Vegetarian diet approach
A vegetarian diet approach for high blood pressure is similar to DASH except it excludes flesh foods, which includes meats, fish, and poultry. Not all vegetarian diets are the same: for example, some people eat eggs but not dairy (ovo vegetarians), others eat dairy but not eggs (lacto vegetarians), while yet others avoid both eggs and dairy (ovo-lacto vegetarians). Individuals who make these choices do so because of ethical and/or health reasons. Regardless of which type of vegetarian diet you may want to choose, it is easy to make adjustments to your menus to ensure you get balanced and varied nutrition that supports your desire to lower blood pressure and experience other health benefits as a bonus!
For example, people who are new to a vegetarian diet often worry about getting enough protein. “If I don’t eat meat or chicken, where will I get my protein?” is a common question. Vegetarians who eat dairy and/or eggs can get some of their protein from these sources, as well as from substituting beans, seeds, and nuts for meat protein.
The DASH diet recommends consuming only small amounts of meat, fish, and poultry, so it is not difficult to find delicious substitutes for these protein foods if you choose a vegetarian route. For example, bean or veggie burgers, no-meat chili, grilled seitan (a high-protein wheat protein food), split-pea soup, scrambled eggs and mushrooms, marinated tofu, cashew butter on whole wheat toast, hummus and brown rice, macaroni and cheese, and stir-fried mock chicken and vegetables are all excellent alternatives to animal-flesh protein sources. If you have decided to opt out of dairy, try soy dairy foods such as soy yogurt, soy beverages (including vanilla and chocolate flavors), and soy- and grain-based cheeses.
Is a vegetarian diet healthy? Absolutely! The mainstream American Dietetic Association reported in its 2009 position paper: “ Vegetarians seem to have minor low-density lipoprotein cholesterol levels, lower rates of hypertension, lower blood pressure and type 2 diabetes compared to non-vegetarians.” It credited these health benefits to certain features of a vegetarian diet, such as lower intake of saturated fat and cholesterol and greater intakes of fruits, vegetables, whole grains, fiber, soy foods, nuts, and phytochemicals.
Numerous studies show that people who follow a vegetarian diet have a lower risk and a lower prevalence of high blood pressure, as well as related conditions. Among the many studies conducted, a critical review from Loma Linda University and published in the American Journal of Clinical Nutrition explored the evidence on the health effects of a vegetarian diet. The author explained that there is “undoubted indication that vegetarians have lesser chances of heart disease, mostly clarified by low LDL cholesterol, possible lower chance of hypertension and diabetes mellitus, and minor incidence of obesity.”
A vegetarian diet also tends to involve greater consumption of foliate, potassium, vitamin C, and flavonoids, largely because of the increased consumption of fruits and vegetables. Potassium in particular is associated with a reduction in blood pressure, and both fruits and vegetables are major sources of this mineral and electrolyte. Vegetarians also tend to consume a healthy amount of L-arginine, an amino acid that is involved in the production of nitric oxide, a substance that helps dilate blood vessels and thus improve blood flow.
Another advantage of a vegetarian diet is the lack of saturated fat from meats. Saturated fat appears to have a negative impact on blood viscosity, which in turn worsens blood pressure. Fats from non-animal sources (polyunsaturated fats such as linoleic acid and alpha-linoleic acids) are associated with a lower risk of developing high blood pressure.
Vegan diet approach
A vegan diet approach is rich in fruits, vegetables, whole grains, legumes, seeds, and nuts and excludes meats, fish, poultry, eggs, and dairy foods. A major advantage of a vegan diet for high blood pressure is the lack of cholesterol and a very low amount of saturated fat and, typically, total fat as well. However, don’t be fooled into thinking a vegan diet is always a low-fat diet. If you tend to eat a lot of French fries, onion rings, and pasta and skip the fruits and veggies, then you can quickly pack on the pounds and the fat. There are ways to eat smart and not so smart regardless of which dietary approach you choose!
Admittedly, following a vegan diet can be a challenge for many people who are used to eating animal-based foods and who feel this dietary approach is too restrictive. However, another way to look at a vegan approach is that it can open the door for opportunities to try foods you may never have considered before, including the ever-growing selection of mock meat, poultry, fish, and dairy foods now available in many mainstream supermarkets. Most of these selections have been improved to the point where texture, taste, and aroma are similar and, in many cases, barely discernible from the “real” thing.
If you choose to try a vegan approach to high blood pressure, you will need to make some adjustments to the recommended servings in the various categories of the DASH diet. Here are some guidelines for those who choose a vegetarian or vegan diet for prevention and management of high blood pressure.
Daily servings for vegetarian and vegan diets
Note: Compare the number of servings here with those of DASH. You will notice that the numbers of servings for legumes, nuts, and seeds are more than double, as they take the place of meat, fish, poultry, and (for vegans) dairy and eggs.
- Grains: 5—12 servings of whole grains
- Fruits: 3—4 servings
- Vegetables: 6-9 servings
- Nuts, seeds, legumes: 2—5 servings daily (not 3-6 per week as in the DASH diet)
- Oils, dairy, eggs: 1-2 servings daily; eliminate dairy and eggs for vegans
Vegetarians and especially vegans need to be mindful of certain nutrients that are more difficult to get when following a plant-based diet. Vitamin B12, for example, is found only in animal foods. Therefore, be sure to eat foods that have been fortified with B12 (such as some cereals, tofu, and other soy products, including soy beverages) or take a supplement that provides this necessary nutrient. Other nutrients that may be consumed in insufficient amounts, depending on your food choices, include calcium, iron, zinc, and vitamin D. Members of the legume family tend to be good sources of the first three of these nutrients, so be sure to make beans, split peas, lentils, and other legumes a significant part of your diet. Again, foods fortified with these vitamins and minerals and/or supplements are recommended.
