Devlin Brown at the watercooler: Can I lower my blood pressure by changing my diet?

Q: I got a shock at a routine check-up. Which lifestyle changes besides the DASH diet would have the biggest impact on lowering my blood pressure?

Leave SA. If that’s impractical, turn off the news. Twitterati say it best: this country can give anyone chest pains. However, if burying your head in the sand doesn’t appeal to you, there are a few other options.

If you’re a regular reader you may remember that I, too, was dealt the unfortunate news that my body was on the verge of becoming a failed state. OK, that’s a tad melodramatic, so let’s rephrase: my internal grid was on the verge of collapse. I can’t help it, I have an arts degree!

The family GP insisted on a vote of no-confidence in the coalition between my blood lipids and blood pressure. This, despite no obvious cause other than a bad habit (or two), a penchant for rib-eye, soiled DNA and an inability not to take every darn headline personally.

I’ll never forget the moment the giggly nurse walked over to me. “Good news. Your ECG is perfect, your blood sugar is perfect, your BMI is perfect, but you’ll be on medication for the rest of your life.”

What a sentence, I thought. Not of the semantic kind, but of the penance variety. Penance for what? High cholesterol, which quite literally runs in the veins of my maternal heritage? Another family member was taken off high blood pressure medication after many years as a result of one lifestyle change: he quit alcohol. Life sentence? I’ll show you, nurse.

Heart.org says that you should eat a balanced diet low in salt, limit alcohol, enjoy regular physical activity (yes, it does say “enjoy”), manage stress, maintain a healthy weight, quit smoking, take medications properly and work with your doctor in good faith.

Has the diagnosis changed my training? No, I train as hard as ever. Has it changed how I eat? No, I am blessed to live with a gifted culinary artist who has taught me how to prepare the most delicious, Mediterranean high-protein masterpieces. I try my hardest to be mindful of stress and anxiety triggers. The numbers look very promising but I’m still too scared to test it without the nurse’s little white pill.

No matter where you look, besides being told to exercise regularly and quit vices, diet is always emphasised. And in the arena of hypertension, the most common advice is the DASH diet, which is a low-sodium (salt) diet, with guidelines on servings per day of a variety of grains such as whole wheat and rice, vegetables, fruits, low-fat dairy, a low to modest amount of lean protein and a few other pointers. 

I don’t like low-fat dairy products. Perhaps it’s my Tim Noakes hangover, but surely sugar is a bigger enemy than fat? And yet, when the GP told me to go easy on the fat it felt as though I were being asked to place my bet on red or black. And when the chips were down I backed conventional wisdom, albeit not unselfconsciously. 

Coincidentally, a study published in a journal called The Annals of Family Medicine found that adults with hypertension, prediabetes or type 2 diabetes, and those who are overweight or obese showed better improvements in systolic blood pressure, blood sugar control and weight management over a four-month period with a very low carbohydrate diet than those who followed the DASH diet. It’s just one study — the DASH diet works and if you like it, follow it.

This author has not had a carbohydrate with every meal (which most DASH sample diets advocate) since at least the day before Siphiwe Tshabalala scored the cracker in the 2010 World Cup opener. However, that is more to do with taste than dogma and a preference for a 32-inch waist as opposed to 34. 

This Agony Aunt doesn’t dispense advice, it dishes out high-fat portions of reality checks. Today’s le plat principal is that most people eat terribly. It’s a good place to start if you want a healthier body and safer blood pressure.

Then, understand that outside certain genetic predispositions and underlying issues, we kill ourselves with our lifestyles: processed food, excessive alcohol, smoking, a lack of exercise and dangerous levels of stress. And SA Twitter addiction — that’s palpitation paradise.