meat-eaters with normal or high blood pressure can soon shave a few points off their numbers by switching to a vegetarian diet according to the Baker IDI Blood Pressure Diet and Lifestyle Plan written by the Baker IDI Heart and Diabetes Institute.
Don't want to go quite that far? There's also the DASH Diet developed in the United States to lower blood pressure without medication. This involves eating less meat but including two to three serves of low-fat dairy food daily, along with three to four serves of vegetables and five serves of fruit. What sets this eating plan apart from a standard Australian diet is that it's a good source of magnesium, potassium and calcium, Thornton says.
"These three minerals are important for healthy blood pressure for two reasons – they help balance sodium levels in the body and they help regulate the heart beat," she explains. "It's also a way of eating that encourages weight loss and weight loss helps reduce blood pressure."
More plant foods are also a key to better blood pressure – doubling your vegie and fruit intake and halving your normal salt intake can bring systolic blood pressure (the top number in a blood pressure reading) down by as much as four points according to the Baker IDI. Less alcohol is smart too – just four standard drinks a day over four weeks can be enough to get blood pressure climbing – but a little dark chocolate may be on your side. Some studies suggest that eating 25 to 30 grams of very dark chocolate a day may provide enough epicatechin to lower systolic blood pressure by as much as four points.
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